WorldWideScience

Sample records for residential care environments

  1. Residential Care

    Science.gov (United States)

    ... skilled nursing facility, long-term care facility, custodial care) Nursing homes provide round-the-clock care and long- ... as nutrition, care planning, recreation, spirituality and medical care. Different nursing homes have different staff-to-resident ratios. Also, ...

  2. WHERE HAS THE COMPASSION GONE FROM THE RESIDENTIAL AGED CARE ENVIRONMENT?

    Science.gov (United States)

    Oliver, Kim

    2017-02-01

    Would working in residential aged care be your dream job as a newly qualified nurse, probably not, but why not? Montayre (2015) suggests that although nurses don't like to talk about it, or even less, what the real problem is perceived to be with this practice area, residential aged care nursing is thought to be less exciting, monotonous, and requiring less skill than other areas such as emergency nursing, or medical nursing.

  3. ïSCOPE: Safer care for older persons (in residential environments: A study protocol

    Directory of Open Access Journals (Sweden)

    Barnard Debbie

    2011-07-01

    Full Text Available Abstract Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012 proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility are led by healthcare aides (non-regulated caregivers and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement

  4. College residential sleep environment.

    Science.gov (United States)

    Sexton-Radek, Kathy; Hartley, Andrew

    2013-12-01

    College students regularly report increased sleep disturbances as well as concomitant reductions in performance (e.g., academic grades) upon entering college. Sleep hygiene refers to healthy sleep practices that are commonly used as first interventions in sleep disturbances. One widely used practice of this sort involves arranging the sleep environment to minimize disturbances from excessive noise and light at bedtime. Communal sleep situations such as those in college residence halls do not easily support this intervention. Following several focus groups, a questionnaire was designed to gather self-reported information on sleep disturbances in a college population. The present study used The Young Adult Sleep Environment Inventory (YASEI) and sleep logs to investigate the sleep environment of college students living in residential halls. A summary of responses indicated that noise and light are significant sleep disturbances in these environments. Recommendations are presented related to these findings.

  5. Disability, residential environment and social participation: factors influencing daily mobility of persons living in residential care facilities in two regions of France.

    Science.gov (United States)

    Rapegno, Noémie; Ravaud, Jean-François

    2017-09-29

    Despite the context of individualization of public policies and promotion of independent living, residential care facilities (RCFs) (called "établissements medico-sociaux" in France) still represent the main system used by disabled people. Through a study of their daily mobility, this article proposes a geographical approach to the examination of factors influencing the social participation of disabled persons with motor impairments who live in residential care facilities. The data were collected in three stages from several sources. We first carried out 24 semi-directive interviews among supervisory staff in all the institutions in two regions of France (Greater Paris and Upper Normandy) to better understand the nature of services offered by medico-social facilities. We next did field work in greater detail in 10 of these institutions. We selected residents by random sampling. These first stages then allowed us to study the mobility of residents and record their perceptions. We conducted participant observation and interviews with 81 disabled residents within the 10 RCF. Data analysis enabled consideration not only of the role of the residential environment in people's daily mobility, but the role of the institutions as well. We identified three typical profiles of mobility practices depending on the facilities: "the islanders", living in isolated facilities far from public transportation, or in so-called "difficult" neighborhoods; people who alternate individual and group mobility in a more or less large area; and "the navigators" who have high mobility over a very large area, often living in facilities located in urban areas. The study also enabled an analysis of the obstacles and facilitators inside and outside the residential facilities. These place restrictions on social participation by disabled adults. However, possibilities for individual negotiation may enable bypassing some obstacles. The three ideal-type profiles of mobility analyzed constitute

  6. Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people.

    Science.gov (United States)

    McCormack, Brendan; Dewing, Jan; Breslin, Liz; Coyne-Nevin, Ann; Kennedy, Kate; Manning, Mary; Peelo-Kilroe, Lorna; Tobin, Catherine; Slater, Paul

    2010-06-01

    To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. © 2010 Blackwell Publishing Ltd.

  7. 'Nothing works' in secure residential youth care?

    NARCIS (Netherlands)

    Souverein, F.A.; van der Helm, G.H.P.; Stams, G.J.J.M.

    2013-01-01

    A debate about the effectiveness of secure residential youth care is currently going on. While some continue to support secure residential youth care, others conclude that ‘nothing works’ in secure residential youth care, and argue that non-residential treatment is superior to secure residential

  8. Residential care : Dutch and Italian residents of residential care facilities compared

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk

    2008-01-01

    Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their

  9. [Therapeutic Residential Care for Children and Youth: A Consensus Statement of the International Work Group on Therapeutic Residential Care].

    Science.gov (United States)

    Whittaker, James K; Holmes, Lisa; Del Valle, Jorge F; Ainsworth, Frank; Andreassen, Tore; Anglin, James; Bellonci, Christopher; Berridge, David; Bravo, Amaia; Canali, Cinzia; Courtney, Mark; Currey, Laurah; Daly, Daniel; Gilligan, Robbie; Grietens, Hans; Harder, Annemiek; Holden, Martha; James, Sigrid; Kendrick, Andrew; Knorth, Erick; Lausten, Mette; Lyons, John; Martin, Eduardo; McDermid, Samantha; McNamara, Patricia; Palareti, Laura; Ramsey, Susan; Sisson, Kari; Small, Richard; Thoburn, June; Thompson, Ronald; Zeira, Anat

    2017-08-01

    Therapeutic Residential Care for Children and Youth: A Consensus Statement of the International Work Group on Therapeutic Residential Care. In many developed countries around the world residential care interventions for children and adolescents have come under increasing scrutiny. Against this background an international summit was organised in England (spring 2016) with experts from 13 countries to reflect on therapeutic residential care (TRC). The following working definition of TRC was leading: “Therapeutic residential care involves the planful use of a purposefully constructed, multi-dimensional living environment designed to enhance or provide treatment, education, socialization, support, and protection to children and youth with identified mental health or behavioral needs in partnership with their families and in collaboration with a full spectrum of community based formal and informal helping resources”. The meeting was characterised by exchange of information and evidence, and by preparing an international research agenda. In addition, the outlines of a consensus statement on TRC were discussed. This statement, originally published in English and now reproduced in a Spanish translation, comprises inter alia five basic principles of care that according to the Work Group on Therapeutic Residental Care should be guiding for residential youth care provided at any time.

  10. Managing malnutrition for older people in residential care

    OpenAIRE

    Ojo, Omorogieva

    2016-01-01

    Malnutrition is a major concern for those in the care sector. In this article, Omorogieva Ojo discusses how malnutrition can be managed in the care home using oral nutritional supplements (ONS), such as powders, sip feeds and thickened drinks. Residential care provides a unique environment, offering support for older people, in order to help with the activities of daily living, including eating and drinking. With an increase in the aging population in the UK, the number of older people living...

  11. Therapeutic Residential Care for Children and Youth:

    DEFF Research Database (Denmark)

    Whittaker, James K.; Holmes, Lisa; del Valle, Jorge F.

    2016-01-01

    for Child and Family Research, Loughborough University in the U.K. for a Summit meeting on therapeutic residential care for children and youth funded by the Sir Halley Stewart Trust (UK). The focus centered on what is known about therapeutic residential care and what key questions should inform a priority......In many developed countries around the world, ‘group care’ interventions for children and adolescents have come under increasing scrutiny from central government, private philanthropic and child advocacy agencies desirous of (1) achieving better outcomes for vulnerable children and youth; (2) doing...... alternatives to serve high-resource needing youth has had unintended and negative consequences. It is within this context that a working group international experts representing research, policy, service delivery and families (International Work Group for Therapeutic Residential Care) convened at the Centre...

  12. Interprofessional student teams augmenting service provision in residential aged care.

    Science.gov (United States)

    Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag

    2016-09-01

    The aim of this study was to determine the usefulness of student-led interprofessional consultations within residential aged care in augmenting patient care and enhancing student education. Volunteer fourth and final year health-care students conducted interprofessional consultations. In a mixed methods design, residents' health-care changes and perspectives were collected prospectively, and student and educator perceptions were measured by survey and interview. Sixteen aged care residents were consulted by interprofessional teams. Students identified two new health issues and proposed 17 recommendations for referrals and five changes to medication management. At six-weeks follow-up, two recommendations had been acted upon clinically, and two medication changes had been implemented. Reasons for the low uptake of recommendations were determined. Residents, students and educators reported high levels of satisfaction. Residential care facilities offer a useful interprofessional learning environment. Student consultations are positively regarded by patients, students and educators and may augment existing health services. © 2016 AJA Inc.

  13. Residential care: Dutch and Italian residents of residential care facilities compared.

    Science.gov (United States)

    de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D; Sytema, Sjoerd; Wiersma, Durk

    2008-01-01

    Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their residential patient populations. Data from the Dutch UTOPIA-study (UTilization & Outcome of Patients In the Association of Dutch residential care providers) and the Italian PROGRES-study were used. Dutch residents were more likely to suffer from substance or alcohol abuse than Italian residents. The latter were more likely to suffer from schizophrenia or a related disorder, less likely to have experienced mental hospital admissions and showed an overall shorter duration of stay in residential care facilities. Contrary to our expectations Dutch residents, who still have good access to long stay beds in mental hospitals, are not less disabled than Italian residents. Finally, the number of beds in residential care facilities per 10,000 inhabitants in the Netherlands is twice (6) as high as in Italy (3). The Italian and Dutch deinstitutionalisation processes have resulted in a different availability in the number of residential beds. However, it did not influence the overall level of functioning of both residential populations.

  14. Use of Electronic Health Records in Residential Care Communities

    Science.gov (United States)

    ... the National Technical Information Service NCHS Use of Electronic Health Records in Residential Care Communities Recommend on ... Facilities Most residential care communities did not use electronic health records in 2010, and use varied by ...

  15. Palliative care in residential aged care: An overview.

    Science.gov (United States)

    Butler, Juliet

    2017-12-01

    To measure how care needs, health and length of stay in permanent residential aged care differs by assessed need for palliative care. On entry into permanent residential aged care, people's care needs and health conditions are assessed on the Aged Care Funding Instrument. Data for the period 2008-2009 and 2015-2016 were analysed for trends in care needs, health conditions, length of stay and separation reason across assessed need for palliative care. Assessed care needs have increased for all people in residential aged care over this period, and people appraised for palliative care were more likely to be rated 'high' in need for support in activities of daily living. People appraised for palliative care had a higher prevalence of cancer and shorter length of stays. Palliative care appraisal is associated with increased complexity in assessed care needs, different profiles of health and shorter length of stays in permanent residential aged care. © 2017 Australian Institute of Health and Welfare Australasian Journal on Ageing © 2017 AJA Inc.

  16. Continuity of Care and Outcomes in Residential Care: A Comparison of Two Care Giving Models

    Science.gov (United States)

    Jones, Loring

    2006-01-01

    This study examined differences in two residential care giving models (houseparent vs. child care worker) in providing continuity of care for youth in residential placement, and the effect that a care giving model had on selected program outcomes. Data for this research were collected in a residential facility that used both models. Youth with…

  17. Indoor Environment in Residential Prefabricated Buildings

    Science.gov (United States)

    Kraus, Michal; Juhásová Šenitková, Ingrid

    2017-10-01

    The contribution presents results of the experimental measurement of indoor air quality in residential prefabricated buildings. People spend about 90% of their life in the indoor environment of buildings. Hygrothermal parameters and indoor air quality are the essential component that define the quality of the indoor environment. The results of case study characterize the quality of the indoor environment of the ordinary occupants in housing unit of residential prefabricated building. A current problem of revitalized prefabricated buildings is inadequate air exchange and related thereto to poor indoor air quality. The experimental measurements were carried out just before and at the beginning of the heating season (from 1st October to 30th November 2016). Heating season was launched in the middle of experimental measurement. The wireless indoor sensor Elgato Eve Room was used for measurements. The obtained values of indoor air temperature [°C], relative humidity [%] and indoor air quality [ppm] are describe and analysis in this study. The results of the study indicate that the values of temperature and indoor air quality meet optimal levels during the experiment with nuances. The mean air temperature in the indoor environment is 22.43 °C. The temperature of the indoor environment is held at the optimum level (18-24 °C) for 94.50% time of the experimental measurements. In addition, the indoor air quality in the context of the content of harmful volatile organic compounds (VOCs) has been excellent for almost 91% time of the total experiment. However, the values of relative humidity were less than the optimum value nearly 40% of the total observed time. The mean 10-minutes values of relative humidity during the heating season is about 10% lower than the mean 10-minutes relative humidity before the heating season.

  18. Comparison of a traditional and non-traditional residential care facility for persons living with dementia and the impact of the environment on occupational engagement.

    Science.gov (United States)

    Richards, Kieva; D'Cruz, Rachel; Harman, Suzanne; Stagnitti, Karen

    2015-12-01

    Dementia residential facilities can be described as traditional or non-traditional facilities. Non-traditional facilities aim to utilise principles of environmental design to create a milieu that supports persons experiencing cognitive decline. This study aimed to compare these two environments in rural Australia, and their influence on residents' occupational engagement. The Residential Environment Impact Survey (REIS) was used and consists of: a walk-through of the facility; activity observation; interviews with residents and employees. Thirteen residents were observed and four employees interviewed. Resident interviews did not occur given the population diagnosis of moderate to severe dementia. Descriptive data from the walk-through and activity observation were analysed for potential opportunities of occupational engagement. Interviews were thematically analysed to discern perception of occupational engagement of residents within their facility. Both facilities provided opportunities for occupational engagement. However, the non-traditional facility provided additional opportunities through employee interactions and features of the physical environment. Interviews revealed six themes: Comfortable environment; roles and responsibilities; getting to know the resident; more stimulation can elicit increased engagement; the home-like experience and environmental layout. These themes coupled with the features of the environment provided insight into the complexity of occupational engagement within this population. This study emphasises the influence of the physical and social environment on occupational engagement opportunities. A non-traditional dementia facility maximises these opportunities and can support development of best-practice guidelines within this population. © 2015 Occupational Therapy Australia.

  19. Residential Group Care Quarterly. Volume 5, Number 3, Winter 2005

    Science.gov (United States)

    Michael, Jennifer, Ed.

    2005-01-01

    This issue of "Residential Group Care Quarterly" contains the following articles: (1) "Promising Practices for Adequately Funding and Reimbursing Residential Services" (Lloyd Bullard); (2) "Closing the Gender Gap" (Erin Andersen); (3) "Residential Child Care: Guidelines for Physical Techniques, Crisis Prevention, and Management" (Kurk Lalemand);…

  20. Residential hospice environments: evidence-based architectural and landscape design considerations.

    Science.gov (United States)

    Verderber, Stephen

    2014-01-01

    The residential hospice care movement is increasingly accepted and supported globally, and yet, unfortunately, the amount of literature on best practices in the planning and design of residential hospice facilities and adjacent outdoor spaces remains relatively small. This paper reports on a compendium of architectural and landscape design considerations that reflect the fundamental dimensions of the residential hospice experience: site and context, arrival spaces, communal and private spaces of the residential milieu, transitional spaces, and nature connectivity. Additionally, key staffing and administrative ramifications of this built-environment compendium are addressed, as are prognostications and challenges for the future.

  1. Human response to vibration in residential environments.

    Science.gov (United States)

    Waddington, David C; Woodcock, James; Peris, Eulalia; Condie, Jenna; Sica, Gennaro; Moorhouse, Andrew T; Steele, Andy

    2014-01-01

    This paper presents the main findings of a field survey conducted in the United Kingdom into the human response to vibration in residential environments. The main aim of this study was to derive exposure-response relationships for annoyance due to vibration from environmental sources. The sources of vibration considered in this paper are railway and construction activity. Annoyance data were collected using questionnaires conducted face-to-face with residents in their own homes. Questionnaires were completed with residents exposed to railway induced vibration (N = 931) and vibration from the construction of a light rail system (N = 350). Measurements of vibration were conducted at internal and external positions from which estimates of 24-h vibration exposure were derived for 1073 of the case studies. Sixty different vibration exposure descriptors along with 6 different frequency weightings were assessed as potential predictors of annoyance. Of the exposure descriptors considered, none were found to be a better predictor of annoyance than any other. However, use of relevant frequency weightings was found to improve correlation between vibration exposure and annoyance. A unified exposure-response relationship could not be derived due to differences in response to the two sources so separate relationships are presented for each source.

  2. Demand of elderly people for residential care: an exploratory study

    NARCIS (Netherlands)

    van Bilsen, P.; Hamers, J.; Groot, W.; Spreeuwenberg, C.

    2006-01-01

    Background: Because of the rapid aging population, the demand for residential care exceeds availability. This paper presents the results of a study that focuses on the demand of elderly people for residential care and determinants (elderly people's personal characteristics, needs and resources) that

  3. Examination of Negative Peer Contagion in a Residential Care Setting

    Science.gov (United States)

    Huefner, Jonathan C.; Ringle, Jay L.

    2012-01-01

    There has been ongoing concern about the negative impact of residential treatment on youth in care. Research examining the impact of negative peer influence in juvenile justice, education, and residential care settings is reviewed. A study was conducted to examine the impact of negative peer contagion on the level of problem behavior in a…

  4. Spatial access to residential care resources in Beijing, China

    Directory of Open Access Journals (Sweden)

    Cheng Yang

    2012-08-01

    Full Text Available Abstract Background As the population is ageing rapidly in Beijing, the residential care sector is in a fast expansion process with the support of the municipal government. Understanding spatial accessibility to residential care resources by older people supports the need for rational allocation of care resources in future planning. Methods Based on population data and data on residential care resources, this study uses two Geographic Information System (GIS based methods – shortest path analysis and a two-step floating catchment area (2SFCA method to analyse spatial accessibility to residential care resources. Results Spatial accessibility varies as the methods and considered factors change. When only time distance is considered, residential care resources are more accessible in the central city than in suburban and exurban areas. If care resources are considered in addition to time distance, spatial accessibility is relatively poor in the central city compared to the northeast to southeast side of the suburban and exurban areas. The resources in the northwest to southwest side of the city are the least accessible, even though several hotspots of residential care resources are located in these areas. Conclusions For policy making, it may require combining various methods for a comprehensive analysis. The methods used in this study provide tools for identifying underserved areas in order to improve equity in access to and efficiency in allocation of residential care resources in future planning.

  5. Aspects of nursing student placements associated with perceived likelihood of working in residential aged care.

    Science.gov (United States)

    Lea, Emma; Mason, Ron; Eccleston, Claire; Robinson, Andrew

    2016-03-01

    To investigate which aspects of student nurses' experiences of residential aged care facility clinical placements affect perceived likelihood of choosing a career in residential aged care post graduation. Poor clinical placement experiences as a student contribute to nurses' reluctance to work in aged care. Various factors have been found to improve the placement experience and influence students' attitudes and employment intentions. Missing from the literature is a quantitative - rather than qualitative - exploration of which attributes of an aged care placement link to perceived likelihood of working in residential aged care post graduation. Supported residential aged care placement programmes were developed for nursing students using an evidence-based best-practice model within an action research framework. Staff formed a mentor group in two facilities. During placement, weekly feedback meetings were held for students and mentors. Second-year nursing students (n = 71) participating in a three- or four-week placement programme at two Tasmanian residential aged care facilities (September 2011-May 2013) completed questionnaires on placement experiences. Measures of association (correlation coefficients) were used to assess the effect of a range of variables on the likelihood of working in an aged care facility post graduation. Associations were identified between the likelihood of working in residential aged care post graduation and nurse mentor-student feedback exchange, Teaching and Learning Score and supportiveness of care workers. This study adds to the literature by providing quantitative evidence that certain aspects of aged care placements influence attitudes to working in these sites post graduation. To increase interest in working in residential aged care, the teaching and learning environment needs improvement, opportunities should be proffered for mentor-student feedback exchange during placements and care workers need support to mentor effectively.

  6. Lead in a residential environment in Jamaica.

    Science.gov (United States)

    Anglin-Brown, B; Armour-Brown, A; Lalor, G C; Preston, J; Vutchkov, M K

    1996-09-01

    The background levels of lead in Jamaica in soils and sediments, estimated at 37 mg kg(-1), are relatively high compared with world averages. Several areas have values in excess of this due to mineralisation and pollution. One such is the residential Hope Flats/Kintyre area in which levels of lead up to 2.5% are found in the soils and up to 8 μg kg(-1) in the water of the nearby Hope River. The blood lead levels of a sample of children were in the range 5.7-57 μg dl(-1). The high lead levels suggest a potential health risk, particularly for the children. This can be minimised by programmes which include community education, case management and abatement to reduce the lead exposure.

  7. Invisible Elderly in Danish and Swedish Residential Care Home Architecture

    DEFF Research Database (Denmark)

    E Andersson, Jonas; Grangaard, Sidse

    2015-01-01

    This study of two architectural competitions suggests that the fit between architectural design and older users, who depend on regular caregiving due to cognitive or functional disabilities, requires a particular consideration when designing new residential care homes.......This study of two architectural competitions suggests that the fit between architectural design and older users, who depend on regular caregiving due to cognitive or functional disabilities, requires a particular consideration when designing new residential care homes....

  8. Indoor Thermal Environment in Tropical Climate Residential Building

    Directory of Open Access Journals (Sweden)

    Jamaludin Nazhatulzalkis

    2014-01-01

    Full Text Available Indoor thermal environment is one of the criteria in sustainable building. This criterion is important in ensuring a healthy indoor environment for the occupants. The consideration of environmental concerns at the early design stage would effectively integrate the sustainability of the building environment. Global climate changes such as global warming do affect human comfort since people spend most of their time and activities in the building. The increasing of urban population required additional housing for households, as well as places to shop, office and other facilities. Occupants are now more conscious the importance of sustainability for a better quality of life. Good thermal environment is essential for human wellness and comfort. A residential environment will influence residents’ health and safety. The global warming increase the earth’s temperature and greenhouse emission to the atmosphere cause adverse effects to the outdoor environment. Residential developments modify the materials, structure and energy balance in urban climate effects of human economic activities. As an indoor environment is influenced by the outdoor condition, the factors affecting indoor thermal environment are crucial in improving a comfortable and healthy environment in residential building. The microclimatic of a site such as temperature and relative humidity, and wind movement led to the variation of indoor thermal environment in the building.

  9. Problems of European inner cities and their residential environments

    Czech Academy of Sciences Publication Activity Database

    Vaishar, Antonín; Zapletalová, Jana

    2003-01-01

    Roč. 11, č. 2 (2003), s. 24-35 ISSN 1210-8812 Grant - others:Evropská unie(XE) EVK4-CT-2002-00086 Institutional research plan: CEZ:AV0Z3086906 Keywords : inner city, residential environment , sustainibility, re- urbanization , Brno Subject RIV: DE - Earth Magnetism, Geodesy, Geography

  10. Challenges faced by western-modelled residential care institutions ...

    African Journals Online (AJOL)

    Some commentators have blamed these residential care centres for their apparent failure to bring up the orphans and other vulnerable children in their care, sufficiently well groomed in local culture and values, and that the perceived failure had led to a situation where such children grew up with anti-social tendencies.

  11. Waste removal systems and recycling participation in residential environments

    DEFF Research Database (Denmark)

    Thøgersen, John

    2002-01-01

    health are severely impaired (Pieters, 1989). More recently, resource waste and environmental hazards from waste have given rise to public and political concern as well, even when disposal systems are well managed. This concern has led to efforts to divert solid waste away from disposal and towards some......Systems for the removal of waste are important although often overlooked elements of any residential environment. It is an old insight that when these systems are ineffective (and this is globally and historically the rule rather than the exception), human living conditions and often even human...... form of recycling (Ackerman, 1997; Pieters, 1989). Therefore, residential environments in developed countries increasingly contain separate collection systems for that fraction of waste that can be recycled, and hence re-utilized, in the production of new goods. These collection systemsare in addition...

  12. Valuing narrative in the care of older people: a framework of narrative practice for older adult residential care settings.

    Science.gov (United States)

    Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta

    2014-09-01

    To report on the development of a framework of narrative practice, in residential care settings for older people. Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. A hermeneutic approach incorporating narrative methods was used. Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. © 2013 John Wiley & Sons Ltd.

  13. Costs and benefits of home care for the elderly versus residential care: a comparison using propensity scores

    NARCIS (Netherlands)

    Kok, L.; Berden, C.; Sadiraj, K.

    2015-01-01

    A comparison of the costs of residential care and home care shows that the former is more expensive for society. However, elderly people seem to be happier in residential care. All stakeholders, except the state (and thus the taxpayer), benefit if elderly people enter residential care. This reveals

  14. Mental Health Problems in Residential Care for Street Children ...

    African Journals Online (AJOL)

    Results: Nearly three quarters of street children in residential care were rated as having a mental health problem, as indicated by findings from both the self rated SDQ and the Carers' SDQ i.e. 48 children (76.1%) and 54 children (73.0%) respectively. Out of this population approximately one third were assessed as having ...

  15. The Family Characteristics of Youth Entering a Residential Care Program

    Science.gov (United States)

    Griffith, Annette K.; Ingram, Stephanie D.; Barth, Richard P.; Trout, Alexandra L.; Hurley, Kristin Duppong; Thompson, Ronald W.; Epstein, Michael H.

    2009-01-01

    Although much is known about the mental health and behavioral functioning of youth who enter residential care programs, very little research has focused on examining the family characteristics of this population. Knowledge about family characteristics is important, however, as it can aid in tailoring programs to meet the needs of families who are…

  16. Hepatitis B infection in black children from residential care facilities ...

    African Journals Online (AJOL)

    Objectives. A study was undertaken to assess the prevalence of hepatitis B infection in selected residential child care facilmes in Natal. Design. All residents at three facilities in the Durban and. Pietermaritzburg areas of Kwazulu-Natal were tested for markers of hepatitis B infection as part of a broader health.

  17. Sexual abuse of children in residential care : an international review

    NARCIS (Netherlands)

    Timmerman, Margaretha; Schreuder, Pauline

    2014-01-01

    This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945-2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or

  18. Hepatitis B infection in black children from residential care facilities ...

    African Journals Online (AJOL)

    socio-economic conditions suggested that poor hygienic standards and a high prevalence of hepatitis B e antigen. (HBeAg) carriage were high risk factors for horizontal transmission of hepatitis 8 infection in these institutions.3. In South Africa, where residential care facilities have until recently been racially segregated, ...

  19. Communication Supports in Congregate Residential Care Settings in Ohio

    Science.gov (United States)

    Mitchell, Pamela R.

    2009-01-01

    Background: Communication skills are important to the pursuit of increased self-determination in individuals with disabilities. The aim of this investigation was to gather information about communication supports in state-run residential care facilities in Ohio, and to compare findings with a previous investigation on this topic examining such…

  20. 78 FR 32124 - Community Residential Care

    Science.gov (United States)

    2013-05-29

    ... does not jeopardize the health or safety of the residents, the CRC facility may obtain provisional... deficiency. If the deficiency is not corrected per the agreement, the provisional approval is terminated, as....009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care...

  1. Psychological Indicators and Perceptions of Adolescents in Residential Care

    OpenAIRE

    Fernandes, Amanda Oliveira; Oliveira-Monteiro, Nancy Ramacciotti de

    2016-01-01

    Abstract The institutionalization of adolescents has been mentioned in the literature with positive and negative aspects. This study investigated 61 adolescents in residential care aiming to evaluate psychological problems and perceptions related to the care, using interviews and the YSR. Data was evaluated using quantitative and qualitative analysis, using gender, age and length of institutionalization as variables. Results indicated clinical scores for psychological problems, except for ext...

  2. Perception Analysis Of Living Environment At Taman Melati Residential Areas

    Directory of Open Access Journals (Sweden)

    ABDUL AZEEZ Kadar Hamsa

    2010-12-01

    Full Text Available Rapid physical development in a residential area will deteriorate living environment of the residents especially if it takes place haphazardly without applying adequate planning guidelines. It will, eventually, exert more pressure on physical infrastructure of the area. As a result, residents of the area will be subjected to dissatisfaction on the present supporting infrastructure as the demand exceeds the supply. Evidently, it may lead to poor living conditions of the area, which ultimately slow the progressiveness of the society to achieve the quality of living standards. This paper investigates residents' perceptions on present living environmental setting at Taman Melati residential area in Kuala Lumpur. Questionnaire survey was administered to determine the perceptions of the residents on physical environmental parameters such as air, noise, streetlight illuminance, and traffic volume. The level of satisfaction of the residents on the living environment had showed nearly 64% of the respondents expressed 'satisfied strongly' or 'satisfied'. The level of willingness of the residents to stay further continuously at Taman Melati indicates about 56% of the respondents expressed 'strongly willing' or 'willing'. It is also seen that the overall satisfaction level of the residents on the living environment was high albeit satisfaction level on individual physical environmental parameters was low.

  3. [Children's and Adolescents' Mental Health in Residential Youth Care Settings].

    Science.gov (United States)

    Niemann, Katrin; Häßler, Frank

    2014-01-01

    Children's and Adolescents' Mental Health in Residential Youth Care Settings Young people in residential youth care show a higher prevalence of mental problems than other children. This study gives an overview about the current situation of children and young people in the residential youth welfare service in Rostock (Mecklenburg-Western Pomerania, Germany). In 2008 a similar study for the rural district Bad Doberan (Mecklenburg-Western Pomerania, Germany) was conducted by Engel, Pätow, and Häßler (2009). This research was carried out with two measuring times over a period of eight months starting 2010. 48 young people and their keyworker as well as teachers answered Achenbach's self- and third-party-assessment forms for mental problems. Furthermore the Barrat-Impulsiveness Scale (BIS-11) and the Youth-Psychopathic Inventory were used to get information about traits of Psychopathy. The result showed that 51 % of the young people rated themselves as clinical relevant. Female probands reached higher scores than the male. The third-party assessment displayed 45 % in clinical scores. These scores, presented by a dimensional assessment, confirm the higher prevalence of mental problems in residential youthcare settings. A long term improvement of the life situation of psychological stressed children and adolescents, who are living in residential care homes, can only be achieved by an intensive cooperation of all the involved institutions and professions. The basis for this is the realisation of this necessity as well as the deduction and implementation of appropriate curricula, which imparts the required abilities needed for the conversion in the respective professions.

  4. On public space design for Chinese urban residential area based on integrated architectural physics environment evaluation

    Science.gov (United States)

    Dong, J. Y.; Cheng, W.; Ma, C. P.; Tan, Y. T.; Xin, L. S.

    2017-04-01

    The residential public space is an important part in designing the ecological residence, and a proper physics environment of public space is of greater significance to urban residence in China. Actually, the measure to apply computer aided design software into residential design can effectively avoid an inconformity of design intent with actual using condition, and a negative impact on users due to bad architectural physics environment of buildings, etc. The paper largely adopts a design method of analyzing architectural physics environment of residential public space. By analyzing and evaluating various physics environments, a suitability assessment is obtained for residential public space, thereby guiding the space design.

  5. National estimation of children in residential care institutions in Cambodia: a modelling study.

    Science.gov (United States)

    Stark, Lindsay; Rubenstein, Beth L; Pak, Kimchoeun; Kosal, Sok

    2017-01-16

    The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg, age, sex, duration of stay, education and health). The data were intended to guide recent efforts by the Government of Cambodia to reduce the number of children living in residential care institutions and increase the number of children growing up in supportive family environments. Data were collected in Cambodia across 24 sites at the commune level. Communes-administrative divisions roughly equivalent to counties-were selected by the National Institute of Statistics using a two-stage sampling method. Government lists and key informant interviews were used to construct a complete roster of institutions across the 24 communes. All identified institutions were visited to count the number of children and gather data on their basic characteristics. The rate of children in residential care in the selected communes was calculated as a percentage of total population using a Poisson model. This rate was applied to all districts in Cambodia with at least one reported residential care institution. A total of 3588 children were counted across 122 institutions. A child living in a residential care institution was defined as anyone under the age of 18 years who was sleeping in the institution for at least four nights per week during the data collection period. There are an estimated 48 775 children living in residential care institutions in Cambodia. The vast majority of children have a living parent and are school-aged. More than half are between 13 and 17 years of age. Nearly 1 of every 100 children in Cambodia is living in residential care. This raises substantial concerns for child health, protection and national development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  6. Registered nurses' experience of delegating the administration of medicine to unlicensed personnel in residential care homes.

    Science.gov (United States)

    Gransjön Craftman, Åsa; Grape, Charlotte; Ringnell, Katarina; Westerbotn, Margareta

    2016-11-01

    The aim was to describe registered nurses' experience in the context of delegating the administration of medication to unlicensed personnel in residential care homes. The residents in residential care homes have a need for extensive care and nursing, and large amounts of medicines are common practice. Registered nurses' workload and difficulties in fulfilling their duties, such as administration of medicines, have led to frequent delegation of this task between the registered nurses and unlicensed assisting personnel. It is, of course, a great responsibility to ensure that the care of the older people remains safe while maintaining quality in the prevailing situation. A qualitative inductive descriptive study. Data were collected using audio-recorded semistructured interviews with a purposive sample of 18 registered nurses and interpreted using manifest content analysis. The study was approved by the ethical research committee. Registered nurses found the organisation unsupportive with regard to nursing interventions. The delegation context was experienced as a grey zone; the rules and regulations were not in line with the unspoken expectation to delegate the administration of medicine to unlicensed personnel, in order to be able to manage their daily work. The slimmed organisation of residential care homes relies upon registered nurses' use of delegation of medicine administration to unlicensed assistant personnel. It becomes an inevitable assignment entailing a challenging responsibility for patient safety and the quality of care. The results of this study may contribute to a better understanding of the complexity of caring for older people in residential care homes and to improving the work environment of all healthcare personnel. © 2016 John Wiley & Sons Ltd.

  7. Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

    Science.gov (United States)

    Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

    2018-04-23

    This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  8. Indoor radon concentration in Korea residential environments.

    Science.gov (United States)

    Park, Tae Hyun; Kang, Dae Ryong; Park, Si Hyun; Yoon, Dan Ki; Lee, Cheol Min

    2018-02-21

    The purpose of this study is to provide basic data for the evaluation and management of health effects with respect to exposure to radon within residential environments in South Korea. It is part of a case-control study to develop a management plan based on indoor radon exposure levels and assess their impact on health. To investigate the long-term cumulative concentration levels of radon, 599 patients who have respiratory diseases were recruited in South Korea, and alpha track detectors were installed in their residences for a period of 3 months from mid-2015 to late 2016. A survey was then conducted to determine the factors affecting the radon concentration. The radon concentration levels were analyzed in conjunction with the survey results. The results show that the arithmetic mean of the radon concentrations in domestic residences was in the range of 70.8 ± 65.2 Bq/m 3 . An analysis of covariance (ANCOVA) was performed to identify the environmental factors affecting the radon concentration and contributing to variations in the residential radon concentration based on the height of the residence. The results show that the contribution of the local environmental factor to the variation in radon concentration (p  0.05), the same was found with regard to the construction year after the control (p < 0.05).

  9. Positive and Negative Peer Influence in Residential Care.

    Science.gov (United States)

    Huefner, Jonathan C; Smith, Gail L; Stevens, Amy L

    2017-10-13

    The potential for negative peer influence has been well established in research, and there is a growing interest in how positive peer influence also impacts youth. No research, however, has concurrently examined positive and negative peer influence in the context of residential care. Clinical records for 886 residential care youth were used in a Hierarchical Linear Model analysis to examine the impact of negative and positive peer influence on naturally occurring patterns of serious problem behavior over time. Negative peer influence, where the majority of youth in a home manifested above the average number of serious behavior problems, occurred 13.7% of the time. Positive peer influence, where the majority of youth manifested no serious problem behaviors for the month, occurred 47.7% of the time. Overall, youth problem behavior improved over time. There were significantly lower rates of serious problem behavior in target youth during positive peer influence months. Conversely, there were significantly higher rates of serious problem behaviors in target youth during negative peer influence months. Negative peer influence had a relatively greater impact on target peers' serious behavior problems than did positive peer influence. Caregiver experience significantly reduced the impact of negative peer influence, but did not significantly augment positive peer influence. Months where negative peer influence was combined with inexperienced caregivers produced the highest rates of serious problem behavior. Our results support the view that residential programs for troubled youth need to create circumstances that promote positive and control for negative peer influence.

  10. Where's the evidence? a systematic review of economic analyses of residential aged care infrastructure.

    Science.gov (United States)

    Easton, Tiffany; Milte, Rachel; Crotty, Maria; Ratcliffe, Julie

    2017-03-21

    Residential care infrastructure, in terms of the characteristics of the organisation (such as proprietary status, size, and location) and the physical environment, have been found to directly influence resident outcomes. This review aimed to summarise the existing literature of economic evaluations of residential care infrastructure. A systematic review of English language articles using AgeLine, CINAHL, Econlit, Informit (databases in Health; Business and Law; Social Sciences), Medline, ProQuest, Scopus, and Web of Science with retrieval up to 14 December 2015. The search strategy combined terms relating to nursing homes, economics, and older people. Full economic evaluations, partial economic evaluations, and randomised trials reporting more limited economic information, such as estimates of resource use or costs of interventions were included. Data was extracted using predefined data fields and synthesized in a narrative summary to address the stated review objective. Fourteen studies containing an economic component were identified. None of the identified studies attempted to systematically link costs and outcomes in the form of a cost-benefit, cost-effectiveness, or cost-utility analysis. There was a wide variation in approaches taken for valuing the outcomes associated with differential residential care infrastructures: 8 studies utilized various clinical outcomes as proxies for the quality of care provided, and 2 focused on resident outcomes including agitation, quality of life, and the quality of care interactions. Only 2 studies included residents living with dementia. Robust economic evidence is needed to inform aged care facility design. Future research should focus on identifying appropriate and meaningful outcome measures that can be used at a service planning level, as well as the broader health benefits and cost-saving potential of different organisational and environmental characteristics in residential care. International Prospective Register of

  11. Objectively Measured Activity Patterns among Adults in Residential Aged Care

    Directory of Open Access Journals (Sweden)

    Natasha Reid

    2013-12-01

    Full Text Available Objectives: To determine the feasibility of using the activPAL3TM activity monitor, and, to describe the activity patterns of residential aged care residents. Design: Cross-sectional. Setting: Randomly selected aged care facilities within 100 km of the Gold Coast, Queensland, Australia. Participants: Ambulatory, older (≥60 years residential aged care adults without cognitive impairment. Measurements: Feasibility was assessed by consent rate, sleep/wear diary completion, and through interviews with staff/participants. Activity patterns (sitting/lying, standing, and stepping were measured via activPAL3TM monitors worn continuously for seven days. Times spent in each activity were described and then compared across days of the week and hours of the day using linear mixed models. Results: Consent rate was 48% (n = 41. Activity patterns are described for the 31 participants (mean age 84.2 years who provided at least one day of valid monitor data. In total, 14 (45% completed the sleep/wear diary. Participants spent a median (interquartile range of 12.4 (1.7 h sitting/lying (with 73% of this accumulated in unbroken bouts of ≥30 min, 1.9 (1.3 h standing, and 21.4 (36.7 min stepping during their monitored waking hours per day. Activity did not vary significantly by day of the week (p ≥ 0.05; stepping showed significant hourly variation (p = 0.018. Conclusions: Older adults in residential aged care were consistently highly sedentary. Feasibility considerations for objective activity monitoring identified for this population include poor diary completion and lost monitors.

  12. 25 CFR 20.509 - What must the social services worker do when a child is placed in foster care or residential care...

    Science.gov (United States)

    2010-04-01

    ... placed in foster care or residential care facility? 20.509 Section 20.509 Indians BUREAU OF INDIAN... Assistance Foster Care § 20.509 What must the social services worker do when a child is placed in foster care or residential care facility? When a child is placed in foster care or a residential care facility...

  13. Defining pastoral care for older people in residential care.

    Science.gov (United States)

    Wilkes, Lesley; Cioffi, Jane; Fleming, Andrew; LeMiere, Jenny

    2011-02-01

    The concept and definition of pastoral care in aged care remains ambiguous. This paper reports on the defining characteristics and meaning of pastoral care from the perspective of older recipients, their family members and pastoral care workers. Using a qualitative descriptive approach semi-structured in-depth interviews were conducted with 18 pastoral care workers and 11 older people. Transcribed data were analysed using NVivo software and coded for emerging themes. The defining characteristics of pastoral care that emerged from analysis of transcribed interviews were: a trusting relationship, spiritual support, emotional support and practical support. Findings also portray the role of the pastoral care worker as spiritual guide, confidante, and emotional and practical supporter acting within a trusting relationship. Future studies should confirm these results by exploring the perceptions of experts in the field of pastoral care.

  14. [Regulation of sexual expression in residential aged care facilities: A professional point of view].

    Science.gov (United States)

    Villar, Feliciano; Fabà, Josep; Celdrán, Montserrat; Serrat, Rodrigo

    2014-01-01

    The purpose of this study is to determine the opinion of professionals working in residential aged care facilities on the regulation of sexuality in these settings. Fifty-three professionals from five residential aged care facilities located in the metropolitan area of Barcelona answered several questions regarding the advisability of establishing measures for the regulation of sexuality in RACFs, the elements that could contribute to this, and the aspects that such regulations should consider. Around 50% of the participants recognized the advisability of having some type of measures for sexuality regulation in residential aged care facilities. According to their responses this should be developed taking into account professional opinions, but also the points of view of the residents and their relatives. The most frequently mentioned regulations were those that ensured that any kind of sexually charged situation occurred in a private environment. The development of strategies are suggested to distinguish those people with dementia that are competent to consent to sexual acts from those who are not. The opinion of professionals working in RACFs regarding the advisability of establishing measures for sexuality regulation seems to be considerably divided. Thus, whilst around 50% of them recognize their potential usefulness, the other half consider them unnecessary or even counterproductive for the sexual freedom of residents. Associating regulation with prohibition and sexuality with sexual activity was not uncommon among the responses of the participants. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  15. Children With Intellectual Disability and Hospice Utilization: The Moderating Effect of Residential Care.

    Science.gov (United States)

    Lindley, Lisa C

    2017-01-01

    Children with intellectual disability commonly lack access to pediatric hospice care services. Residential care may be a critical component in providing access to hospice care for children with intellectual disability. This research tested whether residential care intensifies the relationship between intellectual disability and hospice utilization (ie, hospice enrollment, hospice length of stay), while controlling for demographic characteristics. Multivariate regression analyses were conducted using 2008 to 2010 California Medicaid claims data. The odds of children with intellectual disability in residential care enrolling in hospice care were 3 times higher than their counterparts in their last year of life, when controlling for demographics. Residential care promoted hospice enrollment among children with intellectual disability. The interaction between intellectual disability and residential care was not related to hospice length of stay. Residential care did not attenuate or intensify the relationship between intellectual disability and hospice length of stay. The findings highlight the important role of residential care in facilitating hospice enrollment for children with intellectual disability. More research is needed to understand the capability of residential care staff to identify children with intellectual disability earlier in their end-of-life trajectory and initiate longer hospice length of stays.

  16. External built residential environment characteristics that affect mental health of adults.

    Science.gov (United States)

    Ochodo, Charles; Ndetei, D M; Moturi, W N; Otieno, J O

    2014-10-01

    External built residential environment characteristics include aspects of building design such as types of walls, doors and windows, green spaces, density of houses per unit area, and waste disposal facilities. Neighborhoods that are characterized by poor quality external built environment can contribute to psychosocial stress and increase the likelihood of mental health disorders. This study investigated the relationship between characteristics of external built residential environment and mental health disorders in selected residences of Nakuru Municipality, Kenya. External built residential environment characteristics were investigated for 544 residents living in different residential areas that were categorized by their socioeconomic status. Medically validated interview schedules were used to determine mental health of residents in the respective neighborhoods. The relationship between characteristics of the external built residential environment and mental health of residents was determined by multivariable logistic regression analyses and chi-square tests. The results show that walling materials used on buildings, density of dwelling units, state of street lighting, types of doors, states of roofs, and states of windows are some built external residential environment characteristics that affect mental health of adult males and females. Urban residential areas that are characterized by poor quality external built environment substantially expose the population to daily stressors and inconveniences that increase the likelihood of developing mental health disorders.

  17. Hygrothermal Analysis of Indoor Environment of Residential Prefabricated Buildings

    Science.gov (United States)

    Kraus, Michal

    2017-10-01

    Recent studies show that the relative humidity and the indoor air temperature constitute an important determinant of the quality of indoor air. Hygrothermal microclimate has a significant impact on occupant’s health and their comfort. The study presents the results of experimental measurement of indoor air temperature and relative humidity in selected apartment in prefabricated panel house situated in Ostrava, Czechia. The contribution describes and analysis the relation between indoor air temperature [°C] and relative humidity [%] in this apartment. The experimental object is selected with respect to the housing stock in the Czech Republic. A third of the housing stock in the Czech Republic is composed of prefabricated panel houses. Regeneration and revitalization of these buildings were in the focus of interest during recent years. Building modifications, such as thermal insulation of building envelope or window replacement, lead to a significantly higher level of airtightness of these objects. Humidity and indoor air temperature are measured in 10-minute cycles for two periods. The values of temperature and humidity are measured for the non-heating and the heating season. The length of each experimental period is 30 days. The mean value of indoor air temperature is 22.21 °C and average relative humidity is 45.87% in the non-heating period. The values of 22.62 °C and 35.20% represent average values for the heating period. A slight increase of the average temperature of the indoor environment (+1.85%) is observed. The decrease of the relative humidity is evident at first glance. The relative humidity of the internal environment is approximately 10% lower in the heating period. Long-term decline of relative humidity below 30% brings many problems. It is necessary to take measures to increase of relative humidity in residential prefabricated building. The aquarium appears to be ineffective. The solution may be forced artificial ventilation or humidifiers.

  18. Blood pressure in young adulthood and residential greenness in the early-life environment of twins.

    Science.gov (United States)

    Bijnens, Esmée M; Nawrot, Tim S; Loos, Ruth Jf; Gielen, Marij; Vlietinck, Robert; Derom, Catherine; Zeegers, Maurice P

    2017-06-05

    Previous research shows that, besides risk factors in adult life, the early-life environment can influence blood pressure and hypertension in adults. However, the effects of residential traffic exposure and residential greenness in the early-life on blood pressure in young adulthood are currently unknown. Ambulatory (24-h) blood pressures of 278 twins (132 pairs) of the East Flanders Prospective Twins Study were obtained at the age of 18 to 25 years. Prenatal and adulthood residential addresses were geocoded and used to assign prenatal and postnatal traffic and greenness indicators. Mixed modelling was performed to investigate blood pressure in association with greenness while adjusting for potential confounding factors. Night-time systolic blood pressure was inversely associated with greenness at the residential address in twins living at the same address their entire life (non-movers, n = 97, 34.9%). An interquartile increase in residential greenness exposure (1000 m radius) was associated with a 3.59 mmHg (95% CI: -6.0 to -1.23; p = 0.005) lower adult night systolic blood pressure. Among twins who were living at a different address than their birth address at time of the measurement (n = 181, 65.1%), night-time blood pressure was inversely associated with residential surrounding greenness at adult age as well as with residential greenness in early-life. However after additional adjustment for residential greenness exposure in adulthood, only residential greenness exposure in early-life was significantly associated with night systolic blood pressure. While no significant effect of adult residential greenness with adult blood pressure was observed, while accounting for the early-life greenness exposure. Lower residential greenness in the early-life environment was independently associated with a higher adult blood pressure. This indicates that residential greenness has persistent effects on blood pressure.

  19. Homesick: residential and care patterns in patients with severe mental illness

    NARCIS (Netherlands)

    de Mooij, Liselotte D.; Kikkert, Martijn; Lommerse, Nick M.; Theunissen, Jan; de Koning, Mariken B.; de Haan, Lieuwe; Beekman, Aartjan T. F.; Duurkoop, Pim W. R. A.; Dekker, Jack J. M.

    2016-01-01

    Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between

  20. A challenging job: Physical and sexual violence towards group workers in youth residential care.

    NARCIS (Netherlands)

    Alink, L.R.A.; Euser, S.; Bakermans-Kranenburg, M.J.; van IJzendoorn, M.H.

    2014-01-01

    Background: Residential or group care social workers appear to be at increased risk for experiencing physical violence at work. However, little is known about sexual harassment in addition to physical victimization of social workers in youth residential or group care. Objective: We investigated the

  1. Attachment Style, Home-Leaving Age and Behavioral Problems among Residential Care Children

    Science.gov (United States)

    Shechory, Mally; Sommerfeld, Eliane

    2007-01-01

    In a prospective study, the attachment style, home-leaving age, length of time in residential care, and behavioral problems among Israeli residential care children (N=68), were studied. Data analyses showed that children removed from their homes at a later age suffered from higher levels of anxiety, depression and social problems compared to…

  2. From home to 'home': Mapping the caregiver journey in the transition from home care into residential care.

    Science.gov (United States)

    Hainstock, Taylor; Cloutier, Denise; Penning, Margaret

    2017-12-01

    Family caregivers play a pivotal role in supporting the functional independence and quality of life of older relatives, often taking on a wide variety of care-related activities over the course of their caregiving journey. These activities help family members to remain in the community and age-in-place for as long as possible. However, when needs exceed family capacities to provide care, the older family member may need to transition from one care environment to another (e.g., home care to nursing home care), or one level of care to another (from less intense to more intensive services). Drawing upon qualitative interview data collected in a populous health region in British Columbia, Canada, this study explores the roles and responsibilities of family caregivers for family members making the care transition from home care to residential care. A thematic analysis of the interview transcripts resulted in the development of a conceptual framework to characterize the "Caregiver Journey" as a process that could be divided into at least three phases: 1) Precursors to transition - recognizing frailty in family members and caregivers prior to transition; 2) Preparing to transition into residential nursing home care (RC) and 3) Post-transition: Finding a new balance - where caregivers adjust and adapt to new caregiving responsibilities. Our analyses revealed that the second phase is the most complex involving a consideration of the various activities, and roles that family caregivers take on to prepare for the care transition including: information gathering, advocacy and system navigation. We conclude that there is a need for family caregivers to be better supported during care transitions; notably through ongoing and enhanced investments in strategies to support caregiver communication and education. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  3. Stepping Down and Stepping In: Youth’s Perspectives on Making the Transition from Residential Treatment to Treatment Foster Care

    OpenAIRE

    Narendorf, Sarah Carter; Fedoravicius, Nicole; McMillen, J. Curtis; McNelly, David; Robinson, Debra R.

    2012-01-01

    Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth’s perspective on making this transition. This study utilized qualitative intervi...

  4. Fear and overprotection in Australian residential aged-care facilities: The inadvertent impact of regulation on quality continence care.

    Science.gov (United States)

    Ostaszkiewicz, Joan; O'Connell, Beverly; Dunning, Trisha

    2016-06-01

    Most residents in residential aged-care facilities are incontinent. This study explored how continence care was provided in residential aged-care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care. Using grounded theory methodology, 18 residential aged-care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures. Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use. There is a need to rethink the quality of continence care and its measurement in Australian residential aged-care facilities. © 2015 AJA Inc.

  5. Presence of water in residential environments - value for money?

    NARCIS (Netherlands)

    Kauko, T.J.; Goetgeluk, R.W.; Straub, A.; Priemus, H.

    2003-01-01

    The role of water in the locational bundle of residential value and choice determinants is multiple. Relevant attributes pertain to water quality, proximity and length of water frontage, view, size of water body, coastal development costs, and costs caused by flooding. They also pertain to different

  6. THE PREVALENCE OF DEPRESSION AND ITS RISK FACTORS AMONG MALAY ELDERLY IN RESIDENTIAL CARE

    OpenAIRE

    R. Normala; C. Azlini; M. J. Nurul Jannah; Z. M. Lukman

    2014-01-01

    The motivation for the study is to improve the quality of life for elderly in residential care particularly the mental health aspect. Hence, the aim of this study is to examine the prevalence of depression and to identify risk factors related to depression among Malay elderly in residential care. Changes in social structure and economic status have shifted the direction of care for elderly people, as the value of filial piety has gradually declined among the modern Malays. The researchers hyp...

  7. What Do They Do at Home? The Literacies of Children Living in Residential Care in Malaysia

    Science.gov (United States)

    Tan, Jennifer

    2015-01-01

    This paper presents an ethnographic study of the out of school literacy practices of children living in residential care in Malaysia. Although residential homes generate much publicity, especially during the festive seasons, not much is known about the children living within the confines of these homes. Even more lacking is research on their…

  8. The Role of Therapeutic Alliance in Therapy Outcomes for Youth in Residential Care

    Science.gov (United States)

    Handwerk, Michael L.; Huefner, Jonathan C.; Ringle, Jay L.; Howard, Brigid K.; Soper, Stephen H.; Almquist, Julie K.; Chmelka, M. Beth

    2008-01-01

    This study examined the impact of therapeutic alliance (TA) on therapy outcomes for youth with behavioral and emotional problems residing in residential care. Study participants were 71 youth in an out-of-home family-style residential treatment facility who were referred to an onsite psychotherapy clinic. A therapeutic alliance scale was completed…

  9. Refining the COPES to Measure Social Climate in Therapeutic Residential Youth Care

    NARCIS (Netherlands)

    Leipoldt, Jonathan David; Kayed, Nanna; Harder, A.T.; Grietens, Hans; Rimehaug, Tormod

    Background Previous studies have shown that social climate in therapeutic residential youth care (TRC) is important to the welfare of residents, staff, and assessing treatment outcomes. The most influential theory on social climate in residential settings is the theory of Moos. The measurement of

  10. Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review.

    Science.gov (United States)

    Dwyer, Drew

    2011-12-01

    The phenomenon of an ageing population is being experienced globally, as countries struggle to change and improve residential models of care and provide services to the elderly. The role of the registered nurse (RN) is considered crucial to the clinical governance and management of care given. To date, however, no systematic review has examined the RN's experience in leadership and management. The objective of this review is to critically appraise, synthesise and present best available evidence on the experiences of RNs as clinical leaders and managers in residential aged care facilities. This review considered qualitative research papers that addressed the experiences of RNs as clinical leaders and managers in residential aged care facilities. Participants of interest were RNs, nurse leaders, nurses holding registration and or regulation under a board of nursing, nurses working in residential aged care and long-term care facilities. The diversity and use of language to describe nurses' roles and models of care for the elderly care environment were considered in the review. The search strategy sought to find both published studies and papers, limited to the English language and published between January 1997 and February 2011. An initial limited search was done in Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index to Nursing and Allied Health Literature databases to identify the key words contained in the title or abstract and index terms used to describe the relevant terms in the article. A second extensive search was undertaken and extended to other relevant databases using all identified keywords and index terms. The third step involved searching reference lists and bibliographies of chosen articles for additional studies. Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management

  11. Love, intimacy and sexuality in residential dementia care: A spousal perspective.

    Science.gov (United States)

    Roelofs, Tineke Sm; Luijkx, Katrien G; Embregts, Petri Jcm

    2017-01-01

    The experiences and needs of spouses of residential care facility residents with dementia, regarding friendship, love, intimacy, and sexuality were explored. Understanding of how spouses make sense of their experiences was pursued. Semi-structured interviews were held with nine spouses of people with dementia, living in high intensive 24-hour care units within residential care facilities. The results show that friendship, love, intimacy, and sexuality were still embedded in the couples' marital lives, but all in their own way. Changing roles and a shift in purpose of the relationship recurred. Although intimacy was found to be still important in the lives of spouses, emotional, and practical residential care facility barriers were experienced by the spouses, of which the absence of communication were most important. Our findings on the experiences of spouses with regard to intimacy and sexuality can help residential care facility staff and policymakers to recognize the needs of couples and take these into account.

  12. Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Gaskin Sarah

    2012-08-01

    Full Text Available Abstract Background The provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals. Methods A survey of staff (n = 119, including managers, health informatics officers (HIOs, quality improvement staff, registered nurses (RNs, enrolled nurses (ENs/endorsed enrolled nurses (EENs and assistants in nursing (AINs was carried out in four residential aged care facilities in New South Wales and Victoria, Australia. Sites varied in size and displayed a range of information technology (IT capabilities. The survey investigated how and by whom information is collected, retrieved and exchanged, and the frequency and amount of time devoted to these tasks. Descriptive analysis was performed using SPSS, and open responses to questions were coded into key themes. Results Staff completed a median of six forms each, taking a median of 30 min per shift. 68.8% of staff reported transferring information from paper to a computer system, which took a median of 30 min per shift. Handover and face-to-face communication was the most frequently used form of information exchange within facilities. There was a large amount of faxing and telephone communication between facility staff and General Practitioners and community pharmacists, with staff reporting sending a median of 2 faxes to pharmacy and 1.5 faxes to General Practitioners, and initiating 2 telephone calls to pharmacies and 1.5 calls to General Practitioners per shift. Only 38.5% of respondents reported that they always had information available at the point-of-care and only 35.4% of respondents reported that they always had access to hospital stay information of residents

  13. Fitting clinical workflow: the case for wound care in a residential aged care home.

    Science.gov (United States)

    Qian, Siyu; Yu, Ping

    2014-01-01

    Residential aged care homes have, or are in the process of implementing, electronic health record (EHR) systems to improve quality of care and reduce cost. For the system to deliver benefits, it must support nursing tasks and be seamlessly integrated into the nursing workflow. To identify whether and how an EHR system can do this most effectively, direct observation was conducted in a residential aged care home on nurses' use of EHR for wound care. The work processes of wound care and its documentation were investigated. Problems in the use of EHR were identified: 1) functional deficiencies of the EHR system which included a lack of functions to remind nurses of the existence of a wound chart, unavailability of an existent function when needed and a lack of sufficient detail in the information provided; 2) a lack of mobile devices to allow nurses to access the EHR system at the point-of-care, resulting in nurses using paper for point-of-care documentation. The findings suggest that continuous improvement in both the EHR system and its management is required to achieve integration of people, task, process and technology for the optimal benefits of EHR.

  14. Job satisfaction and intention to stay within community and residential aged care employees.

    Science.gov (United States)

    Radford, Katrina; Meissner, Ellen

    2017-09-01

    This study investigated the different facets of job satisfaction that influence community care and residential care employees' intention to stay in the aged care workforce. A survey of four organisations in Australia was undertaken. t-Tests were conducted to analyse differences between groups. Regression analyses were performed to examine the factors influencing intentions to stay in the workforce. Community care workers were more satisfied with various facets of job satisfaction including work on their present job, supervision, people in their present job and the job in general. There was a difference between how the various facets of job satisfaction influenced intentions to stay for residential care compared to community care workers. Both workers were satisfied with their work conditions and work to different extents. There is an opportunity for residential care to look to the practices within the community care sector to improve employees' intentions to stay. © 2017 AJA Inc.

  15. Daily activities and living at a Therapeutic Residential Care Center

    Directory of Open Access Journals (Sweden)

    Luciane Prado Kantorki

    2014-12-01

    Full Text Available This study describes and analyzes day-to-day issues in a Therapeutic Residential Care Center and the daily life characteristics of its residents. This case study was conducted in Caxias do Sul, based on an evaluation of the fourth generation together with a Methodology for Analyzing Everyday Life Networks. The following categories emerged: possibilities in the territory, participation and flexibility in household tasks, situations that mark living, employees who are mediators in conflict resolution, staff committed to the resident, freedom as a therapeutic tool, difficulties in daily life, and building of alliances. This study helped to get to know the structure of everyday life experienced by the residents, identifying some difficulties they face and the mechanisms used to overcome them, in addition to noticing that the professionals can be instrumental in strengthening a daily living that can be pluralized, busy, and enriched, while still respecting the uniqueness of each resident. doi: 10.5216/ree.v16i4.22923.

  16. Effects of the Residential Environment on Health in Japan Linked with Travel Behavior

    Directory of Open Access Journals (Sweden)

    David Perez Barbosa

    2016-02-01

    Full Text Available This paper aims to clarify how the residential environment is associated with overall health-related quality of life (QOL via active travel (walking and cycling, by reflecting the influence of different trip purposes in Japan. The health-related QOL includes physical, mental, and social dimensions. For this study we implemented a questionnaire survey in 20 cities in Japan in 2010 and obtained valid answers from 1202 respondents. The residential environment is defined in terms of distances to and densities of different daily facilities extracted from both the survey and external GIS data. We found that the effects of residential environment on active travel behavior are mixed and limited, depending on types of trip makers. Unexpectedly, travel behavior has no direct effects on the health-related QOL. The residential environment, which is only observed indirectly via lifestyle habits for commuters, has limited effects on health. As for noncommuters, neither their travel behavior nor the residential environment influences their health-related QOL.

  17. Substance use among adolescents in special education and residential youth care : Prevalence, onset and risk factors

    NARCIS (Netherlands)

    Kepper, A.S.

    2013-01-01

    Adolescents attending special education for learning disabilities (SEL), special education for behavioural problems (SEB) and adolescents living in a residential youth care (RYC) institution present a complex risk profile including severe behavioural and emotional problems, deviant peer networks,

  18. The meaning of activities in the dwelling and residential environment : A structural approach in people-environment relations.

    NARCIS (Netherlands)

    Meesters, J.

    2009-01-01

    The dwelling is a central setting in people’s everyday life. People use their dwelling and residential environment for a large variety of activities and purposes. This study systematically relates activities, settings and meanings to improve the insight into people-environment relations. This is

  19. Privacy and senior willingness to adopt smart home information technology in residential care facilities.

    Science.gov (United States)

    Courtney, K L

    2008-01-01

    With large predicted increases of the older adult (65 years and older) population, researchers have been exploring the use of smart home information technologies (IT) in residential care (RC) facilities to enhance resident quality of life and safety. Older adults' perceptions of privacy can inhibit their acceptance and subsequent adoption of smart home IT. This qualitative study, guided by principles of grounded theory research, investigated the relationship between privacy, living environment and willingness of older adults living in residential care facilities to adopt smart home IT through focus groups and individual interviews. The findings from this study indicate that privacy can be a barrier for older adults' adoption of smart home IT; however their own perception of their need for the technology may override their privacy concerns. Privacy concerns, as a barrier to technology adoption, can be influenced by both individual-level and community-level factors. Further exploration of the factors influencing older adults' perceptions of smart home IT need is necessary.

  20. Staff awareness of food and fluid care needs for older people with dementia in residential care: A qualitative study.

    Science.gov (United States)

    Lea, Emma J; Goldberg, Lynette R; Price, Andrea D; Tierney, Laura T; McInerney, Fran

    2017-12-01

    To examine awareness of aged care home staff regarding daily food and fluid care needs of older people with dementia. Older people in residential care frequently are malnourished, and many have dementia. Staff knowledge of the food and fluid needs of people with dementia is limited. Qualitative research on this topic is scarce but can provide insight into how nutrition and hydration care may be improved. Qualitative, interview-based study. Eleven staff in a range of positions at one care home were interviewed regarding their perceptions of current and potential food/fluid care practices. Transcripts were coded and analysed thematically. Key food and fluid issues reported by these staff members were weight loss and malnutrition, chewing and swallowing difficulties (dysphagia), and inadequate hydration. Staff identified a number of current care practices that they felt to be effective in facilitating older people's food and fluid intake, including responsiveness to their needs. Staff suggestions to facilitate food and fluid intake centred on improved composition and timing of meals, enhanced physical and social eating environment, and increased hydration opportunities. Staff commented on factors that may prevent changes to care practices, particularly the part-time workforce, and proposed changes to overcome such barriers. Staff were aware of key food and fluid issues experienced by the older people in their care and of a range of beneficial care practices, but lacked knowledge of many promising care practices and/or how to implement such practices. Staff need to be supported to build on their existing knowledge around effective food and fluid care practices. The numerous ideas staff expressed for changing care practices can be leveraged by facilitating staff networking to work and learn together to implement evidence-based change. © 2017 John Wiley & Sons Ltd.

  1. Stepping Down and Stepping In: Youth's Perspectives on Making the Transition from Residential Treatment to Treatment Foster Care.

    Science.gov (United States)

    Narendorf, Sarah Carter; Fedoravicius, Nicole; McMillen, J Curtis; McNelly, David; Robinson, Debra R

    2012-01-01

    Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth's perspective on making this transition. This study utilized qualitative interviews with youths who were participating in a treatment foster care intervention study (n=8) to gain their perspectives on the process of transitioning from residential care. Youths were interviewed right before they exited residential care and two months after placement in the new foster home. Youths reported hopes for gaining family in the new home as well as fears of placement disruption. Findings point to the need to enlist youths in discussion and problem solving about difficulties they anticipate in the new home and expectations for their relationship with the new foster parents. In addition, the struggles described after two months in the home point to the need for youths to build specific skills to better manage ongoing relationships with foster parents and for foster parent training on how to help build these skills.

  2. Emergency residential care settings: A model for service assessment and design.

    Science.gov (United States)

    Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

    2018-02-01

    There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 25 CFR 20.508 - What must the social services agency do when a child is placed in foster care, residential care...

    Science.gov (United States)

    2010-04-01

    ... placed in foster care, residential care or guardianship home? 20.508 Section 20.508 Indians BUREAU OF... PROGRAMS Child Assistance Foster Care § 20.508 What must the social services agency do when a child is placed in foster care, residential care or guardianship home? The social services agency must make...

  4. Predictors of Student Persistence: Student Satisfaction and Aspects of the Residential Environment

    Science.gov (United States)

    Nayor, Gregory J.

    2009-01-01

    Research in higher education over the past several decades has extensively examined the extent to which various aspects of the college environment affect student persistence (Astin, 1962, 1993; Bean, 1980; Pascarella & Terenzini, 2005; Tinto, 1975, 1988, 1993). Furthermore, researchers have noted the importance of the residential living…

  5. Dental Care Utilization and Satisfaction of Residential University ...

    African Journals Online (AJOL)

    Aim: The objective of this study was to provide information on the level of utilization and satisfaction of residential university students with the dental services provided by the dental clinic of a teaching hospital. Volunteers and Material: A stratified sampling technique was used to recruit volunteers from the outpatient clinic of ...

  6. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...... status. RESULTS: Two thirds of the citizens (64.5%) used one or more PMs (antipsychotics 15.9%, antidepressants 43.5%, anxiolytics/hypnotics 27.1% and anti-dementia drugs 16.4%). Citizens treated with antipsychotics were also prescribed antidepressants (52.9%), anxiolytics/hypnotics (35.3%) and anti...

  7. Nitrogen input from residential lawn care practices in suburban watersheds in Baltimore county, MD

    Science.gov (United States)

    Neely L. Law; Lawrence E. Band; J. Morgan. Grove

    2004-01-01

    A residential lawn care survey was conducted as part of the Baltimore Ecosystem Study, a Long-term Ecological Research project funded by the National Science Foundation and collaborating agencies, to estimate the nitrogen input to urban watersheds from lawn care practices. The variability in the fertilizer N application rates and the factors affecting the application...

  8. Education secured? The school performance of adolescents in secure residential youth care

    NARCIS (Netherlands)

    Harder, Annemiek T.; Huyghen, Anne-Marie N.; Knot-Dickscheit, Jana; Kalverboer, Margrite E.; Köngeter, Stefan; Zeller, Maren; Knorth, Erik J.

    Despite poor school performance by adolescents in secure residential care and the potential importance of education during care, little is known about how to achieve academic success with these adolescents. Therefore, the aim of the present study is to assess adolescents' academic achievement during

  9. An Empirical Typology of Residential Care/Assisted Living Based on a Four-State Study

    Science.gov (United States)

    Park, Nan Sook; Zimmerman, Sheryl; Sloane, Philip D.; Gruber-Baldini, Ann L.; Eckert, J. Kevin

    2006-01-01

    Purpose: Residential care/assisted living describes diverse facilities providing non-nursing home care to a heterogeneous group of primarily elderly residents. This article derives typologies of assisted living based on theoretically and practically grounded evidence. Design and Methods: We obtained data from the Collaborative Studies of Long-Term…

  10. Medical Service Utilization among Youth with School-Identified Disabilities in Residential Care

    Science.gov (United States)

    Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald

    2016-01-01

    Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with…

  11. Prevalence of Weight Problems among Youth with High-Incidence Disabilities in Residential Care

    Science.gov (United States)

    Trout, Alexandra L.; Lambert, Matthew C.; Nelson, Timothy D.; Thompson, Ronald W.

    2014-01-01

    The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of…

  12. Characteristics of Children in Foster Care, Family-Style Group Care, and Residential Care: A Scoping Review.

    Science.gov (United States)

    Leloux-Opmeer, Harmke; Kuiper, Chris; Swaab, Hanna; Scholte, Evert

    When risky child and family circumstances cannot be resolved at home, (temporary) 24-h out-of-home placement of the child may be an alternative strategy. To identify specific placement risks and needs, care professionals must have information about the child and his or her family, care history, and social-cultural characteristics at admission to out-of-home care. However, to date information on case characteristics and particular their similarities and differences across the three main types of out-of-home settings (namely foster care, family-style group care, and residential care) is largely lacking. This review compiles and compares characteristics of school-aged children of average intelligence and their families at the time of each child's admission to one of the three care modalities. A scoping review technique that provides a broad search strategy and ensures sufficient coverage of the available literature is used. Based on the 36 studies included, there is consensus that the majority of normally intelligent children in care demonstrate severe developmental and behavioral problems. However, the severeness as well as the kinds of defining characteristics present differ among the children in foster care, family-style group care, and residential care. The review also identifies several existing knowledge gaps regarding relevant risk factors. Future research is recommended to fill these gaps and determine the developmental pathway in relation to children's risks and needs at admission. This will contribute to the development of an evidence-based risks and needs assessment tool that will enable care professionals to make informed referrals to a specific type of out-of-home care when such a placement is required.

  13. TRANSLOCATION AND REDISTRIBUTION OF PESTICIDES APPLIED IN THE RESIDENTIAL ENVIRONMENT

    Science.gov (United States)

    Pesticides are introduced into the indoor environment for pest control by direct application (e.g., insect sprays and bombs). They are also applied outdoors on lawns, in gardens, or around house foundations to control weed and insect populations. Insecticides and herbicides a...

  14. Older adult stereotypes among care providers in residential care facilities: examining the relationship between contact, eduaction, and ageism.

    Science.gov (United States)

    Reyna, Christine; Goodwin, Eric J; Ferrari, Joseph R

    2007-02-01

    One barrier to quality elder care is ageism among care providers. In the present study, two models of stereotype reduction were tested with care providers at residential homes for older adults--the effects of contact and the effects of education on prejudice. Caregivers at five residential programs in Australia completed a survey assessing education, training, contact with older clients, prior experience, and stereotypes toward older adults. Results revealed that contact was not associated with fewer stereotypes but education (both specific and general) was associated with fewer stereotypes. Implications are discussed in terms of possible interventions and increasing optimal contact with older clients.

  15. Oral hygiene care status of elderly with dementia and in residential aged care facilities.

    Science.gov (United States)

    Philip, Philcy; Rogers, Clive; Kruger, Estie; Tennant, Marc

    2012-06-01

    To explore the effectiveness of oral hygiene care on plaque and gingival status of residents with dementia. Oral hygiene and oral hygiene care has been reported to be poor among the institutionalised elderly with dementia. The severity of oral diseases has been shown to increase with the severity of physical and cognitive impairment related with dementia. Little research has been carried out on plaque and gingival status of elderly with dementia and the impact of disability related with dementia on oral health in residential aged care facilities (RACF). A cross-sectional study of 205 elderly residing in RACF in Perth. Forty-one percent of the residents in RACF had dementia. Sixty percent of the residents with dementia and 75% of the residents with an Activities of Daily Living Oral Health score of D were assisted with oral care. Mean plaques scores and extent of gingival inflammation were higher for residents in the DD and D subgroups and resident with dementia. Residents assisted with brushing had higher mean plaque score and more moderate gingival inflammation. Oral hygiene care status in residents with dementia was poor despite the fact that oral care assistance was being provided. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

  16. [Social support network and adjustment of minors in residential child care].

    Science.gov (United States)

    Martín, Eduardo; Dávila, Luz María

    2008-05-01

    In this study, the relationship between the social support network and the personal, social and academic adjustment of minors in residential care is analyzed. The sample consisted of 102 minors who lived in residential care and who completed the Social Support Questionnaire and the TAMAI. The results show that social support from the family, despite its being the greatest provider of support, does not affect the minors' adjustment. Neither does social support from peers affect their adjustment. However, social support from adults outside the family, and mainly their affection, seems to have a positive influence on the minors' adjustment, particularly at school and in social settings. These results are discussed in relation to their implications for the improvement of programs of residential child care.

  17. Socio-Spatial Integration of Older Adults in Four Types of Residential Environments in Israel.

    Science.gov (United States)

    Schorr, Adi Vitman; Iecovich, Esther; Alfasi, Nurit; Shamai, Shmuel

    2017-10-01

    The socio-spatial integration of older people in different types of residential environments is a key factor affecting the well-being of older people. This study, which included a convenience sample of 565 participants, examined the socio-spatial integration of older people living in two different regional areas (central and peripheral) and four different residential environments (metropolitan hub, city, and town and rural settlements) in Israel. Willing participants were asked to complete a self-administered questionnaire. Socio-spatial integration was assessed by recognition of their neighbors and sense of belonging to the residential environment. The findings show that older adults who resided in the town and in rural settlements were more socio-spatially integrated in their living environments compared with their counterparts who resided in cities. The best predictors of socio-spatial integration were a combination of personal characteristics and characteristics of the environment (perceived accessibility) except for rural settlements, where none of the variables predicted socio-spatial integration.

  18. Introducing consumer directed care in residential care settings for older people in Australia: views of a citizens' jury.

    Science.gov (United States)

    Laver, Kate; Gnanamanickam, Emmanuel; Whitehead, Craig; Kurrle, Susan; Corlis, Megan; Ratcliffe, Julie; Shulver, Wendy; Crotty, Maria

    2018-01-01

    Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens' jury to elicit views of members of the public regarding consumer directed care in residential care. Methods A citizens' jury involving 12 members of the public was held over two days in July 2016, exploring the question: For people with dementia living in residential care facilities, how do we enable increased personal decision making to ensure that care is based on their needs and preferences? Jury members were recruited through a market research company and selected to be broadly representative of the general public. Results The jury believed that person-centred care should be the foundation of care for all older people. They recommended that each person's funding be split between core services (to ensure basic health, nutrition and hygiene needs are met) and discretionary services. Systems needed to be put into place to enable the transition to consumer directed care including care coordinators to assist in eliciting resident preferences, supports for proxy decision makers, and accreditation processes and risk management strategies to ensure that residents with significant cognitive impairment are not taken advantage of by goods and service providers. Transparency should be increased (perhaps using technologies) so that both the resident and nominated family members can be sure that the person is receiving what they have paid for. Conclusions The views of the jury (as representatives of the public) were that people in residential care should have more say regarding the way in which their care is provided and that a model of consumer directed care should be introduced. Policy makers should consider implementation of consumer directed care models that are economically viable

  19. Rooftop Surface Temperature Analysis in an Urban Residential Environment

    Directory of Open Access Journals (Sweden)

    Qunshan Zhao

    2015-09-01

    Full Text Available The urban heat island (UHI phenomenon is a significant worldwide problem caused by rapid population growth and associated urbanization. The UHI effect exacerbates heat waves during the summer, increases energy and water consumption, and causes the high risk of heat-related morbidity and mortality. UHI mitigation efforts have increasingly relied on wisely designing the urban residential environment such as using high albedo rooftops, green rooftops, and planting trees and shrubs to provide canopy coverage and shading. Thus, strategically designed residential rooftops and their surrounding landscaping have the potential to translate into significant energy, long-term cost savings, and health benefits. Rooftop albedo, material, color, area, slope, height, aspect and nearby landscaping are factors that potentially contribute. To extract, derive, and analyze these rooftop parameters and outdoor landscaping information, high resolution optical satellite imagery, LIDAR (light detection and ranging point clouds and thermal imagery are necessary. Using data from the City of Tempe AZ (a 2010 population of 160,000 people, we extracted residential rooftop footprints and rooftop configuration parameters from airborne LIDAR point clouds and QuickBird satellite imagery (2.4 m spatial resolution imagery. Those parameters were analyzed against surface temperature data from the MODIS/ASTER airborne simulator (MASTER. MASTER images provided fine resolution (7 m surface temperature data for residential areas during daytime and night time. Utilizing these data, ordinary least squares (OLS regression was used to evaluate the relationships between residential building rooftops and their surface temperature in urban environment. The results showed that daytime rooftop temperature was closely related to rooftop spectral attributes, aspect, slope, and surrounding trees. Night time temperature was only influenced by rooftop spectral attributes and slope.

  20. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC State | GIS Inventory — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and 81...

  1. Associations between children's diets and features of their residential and school neighbourhood food environments.

    Science.gov (United States)

    Van Hulst, Andraea; Barnett, Tracie A; Gauvin, Lise; Daniel, Mark; Kestens, Yan; Bird, Madeleine; Gray-Donald, Katherine; Lambert, Marie

    2012-07-26

    Among studies of the built environment, few examine neighbourhood food environments in relation to children's diets. We examined the associations of residential and school neighbourhood access to different types of food establishments with children's diets. Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), an ongoing study on the natural history of obesity in 630 Quebec youth aged 8-10 years with a parental history of obesity, were analyzed (n=512). Three 24-hour diet recalls were used to assess dietary intake of vegetables and fruit, and sugar-sweetened beverages. Questionnaires were used to determine the frequency of eating/snacking out and consumption of delivered/take-out foods. We characterized residential and school neighbourhood food environments by means of a Geographic Information System. Variables included distance to the nearest supermarket, fast-food restaurant and convenience store, and densities of each food establishment type computed for 1 km network buffers around each child's residence and school. Retail Food Environment indices were also computed. Multivariable logistic regressions (residential access) and generalized estimating equations (school access) were used for analysis. Residential and school neighbourhood access to supermarkets was not associated with children's diets. Residing in neighbourhoods with lower access to fast-food restaurants and convenience stores was associated with a lower likelihood of eating and snacking out. Children attending schools in neighbourhoods with a higher number of unhealthful relative to healthful food establishments scored most poorly on dietary outcomes. Further investigations are needed to inform policies aimed at shaping neighbourhood-level food purchasing opportunities, particularly for access to fast-food restaurants and convenience stores.

  2. Residential Environment for Outdoor Play Among Children in Latino Farmworker Families.

    Science.gov (United States)

    Arcury, Thomas A; Suerken, Cynthia K; Ip, Edward H; Moore, Justin B; Quandt, Sara A

    2017-04-01

    Child health and development benefit from physical activity. This analysis describes the residential play environment for children aged 2-4 years in farmworker families, their parent-reported levels of play and media time, and the association of residential environment with play and media time. Mothers with a child aged 2-4 years in farmworker families (n = 248) completed interviews over 2 years. Outcome measures were daily outdoor play time and media time. Measures of the residential environment included physical and social components. The mean min/day for outdoor play was 81.8 (SD 57.3) at baseline, 111.4 (SD 90.1) at year 1 follow-up, and 103.6 (SD 76.2) at year 2 follow-up. The mean media min/day at baseline was 83.8 (SD 64.3), 93.7 (SD 80.3) min/day at year 1 follow-up, and 59.9 min/day (SD (45.6) at year 2 follow-up. One additional person per bedroom was associated with 6 fewer min/day with media. The addition of each age appropriate toy was associated with an additional 12.3 min/day of outdoor play. An additional type of inappropriate media was associated with 6.8 more min/day with media. These results suggest changes to the residential environment to improve physical activity among children in Latino farmworker families.

  3. Meaningful engagement and person-centered residential dementia care: A critical interpretive synthesis.

    Science.gov (United States)

    Du Toit, Sanetta H J; Shen, Xizi; McGrath, Margaret

    2018-02-28

    People with moderate to advanced dementia living in residential care are at risk of occupational deprivation. Person-centered care has been adopted as a guiding principle in the provision of residential care for older adults with dementia. In this context, there has been shift in occupational therapy practice from addressing occupational performance towards focusing on meaningful engagement. While both meaningful engagement and person-centered care have been well researched the relationship between the two concepts is poorly understood. A critical interpretative synthesis was conducted to determine how principles of person-centered care inform occupational therapy practice in relation to promotion of meaningful engagement among residents with moderate to advanced dementia. A systematic search of research addressing meaningful engagement of people with moderate to advanced dementia identified 26 papers. Papers were classified as theoretical papers and empirical research. Two overarching constructs emerged, namely promoting a culture of collaborative care and understanding the resident as a person with a past, present and future. Occupational deprivation prevails and person-centered care is not fully addressed if opportunities for growth and engagement for residents with moderate to advanced dementia is not extended beyond their life history. Creating continued opportunities for building agency of residents with dementia could promote occupational justice in residential care.

  4. A Framework for Exploring the Sense of Community and Social Life in Residential Environments

    Directory of Open Access Journals (Sweden)

    Leila Mahmoudi Farahani

    2014-11-01

    Full Text Available Sense of community and social life are two key concepts related to social cohesion, which have been the subject of extensive studies in several disciplines including sociology, psychology and built environment. Social life studies have been mostly conducted in the built environment discipline focusing on city centres; while sense of community studies were mostly the target of sociologists and psychologists focusing on neighbourhoods. As a result, the role of the built environment on the sense of community and social life of neighbourhoods is considered as a missing gap in the literature. This paper, through defining the concepts of social life and sense of community, aims to develop a conceptual framework for further implementation in future research. Accurate implication and interpretation of the concepts show that neighbourhoods can include the sense of community in the residential environment and the social life in the commercial environment. This is because residential environments are where residents’ requirements can be met through their commitment to the community and commercial environments are the fulcrum of interaction and communication.

  5. Nursing staff work patterns in a residential aged care home: a time-motion study.

    Science.gov (United States)

    Qian, Siyu; Yu, Ping; Hailey, David

    2016-11-01

    Objective Residential aged care services are challenged by an increasing number of residents and a shortage of nursing staff. Developing strategies to overcome this challenge requires an understanding of nursing staff work patterns. The aim of the present study was to investigate the work processes followed by nursing staff and how nursing time is allocated in a residential aged care home. Methods An observational time-motion study was conducted at two aged care units for 12 morning shifts. Seven nurses were observed, one per shift. Results In all, there were 91h of observation. The results showed that there was a common work process followed by all nurse participants. Medication administration, documentation and verbal communication were the most time-consuming activities and were conducted most frequently. No significant difference between the two units was found in any category of activities. The average duration of most activities was less than 1min. There was no difference in time utilisation between the endorsed enrolled nurses and the personal carers in providing nursing care. Conclusion Medication administration, documentation and verbal communication were the major tasks in morning shifts in a residential aged care home. Future research can investigate how verbal communication supports nursing care. What is known about the topic? The aging population will substantially increase the demand for residential aged care services. There is a lack of research on nurses' work patterns in residential aged care homes. What does this paper add? The present study provides a comprehensive understanding of nurses' work patterns in a residential aged care home. There is a common work process followed by nurses in providing nursing care. Medication administration, verbal communication and documentation are the most time-consuming activities and they are frequently conducted in the same period of time. Wound care, physical review and documentation on desktop computers are

  6. Love, intimacy and sexuality in residential dementia care : A spousal perspective

    NARCIS (Netherlands)

    Roelofs, T.S.M.; Luijkx, K.G.; Embregts, P.J.C.M.

    2018-01-01

    The experiences and needs of spouses of residential care facility residents with dementia, regarding friendship, love, intimacy, and sexuality were explored. Understanding of how spouses make sense of their experiences was pursued. Semi-structured interviews were held with nine spouses of people

  7. School adjustment of children in residential care: a multi-source analysis.

    Science.gov (United States)

    Martín, Eduardo; Muñoz de Bustillo, María del Carmen

    2009-11-01

    School adjustment is one the greatest challenges in residential child care programs. This study has two aims: to analyze school adjustment compared to a normative population, and to carry out a multi-source analysis (child, classmates, and teacher) of this adjustment. A total of 50 classrooms containing 60 children from residential care units were studied. The "Método de asignación de atributos perceptivos" (Allocation of perceptive attributes; Díaz-Aguado, 2006), the "Test Autoevaluativo Multifactorial de Adaptación Infantil" (TAMAI [Multifactor Self-assessment Test of Child Adjustment]; Hernández, 1996) and the "Protocolo de valoración para el profesorado (Evaluation Protocol for Teachers; Fernández del Valle, 1998) were applied. The main results indicate that, compared with their classmates, children in residential care are perceived as more controversial and less integrated at school, although no differences were observed in problems of isolation. The multi-source analysis shows that there is agreement among the different sources when the externalized and visible aspects are evaluated. These results are discussed in connection with the practices that are being developed in residential child care programs.

  8. Hazards of Immobility: Bedsores. Adult Residential Care Home, Lesson Plan No. 5.

    Science.gov (United States)

    Lin, Kathleen

    Developed as part of a 104-hour course on adult residential care homes (ARCHs), this 50-minute lesson is designed to enable a student to: (1) define a bedsore; (2) list and describe three major causes of bedsores; (3) identify potential bedsore sites in the back-lying, side-lying, and sitting positions; and (4) calculate the risk for developing…

  9. Forming Identities in Residential Care for Children: Manoeuvring between Social Work and Peer Groups

    Science.gov (United States)

    Stokholm, Anja

    2009-01-01

    The general goal of Danish residential care institutions with a therapeutic objective is to change children's behaviour and redirect their identity formation. This goal is pursued through an individualized focus on development. Dynamics of the resident group is rarely targeted directly in the pedagogical work. This article challenges the implicit…

  10. Technology-Based Training of Administrators in Residential Care Facilities for the Elderly

    Science.gov (United States)

    Macias, Ron J.

    2011-01-01

    The Problem: The problem in this study was to determine whether there is a difference between technology-based and instructor-led RCFE administrator training. Method: A quasi-experimental research design study was conducted, and 70 students enrolled in the Residential Care Facility for the Elderly (RCFE) Administration Licensing renewal course…

  11. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Helnæs, Ann Kathrine; Schultz, Hanne

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...

  12. Care staff training in detection of depression in residential homes for the elderly: randomised trial

    NARCIS (Netherlands)

    Eisses, A.M.H.; Kluiter, H.; Jongenelis, K.; Pot, A.M.; Beekman, A.T.F.; Ormel, J.

    2005-01-01

    Background: Many people with depression in residential care homes for the elderly do not receive treatment because their depression remains undetected. Aims: To determine the effects of staff training on the detection, treatment and outcome of depression in residents of ten homes. Method: We

  13. Care staff training in detection of depression in residential homes for the elderly - Randomised trial

    NARCIS (Netherlands)

    Eisses, AMH; Kluiter, H; Jongenelis, K; Beekman, ATF; Ormel, J

    Background. Many people with depression in residential care homes for the elderly do not receive treatment because their depression remains undetected. Aims. To determine the effects of staff training on the detection, treatment and outcome of depression in residents often homes. Method. We

  14. Safeguarding children and youth in residential and foster care: Supporting healthy sexual development

    DEFF Research Database (Denmark)

    Hansen, Gitte Riis; Grandal*, Niels

    In The Netherlands, Denmark and Scotland special awareness on the subject of sexual abuse and sexual exploitation was raised by national investigations on the prevalence and content of sexual abuse in residential and foster care. In Flanders (Belgium) it was the start of the so called Helpline 17...

  15. 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

  16. An Ethnographic Study of Stigma and Ageism in Residential Care or Assisted Living

    Science.gov (United States)

    Dobbs, Debra; Eckert, J. Kevin; Rubinstein, Bob; Keimig, Lynn; Clark, Leanne; Frankowski, Ann Christine; Zimmerman, Sheryl

    2008-01-01

    Purpose: This study explored aspects of stigmatization for older adults who live in residential care or assisted living (RC-AL) communities and what these settings have done to address stigma. Design and Methods: We used ethnography and other qualitative data-gathering and analytic techniques to gather data from 309 participants (residents, family…

  17. Insomnia, Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

    Science.gov (United States)

    Moreau, Vincent; Belanger, Lynda; Begin, Gilles; Morin, Charles M.

    2009-01-01

    The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration,…

  18. Enhancing adolescents' motivation for treatment in compulsory residential care: A clinical review

    NARCIS (Netherlands)

    Brauers, Malou; Kroneman, Leoniek; Otten, Rene; Lindauer, Ramon; Popma, Arne

    2016-01-01

    Youths in compulsory residential care show a high prevalence of various mental health problems but often lack motivation to engage in therapeutic treatment. Although the self-determination-theory (SDT) and the transtheoretical model of change (TTM) offer a useful framework for treatment motivation,

  19. Validation of a Job Satisfaction Instrument for Residential-Care Employees.

    Science.gov (United States)

    Sluyter, Gary V.; Mukherjee, Ajit K.

    1986-01-01

    A new job satisfaction instrument for employees of a residential care facility for mentally retarded persons effectively measures the employees' satisfaction with 12 work related variables: salary, company policies, supervision, working conditions, interpersonal relations, security, advancement, recognition, achievement, work responsibility, and…

  20. Trauma Experiences, Maltreatment-Related Impairments, and Resilience among Child Welfare Youth in Residential Care

    Science.gov (United States)

    Collin-Vezina, Delphine; Coleman, Kim; Milne, Lise; Sell, Jody; Daigneault, Isabelle

    2011-01-01

    The aim of this paper was to provide a description of the trauma experiences, trauma-related sequels, and resilience features of a sample of Canadian youth in residential care facilities, as well as to explore the impact of gender and of the number of different traumas experienced on trauma-related sequels and resilience features. A convenience…

  1. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or ho...

  2. National survey 2004 on medical services for persons with intellectual disability in residential care in Israel.

    Science.gov (United States)

    Merrick, Joav; Kandel, Isack; Raskas, Mordechai; Caplan, Lee; Morad, Mohammed

    2010-01-01

    In Israel, the Office of the Medical Director of the Ministry of Social Affairs is responsible for the medical service in residential-care centers for persons with intellectual disability (ID). A standard annual questionnaire was developed during 1997-1998, and the first national survey study was conducted in 1998. This present paper presents the findings of the seventh national survey in 2004, for which the following information was gathered via questionnaires: age, gender, and level of intellectual disability of persons served at the residential care center in question, status of the population served, functional profile, nursing, medical, and allied professional staff, number of annual examinations, preventive medicine aspects, medications, number of annual cases of infectious disease, annual unintentional injuries, number of deaths, number of hospitalizations, internal residential center hospitalization, ambulatory out-patient use, use of outside laboratory examinations, and dental care. In 2004, 6,610 persons were served in nine government, 37 private, and 12 public centers. The average number of persons served per center was 113.97 (range 23 to 372). The survey in 2004 showed that 79.2% of the population with ID in residential care in Israel was between 20 and 60 years of age; 48.8% had severe or profound ID, 41% had moderate ID, and 10% had mild ID; 23% were nursing patients; 19% were confined to a wheelchair; 31% had epilepsy; 83% were receiving medication daily for chronic illness; and 52.5% were receiving psychotropic medication for psychiatric illness.

  3. National survey 2007 on medical services for persons with intellectual disability in residential care in Israel.

    Science.gov (United States)

    Merrick, Joav; Kandel, Isack; Lotan, Meir; Aspler, Shoshana; Fuchs, Brian Seth; Morad, Mohammed

    2010-01-01

    In Israel, the Office of the Medical Director of the Ministry of Social Affairs is responsible for the medical service in residential-care centers for persons with intellectual disability (ID). A standard annual questionnaire was developed during 1997-1998, and the first national survey study was conducted in 1998. This present paper presents the findings of the seventh national survey in 2007, for which the following information was gathered via questionnaires: age, gender, and level of intellectual disability of persons served at the residential care center in question, status of the population served, functional profile, nursing, medical, and allied professional staff, number of annual examinations, preventive medicine aspects, medications, number of annual cases of infectious disease, annual unintentional injuries, number of deaths, number of hospitalizations, internal residential center hospitalization, ambulatory out-patient use, use of outside laboratory examinations, and dental care. In 2007, 6,872 persons were served in 9 government, 37 private, and 13 public centers. The average number of persons served per center was 116.47 (range 24 to 341). The survey in 2007 showed that 79% of the population with ID in residential care in Israel was between the ages of 20 and 60 years old, 44% with severe or profound ID, 43% with moderate and 13% with mild ID. Twenty-seven percent were nursing patients, and 18% were confined to a wheelchair, 34% had epilepsy, 86% were found to be receiving medication daily for chronic illness, and 51% received psychotropic medication for psychiatric illness.

  4. Improving pregnancy outcome during imprisonment: a model residential care program.

    Science.gov (United States)

    Siefert, K; Pimlott, S

    2001-04-01

    The female prison population has increased dramatically in recent years. Most women prisoners are involved with drugs, and as many as 25 percent are pregnant or have delivered within the past year. Reproductive health and drug treatment services for women in prison are inadequate, if they are available at all, and although illicit drugs are readily available in prison, drug-involved pregnant women often are incarcerated to protect fetal health. Studies of pregnancy outcome among women prisoners have demonstrated high rates of perinatal mortality and morbidity. This article examines issues related to pregnancy among women prisoners and describes an innovative residential program designed for pregnant, drug-dependent women in a state adult corrections system. Social workers can play an important role in promoting policy reform and improved services for this underserved population.

  5. What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand.

    Science.gov (United States)

    Frey, Rosemary; Boyd, Michal; Foster, Sue; Robinson, Jackie; Gott, Merryn

    2016-07-01

    Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal. © 2015 John Wiley & Sons Ltd.

  6. Virtual Environment as a Design Tool for Sustainable Residential Spaces in Light of Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Hebatalla Sherin Nazmy

    2016-01-01

    Full Text Available This study aims to reveal the impact of Virtual Environment as a design tool on the interior architect's design behavior towards adopting sustainable residential interior design practices. This approach is guided by the Theory of Planned Behaviour as a theoretical framework; the purpose as such would serve to bridge the gap between theoretical knowledge and its practical implementation to promote sustainable design practices. Findings revealed that Virtual Environment is anticipated to assist the interior architect in integrating the complex sustainable residential design objectives, and thus positively affect the interior architect's behavioral performance towards embracing sustainable residential design solutions.

  7. Live a life in residential care : The importance of social climate for the well-being of adolescents in care

    NARCIS (Netherlands)

    Leipoldt, Jonathan David; Rimehaug, Tormod; Harder, A.T.; Kayed, Nanna; Grietens, Hans

    2015-01-01

    Troubled youngsters in residential youth care (RYC) institutions live their daily life in and around the institutions with other disturbed youngsters and different staff members. The effect that this emerging social climate has on residents in RYC institutions is not very clear and sometimes

  8. Objectively measured residential environment and self-reported health: a multilevel analysis of UK census data.

    Directory of Open Access Journals (Sweden)

    Frank Dunstan

    Full Text Available Little is known about the association between health and the quality of the residential environment. What is known is often based on subjective assessments of the environment rather than on measurements by independent observers. The aim of this study, therefore, was to determine the association between self-reported general health and an objectively assessed measure of the residential environment. We studied over 30,000 residents aged 18 or over living in 777 neighbourhoods in south Wales. Built environment quality was measured by independent observers using a validated tool, the Residential Environment Assessment Tool (REAT, at unit postcode level. UK Census data on each resident, which included responses to a question which assessed self-reported general health, was linked to the REAT score. The Census data also contained detailed information on socio-economic and demographic characteristics of all respondents and was also linked to the Welsh Index of Multiple Deprivation. After adjusting for both the individual characteristics and area deprivation, respondents in the areas of poorest neighbourhood quality were more likely to report poor health compared to those living in areas of highest quality (OR 1.36, 95% confidence interval 1.22-1.49. The particular neighbourhood characteristics associated with poor health were physical incivilities and measures of how well the residents maintained their properties. Measures of green space were not associated with self-reported health. This is the first full population study to examine such associations and the results demonstrate the importance for health of the quality of the neighbourhood area in which people live and particularly the way in which residents behave towards their own and their neighbours' property. A better understanding of causal pathways that allows the development of interventions to improve neighbourhood quality would offer significant potential health gains.

  9. Medication administration errors for older people in long-term residential care

    Directory of Open Access Journals (Sweden)

    Szczepura Ala

    2011-12-01

    Full Text Available Abstract Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing. Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors. Results A total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors was attempting to give medication at the wrong time. Over the 3-month observation period, half (52% of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p Conclusions The incidence of medication administration errors is high in long-term residential care. A barcode medication administration system can capture medication

  10. How architectural design affords experiences of freedom in residential care for older people.

    Science.gov (United States)

    Van Steenwinkel, Iris; Dierckx de Casterlé, Bernadette; Heylighen, Ann

    2017-04-01

    Human values and social issues shape visions on dwelling and care for older people, a growing number of whom live in residential care facilities. These facilities' architectural design is considered to play an important role in realizing care visions. This role, however, has received little attention in research. This article presents a case study of a residential care facility for which the architects made considerable effort to match the design with the care vision. The study offers insights into residents' and caregivers' experiences of, respectively, living and working in this facility, and the role of architectural features therein. A single qualitative case study design was used to provide in-depth, contextual insights. The methods include semi-structured interviews with residents and caregivers, and participant observation. Data concerning design intentions, assumptions and strategies were obtained from design documents, through a semi-structured interview with the architects, and observations on site. Our analysis underlines the importance of freedom (and especially freedom of movement), and the balance between experiencing freedom and being bound to a social and physical framework. It shows the architecture features that can have a role therein: small-scaleness in terms of number of residents per dwelling unit, size and compactness; spatial generosity in terms of surface area, room to maneuver and variety of places; and physical accessibility. Our study challenges the idea of family-like group living. Since we found limited sense of group belonging amongst residents, our findings suggest to rethink residential care facilities in terms of private or collective living in order to address residents' social freedom of movement. Caregivers associated 'hominess' with freedom of movement, action and choice, with favorable social dynamics and with the building's residential character. Being perceived as homey, the facility's architectural design matches caregivers

  11. Dental Care Utilization and Satisfaction of Residential University Students

    Directory of Open Access Journals (Sweden)

    Bamise CT

    2008-01-01

    Full Text Available Aim: The objective of this study was to provide information on the level of utilization and satisfaction of residential university students with the dental services provided by the dental clinic of a teaching hospital. Volunteers and Material: A stratified sampling technique was used to recruit volunteers from the outpatient clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Information was collected by a self-administered questionnaire composed of questions that measure the level of utilization and satisfaction with the dental services provided. Questionnaires were provided to 650 randomly chosen students residing in the University hostels. There were 39 refusals, and 6 incomplete questionnaires were discarded. This left a sample size of 605 volunteers. Results: Forty seven students (7.8% indicated that they visited the dental hospital within the last 12 months. Males and females utilized the dental services equally, and utilization increased with age and the number of years spent on campus. Anticipation of painful dental treatment, high dental charges, long waiting times and being too busy for a dental visit were cited as the most important impediments to seeking dental treatment. Females expressed greater satisfaction with the services. Conclusion: Dental service utilization among the students was found to be low. Oral health awareness campaigns, improving the quality of the services, and shortening the waiting time are expected to increase service utilization and satisfaction.

  12. 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

  13. Aquatic exercise for residential aged care adults with dementia: benefits and barriers to participation.

    Science.gov (United States)

    Henwood, Timothy; Neville, Christine; Baguley, Chantelle; Beattie, Elizabeth

    2017-09-01

    Pilot work by our group has demonstrated that aquatic exercise has valuable functional and psychosocial benefits for adults living in the residential aged care setting with dementia. The aim of the currents study was to advance this work by delivering the Watermemories Swimming Club aquatic exercise program to a more representative population of older, institutionalized adults with dementia. The benefits of 12 weeks of twice weekly participation in the Watermemories Swimming Club aquatic exercise program were assessed among an exercise and usual care control group of residential aged care adults with advanced dementia. A battery of physical and psychosocial measures were collected before and after the intervention period, and program implementation was also investigated. Seven residential aged care facilities of 24 approached, agreed to participate and 56 residents were purposefully allocated to exercise or control. Twenty-three participants per group were included in the final analysis. Both groups experienced decreases in skeletal muscle index and lean mass (p exercise stifled losses in muscle strength and transition into sarcopenic. Behavioral and psychological symptoms of dementia and activities of daily living approached significance (p = 0.06) with positive trends observed across other psychosocial measures. This study demonstrates the value of exercise participation, and specifically aquatic exercise in comparison to usual care for older, institutionalized adults with advanced dementia. However, it also highlights a number of barriers to participation. To overcome these barriers and ensure opportunity to residents increased provider and sector support is required.

  14. Residents Living in Residential Care Facilities: United States, 2010

    Science.gov (United States)

    ... The Urban Institute. 2006. Polzer K. Assisted living state regulatory review 2011. Washington, DC: National Center for Assisted Living. 2011. MetLife Mature Market Institute. Market Survey of Long-Term Care Costs. ...

  15. Exploring staff diabetes medication knowledge and practices in regional residential care: triangulation study.

    Science.gov (United States)

    Wellard, Sally Jane; Rasmussen, Bodil; Savage, Sally; Dunning, Trisha

    2013-07-01

    This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.

  16. Under one roof : A review and selective meta-analysis on the outcomes of residential child and youth care

    NARCIS (Netherlands)

    Knorth, Erik J.; Harder, Annemiek T.; Zandberg, Tjalling; Kendrick, Andrew J.

    Residential child and youth care is a radical intervention that in many countries is perceived as a 'last resort' solution that should be avoided if at all possible - not least because of scepticism about its effectiveness. Against this, there is the view that a residential placement can contribute

  17. Nursing practice in nutritional care: a comparison between a residential aged care setting and a hospital setting.

    Science.gov (United States)

    Ullrich, Sandra; McCutcheon, Helen; Parker, Barbara

    2014-08-01

    To explore the similarities and differences in the nursing practice in nutritional care between a residential aged care setting and a hospital setting. Despite being preventable and treatable, undernutrition remains a problem for many older people in residential aged care and hospital settings. Nurses have a crucial role in assisting people who are unable to eat independently and are uniquely positioned to implement solutions that will lead to better nutritional care. During 2007-2010, an action research study was conducted, underpinned by the principles of the participatory world view to address undernutrition in a residential aged care setting and a hospital setting. The multimethod approach of data and between-method triangulation were used to collect and analyse qualitative non-participant observations and action research group data. Non-participant observations and action research group data were qualitatively analysed using the Analytic Hierarchy. How nurses chose to participate in the provision of nutritional care and assert their autonomy when changing practice to nutritional care affected the quality of the resident/patient mealtime experience. Operational efficiency influenced the choices that nurses made about the type of intervention to implement to improve nursing practice in nutritional care. Nurses required management approval to change practice in nutritional care. The reasons for undernutrition are multifactorial and more research is needed to investigate the organizational structures and processes that affect the delivery of nutritional care across role functions, how these affect the continuity of care and the nurses' role in defining the culture around resident/patient mealtimes. © 2014 John Wiley & Sons Ltd.

  18. Medication administration errors for older people in long-term residential care.

    Science.gov (United States)

    Szczepura, Ala; Wild, Deidre; Nelson, Sara

    2011-12-07

    Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. A prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs) and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors. A total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors) was attempting to give medication at the wrong time. Over the 3-month observation period, half (52%) of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p < 0.001) in nursing homes as in residential homes. The level of non-compliance with system alerts was very low in both settings (0.075% of administrations). The pre-study survey revealed that only 12/41 staff administering

  19. Work-related change in residential elderly care: Trust, space and connectedness.

    Science.gov (United States)

    van der Borg, Wieke E; Verdonk, Petra; Dauwerse, Linda; Abma, Tineke A

    2017-07-01

    Increasing care needs and a declining workforce put pressure on the quality and continuity of long-term elderly care. The need to attract and retain a solid workforce is increasingly acknowledged. This study reports about a change initiative that aimed to improve the quality of care and working life in residential elderly care. The research focus is on understanding the process of workforce change and development, by retrospectively exploring the experiences of care professionals. A responsive evaluation was conducted at a nursing home department in the Netherlands one year after participating in the change program. Data were gathered by participant observations, interviews and a focus and dialogue group. A thematic analysis was conducted. Care professionals reported changes in workplace climate and interpersonal interactions. We identified trust, space and connectedness as important concepts to understand perceived change. Findings suggest that the interplay between trust and space fostered interpersonal connectedness. Connectedness improved the quality of relationships, contributing to the well-being of the workforce. We consider the nature and contradictions within the process of change, and discuss how gained insights help to improve quality of working life in residential elderly care and how this may reflect in the quality of care provision.

  20. Characteristics of residents living in residential care communities, by community bed size: United States, 2012.

    Science.gov (United States)

    Caffrey, Christine; Harris-Kojetin, Lauren; Rome, Vincent; Sengupta, Manisha

    2014-11-01

    In 2012, there was a higher percentage of older, female residents in communities with more than 25 beds compared with communities with 4–25 beds. Residents in communities with 4–25 beds were more racially diverse than residents in larger communities. The percentage of Medicaid beneficiaries was higher in communities with 4–25 beds than it was in communities with 26–50 and more than 50 beds. A higher percentage of residents living in communities with 4–25 beds had a diagnosis of Alzheimer’s disease or other dementias compared with residents in larger communities. Need for assistance with each of the activities of daily living (ADLs) examined (except walking or locomotion) was substantially higher among residents in communities with 4–25 beds, compared with residents in larger communities. Emergency department visits and discharges from an overnight hospital stay in a 90-day period did not vary across residents by community bed size. This report presents national estimates of residents living in residential care, using data from the first wave of NSLTCP. This brief profile of residential care residents provides useful information to policymakers, providers, researchers, and consumer advocates as they plan to meet the needs of an aging population. The findings also highlight the diversity of residents across the different sizes of residential care communities. Corresponding state estimates and their standard errors for the national figures in this data brief can be found on the NSLTCP website, available from: http://www.cdc.gov/nchs/nsltcp/nsltcp_products.htm. These national and state estimates establish a baseline for monitoring trends among residents living in residential care. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  1. Leisure, functional disability and depression among older Chinese living in residential care homes.

    Science.gov (United States)

    Ouyang, Zheng; Chong, Alice M L; Ng, Ting Kin; Liu, Susu

    2015-01-01

    Previous research has rarely examined the intervening and buffering effects of leisure on the relationship between age-related stress and health among institutionalized elders, especially in the Chinese context. This study thus examines the extent to which participation in leisure activities mediates and moderates the impact of functional disability on depression among older adults living in residential care homes in China. A total of 1429 participants (858 men) aged over 60 living in residential care homes, of which 46.1% experienced depression using a cut-off score ≥ 5 on the 15-item Geriatric Depression Scale, were selected from a national survey across China by using the probability proportional to size sampling method. The findings showed that depression was positively predicted by functional disability and negatively predicted by participation in leisure activities. The results of the mediation analysis showed that participation in leisure activities partially mediated the relationship between functional disability and depression. Functional disability predicted depression both directly and indirectly through its negative influence on participation in leisure activities. Participation in leisure activities also significantly buffered the relationship between functional disability and depression such that the impact of functional disability was weaker for those who participated in leisure activities more frequently. These results provide support for the mediating and moderating roles of leisure in the stress-health relationship among institutionalized elders. To enhance residents' psychological health, residential care homes are recommended to organize more leisure activities.

  2. Characteristics of the residential neighborhood environment differentiate intimate partner femicide in urban versus rural settings.

    Science.gov (United States)

    Beyer, Kirsten M M; Layde, Peter M; Hamberger, L Kevin; Laud, Purushottam W

    2013-06-01

    A growing body of work examines the association between neighborhood environment and intimate partner violence (IPV). As in the larger literature examining the influence of place context on health, rural settings are understudied and urban and rural residential environments are rarely compared. In addition, despite increased attention to the linkages between neighborhood environment and IPV, few studies have examined the influence of neighborhood context on intimate partner femicide (IPF). In this paper, we examine the role for neighborhood-level factors in differentiating urban and rural IPFs in Wisconsin, USA. We use a combination of Wisconsin Violent Death Reporting System (WVDRS) data and Wisconsin Coalition Against Domestic Violence (WCADV) reports from 2004 to 2008, in concert with neighborhood-level information from the US Census Bureau and US Department of Agriculture, to compare urban and rural IPFs. Rates of IPF vary based on degree of rurality, and bivariate analyses show differences between urban and rural victims in race/ethnicity, marital status, country of birth, and neighborhood characteristics. After controlling for individual characteristics, the nature of the residential neighborhood environment significantly differentiates urban and rural IPFs. Our findings suggest a different role for neighborhood context in affecting intimate violence risk in rural settings, and that different measures may be needed to capture the qualities of rural environments that affect intimate violence risk. Our findings reinforce the argument that multilevel strategies are required to understand and reduce the burden of intimate violence, and that interventions may need to be crafted for specific geographical contexts. © 2013 National Rural Health Association.

  3. Inter-relationships between objective and subjective measures of the residential environment among urban African American women.

    Science.gov (United States)

    Sealy-Jefferson, Shawnita; Messer, Lynne; Slaughter-Acey, Jaime; Misra, Dawn P

    2017-03-01

    The inter-relationships between objective (census based) and subjective (resident reported) measures of the residential environment is understudied in African American (AA) populations. Using data from the Life Influences on Fetal Environments Study (2009-2011; n = 1387) of AA women, we quantified the area-level variation in subjective reports of residential healthy food availability, walkability, safety, and disorder that can be accounted for with an objective neighborhood disadvantage index (NDI). Two-level generalized linear models estimated associations between objective and subjective measures of the residential environment, accounting for individual-level covariates. In unconditional models, intraclass correlation coefficients for block-group variance in subjective reports ranged from 11% (healthy food availability) to 30% (safety). Models accounting for the NDI (vs. both NDI and individual-level covariates) accounted for more variance in healthy food availability (23% vs. 8%) and social disorder (40% vs. 38%). The NDI and individual-level variables accounted for 39% and 51% of the area-level variation in walkability and safety, respectively. Associations between subjective and objective measures of the residential environment were significant and in the expected direction. Future studies on neighborhood effects on health, especially among AAs, should include a wide range of residential environment measures, including subjective, objective, and spatial contextual variables. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Skibbereen Residential Care Centre, Baltimore Road, Skibbereen, Cork.

    LENUS (Irish Health Repository)

    Boland, Karen

    2016-10-01

    The equitable provision of home enteral nutrition (HEN) in the community can have a transformative effect on patient experience and family life for adults and children alike. While optimising quality of life in HEN patients can be challenging, the initiation of HEN positively impacts this measure of healthcare provision.1 Quality of life scores have been shown to improve in the weeks after hospital discharge, and HEN is physically well tolerated. However, it may be associated with psychological distress, and sometimes reluctance among HEN patients to leave their homes.2 Globally, HEN can attenuate cumulative projected patient care costs through a reduction in hospital admission and complications including hospital acquired infections.3 In an era where the cost of disease related malnutrition and associated prolonged hospital stay is being tackled in our healthcare systems, the role of HEN is set to expand. This is a treatment which has clear clinical and social benefits, and may restore some independence to patients and their families. Rather than the indications for HEN being focused on specific diagnoses, the provision of months of quality life at home for patients is adequate justification for its prescription.4 Previously, a review of HEN service provision in 39 cases demonstrated that patients want structured follow-up after hospital discharge, and in particular, would like one point of contact for HEN education and discharge.5 Management structures, funding challenges and the need for further education, particularly within the primary care setting may limit optimal use of HEN. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) aims to develop a national guideline document, drawing on international best practice, forming a template and standards for local policy development in the area of HEN service provision, training and follow-up. The first step in guideline development was to investigate patient experience for adults and children alike. Care

  5. The study of residential life support environment system to initiate policy on sustainable simple housing

    Science.gov (United States)

    Siahaan, N. M.; Harahap, A. S.; Nababan, E.; Siahaan, E.

    2018-02-01

    This study aims to initiate sustainable simple housing system based on low CO2 emissions at Griya Martubung I Housing Medan, Indonesia. Since it was built in 1995, between 2007 until 2016 approximately 89 percent of houses have been doing various home renewal such as restoration, renovation, or reconstruction. Qualitative research conducted in order to obtain insights into the behavior of complex relationship between various components of residential life support environment that relates to CO2 emissions. Each component is studied by conducting in-depth interviews, observation of the 128 residents. The study used Likert Scale to measure residents’ perception about components. The study concludes with a synthesis describing principles for a sustainable simple housing standard that recognizes the whole characteristics of components. This study offers a means for initiating the practice of sustainable simple housing developments and efforts to manage growth and preserve the environment without violating social, economics, and ecology.

  6. Cleaning, resistant bacteria, and antibiotic prescribing in residential aged care facilities.

    Science.gov (United States)

    Cowan, Raquel U; Kishan, Divya; Walton, Aaron L; Sneath, Emmy; Cheah, Thomas; Butwilowsky, Judith; Friedman, N Deborah

    2016-03-01

    Residents of residential aged care facilities (RACFs) are at risk of colonization and infection with multidrug-resistant bacteria, and antibiotic prescribing is often inappropriate and not based on culture-proven infection. We describe low levels of resident colonization and environmental contamination with resistant gram-negative bacteria in RACFs, but high levels of empirical antibiotic use not guided by microbiologic culture. This research highlights the importance of antimicrobial stewardship and environmental cleaning in aged care facilities. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  7. [The Relationship Between Burnout Symptoms and Work Satisfaction Among Child Welfare Workers in Residential Care].

    Science.gov (United States)

    Steinlin, Célia; Dölitzsch, Claudia; Fischer, Sophia; Schmeck, Klaus; Fegert, Jörg M; Schmid, Marc

    2016-01-01

    Working in residential care is associated with high demands and high stress. As a result, employees may develop symptoms of burnout. These symptoms lead to absence from work and have a negative effect on the continuity and quality of the residential care. Until now, little is known about burnout risks in child welfare workers, although children and adolescents are especially dependent on continuous relationships and healthy caregivers. A better understanding of the relationship between burnout symptoms and work satisfaction may help to identify starting points for prevention and intervention. The present study assessed symptoms of burnout in a sample of 319 social education workers in residential care in Switzerland using the burnout-screening-scales (BOSS). Work satisfaction was assessed with a newly developed questionnaire based on concepts of trauma-sensitive care. The questionnaire was tested for reliability and factorial validity in the present study. In order to estimate the relationship between burnout symptoms and work satisfaction, correlations and relative risks were calculated. Almost one fifth (18 %) of the sample showed a risk of burnout. The principal component analysis of the questionnaire on work satisfaction revealed four factors: support by superiors, participation and transparency; communication and support within the team; gratification in the work; and institutional structures and resources. All four factors as well as the total score showed significant correlations with burnout symptoms. Among employees with a comparably lower work satisfaction, the risk of burnout was 5.4 times higher than among employees with a comparably higher work satisfaction. It is discussed how work satisfaction could be promoted and how, as a result, the quality and continuity of care for the children and adolescents could be improved.

  8. [Evaluation of a residential care and supported housing program in the regional association of Westphalia-Lippe].

    Science.gov (United States)

    Richter, Dirk

    2010-04-01

    During the deinstitutionalisation of psychiatric care in Germany, new psychiatric care approaches have been developed, which have been rarely scientifically evaluated. This study aims at evaluating the residential care and supported housing program of a public service in Westphalia, Northwestern Germany. Data on 1486 clients about sociodemographics, individual biographies, housing, social integration and perspective of care were collected by staff. Individual interviews on the clients' quality of life were conducted with 941 subjects. The residential care and supported housing program clients are chronically mentally ill and disabled. Clients from the supported housing sector have a much more favorable biographical and social background compared to those from residential care. Integration into the regular workforce does usually not happen. Clients from the residential care sector have only few social contacts outside their institution. The quality of life assessment revealed no differences between the settings. More external social contacts should be provided especially for the residential care clients. Motivational interventions might enhance the clients' social inclusion further. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  9. Avoiding costly hospitalisation at end of life: findings from a specialist palliative care pilot in residential care for older adults.

    Science.gov (United States)

    Chapman, Michael; Johnston, Nikki; Lovell, Clare; Forbat, Liz; Liu, Wai-Man

    2018-03-01

    Specialist palliative care is not a standardised component of service delivery in nursing home care in Australia. Specialist palliative care services can increase rates of advance care planning, decrease hospital admissions and improve symptom management in such facilities. New approaches are required to support nursing home residents in avoiding unnecessary hospitalisation and improving rates of dying in documented preferred place of death. This study examined whether the addition of a proactive model of specialist palliative care reduced resident transfer to the acute care setting, and achieved a reduction in hospital deaths. A quasi-experimental design was adopted, with participants at 4 residential care facilities. The intervention involved a palliative care nurse practitioner leading 'Palliative Care Needs Rounds' to support clinical decision-making, education and training. Participants were matched with historical decedents using propensity scores based on age, sex, primary diagnosis, comorbidities and the Aged Care Funding Instrument rating. Outcome measures included participants' hospitalisation in the past 3 months of life and the location of death. The data demonstrate that the intervention is associated with a substantial reduction in the length of hospital stays and a lower incidence of death in the acute care setting. While rates of hospitalisation were unchanged on average, length of admission was reduced by an average of 3.22 days (pcare service delivery in residential facilities. 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/.

  10. Leveraging Human-environment Systems in Residential Buildings for Aggregate Energy Efficiency and Sustainability

    Science.gov (United States)

    Xu, Xiaoqi

    Reducing the energy consumed in the built environment is a key objective in many sustainability initiatives. Existing energy saving methods have consisted of physical interventions to buildings and/or behavioral modifications of occupants. However, such methods may not only suffer from their own disadvantages, e.g. high cost and transient effect, but also lose aggregate energy saving potential due to the oftentimes-associated single-building-focused view and an isolated examination of occupant behaviors. This dissertation attempts to overcome the limitations of traditional energy saving research and practical approaches, and enhance residential building energy efficiency and sustainability by proposing innovative energy strategies from a holistic perspective of the aggregate human-environment systems. This holistic perspective features: (1) viewing buildings as mutual influences in the built environment, (2) leveraging both the individual and contextualized social aspects of occupant behaviors, and (3) incorporating interactions between the built environment and human behaviors. First, I integrate three interlinked components: buildings, residents, and the surrounding neighborhood, and quantify the potential energy savings to be gained from renovating buildings at the inter-building level and leveraging neighborhood-contextualized occupant social networks. Following the confirmation of both the inter-building effect among buildings and occupants' interpersonal influence on energy conservation, I extend the research further by examining the synergy that may exist at the intersection between these "engineered" building networks and "social" peer networks, focusing specifically on the additional energy saving potential that could result from interactions between the two components. Finally, I seek to reach an alignment of the human and building environment subsystems by matching the thermostat preferences of each household with the thermal conditions within their

  11. School Functioning of a Particularly Vulnerable Group: Children and Young People in Residential Child Care

    Directory of Open Access Journals (Sweden)

    Carla González-García

    2017-07-01

    Full Text Available A large proportion of the children and young people in residential child care in Spain are there as a consequence of abuse and neglect in their birth families. Research has shown that these types of adverse circumstances in childhood are risk factors for emotional and behavioral problems, as well as difficulties in adapting to different contexts. School achievement is related to this and represents one of the most affected areas. Children in residential child care exhibit extremely poor performance and difficulties in school functioning which affects their transition to adulthood and into the labor market. The main aim of this study is to describe the school functioning of a sample of 1,216 children aged between 8 and 18 living in residential child care in Spain. The specific needs of children with intellectual disability and unaccompanied migrant children were also analyzed. Relationships with other variables such as gender, age, mental health needs, and other risk factors were also explored. In order to analyze school functioning in this vulnerable group, the sample was divided into different groups depending on school level and educational needs. In the vast majority of cases, children were in primary or compulsory secondary education (up to age 16, this group included a significant proportion of cases in special education centers. The rest of the sample were in vocational training or post-compulsory secondary school. Results have important implications for the design of socio-educative intervention strategies in both education and child care systems in order to promote better school achievement and better educational qualifications in this vulnerable group.

  12. [Disclosure of Adolescents in Residential Care Institutions and Boarding Schools after Exposure to Sexual Violence].

    Science.gov (United States)

    Rau, Thea; Ohlert, Jeannine; Fegert, Jörg M; Allroggen, Marc

    2016-11-01

    Disclosure of Adolescents in Residential Care Institutions and Boarding Schools after Exposure to Sexual Violence In international research, many papers exist about the issue of disclosure after having experienced sexual violence. However, specific research regarding disclosure processes of children and adolescents in institutional care are missing, even though those are particularly often affected by sexual violence. In the Germany-wide study "Sprich mit!", adolescents from the age of 15 up (n = 322; average age 16,69 (SD = 1,3); 57,1 % males) who live in residential care or boarding schools were asked for experiences of sexual violence and their consequences by means of a self-report questionnaire. Results showed that the majority of the adolescents (82 %) entrusted themselves to someone, mostly towards peers (56 %) and less frequent towards adults (24 %). Boys and girls opened up equally often, regardless of the severity of the experienced violence. Adolescents who entrusted themselves towards their peers indicated retrospectively more satisfaction than those entrusting themselves towards adults, even if there were no consequences following the disclosure. Considering that the disclosure towards peers did not initiate a process of help, adolescents in institutional care should be better informed about relevant possibilities to entrust themselves and receive support.

  13. Urban environment and well-being: cross-cultural studies on Perceived Residential Environment Quality Indicators (PREQIs).

    Science.gov (United States)

    Bonaiuto, Marino; Fornara, Ferdinando; Alves, Susana; Ferreira, Ines; Mao, Yanhui; Moffat, Eva; Piccinin, Gloria; Rahimi, Leila

    2015-09-01

    Architectural and environmental psychology literature has shown the importance of urban design in provoking stress feelings or enhancing well-being and quality of life. The aim of this contribution is to show the main results of a set of cross-cultural survey studies concerning the perceived quality of urban features at the neighbourhood level. A questionnaire was used including the extended or the short version of the 11 scales measuring Perceived Residential Environment Quality Indicators (PREQIs), which cover architectural, social, functional, and contextual aspects. Both versions of PREQIs showed a similar factorial structure and a good (or at least acceptable) reliability across different geographical contexts, even though some differences emerged in those countries that are more distant from the Western linguistic and cultural milieu. The development of tools like PREQIs should increase a "user-centred" vision on urban issues.

  14. The prevalence of child sexual abuse in out-of-home care: a comparison between abuse in residential and in foster care.

    Science.gov (United States)

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

    2013-11-01

    We investigated the 2010 year prevalence of child sexual abuse (CSA) in residential and foster care and compared it with prevalence rates in the general population. We used two approaches to estimate the prevalence of CSA. First, 264 professionals working in residential or foster care (sentinels) reported CSA for the children they worked with (N = 6,281). Second, 329 adolescents staying in residential or foster care reported on their own experiences with CSA. Sentinels and adolescents were randomly selected from 82 Dutch out-of-home care facilities. We found that 3.5 per 1,000 children had been victims of CSA based on sentinel reports. In addition, 58 per 1,000 adolescents reported having experienced CSA. Results based on both sentinel report and self-report revealed higher prevalence rates in out-of-home care than in the general population, with the highest prevalence in residential care. Prevalence rates in foster care did not differ from the general population. According to our findings, children and adolescents in residential care are at increased risk of CSA compared to children in foster care. Unfortunately, foster care does not fully protect children against sexual abuse either, and thus its quality needs to be further improved.

  15. Clinimetric evaluation of the physical mobility scale supports clinicians and researchers in residential aged care.

    Science.gov (United States)

    Barker, Anna L; Nitz, Jennifer C; Low Choy, Nancy L; Haines, Terry P

    2008-11-01

    To investigate the interrater agreement and the internal construct validity of the Physical Mobility Scale, a tool routinely used to assess mobility of people living in residential aged care. Prospective, multicenter, external validation study. Nine residential aged care facilities in Australia. Residents (N=186). Phase 1 cohort (99 residents; mean age, 85.22+/-5.1y); phase 2 cohort (87 residents; mean age, 81.59+/-10.69y). Not applicable. Kappa statistics, minimal detectable change (MDC(90)) scores, and Bland-Altman plots were used to assess interrater agreement. Scale unidimensionality, item hierarchy, and person separation were examined with Rasch analysis for both cohorts. Agreement between raters on 6 of the 9 Physical Mobility Scale items was high (kappa>.60). The MDC(90) value was 4.39 points, and no systematic differences in scores between raters were found. The Physical Mobility Scale showed a unidimensional structure demonstrated by fit to the Rasch model in both cohorts (phase 1: chi(2)=23.90, P=.16, person separation index=0.96; phase 2: chi(2)=22.00, P=.23, person separation index=0.96). Standing balance was the most difficult item in both cohorts (phase 1: logit=2.48, SE, 0.16; phase 2: logit=2.53, SE, 0.15). The person-item threshold map indicated no floor or ceiling effects in either cohort. The Physical Mobility Scale demonstrated good interrater agreement and internal construct validity with good fit to the Rasch model in both cohorts. The comparative results across the 2 cohorts indicate generality of the findings. The Physical Mobility Scale total raw scores can be converted to Rasch transformed scores, providing an interval measure of mobility. The Physical Mobility Scale may be suited to a range of clinical and research applications in residential aged care.

  16. Open access in the critical care environment.

    Science.gov (United States)

    South, Tabitha; Adair, Brigette

    2014-12-01

    Open access has become an important topic in critical care over the last 3 years. In the past, critical care had restricted access and set visitation guidelines to protect patients. This article provides a review of the literature related to open access in the critical care environment, including the impact on patients, families, and health care providers. The ultimate goal is to provide care centered on patients and families and to create a healing environment to ensure safe passage of patients through their hospital stays. This outcome could lead to increased patient/family satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Measuring end-of-life care and outcomes in residential care/assisted living and nursing homes.

    Science.gov (United States)

    Zimmerman, Sheryl; Cohen, Lauren; van der Steen, Jenny T; Reed, David; van Soest-Poortvliet, Mirjam C; Hanson, Laura C; Sloane, Philip D

    2015-04-01

    The two primary residential options for older adults who require supportive care are nursing homes and residential care/assisted living. More than one-quarter of all deaths in the U.S. occur in these settings. Although the information available on end of life in long-term care has been growing, the comparative suitability of various measures to guide this work is unknown. To determine the optimal measures to assess end-of-life care and outcomes in nursing homes and residential care/assisted living. A total of 264 family members of decedents from 118 settings were interviewed and provided data on 11 instruments that have been used in, but not necessarily developed for, long-term care populations; Overall, 20 scales and subscales/indices were evaluated. Measures were compared on their psychometric properties and the extent to which they discriminated among important resident, family, and setting characteristics. Prioritizing measures that distinguish the assessment of care from the assessment of dying, and secondarily that exhibit an acceptable factor structure, this study recommends two measures of care-the Family Perceptions of Physician-Family Caregiver Communication and the End of Life in Dementia (EOLD)-Satisfaction With Care-and two measures of outcomes-the EOLD-Symptom Management and the EOLD-Comfort Assessment in Dying. An additional measure to assess outcomes is the Mini-Suffering State Examination (MSSE). The care measures and the MSSE are especially valuable as they discriminate between decedents who were and were not transferred immediately before death, an important outcome, and whether the family expected the death, a useful target for intervention. Despite these recommendations, measurement selection should be informed not only on the basis of psychometric properties but also by specific clinical and research needs. The data in this manuscript will help researchers, clinicians, and administrators understand the implications of choosing various

  18. [Behavioural problems in adolescents who are in adoption, residential care, and grandparent fostering].

    Science.gov (United States)

    Fernández-Molina, Milagros; del Valle, Jorge; Fuentes, M Jesús; Bernedo, Isabel María; Bravo, Amaia

    2011-02-01

    The aim of this research is to identify the severity and type of behavioural problems found in a sample of 181 Spanish adolescents, aged 11 and 18, who have been, or still are in the protective system and to provide give up-to-date figures about behavioural problem situations of children are living under protective measures, and to determine the existence of diverse behavioural problems concerning the kind of care the adolescents are receiving (adoption, residential care, or with grandparent fostering). The Child Behavior Checklist (CBCL) was used in this study. The results show that most of the adolescents scored within the normal range and only a small percentage of them had important behavioural problems and were therefore situated within the clinical range of the trial. The adopted adolescents scored higher than the adolescents who were either fostered by their extended families or in residential care. The main problems identified in each section are discussed, along with the results, in the context of modernising the Spanish protection system.

  19. Racial and ethnic residential segregation and access to health care in rural areas.

    Science.gov (United States)

    Caldwell, Julia T; Ford, Chandra L; Wallace, Steven P; Wang, May C; Takahashi, Lois M

    2017-01-01

    This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. Data from the Medical Expenditure Panel Survey were merged with the American Community Survey and the Area Health Resources Files. Segregation was operationalized using the isolation index separately for African Americans and Hispanics. Multi-level logistic regression with random intercepts estimated four outcomes. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans (Adjusted Odds Ratio [AOR]: 1.42, CI: 0.96-2.10) and Hispanics (AOR: 1.25, CI: 1.05-1.49). By broadening the spatial scale of segregation beyond urban areas, findings showed the complex interaction between social and spatial factors in rural areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Organizational factors associated with readiness for change in residential aged care settings.

    Science.gov (United States)

    von Treuer, Kathryn; Karantzas, Gery; McCabe, Marita; Mellor, David; Konis, Anastasia; Davison, Tanya E; O'Connor, Daniel

    2018-02-01

    Organizational change is inevitable in any workplace. Previous research has shown that leadership and a number of organizational climate and contextual variables can affect the adoption of change initiatives. The effect of these workplace variables is particularly important in stressful work sectors such as aged care where employees work with challenging older clients who frequently exhibit dementia and depression. This study sought to examine the effect of organizational climate and leadership variables on organizational readiness for change across 21 residential aged care facilities. Staff from each facility (N = 255) completed a self-report measure assessing organizational factors including organizational climate, leadership and readiness for change. A hierarchical regression model revealed that the organizational climate variables of work pressure, innovation, and transformational leadership were predictive of employee perceptions of organizational readiness for change. These findings suggest that within aged care facilities an organization's capacity to change their organizational climate and leadership practices may enhance an organization's readiness for change.

  1. Bioaerosols in residential micro-environments in low income countries: A case study from Pakistan

    International Nuclear Information System (INIS)

    Nasir, Zaheer Ahmad; Colbeck, Ian; Sultan, Sikander; Ahmed, Shakil

    2012-01-01

    Our knowledge of the concentrations of bioaerosols in residential micro-environments in low income countries is scanty. The present investigation was conducted to assess the culturable concentration and size distribution of bacteria, gram negative bacteria and fungi in two rural and an urban site in Pakistan. The highest indoor culturable bacteria concentration was found at Rural Site II (14,650 CFU/m 3 ) while the outdoor maximum occurred at the urban site (16,416 CFU/m 3 ). With reference to fungi, both indoor and outdoor concentrations were considerably higher at Rural Site I than the other sites. The size distribution of culturable bacteria at all sites showed greater variability than that of culturable fungi. At all sites more than the half (55–93%) of the culturable bacterial and fungal counts were observed in the respirable fraction ( 3 in the indoor environment. ► Elevated levels outdoors due to proximity to cattle and poor sanitary conditions. ► More that 50% of the bacterial and fungal aerosols were respirable. ► Possible increased respiratory exposure of inhabitants. - Bioaerosol concentrations up to 14,650 CFU/m 3 were measured in the indoor environment reflecting the proximity to cattle and poor sanitary conditions. These elevated levels pose a significant health risk.

  2. Shaping a Favorable Environment in Line with Social Expectations on Residential Areas

    Directory of Open Access Journals (Sweden)

    Joanna Agnieszka Pawłowicz

    2017-12-01

    Full Text Available The driving force behind the development of any city includes its residents. Hence, it is very important that they have the opportunity to live, work and rest in a friendly environment. The source of their well-being and positive aesthetic experience is a harmonious landscape shaped by a functional spatial arrangement of streets, shapes of buildings, as well as the accompanying nature, ensuring rational development of the city space. One of the key stages that developers and construction companies must take into consideration when planning new investments, is becoming familiar with people's expectations regarding their future place of residence. It is no secret that each square meter of building land is a potential source of profit for developers. The more apartments they build and sell, the more they earn. However, in order for apartments to be sold, they must meet the expectations of their potential buyers related not only to apartments and buildings themselves, but also to the environment surrounding them. Therefore, it is very important that residential estates be attractive and satisfy the needs of their dwellers, which substantially comes down to the comfort of living, rest and recreation within their place of residence. The primary objective behind meeting these needs is to stimulate the demand for new apartments among people, integrate the local community and increase the people' satisfaction with living in a friendly environment.

  3. A new urban planning code's impact on walking: the residential environments project.

    Science.gov (United States)

    Christian, Hayley; Knuiman, Matthew; Bull, Fiona; Timperio, Anna; Foster, Sarah; Divitini, Mark; Middleton, Nicholas; Giles-Corti, Billie

    2013-07-01

    We examined whether people moving into a housing development designed according to a state government livable neighborhoods subdivision code engage in more walking than do people who move to other types of developments. In a natural experiment of 1813 people building homes in 73 new housing developments in Perth, Western Australia, we surveyed participants before and then 12 and 36 months after moving. We measured self-reported walking using the Neighborhood Physical Activity Questionnaire and collected perceptions of the environment and self-selection factors. We calculated objective measures of the built environment using a Geographic Information System. After relocation, participants in livable versus conventional developments had greater street connectivity, residential density, land use mix, and access to destinations and more positive perceptions of their neighborhood (all P .05). Implementation of the Livable Neighborhoods Guidelines produced more supportive environments; however, the level of intervention was insufficient to encourage more walking. Evaluations of new urban planning policies need to incorporate longer term follow-up to allow time for new neighborhoods to develop.

  4. A New Urban Planning Code’s Impact on Walking: The Residential Environments Project

    Science.gov (United States)

    Knuiman, Matthew; Bull, Fiona; Timperio, Anna; Foster, Sarah; Divitini, Mark; Middleton, Nicholas; Giles-Corti, Billie

    2013-01-01

    Objectives. We examined whether people moving into a housing development designed according to a state government livable neighborhoods subdivision code engage in more walking than do people who move to other types of developments. Methods. In a natural experiment of 1813 people building homes in 73 new housing developments in Perth, Western Australia, we surveyed participants before and then 12 and 36 months after moving. We measured self-reported walking using the Neighborhood Physical Activity Questionnaire and collected perceptions of the environment and self-selection factors. We calculated objective measures of the built environment using a Geographic Information System. Results. After relocation, participants in livable versus conventional developments had greater street connectivity, residential density, land use mix, and access to destinations and more positive perceptions of their neighborhood (all P  .05). Conclusions. Implementation of the Livable Neighborhoods Guidelines produced more supportive environments; however, the level of intervention was insufficient to encourage more walking. Evaluations of new urban planning policies need to incorporate longer term follow-up to allow time for new neighborhoods to develop. PMID:23678917

  5. Residential self-selection and travel : The relationship between travel-related attitudes, built environment characteristics and travel behaviour

    NARCIS (Netherlands)

    Bohte, W.

    2010-01-01

    Most Western national governments aim to influence individual travel patterns – at least to some degree – through spatial planning in residential areas. Nevertheless, the extent to which the characteristics of the built environment influence travel behaviour remains the subject of some debate among

  6. The quasi-market for adult residential care in the UK: Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?

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    Barron, David N; West, Elizabeth

    2017-04-01

    There has been a radical transformation in the provision of adult residential and nursing home care in England over the past four decades. Up to the 1980s, over 80% of adult residential care was provided by the public sector, but today public sector facilities account for only 8% of the available places, with the rest being provided by a mixture of for-profit firms (74%) and non-profit charities (18%). The public sector's role is often now that of purchaser (paying the fees of people unable to afford them) and regulator. While the idea that private companies may play a bigger role in the future provision of health care is highly contentious in the UK, the transformation of the residential and nursing home care has attracted little comment. Concerns about the quality of care do emerge from time to time, often stimulated by high profile media investigations, scandals or criminal prosecutions, but there is little or no evidence about whether or not the transformation of the sector from largely public to private provision has had a beneficial effect on those who need the service. This study asks whether there are differences in the quality of care provided by public, non-profit or for-profit facilities in England. We use data on care quality for over 15,000 homes that are provided by the industry regulator in England: the Care Quality Commission (CQC). These data are the results of inspections carried out between April 2011 and October 2015. Controlling for a range of facility characteristics such as age and size, proportional odds logistic regression showed that for-profit facilities have lower CQC quality ratings than public and non-profit providers over a range of measures, including safety, effectiveness, respect, meeting needs and leadership. We discuss the implications of these results for the ongoing debates about the role of for-profit providers of health and social care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Assisted Living and Residential Care in Oregon: Two Decades of State Policy, Supply, and Medicaid Participation Trends

    Science.gov (United States)

    Hernandez, Mauro

    2007-01-01

    Purpose: The study describes Oregon state policy and supply developments for licensed long-term-care settings, particularly apartment-style assisted living facilities and more traditional residential care facilities. Design and Methods: Data came from a variety of sources, including state agency administrative records, other secondary data…

  8. Drumming as a Medium to Promote Emotional and Social Functioning of Children in Middle Childhood in Residential Care

    Science.gov (United States)

    Flores, Kim; van Niekerk, Caroline; le Roux, Liana

    2016-01-01

    This study explores the potential of drumming to enhance emotional and social functioning of children in residential care. Fifteen children (aged 7-12) from a child and youth care centre in South Africa attended four months of weekly drumming sessions. Gestalt theory principles informed the workshops' theoretical foundation and interpretation of…

  9. Embodied thermal environments: an examination of older-people's sensory experiences in a variety of residential types

    International Nuclear Information System (INIS)

    Henshaw, Victoria; Guy, Simon

    2015-01-01

    Thermal sensations of space, namely temperature, humidity and the movement of air, can be difficult to separate from other sensory information such as the sound of fans or ventilation equipment, or the smell of damp or cool fresh air. Despite this factor, efforts to reduce the consumption of energy through the installation of low-carbon technologies including sealed whole-building systems frequently isolate the thermal environment and fail to recognise and respond to the influence of other sensory information on personal preferences and behaviours. Older people represent an increasing proportion of the UK's population, can be faced with a range of physiological challenges associated with ageing, and sometimes have long-established personal preferences. Drawing from data collected across the Conditioning Demand Project, this paper explores the embodied nature of older people's experiences of low-carbon and more traditional thermal technologies in private residences, extra-care housing and residential care-homes, focussing specifically upon auditory and olfactory stimulus. Exploring the management of the sensory experience across these settings, we analyse each case to inform the development of new design and policy approaches to tackling housing for older people. In doing so, we further build connections between energy research and debates around sensory urbanism. -- Highlights: •Some thermal technologies present particular sensory issues and problems for older people. •Older people use a range of sensory stimuli in evaluating and controlling thermal environments. •Older people use non-thermal sensory information when selecting between thermal technologies. •Sensory information plays an important role in thermal technology maintenance

  10. The Assimilation of Assistive Technology in Residential Care Centers for People with Intellectual Disabilities

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    Eli Carmeli

    2004-01-01

    Full Text Available People with intellectual disability (ID require special support in order to achieve independence in their daily life. Persons with ID are less exposed to assistive technology, although studies have shown that the availability of aids afford an opportunity to reach independence and cooperation. The aim of this study was to examine the nature of the relationship between involvement of the physiotherapy (PT team and the degree to which assistive technology was used. A questionnaire was sent to all PTs employed at all 54 residential care centers for persons with ID of the Division for Mental Retardation at the Ministry of Social Affairs in Israel. A significantly positive correlation was found between the degree of involvement of the PT and the utilization of assistive technology. The study results may be summarized by stating that PTs demonstrated a great deal of involvement, particularly in relation to the extent of their work in the residential care centers. PT's awareness of the importance was indicated as the major reason to use assistive technology.

  11. "Careworkers don't have a voice:" epistemological violence in residential care for older people.

    Science.gov (United States)

    Banerjee, Albert; Armstrong, Pat; Daly, Tamara; Armstrong, Hugh; Braedley, Susan

    2015-04-01

    Drawing on feminist epistemologies, this paper attends to the way the reductionist assumptions have shaped the organization of nursing home carework in manners that are insufficient to the needs of relational care. This paper is informed by a study involving nine focus groups and a survey of Canadian residential care workers (141 RNs, 139 LPNs and 415 frontline careworkers). Four major themes were identified. Reductionist assumptions contributed to routinized, task-based approaches to care, resulting in what careworkers termed "assembly line care." Insufficient time and emphasis on the relational dimensions of care made it difficult to "treat residents as human beings." Accountability, enacted as counting and documenting, led to an "avalanche of paperwork" that took time away from care. Finally, hierarchies of knowledge contributed to systemic exclusions and the perception that "careworkers' don't have a voice." Careworkers reported distress as a result of the tensions between the organization of work and the needs of relational care. We theorize these findings as examples of "epistemological violence," a concept coined by Vandana Shiva (1988) to name the harm that results from the hegemony of reductionist assumptions. While not acting alone, we argue that reductionism has played an important role in shaping the context of care both at a policy and organizational level, and it continues to shape the solutions to problems in nursing home care in ways that pose challenges for careworkers. We conclude by suggesting that improving the quality of both work and care will require respecting the specificities of care and its unique epistemological and ontological nature. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Associations between resident perceptions of the local residential environment and metabolic syndrome.

    Science.gov (United States)

    Baldock, Katherine; Paquet, Catherine; Howard, Natasha; Coffee, Neil; Hugo, Graeme; Taylor, Anne; Adams, Robert; Daniel, Mark

    2012-01-01

    A substantial body of research has arisen concerning the relationships between objective residential area features, particularly area-level socioeconomic status and cardiometabolic outcomes. Little research has explored residents' perceptions of such features and how these might relate to cardiometabolic outcomes. Perceptions of environments are influenced by individual and societal factors, and may not correspond to objective reality. Understanding relations between environmental perceptions and health is important for the development of environment interventions. This study evaluated associations between perceptions of local built and social environmental attributes and metabolic syndrome, and tested whether walking behaviour mediated these associations. Individual-level data were drawn from a population-based biomedical cohort study of adults in Adelaide, South Australia (North West Adelaide Health Study). Participants' local-area perceptions were analysed in cross-sectional associations with metabolic syndrome using multilevel regression models (n = 1, 324). A nonparametric bootstrapping procedure evaluated whether walking mediated these associations. Metabolic syndrome was negatively associated with greater local land-use mix, positive aesthetics, and greater infrastructure for walking, and was positively associated with greater perceived crime and barriers to walking. Walking partially mediated associations between metabolic syndrome and perceived environmental features. Initiatives targeting residents' perceptions of local areas may enhance the utility of environmental interventions to improve population health.

  13. Optimizing Scoring and Sampling Methods for Assessing Built Neighborhood Environment Quality in Residential Areas

    Directory of Open Access Journals (Sweden)

    Joel Adu-Brimpong

    2017-03-01

    Full Text Available Optimization of existing measurement tools is necessary to explore links between aspects of the neighborhood built environment and health behaviors or outcomes. We evaluate a scoring method for virtual neighborhood audits utilizing the Active Neighborhood Checklist (the Checklist, a neighborhood audit measure, and assess street segment representativeness in low-income neighborhoods. Eighty-two home neighborhoods of Washington, D.C. Cardiovascular Health/Needs Assessment (NCT01927783 participants were audited using Google Street View imagery and the Checklist (five sections with 89 total questions. Twelve street segments per home address were assessed for (1 Land-Use Type; (2 Public Transportation Availability; (3 Street Characteristics; (4 Environment Quality and (5 Sidewalks/Walking/Biking features. Checklist items were scored 0–2 points/question. A combinations algorithm was developed to assess street segments’ representativeness. Spearman correlations were calculated between built environment quality scores and Walk Score®, a validated neighborhood walkability measure. Street segment quality scores ranged 10–47 (Mean = 29.4 ± 6.9 and overall neighborhood quality scores, 172–475 (Mean = 352.3 ± 63.6. Walk scores® ranged 0–91 (Mean = 46.7 ± 26.3. Street segment combinations’ correlation coefficients ranged 0.75–1.0. Significant positive correlations were found between overall neighborhood quality scores, four of the five Checklist subsection scores, and Walk Scores® (r = 0.62, p < 0.001. This scoring method adequately captures neighborhood features in low-income, residential areas and may aid in delineating impact of specific built environment features on health behaviors and outcomes.

  14. Older adults' views and experiences of doll therapy in residential care homes.

    Science.gov (United States)

    Alander, Heidi; Prescott, Tim; James, Ian A

    2015-09-01

    The mechanisms underlying the success of doll therapy are poorly understood. The aims of this study were to explore how people in care, doll users and non-users, make sense of doll use in their settings. A grounded theory approach was used, recruiting participants from three residential care homes involving four male and 12 female residents. Data collection occurred in two phases; five participants took part in a focus group and later 11 participants were interviewed individually. Eight of the 11 participants had dementia, and four participants were actively using dolls. The results are presented as themes, and sub-themes, consisting of four main categories (intrapersonal features, interpersonal features, behavioural benefits, ethical and moderating factors). This thematic analysis shows that residents generally support the use of dolls, believing that dolls can have a positive impact on some users. The mechanisms by which this impact is achieved are discussed together with the ethical concerns. © The Author(s) 2013.

  15. Human and organisational aspects of remote patient monitoring in residential care homes.

    Science.gov (United States)

    Bratan, Tanja; Choudrie, Jyoti; Clarke, Malcolm; Jones, Russell

    2007-01-01

    Demographic changes in the population, with a growing proportion of elderly people, make the efficient and effective provision of healthcare for this age group an increasingly important issue. We examine the organisational and human aspects of introducing a Remote Patient Monitoring (RPM) system that uses wireless and broadband networks into three residential care homes in the UK. Stakeholders were identified, and semi-structured one-to-one interviews were carried out in order to identify issues deemed most important to each group. The work is novel, as it requires examination of the issues of communication between healthcare workers in several primary and secondary care organisations. The key finding was the need to identify the changes in working practice and interpersonal communication. A key factor in particular was the change in relationships: staff in the remote centre needing to learn to seek support when reporting and requesting assistance for a problem; and for the staff at the health centres to respond appropriately.

  16. Texture-modified food and fluids in dementia and residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Painter V

    2017-08-01

    Full Text Available Virginia Painter,1 David G Le Couteur,1–3 Louise M Waite1–3 1Aged and Chronic Care Department, Concord Repatriation General Hospital, Concord, NSW, Australia; 2Ageing and Alzheimer’s Institute, Concord Repatriation General Hospital, Concord, NSW, Australia; 3Centre for Education and Research on Ageing, University of Sydney, Concord, NSW, Australia Introduction: Dysphagia is common in people living with dementia and associated with increased risk of aspiration pneumonia, dehydration, malnutrition, and death. Treatment options are limited and the use of texture-modified food and fluids (TMF is a widespread clinical practice. This review aimed to evaluate the evidence for TMF in dementia.Methods: A literature search using terms “dysphagia,” “texture-modified food and fluids,” “dementia,” and “aged care” was performed by using three electronic databases from 1990 to March 2017. Studies were assessed for suitability, then reviewed with data extracted, and grouped by categories of outcome measures.Results: A total of 3,722 publications were identified, and 22 studies met the inclusion criteria. Studies were heterogeneous in design and methodology. There were no publications examining dementia exclusively; however, many subjects with dementia were included in studies of residential aged care facilities. TMF reduced the risk of aspiration seen on videofluoroscopy but not clinical aspiration and pneumonia. TMF was associated with lower daily energy and fluid intake and variable adherence.Conclusion: There is a lack of evidence for people living with dementia and in residential care facilities that TMF improves clinical outcomes such as aspiration pneumonia, nutrition, hydration, morbidity, and mortality. Adverse effects including poorer energy and fluid intake were identified. Keywords: modified diet, dysphagia, aspiration, aged care, nursing homes, dehydration, nutrition

  17. Attitudes toward information and communication technology (ICT) in residential aged care in Western Australia.

    Science.gov (United States)

    Loh, Poh-Kooi; Flicker, Leon; Horner, Barbara

    2009-07-01

    Determine why introduction of health consulting services via Telehealth video conference consultations failed in residential aged care facilities (RACF). Semistructured interview groups and quantitative survey. Two participating not-for-profit RACF. Managers, employed carers, physiotherapist, occupational therapist, registered nurses, and residents from RACF. A survey initially followed by focus groups that centered on 4 questions. How can computers help improve care? What kind of electronic services and products could help improve care? Who should have access to the technology and why was the technology not used? The survey revealed there was awareness of information and communication technology (ICT) in RACF. However, respondents were uncertain of potential benefits provided to their clients. Only 43% of respondents thought a minority of clients would receive the benefits of ICT use. The focus groups revealed several themes regarding the attitudes toward ICT in RACF. Positive attitudes to ICT included themes of saving time, easier doctor access, cost saving, and improved communications. Negative attitudes included themes of loss of human contact, inadequate training, security barriers, not user friendly, limited ability to comply with suggestions, privacy issues, and capital cost. Residents were also concerned about confidentiality and loss of human interaction with the use of Telehealth in residential aged facilities. More training for staff is required to enable them to use ICT efficiently. ICT hardware and software at the user interface must be designed to maintain confidentiality with ease of access. Access to Telehealth services should not impede the routine delivery of personal care and human contact for residents. Studies are required as to where human input to residents is unable to be replaced by Telehealth services.

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

    Science.gov (United States)

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

    2018-02-01

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

  19. Fuzzy Logic Modelling of the Effects of Pollution on Domestic Roof-Harvested Rainwater Quality in Residential and Industrial Environments.

    Science.gov (United States)

    Akintola, Olayiwola Akin; Sangodoyin, Abimbola Yisau; Agunbiade, Foluso Oyedotun

    2016-07-01

    This study presents the effects of environmental pollution on the quality of domestic roof-harvested rainwater (DRHRW) using fuzzy comprehensive assessment (FCA). Seven metals (Cu, Cd, Pb, Zn, Fe, Ca, and Mg) and six water-quality parameters (Acidity, PO4 (3-), SO4 (2-), NO3 (-) , Cl(-), and pH) were investigated in DRHRW sampled from 12 sampling points each from Ibadan (residential) and Lagos (industrial) environments, Nigeria. The results of these parameters were formulated into membership function fuzzy matrices based on four contamination classifications of high, marginal, low, and poor qualities using regulatory limits as criteria. The products membership function matrices and weight matrices generated indices that classified the degree of anthropogenic activity impact on the sites. Results of FCA classified the DRHRW from residential environment as between high and marginal quality, whereas DRHRW from industrial environment is classified between marginal and low quality. Lead and Cd were major contaminants of concern found in these harvested water.

  20. Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification.

    Science.gov (United States)

    Acevedo, Andrea; Lee, Margaret T; Garnick, Deborah W; Horgan, Constance M; Ritter, Grant A; Panas, Lee; Campbell, Kevin; Bean-Mortinson, Jason

    2018-02-01

    Despite the importance of continuity of care after detoxification and residential treatment, many clients do not receive further treatment services after discharged. This study examined whether offering financial incentives and providing client-specific electronic reminders to treatment agencies lead to improved continuity of care after detoxification or residential treatment. Residential (N = 33) and detoxification agencies (N = 12) receiving public funding in Washington State were randomized into receiving one, both, or none (control group) of the interventions. Agencies assigned to incentives arms could earn financial rewards based on their continuity of care rates relative to a benchmark or based on improvement. Agencies assigned to electronic reminders arms received weekly information on recently discharged clients who had not yet received follow-up treatment. Difference-in-difference regressions controlling for client and agency characteristics tested the effectiveness of these interventions on continuity of care. During the intervention period, 24,347 clients received detoxification services and 20,685 received residential treatment. Overall, neither financial incentives nor electronic reminders had an effect on the likelihood of continuity of care. The interventions did have an effect among residential treatment agencies which had higher continuity of care rates at baseline. Implementation of agency-level financial incentives and electronic reminders did not result in improvements in continuity of care, except among higher performing agencies. Alternative strategies at the facility and systems levels should be explored to identify ways to increase continuity of care rates in specialty settings, especially for low performing agencies. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. A difficult mission to work as a nurse in a residential care home--some registered nurses' experiences of their work situation.

    Science.gov (United States)

    Karlsson, Inger; Ekman, Sirkka-Liisa; Fagerberg, Ingegerd

    2009-06-01

    The aim of the study was to describe Registered Nurses' (RNs) experiences of their work environment in residential care homes for older persons. Twelve RNs were interviewed and latent content analysis was used for analysing the data. The data were collected in the spring of 2006. The findings revealed that these RNs experienced a paradoxical work environment: feeling appreciated and valuable, whilst at the same time feeling underestimated and frustrated. They felt appreciated and valuable when they provided nursing care and trust and support to others. The RNs experienced a positive work environment when the border between social and nursing care were clear. They also felt frustrated when they were expected to 'be everywhere and to know everything', but at the same time they felt invisible and underestimated. They experienced themselves as 'lonely fixers', having the ability to solve practical problems when the older persons were discharged from hospital and expected to be able to provide specialist nursing care without having specialised competence and specialist staff team members. In conclusion, it is important that the RNs can identify the border for nursing care. When these are clear, the nursing care objectives are apparent and the RNs become more autonomous, visible and listened to. The manager should listen to and support the RNs, with continuous supervision and competence development being mandatory elements. It is a difficult task for RNs working in residential care homes to meet all of the expectations placed on them, resulting in a risk of moral distress, making mistakes and developing illnesses caused by stress.

  2. Helicobacter pylori Infection in Persons with Intellectual Disability in Residential Care in Israel

    Directory of Open Access Journals (Sweden)

    Joav Merrick

    2001-01-01

    Full Text Available Helicobacter pylori (formerly Campylobacter pylori was identified in 1982 by researchers from Australia as a pathogenic factor in peptic ulcer disease. Due to the few studies on H. pylori infection conducted in the population of persons with intellectual disability it was decided to conduct a clinical study in Israel. The purpose of the study was to determine the occurrence of H. pylori infection in persons who presented with severe dyspeptic symptoms and to monitor clinically the effect of treatment. The Division for Mental Retardation in Israel provides service to 6,022 persons in 53 residential care centers and 1 in central Israel was selected for this pilot study. The study has been performed since 1999 and each patient who came to the medical clinic of the institution with severe dyspeptic symptoms was examined clinically and a blood specimen drawn for IgG antibodies to H. pylori (ELISA, Pharmatop Millenia. In case of positive serology, triple drug treatment (amoxycillin, metronidazole, and pantoprazole or omepra-zole was initiated for 1 week. Since 1999 a total of 43 persons (total population in care was 224 had severe dyspeptic symptoms and 42 persons (98%, 26 males, 16 females, mean age 45 years, mean institutionalization 20 years had Helicobacter infection. All patients were treated for 1 week, but six patients received an extra month of omeprazole due to persistent symptoms. At follow-up, clinically all patients had improvement and only seven still had minor complaints (83% treatment success. Persons with developmental disability, intellectual disability, or mental retardation in residential care presenting with severe dyspeptic symptoms had a high incidence of H. pylori infection. Therefore, we recommend serology or urea breath investigations in this population presenting with dyspeptic symptoms and triple drug treatment for 1 week in case of positive findings.

  3. Closing the Research to Practice Gap in Therapeutic Residential Care: Service Provider-University Partnerships Focused on Evidence-Based Practice

    Science.gov (United States)

    Thompson, Ronald W.; Duppong Hurley, Kristin; Trout, Alexandra L.; Huefner, Jonathan C.; Daly, Daniel L.

    2017-01-01

    Residential care has been criticized for its high cost and limited research evidence. While recent studies and reviews of the literature suggest that a number of evidence-based practices are being implemented in residential care settings, more research is needed to develop and test empirically based practices that can be successfully implemented…

  4. Identifying speech, language and communication needs among children and young people in residential care.

    Science.gov (United States)

    McCool, Susan; Stevens, Irene C

    2011-01-01

    There are claims that elevated levels of speech, language and communication needs (SLCN) exist among looked-after children and young people, and that their needs remain largely undetected and unmet. Scarce empirical evidence exists to support these assertions. To investigate whether elevated levels of communication impairment exist among children and young people in residential care; to begin to explore the nature of any communication impairment indicated, including social and pragmatic difficulties; to consider the extent to which communication impairment may be undetected and unmet; and to consider the suitability of the Children's Communication Checklist 2 (CCC-2) as a screening tool in this context. In four local authority areas in Scotland residential care workers completed the CCC-2 on children and young people well known to them, and provided information about previous concerns and/or referrals regarding communication. Results are presented for 30 children and young people ranging in age from 11;01 to 17;01 years (133-205 months, mean = 172.57, SD = 19.97 months). CCC-2 scores indicated impairment in 19 out of 30 cases. In eight of those 19 cases profiles were suggestive of autistic spectrum disorder (ASD), while for the remaining eleven cases impairment was indicated in other aspects of speech, language or communication. The general trend was towards greater severity of impairment in both ASD and non-ASD profiles. Information regarding previous concerns and/or referrals was available for ten of the 19 cases whose profiles indicated impairment: in nine out of these ten cases there had been no concerns, and in the final case no referrals had been made despite concerns. This study indicates the presence of high levels of SLCN among individuals in residential care, much of it severe and pervasive in nature, and in large part unsuspected. The CCC-2 has the potential for use as a screening tool for this population. There is a compelling case for speech and

  5. The Impact of Brief Play Therapy Training on the Emotional Awareness of Care Workers in a Young Children's Residential Care Setting in Australia

    Science.gov (United States)

    Hunt, Kathryn Frances

    2010-01-01

    This paper is an account of, and reflection on, the author's six-month ethnographic study of a residential care home for severely traumatised and abused children in Australia. During the stay she designed and offered a short six-day course for the care staff and foster carers in the use of play for emotional and therapeutic support. Prior to this,…

  6. The ideal application of surveillance technology in residential care for people with dementia.

    Science.gov (United States)

    Niemeijer, Alistair R; Frederiks, Brenda J M; Depla, Marja F I A; Legemaate, Johan; Eefsting, Jan A; Hertogh, Cees M P M

    2011-05-01

    As our society is ageing, nursing homes are finding it increasingly difficult to deal with an expanding population of patients with dementia and a decreasing workforce. A potential answer to this problem might lie in the use of technology. However, the use and application of surveillance technology in dementia care has led to considerable ethical debate among healthcare professionals and ethicists, with no clear consensus to date. To explore how surveillance technology is viewed by care professionals and ethicists working in the field, by investigating the ideal application of surveillance technology in the residential care of people with dementia. Use was made of the concept mapping method, a computer-assisted procedure consisting of five steps: brainstorming, prioritizing, clustering, processing by the computer and analysis. Various participants (ranging from ethicists to physicians and nurses) were invited on the basis of their professional background. The views generated are grouped into six categories ranging from the need for a right balance between freedom and security, to be beneficial and tailored to the resident, and clearly defined procedures to competent and caring personnel, active monitoring and clear normative guidance. The results are presented in the form of a graphic chart. There appears to be an inherent duality in the views on using surveillance technology which is rooted in the moral conflict between safety and freedom. Elaboration of this ethical issue has proved to be very difficult.

  7. A qualitative study exploring issues related to medication management in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Ahmad Nizaruddin M

    2017-11-01

    Full Text Available Mariani Ahmad Nizaruddin, Marhanis-Salihah Omar, Adliah Mhd-Ali, Mohd Makmor-Bakry Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs.Participants and methods: A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.Results and discussion: Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.Conclusion: There are important issues

  8. A qualitative study exploring issues related to medication management in residential aged care facilities.

    Science.gov (United States)

    Ahmad Nizaruddin, Mariani; Omar, Marhanis-Salihah; Mhd-Ali, Adliah; Makmor-Bakry, Mohd

    2017-01-01

    Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs). A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner. Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes. There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.

  9. Residents' perceptions and experiences of social interaction and participation in leisure activities in residential aged care.

    Science.gov (United States)

    Thomas, Jessica E; O'Connell, Beverly; Gaskin, Cadeyrn J

    2013-10-01

    Social interaction and participation in leisure activities are positively related to the health and well-being of elderly people. The main focus of this exploratory study was to investigate elderly peoples' perceptions and experiences of social interaction and leisure activities living in a residential aged care (RAC) facility. Six residents were interviewed. Themes emerging from discussions about their social interactions included: importance of family, fostering friendships with fellow residents, placement at dining room tables, multiple communication methods, and minimal social isolation and boredom. Excursions away from the RAC facility were favourite activities. Participants commonly were involved in leisure activities to be socially connected. Poor health, family, the RAC facility, staffing, transportation, and geography influenced their social interaction and participation in leisure activities. The use of new technologies and creative problem solving with staff are ways in which residents could enhance their social lives and remain engaged in leisure activities.

  10. Vitamin B12 Deficiency in Persons with Intellectual Disability in a Vegetarian Residential Care Community

    Directory of Open Access Journals (Sweden)

    Mohammed Morad

    2005-01-01

    Full Text Available The goal of this study was to determine the prevalence of vitamin B12 deficiency among intellectually disabled persons in a vegetarian remedial community in Israel. In this community, 47 individuals with intellectual disability (ID live in 7 enlarged families in a kibbutz style agricultural setting. These 47 individuals and 17 of their caregivers were screened for vitamin B12 deficiency. There were 25.5% of the disabled vs. 11.8% of the caregivers found to have levels of vitamin B12 lower than 157 pg/ml. It is concluded that persons with ID in this vegetarian residential care community seemed to be at a higher risk for vitamin B12 deficiency.

  11. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... status. RESULTS: Two thirds of the citizens (64.5%) used one or more PMs (antipsychotics 15.9%, antidepressants 43.5%, anxiolytics/hypnotics 27.1% and anti-dementia drugs 16.4%). Citizens treated with antipsychotics were also prescribed antidepressants (52.9%), anxiolytics/hypnotics (35.3%) and anti-dementia...... drugs (20.9%). Citizens treated with anti-dementia drugs were also prescribed antipsychotics (20.0%) and antidepressants (54.3%). Doses over 20 mg and 10 mg of citalopram and escitalopram, respectively, were given to 28.0% of the citizens treated with these antidepressants. CONCLUSION: Compared...

  12. Role of information and communication technology in promoting oral health at residential aged care facilities.

    Science.gov (United States)

    Adebayo, Bola; Durey, Angela; Slack-Smith, Linda M

    2017-07-01

    Information and communication technology (ICT) can provide knowledge and clinical support to those working in residential aged care facilities (RACFs). This paper aims to: (1) review literature on ICT targeted at residents, staff and external providers in RACFs including general practitioners, dental and allied health professionals on improving residents' oral health; (2) identify barriers and enablers to using ICT in promoting oral health at RACFs; and (3) investigate evidence of effectiveness of these approaches in promoting oral health. Findings from this narrative literature review indicate that ICT is not widely used in RACFs, with barriers to usage identified as limited training for staff, difficulties accessing the Internet, limited computer literacy particularly in older staff, cost and competing work demands. Residents also faced barriers including impaired cognitive and psychosocial functioning, limited computer literacy and Internet use. Findings suggest that more education and training in ICT to upskill staff and residents is needed to effectively promote oral health through this medium.

  13. Well-being, the Decision making process in residential care facilities and accommodation in Denmark

    DEFF Research Database (Denmark)

    Knudstrup, Mary-Ann; Harder, Henrik

    This paper discusses the results from one of the sub-research projects, called “The Decision making process – Process, Architecture, Well-being” a project within the main project “Well-being and Housing” and is based on a case study which consist of four cases, realized and planned projects......-based knowledge is needed: There is a need for research-based knowledge manuals among the actors involved in the planning and project design process which describe systematically the importance of working with the different aspects on well-being in residential care facilities and accommodation in Denmark. 2. More...... time should be devoted to discuss the aspects connected to well-being During the planning and project design process more time should be given to more qualified discussions about what Well-being means to the residents and the employees and these discussions should be embedded in the decision making...

  14. A modification of the token economy for nonresponsive youth in family-style residential care.

    Science.gov (United States)

    Field, Clinton E; Nash, Heather M; Handwerk, Michael L; Friman, Patrick C

    2004-05-01

    Out-of-home treatment for youth with conduct problems is increasing rapidly in this country. Most programs for these youth deliver treatment in a group format and commonly employ some version of a token economy. Despite widespread evidence of effectiveness, a substantial minority of treated youth fail to respond. Participants for this study were 3 youth who were nonresponsive to treatment provided in a family-style residential care program with a comprehensive token economy. Our approach to the "nonresponse" of these youth involved modifications of the frequency and immediacy of their access to the backup rewards earned with tokens. We evaluated the effects of the modifications with a treatment-withdrawal experimental design. Dependent measures included two indices of youth response to treatment: intense behavioral episodes and backup rewards earned. Results showed substantial improvement among these indices during treatment conditions.

  15. Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators.

    Science.gov (United States)

    Vlaeyen, Ellen; Stas, Joke; Leysens, Greet; Van der Elst, Elisa; Janssens, Elise; Dejaeger, Eddy; Dobbels, Fabienne; Milisen, Koen

    2017-05-01

    To identify the barriers and facilitators for fall prevention implementation in residential care facilities. Systematic review. Review registration number on PROSPERO: CRD42013004655. Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills

  16. Dietary supply of selenium for adolescents in three residential care orphanages in Southern Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Adotey, Dennis K., E-mail: kadotey@yahoo.com [Graduate School of Nuclear and Allied Sciences, University of Ghana, Legon (Ghana); National Nuclear Research Institute, Ghana Atomic Energy Commission, P. O. Box LG 80, Legon (Ghana); Stibilj, Vekoslava [Department of Environmental Sciences, Jozef Stefan Institute, Jamova 39, 1000 Ljubljana (Slovenia); Serfor-Armah, Yaw; Nyarko, Benjamin J.B. [Graduate School of Nuclear and Allied Sciences, University of Ghana, Legon (Ghana); National Nuclear Research Institute, Ghana Atomic Energy Commission, P. O. Box LG 80, Legon (Ghana); Jacimovic, Radojko [Department of Environmental Sciences, Jozef Stefan Institute, Jamova 39, 1000 Ljubljana (Slovenia)

    2011-12-01

    Adolescents require optimum dietary supply of the essential trace mineral selenium (Se); however the absence of reliable and accurate data on the dietary supply of selenium for the adolescent population in Ghanaian residential care orphanages have made it difficult for public health nutritionists to assess the adequacy of the dietary supply. The dietary supply of selenium for adolescents (12-15 years) in three residential care orphanages, (Osu, Tutu-Akwapim and Teshie), in Southern Ghana have been evaluated by sampling their 24-h duplicate diets (including water) for 7-consecutive days using the duplicate diet sampling technique. The mass fraction of selenium in the blended lyophilized homogenates of duplicate diets was determined by radiochemical neutron activation analysis (RNAA). The validity of the RNAA method for selenium determination was checked by analyses of NIST SRM 1548a (Typical diet). The chemical yield of the radiochemical separation was determined by spectrophotometry. The average mass fractions of selenium in the blended lyophilized 24-hour duplicate diets for Osu, Tutu-Akwapim and Teshie were; 165 {+-} 61 [117.2-285.2], 203 {+-} 68 [110.5-304.9] and 250 {+-} 92 [128.8-408.0] ng Se g{sup -1} lyophilized matter respectively. The average dietary supply of Se were, 57.6 {+-} 17.3 [42.2-88.4], 82.0 {+-} 30.7 [44.3-136.2] and 91.7 {+-} 44.2 [46.0-153.4] {mu}g Se day{sup -1} for Osu, Tutu-Akwapim and Teshie orphanages respectively. The data generated will help public health nutritionists in the provision of dietary advice and nutritional support for the studied orphanages, as well as other orphanages. The data will also help in the planning of institutional diets.

  17. Dietary supply of selenium for adolescents in three residential care orphanages in Southern Ghana

    International Nuclear Information System (INIS)

    Adotey, Dennis K.; Stibilj, Vekoslava; Serfor-Armah, Yaw; Nyarko, Benjamin J.B.; Jaćimović, Radojko

    2011-01-01

    Adolescents require optimum dietary supply of the essential trace mineral selenium (Se); however the absence of reliable and accurate data on the dietary supply of selenium for the adolescent population in Ghanaian residential care orphanages have made it difficult for public health nutritionists to assess the adequacy of the dietary supply. The dietary supply of selenium for adolescents (12–15 years) in three residential care orphanages, (Osu, Tutu-Akwapim and Teshie), in Southern Ghana have been evaluated by sampling their 24-h duplicate diets (including water) for 7-consecutive days using the duplicate diet sampling technique. The mass fraction of selenium in the blended lyophilized homogenates of duplicate diets was determined by radiochemical neutron activation analysis (RNAA). The validity of the RNAA method for selenium determination was checked by analyses of NIST SRM 1548a (Typical diet). The chemical yield of the radiochemical separation was determined by spectrophotometry. The average mass fractions of selenium in the blended lyophilized 24-hour duplicate diets for Osu, Tutu-Akwapim and Teshie were; 165 ± 61 [117.2–285.2], 203 ± 68 [110.5–304.9] and 250 ± 92 [128.8–408.0] ng Se g −1 lyophilized matter respectively. The average dietary supply of Se were, 57.6 ± 17.3 [42.2–88.4], 82.0 ± 30.7 [44.3–136.2] and 91.7 ± 44.2 [46.0–153.4] μg Se day −1 for Osu, Tutu-Akwapim and Teshie orphanages respectively. The data generated will help public health nutritionists in the provision of dietary advice and nutritional support for the studied orphanages, as well as other orphanages. The data will also help in the planning of institutional diets.

  18. A Long-Term Leisure Program for Individuals with Intellectual Disability in Residential Care Settings: Research to Practice

    Science.gov (United States)

    Fox, Robert A.; Burke, Amie M.; Fung, Michael P.

    2013-01-01

    We studied the effectiveness of an individually-tailored leisure program implemented by direct care staff in a residential program for 28 adults with severe to profound intellectual disability using a multiple baseline design across two homes over a 1.5 year baseline and treatment period followed by another nearly 1.5 year maintenance phase. The…

  19. 25 CFR 20.502 - Can Child Assistance funds be used to place Indian children in residential care facilities?

    Science.gov (United States)

    2010-04-01

    ... OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance How... in residential care facilities? You, the social service program, can use Child Assistance funds to... 25 Indians 1 2010-04-01 2010-04-01 false Can Child Assistance funds be used to place Indian...

  20. "It's Different, but It's the Same": Perspectives of Young Adults with Siblings with Intellectual Disabilities in Residential Care

    Science.gov (United States)

    Jacobs, Paula; MacMahon, Ken

    2017-01-01

    Background: Siblings often play significant roles in the lives of people with intellectual disabilities. This study aimed to give voice to young adults whose siblings have an intellectual disability and are in residential care. Materials and Methods: Six participants were interviewed, with interpretative phenomenological analysis methodology…

  1. Can money buy green? Demographic and socioeconomic predictors of lawn-care expenditures and lawn greenness in urban residential areas

    Science.gov (United States)

    Weiqi Zhou; Austin Troy; J. Morgan Grove; Jennifer C. Jenkins

    2009-01-01

    It is increasingly important to understand how household characteristics influence lawn characteristics, as lawns play an important ecological role in human-dominated landscapes. This article investigates household and neighborhood socioeconomic characteristics as predictors of residential lawn-care expenditures and lawn greenness. The study area is the Gwynns Falls...

  2. Determinants and Effects of Nurse Staffing Intensity and Skill Mix in Residential Care/Assisted Living Settings

    Science.gov (United States)

    Stearns, Sally C.; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L.; Konrad, Thomas R.; Sloane, Philip D.

    2007-01-01

    Purpose: Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes.…

  3. The Impact of Child Sexual Abuse on the Education of Boys in Residential Care between 1950 and 1975

    Science.gov (United States)

    Bode, Andrew; Goldman, Juliette D. G.

    2012-01-01

    Children's education may be adversely impacted by external factors during their childhood. For example, learning to learn, critical reflection, experiential learning and self-direction may be permanently impaired. Many children in out-of-home residential care during the last century suffered ongoing child abuse and neglect, including sexual abuse,…

  4. Conceptual Application of the Discrimination Model of Clinical Supervision for Direct Care Workers in Adolescent Residential Treatment Settings

    Science.gov (United States)

    Byrne, Andrew M.; Sias, Shari M.

    2010-01-01

    This article applies the tenets of Bernard's in "Counselor Edu Supervision" 19:60-68, (1979) discrimination model of clinical supervision to the supervision needs of those who provide direct care to adolescents in residential treatment due to abuse, neglect, behavioral, or emotional problems. The article focuses on three areas…

  5. The care of Filipino juvenile offenders in residential facilities evaluated using the risk-need-responsivity model

    NARCIS (Netherlands)

    Spruit, A.; Wissink, I.B.; Stams, G.J.J.M.

    According to the risk-need-responsivity model of offender, assessment and rehabilitation treatment should target specific factors that are related to re-offending. This study evaluates the residential care of Filipino juvenile offenders using the risk-need-responsivity model. Risk analyses and

  6. Building Bridges between the School and the Home: Understanding the Literacy Practices of Children Living in Residential Care

    Science.gov (United States)

    Tan, Jennifer Poh Sim

    2015-01-01

    Research has consistently shown that children in residential care fall behind at school. This proves a great challenge for educators who have to cater to the students' needs to ensure no one is left behind. Studies investigating family literacy practices of different social classes show a positive implication if the home literacy practices are…

  7. [Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population].

    Science.gov (United States)

    Rau, Thea; Ohlert, Jeannine; Fegert, Jörg M; Andresen, Sabine; Pohling, Andrea; Allroggen, Marc

    2018-01-01

    Childhood Experiences of Adolescents in Boarding Schools. A Comparison with Adolescents in Residential Care and with the General Population Various studies indicate that students in boarding schools experience a lot of violence during their accommodation. However, it is not proved whether adolescents in boarding schools are also a burdensome group regarding early childhood experiences such as neglect and abuse. The aim of the study was to find out more about the experiences of adolescents in boarding schools and to determine whether there are differences between adolescents in residential care and between the general population. Furthermore, it should be examined whether boys and girls differ in their experiences. In the study, adolescents of boarding schools and of residential care all over Germany, starting at the age of 15 (n = 322), were asked regarding physical and emotional neglect/abuse, light/severe parent violence, negative/positive educational behavior of the parents. The results show that students in boarding schools were less likely to be affected by childhood maltreatment and more likely to have experienced positive parental behavior compared to children in residential care. Compared to the general population, students in boarding schools were more often and more severely affected by parental violence. Moreover, girls had experienced parental violence more often than boys. The results indicate that in boarding schools there is a need for support offers for adolescents with a history of violent experiences and that the risk group should be identified directly at the admission to the school.

  8. Spiritual care in a multicultural oncology environment.

    Science.gov (United States)

    Dennis, Kristopher; Duncan, Graeme

    2012-06-01

    Increasingly, oncology is practiced within multicultural environments. All aspects of care, including spiritual care should be delivered to patients with cancer in a culturally sensitive manner. In this article, we discuss the influence of culture on patients with cancer throughout the disease process by highlighting relevant reports in the literature. Most articles focussing on culture and oncology are single-author or single-institution narrative reports pertaining to experiences with an individual racial, ethnic, religious or minority patient group. The majority of articles are found within the palliative care and nursing literature. Health-related values vary widely across cultures, and the experience of spiritual care in oncology differs greatly across cultural groups. Although culture is generally recognized as an important health determinant that impacts the experience of care, the extent of different cultural influences is not well understood due to a paucity of relevant data, and reports on resources and educational strategies to optimize culturally competent spiritual care are similarly lacking.

  9. Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

    Science.gov (United States)

    Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

    2014-01-01

    Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve

  10. Care home managers' views of dental services for older people living in nursing and residential homes in inner city London.

    Science.gov (United States)

    Belsi, A; Gonzalez-Maffe, J; Jones, K; Wright, D; Gallagher, J E

    2013-06-01

    To investigate care home managers' views on the provision of dental care (current and future; urgent, check-up and follow-up) for their residents, barriers to care and the impact of policy changes, by type of home (nursing vs residential), with a view to informing the planning and provision of care. A cross sectional postal questionnaire survey and follow-up semi-structured interviews. Care homes in South East London. PARTCIPANTS: All care home managers in three south east London boroughs. A 72% response rate (n=152) was achieved, 140 of which were designated as nursing and/or residential homes (92%). Almost all managers reported that the care homes had arrangements in place for residents to access some elements of dental care (99%, n=148). Reported barriers to care included residents' fear of treatment (53%), patients' limited mobility (45%) and waiting times for services (42%). Limited mobility (p=0.01) and transport issues (p=0.01) were more significant barriers for nursing homes, whereas fear (p=0.02) was more significant for residential homes. Access to a range of dental services and modes of service delivery were requested for the future; most notable were the demands for domiciliary services to be available to nursing homes and for residential homes to access local general dental practitioners to meet the needs of their residents. Managers report having arrangements in place for residents to access dental services; however, there was a clear view that future arrangements should be more appropriate to the needs and vulnerabilities of their residents.

  11. Safe RESIDential Environments? A longitudinal analysis of the influence of crime-related safety on walking.

    Science.gov (United States)

    Foster, Sarah; Hooper, Paula; Knuiman, Matthew; Christian, Hayley; Bull, Fiona; Giles-Corti, Billie

    2016-02-16

    Numerous cross-sectional studies have investigated the premise that the perception of crime will cause residents to constrain their walking; however the findings to date are inconclusive. In contrast, few longitudinal or prospective studies have examined the impact of crime-related safety on residents walking behaviours. This study used longitudinal data to test whether there is a causal relationship between crime-related safety and walking in the local neighbourhood. Participants in the RESIDential Environments Project (RESIDE) in Perth, Australia, completed a questionnaire before moving to their new neighbourhood (n = 1813) and again approximately one (n = 1467), three (n = 1230) and seven years (n = 531) after relocating. Self-report measures included neighbourhood perceptions (modified NEWS items) and walking inside the neighbourhood (min/week). Objective built environmental measures were generated for each participant's 1600 m neighbourhood at each time-point, and the count of crimes reported to police were generated at the suburb-level for the first three time-points only. The impact of crime-related safety on walking was examined in SAS using the Proc Mixed procedure (marginal repeated measures model with unrestricted variance pattern). Initial models controlled for demographics, time and self-selection, and subsequent models progressively adjusted for other built and social environment factors based on a social ecological model. For every increase of one level on a five-point Likert scale in perceived safety from crime, total walking within the local neighbourhood increased by 18.0 min/week (p = 0.000). This relationship attenuated to an increase of 10.5 min/week after accounting for other built and social environment factors, but remained significant (p = 0.008). Further analyses examined transport and recreational walking separately. In the fully adjusted models, each increase in safety from crime was associated with a 7.0

  12. Staff members' perceived training needs regarding sexuality in residential aged care facilities.

    Science.gov (United States)

    Villar, Feliciano; Celdrán, Montserrat; Fabà, Josep; Serrat, Rodrigo

    2017-01-01

    The purpose of the article is to ascertain if staff members of residential aged care facilities (RACF) perceive the need for training regarding residents' sexuality, and what, if any, benefits from the training were perceived, and to compare perceived benefits of training between care assistants and professional/managerial staff. Interviews were conducted with 53 staff members of five different RACF in Spain. Their responses to two semistructured questions were transcribed verbatim and submitted to content analysis. Results show that most interviewees said they lacked training about sexuality and aging. Two potential highlighted benefits of the training are knowledge/attitudinal (countering negative attitudes regarding sexuality) and procedural (developing common protocols and tools to manage situations related to sexuality). Care assistants and professional staff agreed on the need for training, though the former emphasized the procedural impact and the latter the knowledge/attitudinal benefits. The results suggest that RACF staff should have an opportunity to receive training on residents' sexuality, as sexual interest and behavior is a key dimension of residents' lives.

  13. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities.

    Science.gov (United States)

    Hasan, Syed Shahzad; Thiruchelvam, Kaeshaelya; Kow, Chia Siang; Ghori, Muhammad Usman; Babar, Zaheer-Ud-Din

    2017-10-01

    Medication reviews is a widely accepted approach known to have a substantial impact on patients' pharmacotherapy and safety. Numerous options to optimise pharmacotherapy in older people have been reported in literature and they include medication reviews, computerised decision support systems, management teams, and educational approaches. Pharmacist-led medication reviews are increasingly being conducted, aimed at attaining patient safety and medication optimisation. Cost effectiveness is an essential aspect of a medication review evaluation. Areas covered: A systematic searching of articles that examined the cost-effectiveness of medication reviews conducted in aged care facilities was performed using the relevant databases. Pharmacist-led medication reviews confer many benefits such as attainment of biomarker targets for improved clinical outcomes, and other clinical parameters, as well as depict concrete financial advantages in terms of decrement in total medication costs and associated cost savings. Expert commentary: The cost-effectiveness of medication reviews are more consequential than ever before. A critical evaluation of pharmacist-led medication reviews in residential aged care facilities from an economical aspect is crucial in determining if the time, effort, and direct and indirect costs involved in the review rationalise the significance of conducting medication reviews for older people in aged care facilities.

  14. Education and process change to improve skin health in a residential aged care facility.

    Science.gov (United States)

    Price, Kay; Kennedy, Kate J; Rando, Tabatha L; Dyer, Anthony R; Boylan, Jo

    2017-12-01

    We report on an intervention and evaluation in relation to changes in staff knowledge, time spent on healing and wound prevention and proportion of wounds in the facilities before and after. A rapid review of recent peer-reviewed literature (2006-2016) found 14 education-based intervention articles and provided the background and context for this intervention. A cohort of 164 nurses and personal care workers and 261 residents at two aged care-approved facilities contributed to this intervention on the effect of education, mentoring and practice change on staff knowledge and wound prevalence between 2015 and 2016. There was a significant decrease in pressure injury prevalence and an increase in the early identification of potential wounds between phase 1 and 3 across the two facilities. Overall, registered nurses and enrolled nurses showed significant increase in mean knowledge scores. There was a reorganisation of time spent on various wound care and prevention strategies that better represented education and knowledge. Wound management or prevention education alone is not enough; this study, using an educational intervention in conjunction with resident engagement, practice change, mentorship, onsite champions for healthy skin and product choice suggestions, supported by an organisation that focuses on a healthy ageing approach, showed improvement across two residential sites. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  15. Challenges in transferring individual learning to organizational learning in the residential care of older people.

    Science.gov (United States)

    Augustsson, Hanna; Törnquist, Agneta; Hasson, Henna

    2013-01-01

    The purpose of this paper is to evaluate the outcomes of a workplace learning intervention on organizational learning and to identify factors influencing the creation of organizational learning in residential care of older people. The study consisted of a quasi-experimental intervention for outcome evaluation. In addition, a case study design was used to identify factors influencing organizational learning. Outcomes were evaluated using the validated Dimensions of the Learning Organization Questionnaire at three time points, and interviews were conducted with nursing staff and managers. The intervention had some effects on the individual level, but no improvements in organizational learning were found. Hindering factors for creating organizational learning were poor initial learning climate, managers' uncertainty about their role, lack of ownership and responsibility among staff and managers, managers' views of personality being a more important component than staff development in older people's care, and a lack of systems for capturing acquired knowledge. The study offers suggestions for the transfer of individual-level learning to organizational learning in older people's care.

  16. Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

    OpenAIRE

    Bamford, Claire; Heaven, Ben; May, Carl; Moynihan, Paula

    2012-01-01

    Abstract Background Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibi...

  17. Analysis of urban residential environments using color infrared aerial photography: An examination of socioeconomic variables and physical characteristics of selected areas in the Los Angeles basin, with addendum: An application of the concepts of the Los Angeles residential environment study to the Ontario-Upland region of California

    Science.gov (United States)

    Mullens, R. H., Jr.; Senger, L. W.

    1969-01-01

    Aerial photographs taken with color infrared film were used to differentiate various types of residential areas in the Los Angeles basin, using characteristics of the physical environment which vary from one type of residential area to another. Residential areas of varying quality were classified based on these characteristics. Features of the physical environment, identifiable on CIR aerial photography were examined to determine which of these are the best indicators of quality of residential areas or social areas, as determined by the socioeconomic characteristics of the inhabitants of the selected areas. Association between several physical features and the socioeconomic variables was found to exist.

  18. Risk of Venous Thromboembolism in Patients Nursed at Home or in Long-Term Care Residential Facilities

    Science.gov (United States)

    Arpaia, Guido; Ambrogi, Federico; Penza, Maristella; Ianes, Aladar Bruno; Serras, Alessandra; Boracchi, Patrizia; Cimminiello, Claudio

    2011-01-01

    Background. This study investigated the prevalence of and impact of risk factors for deep venous thrombosis (DVT) in patients with chronic diseases, bedridden or with greatly limited mobility, cared for at home or in long-term residential facilities. Methods. We enrolled 221 chronically ill patients, all over 18 years old, markedly or totally immobile, at home or in long-term care facilities. They were screened at the bedside by simplified compression ultrasound. Results. The prevalence of asymptomatic proximal DVT was 18% (95% CI 13–24%); there were no cases of symptomatic DVT or pulmonary embolism. The best model with at most four risk factors included: previous VTE, time of onset of reduced mobility, long-term residential care as opposed to home care and causes of reduced mobility. The risk of DVT for patients with reduced mobility due to cognitive impairment was about half that of patients with cognitive impairment/dementia. Conclusions. This is a first estimate of the prevalence of DVT among bedridden or low-mobility patients. Some of the risk factors that came to light, such as home care as opposed to long-term residential care and cognitive deficit as causes of reduced mobility, are not among those usually observed in acutely ill patients. PMID:21748017

  19. Risk of Venous Thromboembolism in Patients Nursed at Home or in Long-Term Care Residential Facilities

    Directory of Open Access Journals (Sweden)

    Guido Arpaia

    2011-01-01

    Full Text Available Background. This study investigated the prevalence of and impact of risk factors for deep venous thrombosis (DVT in patients with chronic diseases, bedridden or with greatly limited mobility, cared for at home or in long-term residential facilities. Methods. We enrolled 221 chronically ill patients, all over 18 years old, markedly or totally immobile, at home or in long-term care facilities. They were screened at the bedside by simplified compression ultrasound. Results. The prevalence of asymptomatic proximal DVT was 18% (95% CI 13–24%; there were no cases of symptomatic DVT or pulmonary embolism. The best model with at most four risk factors included: previous VTE, time of onset of reduced mobility, long-term residential care as opposed to home care and causes of reduced mobility. The risk of DVT for patients with reduced mobility due to cognitive impairment was about half that of patients with cognitive impairment/dementia. Conclusions. This is a first estimate of the prevalence of DVT among bedridden or low-mobility patients. Some of the risk factors that came to light, such as home care as opposed to long-term residential care and cognitive deficit as causes of reduced mobility, are not among those usually observed in acutely ill patients.

  20. The effects of the urban built environment on the spatial distribution of lead in residential soils

    International Nuclear Information System (INIS)

    Schwarz, K.; Pickett, Steward T.A.; Lathrop, Richard G.; Weathers, Kathleen C.; Pouyat, Richard V.; Cadenasso, Mary L.

    2012-01-01

    Lead contamination of urban residential soils is a public health concern. Consequently, there is a need to delineate hotspots in the landscape to identify risk and facilitate remediation. Land use is a good predictor of some environmental pollutants. However, in the case of soil lead, research has shown that land use is not a useful proxy. We hypothesize that soil lead is related to both individual landscape features at the parcel scale and the landscape context in which parcels are embedded. We sampled soil lead on 61 residential parcels in Baltimore, Maryland using field-portable x-ray fluorescence. Thirty percent of parcels had average lead concentrations that exceeded the USEPA limit of 400 ppm and 53% had at least one reading that exceeded 400 ppm. Results indicate that soil lead is strongly associated with housing age, distance to roadways, and on a parcel scale, distance to built structures. - Highlights: ► We investigated the effect of landscape heterogeneity on lead in residential soil. ► Landscape heterogeneity was considered at two different spatial scales. ► We sampled soil lead on residential parcels using field-portable x-ray fluorescence. ► Soil lead was associated with housing age and distance to roadways and buildings. ► Research has implications for land planning, health policies and predictive models. - We investigated the influence of landscape heterogeneity on lead in residential soil using x-ray fluorescence and identified important correlations with elements of urban land cover.

  1. Impact of an exercise intervention on methamphetamine use outcomes post-residential treatment care.

    Science.gov (United States)

    Rawson, Richard A; Chudzynski, Joy; Mooney, Larissa; Gonzales, Rachel; Ang, Alfonso; Dickerson, Daniel; Penate, Jose; Salem, Bilal A; Dolezal, Brett; Cooper, Christopher B

    2015-11-01

    We examined the efficacy of an 8-week exercise intervention on posttreatment methamphetamine (MA) use among MA-dependent individuals following residential treatment. 135 individuals newly enrolled in treatment were randomly assigned to a structured 8-week exercise intervention or health education control group. Approximately 1 week after completion of the intervention, participants were discharged to the community. Interview data and urine samples were collected at 1-, 3-, and 6-months post-residential care. Of the sample, 54.8% were classified as higher severity users (using MA more than 18 days in the month before admission) and 45.2% as lower severity users (using MA for up to 18 days in the month before admission). Group differences in MA use outcomes were examined over the 3 timepoints using mixed-multivariate modeling. While fewer exercise participants returned to MA use compared to education participants at 1-, 3- and 6-months post-discharge, differences were not statistically significant. A significant interaction for self-reported MA use and MA urine drug test results by condition and MA severity was found: lower severity users in the exercise group reported using MA significantly fewer days at the three post-discharge timepoints than lower severity users in the education group. Lower severity users in the exercise group also had a lower percentage of positive urine results at the three timepoints than lower severity users in the education group. These relationships were not present in the comparison of the higher severity conditions. Results support the value of exercise as a treatment component for individuals using MA 18 or fewer days/month. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Can short-term residential care for stroke rehabilitation help to reduce the institutionalization of stroke survivors?

    Science.gov (United States)

    Chau, Pui Hing; Tang, Maria W S; Yeung, Fannie; Chan, Tsz Wai; Cheng, Joanna O Y; Woo, Jean

    2014-01-01

    Stroke survivors may not be receiving optimal rehabilitation as a result of a shortage of hospital resources, and many of them are institutionalized. A rehabilitation program provided in a short-term residential care setting may help to fill the service gap. The primary objectives of this study were, first, to examine whether there were significant differences in terms of rehabilitation outcomes at 1 year after admission to the rehabilitation program (defined as baseline) between those using short-term residential care (intervention group) and those using usual geriatric day hospital care (control group), and, second, to investigate whether lower 1-year institutionalization rates were observed in the intervention group than in the control group. 155 stroke survivors who completed at least the first follow-up at 4 months after baseline. The intervention group was stroke survivors using self-financed short-term residential care for stroke rehabilitation. The control group was stroke survivors using the usual care at a public geriatric day hospital. Assessments were conducted by trained research assistants using structured questionnaires at baseline, 4 months, and 1 year after baseline. The primary outcome measures included Modified Barthel Index score, Mini-Mental Status Examination score, and the institutionalization rate. Cognitive status (as measured by Mini-Mental Status Examination score) of patients in both groups could be maintained from 4 months to 1 year, whereas functional status (as measured by Modified Barthel Index score) of the patients could be further improved after 4 months up to 1 year. Meanwhile, insignificant between-group difference in rehabilitation outcomes was observed. The intervention participants had a significantly lower 1-year institutionalization rate (15.8%) than the control group (25.8%). Short-term residential care for stroke rehabilitation promoted improvements in rehabilitation outcomes comparable with, if not better than, the usual

  3. Job Satisfaction among Care Aides in Residential Long-Term Care: A Systematic Review of Contributing Factors, Both Individual and Organizational.

    Science.gov (United States)

    Squires, Janet E; Hoben, Matthias; Linklater, Stefanie; Carleton, Heather L; Graham, Nicole; Estabrooks, Carole A

    2015-01-01

    Despite an increasing literature on professional nurses' job satisfaction, job satisfaction by nonprofessional nursing care providers and, in particular, in residential long-term care facilities, is sparsely described. The purpose of this study was to systematically review the evidence on which factors (individual and organizational) are associated with job satisfaction among care aides, nurse aides, and nursing assistants, who provide the majority of direct resident care, in residential long-term care facilities. Nine online databases were searched. Two authors independently screened, and extracted data and assessed the included publications for methodological quality. Decision rules were developed a priori to draw conclusions on which factors are important to care aide job satisfaction. Forty-two publications were included. Individual factors found to be important were empowerment and autonomy. Six additional individual factors were found to be not important: age, ethnicity, gender, education level, attending specialized training, and years of experience. Organizational factors found to be important were facility resources and workload. Two additional factors were found to be not important: satisfaction with salary/benefits and job performance. Factors important to care aide job satisfaction differ from those reported among hospital nurses, supporting the need for different strategies to improve care aide job satisfaction in residential long-term care.

  4. Job Satisfaction among Care Aides in Residential Long-Term Care: A Systematic Review of Contributing Factors, Both Individual and Organizational

    Directory of Open Access Journals (Sweden)

    Janet E. Squires

    2015-01-01

    Full Text Available Despite an increasing literature on professional nurses’ job satisfaction, job satisfaction by nonprofessional nursing care providers and, in particular, in residential long-term care facilities, is sparsely described. The purpose of this study was to systematically review the evidence on which factors (individual and organizational are associated with job satisfaction among care aides, nurse aides, and nursing assistants, who provide the majority of direct resident care, in residential long-term care facilities. Nine online databases were searched. Two authors independently screened, and extracted data and assessed the included publications for methodological quality. Decision rules were developed a priori to draw conclusions on which factors are important to care aide job satisfaction. Forty-two publications were included. Individual factors found to be important were empowerment and autonomy. Six additional individual factors were found to be not important: age, ethnicity, gender, education level, attending specialized training, and years of experience. Organizational factors found to be important were facility resources and workload. Two additional factors were found to be not important: satisfaction with salary/benefits and job performance. Factors important to care aide job satisfaction differ from those reported among hospital nurses, supporting the need for different strategies to improve care aide job satisfaction in residential long-term care.

  5. Job Satisfaction among Care Aides in Residential Long-Term Care: A Systematic Review of Contributing Factors, Both Individual and Organizational

    Science.gov (United States)

    Squires, Janet E.; Hoben, Matthias; Linklater, Stefanie; Carleton, Heather L.; Graham, Nicole; Estabrooks, Carole A.

    2015-01-01

    Despite an increasing literature on professional nurses' job satisfaction, job satisfaction by nonprofessional nursing care providers and, in particular, in residential long-term care facilities, is sparsely described. The purpose of this study was to systematically review the evidence on which factors (individual and organizational) are associated with job satisfaction among care aides, nurse aides, and nursing assistants, who provide the majority of direct resident care, in residential long-term care facilities. Nine online databases were searched. Two authors independently screened, and extracted data and assessed the included publications for methodological quality. Decision rules were developed a priori to draw conclusions on which factors are important to care aide job satisfaction. Forty-two publications were included. Individual factors found to be important were empowerment and autonomy. Six additional individual factors were found to be not important: age, ethnicity, gender, education level, attending specialized training, and years of experience. Organizational factors found to be important were facility resources and workload. Two additional factors were found to be not important: satisfaction with salary/benefits and job performance. Factors important to care aide job satisfaction differ from those reported among hospital nurses, supporting the need for different strategies to improve care aide job satisfaction in residential long-term care. PMID:26345545

  6. Mental and physical performance of dementia patients in long-term residential care

    Directory of Open Access Journals (Sweden)

    Zbigniew Śliwiński

    2013-10-01

    Full Text Available Introduction: Dementia syndromes are an increasing medical and social problem in today’s world. Preservation of the best possible quality of life in dementia patients relies on prolonging their independence in daily life for as long as possible. Dementia patients require increasing support as the disease progresses and will ultimately become dependent on the help of others. Aim of the research: To assess the level of mental and physical performance and nutritional status in patients with dementia syndromes in long-term residential care. Material and methods : The study group comprised 62 patients with dementia syndromes resident in a Medical and Nursing Care Facility in Pustków. Selected aspects of quality of life were investigated with the Barthel scale, GDS scale according to Reissberg, Abbreviated Mental Test Score (AMTS and Mini-Nutritional Assessment (MNA scale. Results: In our study men performed better than women on the Barthel scale, 58% of all patients were rated moderately severe on that scale, 36% were severe and 7% were mild. Assessment of the current severity of dementia on the GDS scale showed that 28% of the patients had very severe dementia, 27% had mild deficits, 27% had moderate deficits, 11% had moderately severe dementia and 6% had borderline dementia. In a mental state assessment according to the AMTS scale, men scored higher than women. This difference indicates less memory deficit and better psychological and physical status among men. With regard to nutritional status, our study revealed a risk of malnutrition in 65% of the patient and actual malnutrition in 7%. Conclusions : The Barthel scale, rating the performance of dementia patients with regard to activities of daily life, classified more than half of the patients as „moderately severe”. Women had lower mean scores than men in the Barthel scale, AMTS scale and GDS scale, indicating that dementia is more prevalent among women than among men. The findings of the

  7. Determinants and effects of nurse staffing intensity and skill mix in residential care/assisted living settings.

    Science.gov (United States)

    Stearns, Sally C; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L; Konrad, Thomas R; Sloane, Philip D

    2007-10-01

    Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes. We obtained longitudinal data for 1,894 residents of 170 residential care/assisted living facilities participating in the Collaborative Studies of Long-Term Care. Descriptive statistics assessed the levels of direct care staff (registered nurse, licensed practical nurse, personal care aide). Regression analyses evaluated the relationship between two staffing measures (intensity measured as care hours per resident and skill mix measured as the percentage of total care hours by licensed nurses), facility characteristics, and four health outcomes (mortality, nursing home transfer, hospitalization, and incident morbidity). Care hours per resident decreased with facility size (economies of scale) only for very small facilities and increased with dementia prevalence (case-mix effect). Licensed staff accounted for a greater proportion of total hours in nonprofit settings. Health outcomes did not vary by total care hours per resident, but hospitalization rates were significantly lower in facilities with higher proportions of skilled staff hours; this effect was stronger as dementia case mix increased. Current staffing levels for the outcomes analyzed meet most residents' needs. Reduced hospitalization in relation to greater use of licensed staff suggests that increased use of these workers might result in reductions in acute care expenditures.

  8. Customer baseline load models for residential sector in a smart-grid environment

    Directory of Open Access Journals (Sweden)

    R. Sharifi

    2016-11-01

    In this paper, a new method is presented for the calculation of CBL for customers in residential sector in the context of a smart grid, considering the impact of weather changes. The results clearly show the high impact of changes in weather conditions on the calculation of CBL, and also show the extent of effect of buildings’ improved insulation on this parameter. It is also indicated that implementing DR programs can increase the willingness of customers in residential sector to improve the insulations of their buildings.

  9. Cognitive functioning, cognitive reserve, and residential care placement in patients with Alzheimer's and related dementias.

    Science.gov (United States)

    Kadlec, Helena; Dujela, Carren; Beattie, B Lynn; Chappell, Neena

    2018-01-01

    To test the hypothesis that patients with mild to moderate dementia with higher initial cognitive reserve (higher education levels exhibit faster cognitive decline at later stages of disease progression as they approach residential care (RC) placement. Two provincial administrative databases were used. One contained individuals' scores of cognitive functioning (assessed at 6- to 12-month intervals using the Standardized Mini-Mental State Examination, SMMSE, 2007-2014) and education level; the second (BC Ministry of Health Home and Community Care database, 2001-2014) contained individuals' RC placement; N = 10531. During 2.5-0.5 years prior to placement, SMMSE scores of patients with 0-8 years of education dropped slightly (M D 20.6 to 20.0), while patients with 9-12 years and 13+ years of education started higher (M D 21.8 and 21.4), but decreased faster and ended up lower (M D 19.5 and 18.8). Six-months prior to placement, SMMSE scores of all groups dropped almost 2 points. Once cognitive reserve of more highly educated dementia patients is depleted and they approach RC placement, their cognitive functioning deteriorates faster. Finding effective interventions that maintain or enhance cognitive reserve may increase the time in the community for dementia patients.

  10. Oral liquid nutritional supplements for people with dementia in residential aged care facilities.

    Science.gov (United States)

    Hines, Sonia; Wilson, Jacinda; McCrow, Judy; Abbey, Jenny; Sacre, Sandy

    2010-12-01

    This systematic review investigated the prescription, administration and effectiveness of oral liquid nutritional supplements (OLNS) for people with dementia in residential aged care facilities (RACF). A comprehensive search of relevant databases, hand searching and cross-referencing found 15 relevant articles from a total of 2910 possible results. Articles which met the inclusion criteria were critically appraised by two independent reviewers using the relevant Joanna Briggs Institute (JBI) appraisal checklist. Data were extracted using the relevant JBI extraction instruments. No data synthesis was possible due to clinical and methodological heterogeneity. Included studies examined a range of strategies, issues and results related to OLNS for persons with dementia in RACFs; however there appear to be significant gaps in the current body of research, particularly in relation to examinations of effectiveness. This review was unable to produce a definitive finding regarding effectiveness. OLNS may improve the nutritional state of residents with dementia and help prevent weight loss, and there is some suggestion that it may slow the rate of cognitive decline. However, in order for OLNS to be effective, nursing and care staff need to ensure that sufficient attention is paid to the issues of prescription and administration. © 2010 The Authors. International Journal of Evidence-Based Healthcare © 2010 The Joanna Briggs Institute.

  11. Residential Waste

    DEFF Research Database (Denmark)

    Christensen, Thomas Højlund; Fruergaard, Thilde; Matsufuji, Y.

    2011-01-01

    are discussed in this chapter. Characterizing residential waste is faced with the problem that many residences already divert some waste away from the official collection systems, for example performing home composting of vegetable waste and garden waste, having their bundled newspaper picked up by the scouts...... twice a year or bringing their used furniture to the flea markets organized by charity clubs. Thus, much of the data available on residential waste represents collected waste and not necessarily all generated waste. The latter can only be characterized by careful studies directly at the source...

  12. Unintended adverse consequences of introducing electronic health records in residential aged care homes.

    Science.gov (United States)

    Yu, Ping; Zhang, Yiting; Gong, Yang; Zhang, Jiajie

    2013-09-01

    The aim of this study was to investigate the unintended adverse consequences of introducing electronic health records (EHR) in residential aged care homes (RACHs) and to examine the causes of these unintended adverse consequences. A qualitative interview study was conducted in nine RACHs belonging to three organisations in the Australian Capital Territory (ACT), New South Wales (NSW) and Queensland, Australia. A longitudinal investigation after the implementation of the aged care EHR systems was conducted at two data points: January 2009 to December 2009 and December 2010 to February 2011. Semi-structured interviews were conducted with 110 care staff members identified through convenience sampling, representing all levels of care staff who worked in these facilities. Data analysis was guided by DeLone and McLean Information Systems Success Model, in reference with the previous studies of unintended consequences for the introduction of computerised provider order entry systems in hospitals. Eight categories of unintended adverse consequences emerged from 266 data items mentioned by the interviewees. In descending order of the number and percentage of staff mentioning them, they are: inability/difficulty in data entry and information retrieval, end user resistance to using the system, increased complexity of information management, end user concerns about access, increased documentation burden, the reduction of communication, lack of space to place enough computers in the work place and increasing difficulties in delivering care services. The unintended consequences were caused by the initial conditions, the nature of the EHR system and the way the system was implemented and used by nursing staff members. Although the benefits of the EHR systems were obvious, as found by our previous study, introducing EHR systems in RACH can also cause adverse consequences of EHR avoidance, difficulty in access, increased complexity in information management, increased documentation

  13. Living Doubled-Up: Influence of Residential Environment on Educational Participation

    Science.gov (United States)

    Hallett, Ronald E.

    2012-01-01

    Homeless youth face many barriers that limit success in the educational process. Subgroups of homeless youth frequently experience the educational process differently depending upon their residential context. Recent years witness the federal government's expanding the definition of homelessness to include youth living doubled-up. This residential…

  14. Visual and functional components of the built environment: a case study of urban residential neighborhoods

    Science.gov (United States)

    Christopher J. Smith

    1977-01-01

    The hypothesis that visual and functional characteristics of neighborhoods influence the psychological well-being of residents was tested. An informal test by a survey of advertising strategies for selling real estate was first used. Second, data from a variety of published sources were used to identify some of the underlying dimensions of residential neighborhoods The...

  15. 'A Strange Mixture of Caring and Corruption': Residential Care in Christian Brothers Orphanages and Industrial Schools during Their Last Phase, 1940s to 1960s.

    Science.gov (United States)

    Coldrey, Barry

    2000-01-01

    Explores the two Christian Brothers religious orders of the Roman Catholic Church. Focuses on the Irish Congregation that has been controversial, specifically in its residential care for neglected, orphaned, and delinquent children. States that allegations of physical, sexual, and emotional abuse has been reported in their institutions. (CMK)

  16. Stories of change: the text analysis of handovers in an Italian psychiatric residential care home.

    Science.gov (United States)

    Accordini, M; Saita, E; Irtelli, F; Buratti, M; Savuto, G

    2017-05-01

    WHAT IS KNOWN ON THE SUBJECT?: There is a growing emphasis on communication as a result of the move towards the more inclusive approach associated with the community-based rehabilitation model. Therefore, more importance is attached to handovers. Besides ensuring transfer of information, handovers enhance group cohesion, socialize staff members to the practices of the service and capture its organizational culture. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: While handovers are mainly used for information transfer and to manage the services' daily routine, this paper offers an insight on how handovers can be conceived as valuable instruments to document cultural and organizational change. Only a limited amount of studies has focused on handovers in mental healthcare settings, and most of them only consider the perspectives of psychiatric nurses, while embracing a broader perspective, this paper provides valuable insights into the perspectives of various service providers. The overcoming of the dichotomy deficit-based vs. recovery-oriented model is possible if professionals use handovers to reflect upon their practice and the ways in which their cultural models are affected by the environmental context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Handovers are valuable instruments to document organizational change. It would be important for psychiatric and rehabilitation facilities to keep track of the handover records over time as they may provide insightful information about cultural change and the transformations in the core values and beliefs held by professionals. Handovers assure a timely and correct information transfer while socializing workers to the service's culture; however, no study describes them as instruments to document organizational change and only a few have focused on psychiatric settings. Aim To investigate the change in the culture of an Italian psychiatric residential care home as perceived by its mental health workers (MHWs) over the course of

  17. Family Foster Care, Kinship Networks, and Residential Care of Abandoned Infants in Egypt

    Science.gov (United States)

    Megahead, Hamido A.; Cesario, Sandra

    2008-01-01

    While infant abandonment has occurred in all segments of society, on all continents, and across all generations, the motivations for this practice are varied and depend upon the social norms of a specific geographic region at a given point in time. Western approaches addressing the care of abandoned infants focus on terminating parental rights and…

  18. An examination of students' perceptions of their interprofessional placements in residential aged care.

    Science.gov (United States)

    Seaman, Karla; Saunders, Rosemary; Williams, Elly; Harrup-Gregory, Jane; Loffler, Helen; Lake, Fiona

    2017-03-01

    It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30% male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were collected using the Ageing Semantic Differential (ASD) questionnaire and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale (RIPLS). A total of 47 students completed matched ASD and RIPLS surveys. The mean total score on the ASD survey decreased significantly from pre- to post-placement from 116.0 to 108.9 (p = 0.033), indicating attitudes became increasingly positive towards older adults. Significant differences post-placement were seen indicating better readiness for interprofessional learning, for two out of four subscales on the RIPLS, namely "teamwork & collaboration" (42.1-44.0; (p = 0.000)) and "positive professional identity" (18.2-19.3 (p = 0.001)). The degree of change is similar to findings from other settings. The results support IPE-focussed student placements within RACF positively influence student's attitudes towards the older adult as well as increase student's readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.

  19. Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

    Directory of Open Access Journals (Sweden)

    Tariq Amina

    2012-11-01

    Full Text Available Abstract Background Medication incident reporting (MIR is a key safety critical care process in residential aged care facilities (RACFs. Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a design MIR artefacts that facilitate identification of the root causes of medication incidents, b integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

  20. Adolescents' reports of physical violence by peers in residential care settings: an ecological examination.

    Science.gov (United States)

    Khoury-Kassabri, Mona; Attar-Schwartz, Shalhevet

    2014-03-01

    Physical victimization by peers was examined among 1,324 Jewish and Arab adolescents, aged 11 to 19, residing in 32 residential care settings (RCS) for children at-risk in Israel. Hierarchical Linear Modeling (HLM) was used to examine the relationships between physical victimization and adolescents' characteristics (age, gender, self-efficacy, adjustment difficulties, maltreatment by staff, and perceived social climate) as well as institution-level characteristics (care setting type, size, structure, and ethnic affiliation). For this study, we define physical violence as being grabbed, shoved, kicked, punched, hit with a hand, or hit with an object. Over 50% (56%) of the adolescents surveyed reported having experienced at least one form of physical violence by peers. Boys and younger adolescents were more likely to be victimized than girls and older adolescents. The results show that adolescents with adjustment difficulties or low social self-efficacy, and adolescents who perceive an institution's staff as strict and/or had experienced maltreatment by staff, are vulnerable groups for peer victimization. Lower levels of victimization were found in RCS with a familial element than in traditional group settings. Institutions with high concentrations of young people with adjustment difficulties and violent staff behaviors had higher levels of violence among residents. Applying an ecological perspective to an investigation of peer victimization in RCS enables the identification of risk factors at adolescent and institution levels. This type of examination has implications for child welfare practice and policy that can help in the development of prevention and intervention methods designed to tackle the involvement in violence of youth in care.

  1. [A pilot study on pain assessment among elderly with severe dementiain residential aged care facilities of Reggio Emilia district].

    Science.gov (United States)

    Bargellini, Annalisa; Mastrangelo, Stefano; Cervi, Monica; Bagnasco, Michele; Reghizzi, Jlenia; Coriani, Sandra

    2017-01-01

    . A pilot study on pain assessment among elderly with severe dementia in residential aged care facilities of Reggio Emilia district. Despite the availability of pain assessment tools and best practice recommendations for the assessment and management of pain in people with severe dementia, pain in residential aged care facilities is still undetected or misinterpreted. To assess pain prevalence and analgesic load medication in people with severe cognitive impairment admitted to residential aged care facilities of Reggio Emilia (Italy) province. A pilot cross-sectional study was conducted on 84 elderly patients affected by severe dementia and resident in aged care facilities. Pain was assessed with the PAINAD observational scale, both at rest and during routine procedures: positioning in bed, from bed to standing position, from bed to chair or during the medication of a pressure sore (under challenge). 33.4% of patients had pain at rest, mainly mild, and 86.9 % under challenge. During routine interventions, in 64 patients (76.2%) pain increased compared to at rest condition (for 39, 2/3, moderate-severe); although 46 of them were prescribed as-required analgesic medication, none had received the drug. Also patients with analgesics on regular basis experienced more pain during routine procedures. Many patients experienced pain during routine procedures. The regular use of pain assessment tools and adequate training of all healthcare professionals are essential requirements for an effective pain control.

  2. Evidence for the Treatment of Osteoporosis with Vitamin D in Residential Care and in the Community Dwelling Elderly

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    John A. A. Geddes

    2013-01-01

    Full Text Available Introduction. Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts. Aims. To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers. Methods. We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required. Results. Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty. Discussion. A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.

  3. Assessing sarcopenic prevalence and risk factors in residential aged care: methodology and feasibility.

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    Henwood, Timothy R; Keogh, Justin W; Reid, Natasha; Jordan, Will; Senior, Hugh E

    2014-09-01

    Sarcopenia is a significant geriatric syndrome with both health care expenditure and personal burden. Most recently, the European Working Group in Sarcopenia in Older Adults has established a consensus definition and assessment criteria for sarcopenia that includes a below-normal muscle mass and muscle function (either or both of below-normal muscle strength and physical performance). Using these criteria, work is needed to identify the prevalence and risk factors among the old, and those most susceptible to sarcopenia, the very old. This manuscript describes the recruitment and data collection methodology, and direct burden to participants, among a very old cohort residing in a residential aged care (RAC) setting. Eleven RAC facilities participated in the study. Potential participants were identified by the facility service manager and then randomised into the study. All participants gave self or substitute decision maker consent. Participants undertook a single one on one assessment that included measures of sarcopenia, functional capacity, cognitive and nutritional health, falls, activity, facility and hospital history, physical activity and assessment burden. A sub-study of physical activity and sedentary behaviours measured by activPAL3™ inclinometer was also conducted. Of 709 residents, 328 were ineligible to participate. Two hundred and seventy-three residents were randomised to the study and 102 gave informed or substitute decision maker consent. Participants were 84.5 ± 8.2 years of age and had been in care for 1,204.2 ± 1,220.1 days. The groups need for care was high (Aged Care Funding Instrument score of 2.6 ± 1.7) and they had a below-normal functional (Short Physical Performance Battery summery score of 3.5 ± 2.4). The larger percentage of participants had no depression and normal cognitive capacity. A total of 33 residents participated in the activPAL study. Each assessment took an average of 27.0 ± 7.0 min, with a low

  4. The prevention and management of constipation in older adults in a residential aged care facility.

    Science.gov (United States)

    Grieve, Jennifer

    2006-03-01

    The need to implement programs for developing leadership and practice improvement skills using an evidence-based practice approach to practice change is becoming more apparent in the health and aged care services. This is no more apparent than in high care residential health and aged care services, where health professionals are increasingly required to provide care for older people with multifocal and complex healthcare needs. This paper describes one of the projects undertaken as part of the Joanna Briggs Institute Commonwealth Department of Health and Ageing Clinical Aged Care Fellowship program from February 2005 to June 2005. This purpose of this particular project was twofold. First it sought to improve the local practice in the prevention and management of constipation and that this practice was performed according to the best available evidence. Second to use the Joanna Briggs Institute Practical Application of Clinical Guidance (PACES) program to implement a process of audit and feedback as a strategy to improve practice. The project was designed to link in with the facility's existing quality improvement program and better practice continence management project. The project was conducted over 6 months and was divided into six stages involving the identification of evidence-based standards of care, an initial audit to determine appropriate sample size, a clinical audit across the facility, planning of the implementation process, implementation of the action plan and re-audit to assess practice change. Overall, the results were extremely positive and demonstrated a real improvement in practice relating to constipation in the project facility. This success, however, needs to be seen in the context of the benefits of having the support of senior management, an existing quality improvement and continence management better practice project, and a culture of clinical review. Although there will always be more work to be done, the success of this project can be

  5. Can short-term residential care for stroke rehabilitation help to reduce the institutionalization of stroke survivors?

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    Chau PH

    2014-02-01

    Full Text Available Pui Hing Chau,1 Maria WS Tang,2 Fannie Yeung,2 Tsz Wai Chan,1 Joanna OY Cheng,1 Jean Woo2 1School of Nursing, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China; 2Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China Background: Stroke survivors may not be receiving optimal rehabilitation as a result of a shortage of hospital resources, and many of them are institutionalized. A rehabilitation program provided in a short-term residential care setting may help to fill the service gap. Objectives: The primary objectives of this study were, first, to examine whether there were significant differences in terms of rehabilitation outcomes at 1 year after admission to the rehabilitation program (defined as baseline between those using short-term residential care (intervention group and those using usual geriatric day hospital care (control group, and, second, to investigate whether lower 1-year institutionalization rates were observed in the intervention group than in the control group. Participants: 155 stroke survivors who completed at least the first follow-up at 4 months after baseline. Intervention: The intervention group was stroke survivors using self-financed short-term residential care for stroke rehabilitation. The control group was stroke survivors using the usual care at a public geriatric day hospital. Measurements: Assessments were conducted by trained research assistants using structured questionnaires at baseline, 4 months, and 1 year after baseline. The primary outcome measures included Modified Barthel Index score, Mini-Mental Status Examination score, and the institutionalization rate. Results: Cognitive status (as measured by Mini-Mental Status Examination score of patients in both groups could be maintained from 4 months to 1 year, whereas functional status (as measured by Modified Barthel

  6. Promoting psychosocial adaptation of youths in residential care through animal-assisted psychotherapy.

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    Balluerka, Nekane; Muela, Alexander; Amiano, Nora; Caldentey, Miguel A

    2015-12-01

    The goal of this study was to examine the influence of animal-assisted psychotherapy (AAP) on the psychosocial adaptation of a group of adolescents in residential care who had suffered traumatic childhood experiences and who presented with mental health problems. This study recruited 63 youths (mean age=15.27, SD=1.63) who were divided into two groups: a treatment group of 39 youths (19 female and 20 male; mean age=15.03, SD=0.51) and a control group of 24 (five female and 19 male; mean age=15.67, SD=1.63). The youths who underwent the AAP program had higher school adjustment in comparison to their peers who did not receive treatment. Their hyperactive behavior decreased, and they showed better social skills, more leadership, and fewer attention problems. They also showed a more positive attitude toward their teachers in comparison to controls. No differences were observed in other variables associated with clinical symptoms or personal adjustment. These results suggest that AAP can be effective with teenagers who have suffered childhood traumas and who present with problems of psychosocial adaptation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Infection control intervention on meticillin resistant Staphylococcus aureus transmission in residential care homes for the elderly.

    Science.gov (United States)

    Chuang, Vivien Wm; Tsang, Iris Hl; Keung, Jessica Py; Leung, June Yy; Yuk, Janet Mt; Wong, Doris Kw; Au, Sui-Sum; Tam, Rebekah Ky; Lam, Wendy Wy; Kwan, Martin Ct; Wong, Andrew Ty

    2015-03-01

    The objectives were to evaluate the effectiveness of an infection control bundle in controlling the meticillin resistant Staphylococcus aureus (MRSA) transmission in residential care homes for the elderly (RCHEs) in Hong Kong. This was a two-arm cluster randomised controlled trial. Infection control bundles focused on hand hygiene (HH), environmental hygiene, and modified contact precautions were applied to the intervention arm. Nasal swabs from residents; staff HH compliance and effectiveness; and environmental hygiene were assessed by microbiological sampling or observation at the baseline and quarterly after the intervention. A total of 2776 residents from 36 RCHEs were recruited. The overall MRSA prevalence was 20.4% (95% confidence interval, 18.9%-21.9%). The intervention elicited an immediate effect of 2.4% absolute decrease in the prevalence and 3.7% in the intra-facility transmission, though the difference between the two arms was insignificant. Staff HH compliance increased substantially from 5.9% to 45.6% post-intervention ( p  < 0.001). We initiated the infection control culture into the RCHEs and gained their acceptance. However, this behavioural change takes time to emerge. Our study shows that relying on the bundle alone could not bring sustainable MRSA reduction. Administrative control for strengthening infection control infrastructure is important for continuous compliance and improvement.

  8. Factors affecting disclosure among Israeli children in residential care due to domestic violence.

    Science.gov (United States)

    Lev-Wiesel, Rachel; Gottfried, Ruth; Eisikovits, Zvi; First, Maya

    2014-04-01

    Disclosure of child abuse may enable initiating interventions to end maltreatment and mediate its negative physical and psychological consequences. The present study reviews the field of disclosure and examines factors affecting disclosure among a service population of abused children who were placed in residential care due to various forms of abuse (e.g., physical, sexual, emotional, neglect and witnessing domestic violence). The sample consisted of 286 Israeli (Hebrew and Arabic speaking) children aged 12-17 (mean=14±1). Following approval of the Ethics committee of the University and parents' written consent, participants were administered a self-report questionnaire that included the following measures: a Socio-Demographic Questionnaire, the Childhood Trauma Questionnaire (CTQ), the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Results indicated that the three key factors enhancing the likelihood of disclosure were: moral factors, external initiatives and intolerable physical pain. The three key factors inhibiting disclosure were feelings of shame, fear of losing social support and uncertainty as to how and to whom to disclose. Results also showed that children preferred to disclose to their nuclear family members (parents and siblings) in comparison with professionals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Professionals' perspectives towards health promotion in residential aged care: an explorative study in Austria.

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    Marent, Benjamin; Wieczorek, Christina C; Krajic, Karl

    2018-04-01

    Following the trend in most developed countries, in Austria the oldest old are the fastest growing population group. Among this group, there is a high prevalence of multimorbidity, functional impairment, dementia and psychiatric conditions. While health promotion (HP) has been considered relevant in coping with the challenges of an aging population, it has so far been viewed as a foreign concept in relation to the oldest old, especially those living in residential aged care (RAC) facilities. Although there is an acknowledgement that HP should be integrated into routine nursing, there has been little research on how professionals working with RAC interpret and implement HP. In this study, 13 semi-structured interviews were carried out with professionals from four major Austrian RAC providers. The data were analysed using thematic analysis. The findings show that, typically, professionals understand HP as a concept that is oriented towards maintaining potentials and resources, thereby promoting self-determination, autonomy and social integration, including frail and functionally impaired elderly residents. However, data analysis also revealed a gap between the conceptual understanding and positive attitudes towards HP and its implementation in practice. Implementation of HP seems to occur in isolated cases, related to specific health issues. It seems that more complex HP approaches, especially the 'settings approach', are hardly practiced. To implement more comprehensive and systematic HP in Austrian RAC, support from external HP agencies as well as changes in financial incentives are needed.

  10. That which goes unsaid: Experiences of everyday life in residential care for residents with limited communication ability. A collective case study.

    NARCIS (Netherlands)

    MSc Donna Frost

    2008-01-01

    Background The experiences of residents who have communication difficulties such as dysphasia are largely absent from the literature. Aim To illuminate the everyday experiences of four residents with severe communication difficulties living in a residential care setting in the Netherlands.

  11. Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process.

    Science.gov (United States)

    Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

    2013-05-01

    Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May-September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding

  12. Modelling the cost-effectiveness of impact-absorbing flooring in Swedish residential care facilities.

    Science.gov (United States)

    Ryen, Linda; Svensson, Mikael

    2016-06-01

    Fall-related injuries among the elderly, specifically hip fractures, cause significant morbidity and mortality as well as imposing a substantial financial cost on the health care system. Impact-absorbing flooring has been advocated as an effective method for preventing hip fractures resulting from falls. This study identifies the cost-effectiveness of impact-absorbing flooring compared to standard flooring in residential care facilities for the elderly in a Swedish setting. An incremental cost-effectiveness analysis was performed comparing impact-absorbing flooring to standard flooring using a Markov decision model. A societal perspective was adopted and incremental costs were compared to incremental gains in quality-adjusted life years (QALYs). Data on costs, probability transitions and health-related quality of life measures were retrieved from the published literature and from Swedish register data. Probabilistic sensitivity analysis was performed through a Monte Carlo simulation. The base-case analysis indicates that the impact-absorbing flooring reduces costs and increases QALYs. When allowing for uncertainty we find that 60% of the simulations indicate that impact-absorbing flooring is cost-saving compared to standard flooring and an additional 20% that it has a cost per QALY below a commonly used threshold value : Using a modelling approach, we find that impact-absorbing flooring is a dominant strategy at the societal level considering that it can save resources and improve health in a vulnerable population. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  13. Progress towards predicting 1-year mortality in older people living in residential long-term care.

    Science.gov (United States)

    Heppenstall, Claire Patricia; Broad, Joanna B; Boyd, Michal; Gott, Merryn; Connolly, Martin J

    2015-05-01

    frail older people living in residential long-term care (LTC) have limited life expectancy. Identifying those with poor prognosis may improve management and facilitate transition to a palliative approach to care. to develop methods for predicting mortality in LTC. a population-based cohort study. LTC facilities, Auckland, New Zealand. five hundred randomly selected older people in a census-type survey of those living in LTC in 2008. mortality data were obtained from New Zealand Ministry of Health. Two methods for assessing mortality risk were developed using demographic, functional and health service information: (i) two geriatricians blinded to identifying data and to mortality, independently reviewed survey, medications and pre-survey hospitalisations data, and grouped residents according to perceived risk of death within 12 months; (ii) multivariate logistic regression model used the same survey and medication items as the geriatricians. for the geriatricians' assessment, each quintile of perceived risk was associated with a significant increase in mortality (P night attention, all variables which are easily available from LTC records. AUC for the model was 0.70, but when validated against the entire OPAL cohort, it was 0.65. When either or both geriatrician and the model together predicted high risk of death, 1-year mortality was >50%. two methods with the potential to identify older people with limited prognosis are described. Use of these methods allowed identification of over half of those who died within 12 months. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. How to enhance route learning and visuo-spatial working memory in aging: a training for residential care home residents.

    Science.gov (United States)

    Mitolo, Micaela; Borella, Erika; Meneghetti, Chiara; Carbone, Elena; Pazzaglia, Francesca

    2017-05-01

    This study aimed to assess the efficacy of a route-learning training in a group of older adults living in a residential care home. We verified the presence of training-specific effects in tasks similar to those trained - route-learning tasks - as well as transfer effects on related cognitive processes - visuo-spatial short-term memory (VSSTM; Corsi Blocks Test (CBT), forward version), visuo-spatial working memory (VSWM; CBT, backward version; Pathway Span Tasks; Jigsaw Puzzle Test) - and in self-report measures. The maintenance of training benefits was examined after 3 months. Thirty 70-90-year-old residential care home residents were randomly assigned to the route-learning training group or to an active control group (involved in non-visuo-spatial activities). The trained group performed better than the control group in the route-learning tasks, retaining this benefit 3 months later. Immediate transfer effects were also seen in visuo-spatial span tasks (i.e., CBT forward and backward version and Pathway Span Task); these benefits had been substantially maintained at the 3-month follow-up. These findings suggest that a training on route learning is a promising approach to sustain older adults' environmental learning and some related abilities (e.g., VSSTM and VSWM), even in residential care home residents.

  15. Supervised versus non-supervised implementation of an oral health care guideline in (residential care homes: a cluster randomized controlled clinical trial

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    de Baat Cees

    2010-07-01

    Full Text Available Abstract Background The increase of the proportion of elderly people has implications for health care services. Advances in oral health care and treatment have resulted in a reduced number of edentulous individuals. An increasing number of dentate elderly people have tooth wear, periodontal disease, oral implants, and sophisticated restorations and prostheses. Hence, they are in need of both preventive and curative oral health care continuously. Weakened oral health due to neglect of self care and professional care and due to reduced oral health care utilization is already present when elderly people are still community-dwelling. At the moment of (residential care home admittance, many elderly people are in need of oral health care urgently. The key factor in realizing and maintaining good oral health is daily oral hygiene care. For proper daily oral hygiene care, many residents are dependent on nurses and nurse aides. In 2007, the Dutch guideline "Oral health care in (residential care homes for elderly people" was developed. Previous implementation research studies have revealed that implementation of a guideline is very complicated. The overall aim of this study is to compare a supervised versus a non-supervised implementation of the guideline in The Netherlands and Flanders (Belgium. Methods/Design The study is a cluster randomized intervention trial with an institution as unit of randomization. A random sample of 12 (residential care homes accommodating somatic as well as psycho-geriatric residents in The Netherlands as well as in Flanders (Belgium are randomly allocated to an intervention or control group. Representative samples of 30 residents in each of the 24 (residential care homes are monitored during a 6-months period. The intervention consists of supervised implementation of the guideline and a daily oral health care protocol. Primary outcome variable is the oral hygiene level of the participating residents. To determine the

  16. Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities

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    Scherer Samuel

    2009-08-01

    Full Text Available Abstract Background Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF staff and General Practitioners (GPs relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. Methods A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey and 202 GPs (19% of metropolitan GPs. Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Results Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern

  17. Creative solutions for severe dementia with BPSD: a case of art therapy used in an inpatient and residential care setting.

    Science.gov (United States)

    Peisah, C; Lawrence, G; Reutens, S

    2011-08-01

    Behavioral and psychological symptoms of dementia (BPSD) are common, distressing and compromise care. Their diverse etiology necessitates targeted, individualized treatment. We present a case of an 82-year-old with severe dementia and BPSD, and with limited response to a range of pharmacological and non-pharmacological treatments. Individualized art therapy was developed in an inpatient setting using felt material cut into shapes and coloring with stencils and pre-drawn line drawings utilizing preserved skills of coloring, while supporting frontal-executive and language deficits. The activity was replicable and carried over to the residential care setting and supported by family and professional carers.

  18. Learning Residential Electrical Wiring through Computer Simulation: The Impact of Computer-Based Learning Environments on Student Achievement and Cognitive Load

    Science.gov (United States)

    Liu, Han-Chin; Su, I-Hsien

    2011-01-01

    Multimedia learning environments such as computer simulations are widely accepted as tools for supporting science learning. Although the design of multimedia learning environments can be domain specific, few studies have focused on the use of computer simulations for learning residential electrical wiring. This study aimed to determine whether…

  19. Influenza outbreak preparedness: lessons from outbreaks in residential care facilities in 2014.

    Science.gov (United States)

    Vyas, Aditya; Ingleton, Andrew; Huhtinen, Essi; Hope, Kirsty; Najjar, Zeina; Gupta, Leena

    2015-06-30

    This report describes 6 influenza outbreaks in residential care facilities during the 2014 influenza season in the Sydney Local Health District. Vaccination rates were high among residents (95%) and low among staff (39%). The majority of residents with laboratory confirmed influenza (67%) did not meet the influenza-like illness case definition.Positive influenza specimens were subtyped as H3N2 (40%), H1N1 (5%) or not subtyped (55%). We illustrate the implications of low vaccine effectiveness and antigenic drift, and provide recommendations for the effective management of future influenza outbreaks. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or by email to copyright@health.gov.au.

  20. Demonstration of the usefulness of a theoretical framework for humanising care with reference to a residential aged care service in Australia.

    Science.gov (United States)

    Borbasi, Sally; Galvin, Kathleen T; Adams, Trevor; Todres, Les; Farrelly, Brona

    2013-03-01

    To demonstrate the usefulness of a theoretical framework for humanising care of dementia patients. The term humanisation of care has been increasingly used to describe an approach to health care that is informed by core dimensions of what it means to be human. Recent developments in dementia care highlight the importance of maintaining personhood in people with dementia. A conceptual framework is proposed by which the humanisation of care can be understood and applied. Eight dimensions that articulate core features of what needs to be attended to in order for a person to feel more deeply 'met' as a human being are discussed. Evidence from an evaluative study of a dementia outreach service is used to illustrate the usefulness of the humanising framework. Case study examples demonstrate the value of this framework by describing how a dementia outreach service enables care staff in residential aged care facilities to change their focus in the provision of care to residents with dementia. Each of the eight dimensions of humanisation/dehumanisation is used to illustrate how the dementia outreach service team have led to the improvements in resident care. Positive outcomes can be achieved by providing humanised care to residents with dementia. The paper highlights the potential for the humanising framework to be used in dementia care and shows how the framework can be helpfully translated into practice so that carers are supported to adopt an inclusive view of care delivery. A comprehensive framework, grounded in a strong philosophical foundation, can name a breadth of criteria for humanly sensitive care and can be translated into practice in such a way as to potentially transform the provision of care to residents in residential aged care facilities. © 2012 Blackwell Publishing Ltd.

  1. Evaluation of the assessment and documentation of chronic wounds in residential social care in the Czech Republic.

    Science.gov (United States)

    Saibertová, S; Pokorná, A

    2016-11-02

    Accurate evaluation of non-healing, chronic wounds followed by the selection of an appropriate therapeutic strategy is a must for the foundation of health-care management. Assessment of non-healing chronic wounds in clinical practice in the Czech Republic is not standardised in acute care settings or in residential social care facilities. The aim of the study was to analyse the methods being used to assess non-healing, chronic wounds in residential social services in the Czech Republic, where more patients with chronic wounds are present because of the increasing incidence of wounds in old age. The research was carried out at 66 residential social care institutions across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The same methodology was used in previous work which has been done in acute care settings in 2013. The results of this research have corroborated the inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to the evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of the wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were improved when a consultant for wound healing was present. An effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of 'non-healing, chronic wound assessment' algorithm.

  2. Integrating mental health care into residential homes for the elderly: an analysis of six Dutch programs for older people with severe and persistent mental illness

    NARCIS (Netherlands)

    Depla, Marja F. I. A.; Pols, Jeannette; de Lange, Jacomine; Smits, Carolien H. M.; de Graaf, Ron; Heeren, Thea J.

    2003-01-01

    Integrating mental health care into residential homes for the elderly is a potentially effective model to address the complex care needs of older chronically mentally ill people. Because no research was available on the implementation of such integrated care in practice, six programs already

  3. Changes in the Seoul Metropolitan Area Urban Heat Environment with Residential Redevelopment

    Science.gov (United States)

    Hong, Je-Woo; Hong, Jinkyu

    2016-04-01

    Since the industrial revolution, the geographical extent of cities has increased around the world. In particular, following three decades of rapid regional economic growth, many Asian megacities have emerged and continue to expand. Short-term urban redevelopment is, therefore, inevitable. However, in this region the microclimatic impacts of urban redevelopment have not been extensively investigated using long-term in-situ observations. In this study, changes in surface sensible heat exchange, heat storage, and anthropogenic heat emissions due to urban residential redevelopment were quantified and analyzed based on a three-year micrometeorological record from the Seoul metropolitan area. The results show that following urban redevelopment of compact high-rise residential buildings, 1) the daily minimum air temperature near the ground surface increased by ˜0.6 K; 2) the ratio between surface sensible heat and net radiation increased by ˜ 9% (summer) to 31% (winter), anthropogenic heat emissions increased by 12 Wm-2 (spring) to 26 Wm-2 (summer), and daily maximum heat storage ranged by 35 Wm-2 (spring) to 55 Wm-2 (summer), and; 3) there was a transition of local circulation with changes in the surface properties of heat sources and roughness.

  4. Research on the strategies to optimize traditional Korean nationality village residential environment -- Taking the transformation of Chatiao Village in Antu County, Yanbian Korean Nationality Autonomous Prefecture as example

    Science.gov (United States)

    Chaoyang, Sun; Xin, Sui; Mo, Li; Yongqiang, Wang

    2017-04-01

    This research is aimed to make an in-depth research into the strategies and methods to protect and develop the residential environment in the villages and towns with minority group characteristics. In the research on the construction mode and optimization strategy of the residential environment of the original residents in Chatiao Village, Antu County, Korean Nationality Autonomous Prefecture, the contents of architecture and planning were used comprehensively with the philosophy of green design, sociology and economics being combined simultaneously to drive the humanistic and economic development in the minority areas at the same time of providing new employment opportunities and a comfortable residential environment for people, thus realizing the complete development of the characteristic villages in Chinese minority areas.

  5. Evaluation of a mobile X-ray service for elderly residents of residential aged care facilities.

    Science.gov (United States)

    Montalto, Michael; Shay, Simon; Le, Andy

    2015-11-01

    The Royal Melbourne Hospital established a mobile X-ray service (MXS) in 2013. The goal of the MXS is to address the radiology needs of frail, elderly or demented residents of residential aged care facilities (RACFs) who would otherwise require transportation to attend for X-ray. The present study describes the activity of the MXS, and the impact of the MXS on emergency department (ED) attendances by residents of RACFs. The study is a descriptive study and uses a before-and-after cohort approach. Activity for the first year of operation was collected and described. At the end of the first year of operation, the top 30 RACF users of the MXS were identified. The hospital Department of Radiology database was examined to find all plain X-rays performed on any patient presenting from the same 30 RACFs for the 1 year before commencement of the MXS (1 July 2012-30 June 2013) and for the 1 year period after the commencement of the MXS (1 July 2013-30 June 2014). Attendances were compared. The MXS delivered 1532 service attendances to 109 different RACFs. The mean age of patients receiving MXS services was 86 years (range 16-107 years). In all, 1124 services (73.4%) were delivered to patients in high-care RACFs. Most patients (n = 634; 41.4%) were bed or wheelchair bound, followed by those who required assistance to ambulate (n = 457; 29.8%). The most common X-ray examinations performed were chest, hip and pelvis, spine and abdomen. There were 919 service attendances to the top 30 RACFs using the MXS (60.0% of all attendances). There was an 11.5% reduction in ED presentations requiring plain X-ray in the year following the commencement of the MXS (95% confidence interval 0.62-3.98; P = 0.019). The present study suggests a reduction in hospital ED attendances for high users of the MXS. This has benefits for hospitals, patients and nursing homes. It also allows the extension of other programs designed to treat patients in their RACFs. Special rebates for home-based radiology

  6. Effectiveness of interventions to improve family-staff relationships in the care of people with dementia in residential aged care: a systematic review protocol.

    Science.gov (United States)

    Nguyen, Mynhi; Pachana, Nancy A; Beattie, Elizabeth; Fielding, Elaine; Ramis, Mary-Anne

    2015-11-01

    The objective of this review is to identify and appraise existing evidence regarding the effectiveness of interventions designed to enhance staff-family relationships for people with dementia living in residential aged care facilities.More specifically, the objectives are to identify the effectiveness of constructive communication, cooperation programs, and practices or strategies to enhance family-staff relationships. The effectiveness of these interventions will be measured by comparing the intervention to no intervention, comparing one intervention with another, or comparing pre- and post-interventions.Specifically the review question is: What are the most effective interventions for improving communication and cooperation to enhance family-staff relationships in residential aged care facilities? In our aging world, dementia is prevalent and is a serious health concern affecting approximately 35.6 million people worldwide. This figure is expected to increase two-fold by 2030 and three-fold by 2050. Although younger-onset dementia is increasingly recognized, dementia is most commonly a disease that affects the elderly. Among those aged 65 to 85, the prevalence of dementia increases exponentially, and doubles with every five-year increase in age.Dementia is defined as a syndrome, commonly chronic or progressive in nature, and caused by a range of brain disorders that affect memory, thinking and the ability to perform activities of daily living. While the rate of progression and manifestation of decline differs, all cases of dementia share a similar trajectory of decline. The progressive decline in cognitive functions and ultimately physical function that these people face affects not only the person with the disease but also their family caregivers and health care staff.The manifestation of dementia presents unique and extreme challenges for the family caregiver. Generally it causes great physical, emotional and social strain because the caregiving process is long

  7. Co-Occurring Disorders: A Challenge for Mexican Community-Based Residential Care Facilities for Substance Use.

    Science.gov (United States)

    Marín-Navarrete, Rodrigo; Medina-Mora, María Elena; Horigian, Viviana E; Salloum, Ihsan M; Villalobos-Gallegos, Luis; Fernández-Mondragón, José

    2016-01-01

    In Mexico, specialized treatment services for people with co-occurring disorders are limited within public health services, while private options are deemed too costly. More than 2,000 community-based residential care facilities have risen as an alternative and are the main source of treatment for individuals with substance use disorders; however, suboptimal practices within such facilities are common. Information on the clinical characteristics of patients receiving care in these facilities is scarce and capacity to provide high-quality care for co-occurring disorders is unknown. The aims of this study were to examine the prevalence of co-occurring disorders in patients receiving treatment for substance use in these community-based residential centers and to assess whether the presence of co-occurring disorders is associated with higher severity of substance use, psychiatric symptomatology, and other health risks. This study was conducted with 601 patients receiving treatment for substance use disorders at 30 facilities located in five Mexican states, recruited in 2013 and 2014. Patients were assessed with self-report measures on substance use, service utilization, suicidality, HIV risk behaviors, psychiatric symptomatology, and psychiatric disorder diagnostic criteria. The prevalence of any co-occurring disorder in this sample was 62.6%. Antisocial personality disorder was the most prevalent (43.8%), followed by major depressive disorder (30.9%). The presence of a co-occurring disorder was associated with higher severity of psychiatric symptoms (aB = .496, SE = .050, p Co-occurring disorders are highly prevalent in community-based residential centers in Mexico and are associated with significantly increased probability of other health risks. This highlights the need to develop care standards for this population and the importance of clinical research in these settings.

  8. [Design and validation of a satisfaction and quality of life scale for users of residential and social care centres].

    Science.gov (United States)

    Literas, Luciano; Navarro, Albert; Fontanals, María Dulce

    2010-01-01

    In a comprehensive approach to ageing care, the promotion of personal and emotional well-being is fundamental, as well as the development of tools to evaluate outcomes. This approach needs to take into account the subjective perception of the elderly by gathering evidence using indicators that express impacts and satisfaction. Thus, the SAR Foundation's Satisfaction and Quality of Life Scale (SyCV-FSAR) has been developed and validated to assess well-being in residential care settings. Bibliographical reviews, interviews and focal groups with professionals (doctors, nurses, social workers, quality managers, etc.) were conducted to define the questionnaire that was first piloted and then applied in a final survey. Test of validity was carried out by factorial analysis (FA), principal axis factoring and Oblimin rotation. The sampling adequacy was measured by Kaiser-Meyer-Olkin test and Bartlett's sphericity. Test of reliability was carried out by internal consistency analysis (Cronbach's alpha). A total of 475 users took part in the survey, 69.1% of those who fulfilled the criteria. Of these 60.0% were women, an average age 82.1, 47.2% of them between 75 and 84 years old, with a MMSE of 27. The FA identified three factors ("Residential service and geriatric care", "Personal framework" and "Social relationships") that explained 27.5% of the total variability. The measure of sampling adequacy by Kaiser-Meyer-Olkin test was 0.80, and the Bartlett's sphericity test was significant (P<0.001). The global α Cronbach was 0.82. According to the results obtained in the study we can conclude that the SyCV-FSAR Scale is a reliable, simple and easy-to-apply tool, which gathers the users' perception on key aspects of daily life in residential and social care centres. Copyright © 2009 SEGG. Published by Elsevier Espana. All rights reserved.

  9. Resilience and Its Contributing Factors in Adolescents in Long-Term Residential Care Facilities Affiliated to Tehran Welfare Organization

    Directory of Open Access Journals (Sweden)

    Manijeh Nourian

    2016-10-01

    Full Text Available Background: Resilience is a quality that affects an individual’s ability to cope with tension. The present study was conducted to determine resilience and its contributing factors in high-risk adolescents living in residential care facilities affiliated to Tehran Welfare Organization in order to help develop effective preventive measures for them. Methods: The present descriptive study was conducted on 223 adolescents living in 15differentgovernmental residential care centers in 2014. Participants were selected through convenience sampling. The data required were collected via the Wagnild and Young Resilience Scale with content validity (S-CVI=0.92 and a reliability of α=0.77 and r=0.83 (P<0.001. The data obtained were analyzed in SPSS-20 using descriptive and inferential statistics including Chi-square test, independent t-test and ANOVA. Results: The adolescents’ mean score of resilience was 84.41±11.01. The level of resilience was moderate in 46.2% of the participants and was significantly higher in the female than in the male adolescents (P=0.006; moreover, the score obtained was lower in primary school children as compared to middle school and high school students (P<0.001. Conclusion: Directors of care facilities and residential care personnel should adopt preventive resilience-based strategies in order to optimize resilience among adolescents, particularly the male. It is important to provide a basis to prevent adolescents’ academic failure and place a stronger value on education than the past.

  10. The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations.

    Science.gov (United States)

    Davis, Jullet A

    For many service-oriented firms, knowledge is a key commodity, and the process by which knowledge is codified is critical for firm survival. The administrator or top manager acts as the repository and disseminator of organizational knowledge. The purpose of this project is to examine the association between the administrator's educational attainment and innovation in residential care facilities. The study hypothesized that administrator academic education and certification or licensure would be positively associated with facility innovation. Data for this project comes from the 2010 National Survey of Residential Care Facilities. There were 2277 facilities included in the sample (weighted 30 811). Innovation, the dependent variable, was operationalized using 5 dichotomized measures: clinical information systems, pharmaceutical information systems, electronic health records, providing adult day care, and providing respite care. The data were analyzed using logistic regression. Overall, the results reveal that college education or certification/licensure increased the likelihood of technology use. In addition, those with a high school diploma and certification/licensure were more likely to use technology than were individuals who had, at a minimum, some college. The services models were not significant. It may be that the resources necessary to implement information systems vary substantially from the resources necessary to provide services.

  11. Nurses' perceptions of the impact of the aged care reform on services for residents in multi-purpose services and residential aged care facilities in rural Australia.

    Science.gov (United States)

    Henderson, Julie; Willis, Eileen; Xiao, Lily; Toffoli, Luisa; Verrall, Claire

    2016-12-01

    To understand nurses' perceptions of the impact of the aged care reform on care and services for residents in multi-purpose services (MPS) and residential aged care facilities (RACF) in rural South Australia. An interpretative study using semi-structured interviews. Participants comprised registered and enrolled nurses working with aged care residents in rural South Australia. Eleven nurses were interviewed, of these seven worked in MPS and four in RACF. Data were analysed for similarities and differences in participants' experiences of care delivery between MPS and RACF. Common issues were identified relating to funding and resource shortfalls, staffing levels, skill mix and knowledge deficits. Funding and staffing shortfalls in MPS were related by participants to the lower priority given to aged care in allocating resources within MPS. Nurses in these services identified limited specialist knowledge of aged care and care deficits around basic nursing care. Nurses in RACF identified funding and staffing shortfalls arising from empty beds due to the introduction of the accommodation payment. Dependence upon care workers was associated with care deficits in complex care such as pain management, medication review and wound care. Further research is needed into the impact of recent reforms on the capacity to deliver quality aged care in rural regions. © 2016 AJA Inc.

  12. Residential neighborhood, geographic work environment, and work economic sector: associations with body fat measured by bioelectrical impedance in the RECORD Study.

    Science.gov (United States)

    Lewin, Antoine; Pannier, Bruno; Méline, Julie; Karusisi, Noëlla; Thomas, Frédérique; Chaix, Basile

    2014-03-01

    Studies of associations between geographic environment and obesity have mostly examined body mass index and focused on residential neighborhoods. We investigated associations between residential neighborhoods, geographic work environments, and work economic sectors and the fat mass index (FMI) and percentage of fat mass (%FM). Data on 4331 participants from the French RECORD Study geolocated at their residence and workplace were analyzed. Body composition was assessed by bioelectrical impedance analyzers. Multilevel linear regression was used to investigate the determinants of FMI and %FM. After adjustment, among men, the FMI and %FM increased independently with decreasing density of population and educational level in the residential neighborhood. Among women, the residential educational level was related to the FMI and %FM. Among men, a higher FMI and %FM were observed among participants working in the construction and transportation/communication sectors than in the education sector. For women, the FMI was higher among participants working in the public administration and health/social work sectors than in the transport/communication sector. A long home-work distance was associated with a higher FMI among women. There was evidence that body mass index cannot fully capture work economic sector effects on fat mass. Public health interventions to reduce social/territorial disparities in obesity should also consider the different contexts to which the participants belong, such as residential environments and work economic sectors. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Price, environment and security: Exploring multi-modal motivation in voluntary residential peak demand response

    International Nuclear Information System (INIS)

    Gyamfi, Samuel; Krumdieck, Susan

    2011-01-01

    Peak demand on electricity grids is a growing problem that increases costs and risks to supply security. Residential sector loads often contribute significantly to seasonal and daily peak demand. Demand response projects aim to manage peak demand by applying price signals and automated load shedding technologies. This research investigates voluntary load shedding in response to information about the security of supply, the emission profile and the cost of meeting critical peak demand in the customers' network. Customer willingness to change behaviour in response to this information was explored through mail-back survey. The diversified demand modelling method was used along with energy audit data to estimate the potential peak load reduction resulting from the voluntary demand response. A case study was conducted in a suburb of Christchurch, New Zealand, where electricity is the main source for water and space heating. On this network, all water heating cylinders have ripple-control technology and about 50% of the households subscribe to differential day/night pricing plan. The survey results show that the sensitivity to supply security is on par with price, with the emission sensitivity being slightly weaker. The modelling results show potential 10% reduction in critical peak load for aggregate voluntary demand response. - Highlights: → Multiple-factor behaviour intervention is necessarily for effective residential demand response. → Security signals can achieve result comparable to price. → The modelling results show potential 10% reduction in critical peak load for aggregate voluntary demand response. → New Zealand's energy policy should include innovation and development of VDR programmes and technologies.

  14. Working with complexity: experiences of caring for mothers seeking residential parenting services in New South Wales, Australia.

    Science.gov (United States)

    Fowler, Cathrine; Schmied, Virginia; Dickinson, Marie; Dahlen, Hannah Grace

    2017-02-01

    To investigate staff perception of the changing complexity of mothers and infants admitted to two residential parenting services in New South Wales in the decade from 2005-2015. For many mothers with a young child, parenting is difficult and stressful. If parenting occurs within the context of anxiety, mental illness or abuse it often becomes a high-risk situation for the primary caregiver. Residential parenting services provide early nursing intervention before parenting problems escalate and require physical or mental health focused care. A qualitative descriptive design using semi-structured interview questions was used as phase three of a larger study. Data were gathered from 35 child and family health nurses and ten physicians during eight focus groups. Three main themes emerged: (1) dealing with complexity; (2) changing practice; and (3) appropriate knowledge and skills to handle greater complexity. There was a mix of participant opinions about the increasing complexity of the mothers presenting at residential parenting services during the past decade. Some of the nurses and physicians confirmed an increase in complexity of the mothers while several participants proposed that it was linked to their increased psychosocial assessment knowledge and skill. All participants recognised their work had grown in complexity regardless of their perception about the increased complexity of the mothers. Australian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional and physical problems. Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and nurses need to be adequately supported and educated to manage the complex presentations of many families. © 2016 John Wiley & Sons Ltd.

  15. The decision of out-of-home placement in residential care after parental neglect: Empirically testing a psychosocial model.

    Science.gov (United States)

    Rodrigues, Leonor; Calheiros, Manuela; Pereira, Cícero

    2015-11-01

    Out-of-home placement decisions in residential care are complex, ambiguous and full of uncertainty, especially in cases of parental neglect. Literature on this topic is so far unable to understand and demonstrate the source of errors involved in those decisions and still fails to focus on professional's decision making process. Therefore, this work intends to test a socio-psychological model of decision-making that is a more integrated, dualistic and ecological version of the Theory of Planned Behavior's model. It describes the process through which the decision maker takes into account personal, contextual and social factors of the Decision-Making Ecology in the definition of his/her decision threshold. One hundred and ninety-five professionals from different Children and Youth Protection Units, throughout the Portuguese territory, participated in this online study. After reading a vignette of a (psychological and physical) neglect case toward a one-year-old child, participants were presented with a group of questions that measured worker's assessment of risk, intention, attitude, subjective norm, behavior control and beliefs toward residential care placement decision, as well as worker's behavior experience, emotions and family/child-related-values involved in that decision. A set of structural equation modeling analyses have proven the good fit of the proposed model. The intention to propose a residential care placement decision was determined by cognitive, social, affective, value-laden and experience variables and the perceived risk. Altogether our model explained 61% of professional's decision toward a parental neglect case. The theoretical and practical implications of these results are discussed, namely the importance of raising awareness about the existence of these biased psychosocial determinants. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Effectiveness of a low-threshold physical activity intervention in residential aged care – results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cichocki M

    2015-05-01

    Full Text Available Martin Cichocki,1 Viktoria Quehenberger,1 Michael Zeiler,1 Tanja Adamcik,1 Matthias Manousek,1 Tanja Stamm,2 Karl Krajic1 1Ludwig Boltzmann Institute Health Promotion Research, 2Medical University of Vienna & University of Applied Sciences FH Campus, Wien, Vienna, Austria Purpose: Research on effectiveness of low-threshold mobility interventions that are viable for users of residential aged care is scarce. Low-threshold is defined as keeping demands on organizations (staff skills, costs and participants (health status, discipline rather low. The study explored the effectiveness of a multi-faceted, low-threshold physical activity program in three residential aged-care facilities in Austria. Main goals were enhancement of mobility by conducting a multi-faceted training program to foster occupational performance and thus improve different aspects of health-related quality of life (QoL.Participants and methods: The program consisted of a weekly session of 60 minutes over a period of 20 weeks. A standardized assessment of mobility status and health-related QoL was applied before and after the intervention. A total of 222 of 276 participants completed the randomized controlled trial study (intervention group n=104, control group n=118; average age 84 years, 88% female.Results: Subjective health status (EuroQoL-5 dimensions: P=0.001, d=0.36 improved significantly in the intervention group, and there were also positive trends in occupational performance (Canadian Occupational Performance Measure. No clear effects were found concerning the functional and cognitive measures applied.Conclusion: Thus, the low-threshold approach turned out to be effective primarily on subjective health-related QoL. This outcome could be a useful asset for organizations offering low-threshold physical activity interventions. Keywords: physical activity, intervention, residential aged care, effectiveness, aged

  17. [On the question of occurrence and the problem of hygiene rating of fungal air pollution of the environment of residential and public buildings].

    Science.gov (United States)

    Gubernskiĭ, Iu D; Beliaeva, N N; Kalinina, N V; Mel'nikova, A I; Chuprina, O V

    2013-01-01

    Comprehensive sanitary examinations of fungal pollution of the environment of residential and public buildings were performed. There is established the occurrence of sensitization of the population associated with the fungal contamination of the wallings of buildings and presence of viable mold spores in the indoor air environment. Major factors determining the degree of fungal contamination of indoor environments: increasing humidity of indoor air due to leaks and bays, the area of enclosure structures and the temperature factor have been identified.

  18. Do service innovations influence the adoption of electronic health records in long-term care organizations? Results from the U.S. National Survey of Residential Care Facilities.

    Science.gov (United States)

    Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P

    2014-12-01

    Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs. We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs. In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption. Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in

  19. Quality of life among adolescents living in residential youth care: do domain-specific self-esteem and psychopathology contribute?

    OpenAIRE

    Jozefiak, T; Kayed, NS; Ranoyen, I; Greger, HK; Wallander, JL; Wichstrom, L

    2017-01-01

    Purpose Many adolescents living in residential youth care (RYC) institutions perceive their quality of life (QoL) to be low. Enhancing QoL is thus important, but little is known about the potential contributors to their QoL. Early interpersonal trauma and subsequent removal from home and repeated relocations to new placements are expected to affect mental health and self-esteem. We therefore investigated if domain-specific self-esteem contributed to QoL among adolescents living in RYC ins...

  20. The residential context and the division of household and child-caring tasks

    NARCIS (Netherlands)

    de Meester, E.; Zorlu, A.; Mulder, Clara H.

    2011-01-01

    This paper reports a study of the division of household and childcare tasks between partners from a time – space perspective. Data from the 2005 Netherlands Kinship Panel Study and the 2004 ABF Real Estate Monitor are used. The impact of the residential context on the division of household and

  1. Exploring the physical environment in supporting older people in long-term care and shelter accommodation in the Klang Valley in Malaysia

    OpenAIRE

    SARASWATHY VENKATARAMAN

    2017-01-01

    This thesis explores the influence and impact of the physical indoor environment in the context of falls prevention, safety, participation in activities and well-being of older persons. Using a mixed method approach, the first survey covered 240 aged care facilities in the Klang Valley and the second study utilised the Residential Environment Impact Survey (REIS, Version 3.0) at 48 consenting facilities. Major gaps exist in identification of hazards in the physical environment. Screening th...

  2. Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England.

    Science.gov (United States)

    Hewitt, K A; Nalabanda, A; Cassell, J A

    2015-05-01

    Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks.

  3. Exploring Environment-Intervention Fit: A Study of a Work Environment Intervention Program for the Care Sector

    Science.gov (United States)

    Aust, Birgit; Flyvholm, Mari-Ann

    2015-01-01

    Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more “good” work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees' conceptualization of a “good” work day may be useful for intervention research in other sectors. PMID:26380356

  4. The place of surveillance technology in residential care for people with intellectual disabilities: is there an ideal model of application.

    Science.gov (United States)

    Niemeijer, A; Frederiks, B; Depla, M; Eefsting, J; Hertogh, C

    2013-03-01

    The demand for (care) services for people with intellectual disabilities (ID) is on the rise, because of an expanding population of people with ID as resources are concurrently diminishing. As a result, service providers are increasingly turning to technology as a potential answer to this problem. However, the use and application of surveillance technology (ST) in the care for people with ID provokes conflicting reactions among ethicists and healthcare professionals, and no ethical consensus has been reached as of yet. The aim of this study was thus to provide an overview of how ST is viewed by (care) professionals and ethicists working in the field by investigating what the ideal application of ST in the residential care for people with ID might entail. Use was made of the concept mapping method as developed by Trochim; a computer-assisted procedure consisting of five subsequent steps: brainstorming, prioritising, clustering, processing by the computer and finally analysis. Various participants (ranging from ethicists, physicians to support workers) were invited on the basis of their intended (professional) background. Prior to this study, the views of care professionals on the (ideal) application of ST in the residential care of people with dementia have been consulted and analysed using concept mapping. A comparison between the two studies has been made. Results show that the generated views represent six categories, varying from it being beneficial to the client; reducing restraints and it being based on a clear vision to (the need for) staff to be equipped; user friendliness and attending to the client. The results are presented in the form of a graphic chart. Both studies have produced very similar results, but there are some differences, as there appears to be more fear for ST among care professionals in the care for people with ID and views are expressed from a more developmental perspective rather than a person-centred perspective with regard to people

  5. 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.

  6. Material Research on Salt Hydrates for Seasonal Heat Storage Application in a Residential Environment

    Energy Technology Data Exchange (ETDEWEB)

    Ferchaud, C.J.; Zondag, H.A.; De Boer, R. [ECN Biomass and Energy Efficiency, Petten (Netherlands)

    2013-09-15

    Water vapor sorption in salt hydrates is a promising method to realize seasonal solar heat storage in the residential sector. Several materials already showed promising performance for this application. However, the stability of these materials needs to be improved for long-term (30 year) application in seasonal solar heat storages. The purpose of this article is to identify the influence of the material properties of the salt hydrates on the performance and the reaction kinetics of the sorption process. The experimental investigation presented in this article shows that the two salt hydrates Li2SO4.H2O and CuSO4.5H2O can store and release heat under the operating conditions of a seasonal solar heat storage in a fully reversible way. However, these two materials show differences in terms of energy density and reaction kinetics. Li2SO4.H2O can release heat with an energy density of around 0.80 GJ/m{sup 3} within 4 hours of rehydration at 25C, while CuSO4.5H2O needs around 130 hours at the same temperature to be fully rehydrated and reaches an energy density of 1.85 GJ/m{sup 3}. Since the two salts are dehydrated and hydrated under the same conditions, this difference in behavior is directly related to the intrinsic properties of the materials.

  7. Look who's talking : A Motivational Interviewing based observation study of one-on-one conversations between residential care workers and adolescents

    NARCIS (Netherlands)

    Eenshuistra, Annika; Harder, Annemiek T.; Van Zonneveld, Neeltje L.; Knorth, Erik J.

    Despite its relevance and effectiveness in adjoining fields, still surprisingly little attention has been paid to Motivational Interviewing (MI) in the context of residential youth care. This study aims to analyse observed interactions between adolescents and group care workers during one-on-one

  8. Exploratory Investigation of Communication Management in Residential-Aged Care: A Comparison of Staff Knowledge, Documentation and Observed Resident-Staff Communication

    Science.gov (United States)

    Bennett, Michelle K.; Ward, Elizabeth C.; Scarinci, Nerina A.

    2016-01-01

    Background: There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in…

  9. The crucial role of the micro caregiving environment: Factors associated with attachment styles in alternative care in Chile.

    Science.gov (United States)

    Garcia Quiroga, Manuela; Hamilton-Giachritsis, Catherine

    2017-08-01

    The distribution of attachment styles has been shown to differ between groups of children living with their parents and children placed in alternative care (AC), defined as residential or foster. However, this is the first study in Latin America to explore possible factors affecting the quality of attachment in children living in both residential and foster care. Two groups of children (N=57) were compared: one group living in Residential Homes (RC) and the other in Foster Care (FC) in Chile. Children's, caregivers' and structural factors (e.g., child: caregiver ratios) and their links with attachment styles were investigated. The micro caregiving environment (i.e., the specific individual child caregiver relationship), especially the caregivers' engagement, sensitivity, disciplinary control and affection, as well as some structural factors (i.e., child: caregiver ratios), were linked to attachment security in children. Specifically, better emotional caregiving and lower child-caregiver ratios were associated with higher rates of secure attachment. The association between quality of care (as measured by the HOME inventory) and attachment styles seems to be influenced by caregiver relationships (as measured by CCSERSS). Caregiver relationship factors (i.e., affection, engagement and sensitivity) directly impact the quality of the attachment children establish with them while living in AC. However, the relationships that caregivers establish with children under their care can be facilitated by good quality structural factors, particularly child-caregiver ratios. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Garden greenery and the health of older people in residential care facilities: a multi-level cross-sectional study.

    Science.gov (United States)

    Dahlkvist, Eva; Hartig, Terry; Nilsson, Annika; Högberg, Hans; Skovdahl, Kirsti; Engström, Maria

    2016-09-01

    To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. A multi-level, cross-sectional, correlational design. Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis. The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health. Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  11. How prepared is the retirement and residential aged care sector in Western Australia for older non-heterosexual people?

    Science.gov (United States)

    Horner, Barbara; McManus, A; Comfort, J; Freijah, R; Lovelock, G; Hunter, M; Tavener, M

    2012-01-01

    To explore attitudes, knowledge and current practices of retirement and residential aged care providers in Western Australia towards accommodating older gay, lesbian, bisexual, transgender and intersex (GLBTI) individuals. GLBTI is used throughout as a general term to include people who are not exclusively heterosexual in identity, attraction and/or behaviour. Postal surveys were sent to 329 providers of accommodation to ask about their attitudes, knowledge and current practices towards older GLBTI people. Two focus groups were also held with managers of accommodation facilities and GLBTI community members. Few respondents reported having experience with any older GLBTI residents in their retirement or residential aged care facility. There was poor inclusion of GLBTI issues in policy frameworks, and limited understanding regarding same-sex law reforms. Older non-heterosexual people are often obscured within ageing population discourses, and conceal their identity for fear of discrimination. GLBTI-sensitive practices can help to facilitate the disclosure of sexual orientation and/or gender identity that may assist in meeting the unique needs of this group.

  12. Becoming at home in residential care for older people: a material culture perspective.

    Science.gov (United States)

    Lovatt, Melanie

    2018-02-01

    Residential homes encourage new residents to bring belongings with them, so that they can personalise their room and 'feel at home'. Existing literature on material culture in residential homes views objects as symbols and repositories of home and identity, which can facilitate a sense of belonging in residents through their display in residents' rooms. I suggest that this both misunderstands the processual and fluid nature of home and identity, and conceptualises objects as essentially passive. This article uses ethnographic data and theories of practice and relationality to argue that rather than the meaning of home being inherent in objects, or felt subjectively by residents, meaning is generated through ongoing, everyday interactions between the two. I show that residents became at home by acquiring new things -as well as displaying existing possessions - and also through interacting with mundane objects in everyday social and relational practices such as cleaning and hosting. I conclude that being at home in older people's residential homes need not be so different from being at home at other stages of the life course and in other settings. This challenges conceptualisations of older people's homes - and older age itself - as somehow unknowable and unfamiliar. © 2018 Foundation for the Sociology of Health & Illness.

  13. The efficacy of complementary therapies for agitation among older people in residential care facilities: a systematic review.

    Science.gov (United States)

    Watson, Karen; Chang, Esther; Johnson, Amanda

    2012-01-01

    Agitation is recognised by aged care literature as the most common behavioural problem in residential aged care facilities. Complementary therapies are advocated by some as a solution to reduce the effect of agitation in older people and are becoming increasingly incorporating into nursing care. Complementary therapies in nursing management, is endorsed by the Australian Nurses and Midwifery Board for nurse initiation. The review objective was to discover which types of Complementary therapies are being implemented in RACFs for agitation management and which of these therapies where effective in reducing agitation. Participants were people over the age of 65 years living permanently in a residential aged care facility and experiencing agitation, regardless of cognitive ability, gender or ethnicity and existing co-morbidities.The types of complementary therapy interventions explored in this systematic review were Aromatherapy, Exercise, Massage, Music Therapy and Therapeutic TouchThe systematic review considered randomised controlled trials of complementary therapy interventions that could be initiated by a nurseOutcomes measured were the frequency and/or severity of verbal, non-physical aggressive and physical aggressive agitation among the participants. A comprehensive search strategy was developed for eleven electronic databases with dates ranging from January 2000 to September 2010. Searches included unpublished studies and the reference lists from identified papers. Only English language papers were considered due to a lack of interpreter facilities. An adapted version of the Joanna Briggs Institute quality appraisal checklist was used to assess the methodological quality of studies. Appraisal was performed separately by two independent reviewers with any disagreement between appraisers settled by a third appraiser. Data was extracted using the standardised Joanna Briggs Institute Data Extraction Tool. Measurement tools reported different subcategories of

  14. Perceptions and effects of the acoustic environment in quiet residential areas.

    Science.gov (United States)

    Rey Gozalo, Guillermo; Barrigón Morillas, Juan Miguel

    2017-04-01

    Many cities have historical areas clearly distinguished from the rest because of the architecture, urban planning, and functionality. In many cases, these aspects give one the possibility of finding a characteristic acoustic environment and also developing quiet areas. Through an examination of sound levels and surveys, the perception of residents and passers-by concerning the acoustic environment of the old town of Cáceres and its relation with the characteristics of the urban environment were analysed. In addition, the perception and the effects of noise pollution of low intensity were studied. The results indicate that absence of daytime noise is the most influential environmental characteristic on the overall perception of the urban environment studied, even surpassing the feeling of security. The absence of daytime noise was also the most valued characteristic of the urban environment according to respondents. The most annoying noise source proved to be the road traffic. However, for similar levels of sound exposure, the percentages of people who were annoyed and whose sleep was disturbed were lower than those found in previous studies. Bells and birds, both soundmarks of the soundscape of this urban environment, were among the most annoying to passers-by.

  15. Improving the oral health of older people in long-term residential care: a review of the literature.

    Science.gov (United States)

    Miegel, Karen; Wachtel, Tracey

    2009-06-01

    Background.  Unrefutable evidence now links poor oral health with the development of preventable systemic illnesses and debilitating conditions that threaten quality of life and life itself. This is especially significant for an increasing older population who are dependent on others for care. Aims and objectives.  The majority of studies analysing the oral health of older dependent people in long-term residential care have been undertaken by dental professionals. This critical literature review examines the issue from a nursing perspective because nursing care providers have a fundamental role in daily oral health provision for dependent residents. Conclusions.  Multiple barriers were found to negatively impact on daily oral healthcare provision, including lack of care provider education, oral health values, availability of resources, implementation of supportive policies, documentation and oral health assessment tools. Relevance to clinical practice.  The nursing profession, at all levels, must become pro-active in removing financial, political and workforce barriers that impact negatively on oral health outcomes. A multi-faceted approach is required to address these barriers, including development and implementation of oral health education programmes, assessment screening tools, care plans, documentation, supply of oral hygiene aids and the appointment of oral care 'champions'. © 2009 Blackwell Publishing Ltd.

  16. Validation of Geriatric Care Environment Scale in Portuguese Nurses

    OpenAIRE

    Paulo de Almeida Tavares, Jo?o; Leite da Silva, Alcione; S?-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth

    2013-01-01

    The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal...

  17. Mechanisms which help explain implementation of evidence-based practice in residential aged care facilities: a grounded theory study.

    Science.gov (United States)

    Masso, Malcolm; McCarthy, Grace; Kitson, Alison

    2014-07-01

    The context for the study was a nation-wide programme in Australia to implement evidence-based practice in residential aged care, in nine areas of practice, using a wide range of implementation strategies and involving 108 facilities. The study drew on the experiences of those involved in the programme to answer the question: what mechanisms influence the implementation of evidence-based practice in residential aged care and how do those mechanisms interact? The methodology used grounded theory from a critical realist perspective, informed by a conceptual framework that differentiates between the context, process and content of change. People were purposively sampled and invited to participate in semi-structured interviews, resulting in 44 interviews involving 51 people during 2009 and 2010. Participants had direct experience of implementation in 87 facilities, across nine areas of practice, in diverse locations. Sampling continued until data saturation was reached. The quality of the research was assessed using four criteria for judging trustworthiness: credibility, transferability, dependability and confirmability. Data analysis resulted in the identification of four mechanisms that accounted for what took place and participants' experiences. The core category that provided the greatest understanding of the data was the mechanism On Common Ground, comprising several constructs that formed a 'common ground' for change to occur. The mechanism Learning by Connecting recognised the ability to connect new knowledge with existing practice and knowledge, and make connections between actions and outcomes. Reconciling Competing Priorities was an ongoing mechanism whereby new practices had to compete with an existing set of constantly shifting priorities. Strategies for reconciling priorities ranged from structured approaches such as care planning to more informal arrangements such as conversations during daily work. The mechanism Exercising Agency bridged the gap between

  18. Food Environment and Weight Change: Does Residential Mobility Matter?: The Diabetes Study of Northern California (DISTANCE).

    Science.gov (United States)

    Laraia, Barbara A; Downing, Janelle M; Zhang, Y Tara; Dow, William H; Kelly, Maggi; Blanchard, Samuel D; Adler, Nancy; Schillinger, Dean; Moffet, Howard; Warton, E Margaret; Karter, Andrew J

    2017-05-01

    Associations between neighborhood food environment and adult body mass index (BMI; weight (kg)/height (m)2) derived using cross-sectional or longitudinal random-effects models may be biased due to unmeasured confounding and measurement and methodological limitations. In this study, we assessed the within-individual association between change in food environment from 2006 to 2011 and change in BMI among adults with type 2 diabetes using clinical data from the Kaiser Permanente Diabetes Registry collected from 2007 to 2011. Healthy food environment was measured using the kernel density of healthful food venues. Fixed-effects models with a 1-year-lagged BMI were estimated. Separate models were fitted for persons who moved and those who did not. Sensitivity analysis using different lag times and kernel density bandwidths were tested to establish the consistency of findings. On average, patients lost 1 pound (0.45 kg) for each standard-deviation improvement in their food environment. This relationship held for persons who remained in the same location throughout the 5-year study period but not among persons who moved. Proximity to food venues that promote nutritious foods alone may not translate into clinically meaningful diet-related health changes. Community-level policies for improving the food environment need multifaceted strategies to invoke clinically meaningful change in BMI among adult patients with diabetes. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Sustainability of Physical Activity Promoting Environments and Influences on Sustainability Following a Structural Intervention in Residential Children's Homes

    Science.gov (United States)

    Dominick, Gregory M.; Tudose, Alina; Pohlig, Ryan T.; Saunders, Ruth P.

    2016-01-01

    Research examining sustainability of health promotion programs within organizational settings is limited. The Environmental Interventions in Residential Children's Homes (ENRICH) was a structural intervention that trained Wellness Teams (WTs) within residential children's homes (RCH) to target environmental changes that promote physical activity…

  20. The lived experiences of resilience in Iranian adolescents living in residential care facilities: A hermeneutic phenomenological study

    Directory of Open Access Journals (Sweden)

    Manijeh Nourian

    2016-03-01

    Full Text Available Background: Resilience is one of the main factors affecting human health, and perceiving its meaning for high-risk adolescents is of particular importance in initiating preventive measures and providing resilience care. Objectives: This qualitative study was conducted to explain the meaning of resilience in the lived experiences of Iranian adolescents living in governmental residential care facilities. Materials and methods: This study was conducted using the hermeneutic phenomenological method. Semi-structured interviews were conducted with eight adolescents aged 13–17 living in governmental residential care facilities of Tehran province affiliated to the Welfare Organization of Iran who articulated their experiences of resilience. Sampling lasted from May 2014 to July 2015 and continued until new themes were no longer emerging. The researchers analyzed the verbatim transcripts using Van Manen's six-step method of phenomenology. Results: The themes obtained in this study included “going through life's hardships,” “aspiring for achievement,” “self-protection,” “self-reliance,” and “spirituality.” Conclusion: Our study indicates that the meaning of resilience coexists with self-reliance in adolescents’ lived experiences. Adolescents look forward to a better future. They always trust God in the face of difficulties and experience resilience by keeping themselves physically and mentally away from difficulties. Adverse and bitter experiences of the past positively affected their positive view on life and its difficulties and also their resilience. The five themes that emerged from the findings describe the results in detail. The findings of this study enable nurses, health administrators, and healthcare providers working with adolescents to help this vulnerable group cope better with their stressful life conditions and improve their health through increasing their capacity for resilience.

  1. The lived experiences of resilience in Iranian adolescents living in residential care facilities: A hermeneutic phenomenological study.

    Science.gov (United States)

    Nourian, Manijeh; Shahbolaghi, Farahnaz Mohammadi; Tabrizi, Kian Nourozi; Rassouli, Maryam; Biglarrian, Akbar

    2016-01-01

    Resilience is one of the main factors affecting human health, and perceiving its meaning for high-risk adolescents is of particular importance in initiating preventive measures and providing resilience care. This qualitative study was conducted to explain the meaning of resilience in the lived experiences of Iranian adolescents living in governmental residential care facilities. This study was conducted using the hermeneutic phenomenological method. Semi-structured interviews were conducted with eight adolescents aged 13-17 living in governmental residential care facilities of Tehran province affiliated to the Welfare Organization of Iran who articulated their experiences of resilience. Sampling lasted from May 2014 to July 2015 and continued until new themes were no longer emerging. The researchers analyzed the verbatim transcripts using Van Manen's six-step method of phenomenology. The themes obtained in this study included "going through life's hardships," "aspiring for achievement," "self-protection," "self-reliance," and "spirituality." Our study indicates that the meaning of resilience coexists with self-reliance in adolescents' lived experiences. Adolescents look forward to a better future. They always trust God in the face of difficulties and experience resilience by keeping themselves physically and mentally away from difficulties. Adverse and bitter experiences of the past positively affected their positive view on life and its difficulties and also their resilience. The five themes that emerged from the findings describe the results in detail. The findings of this study enable nurses, health administrators, and healthcare providers working with adolescents to help this vulnerable group cope better with their stressful life conditions and improve their health through increasing their capacity for resilience.

  2. Bioaerosols in indoor environment - a review with special reference to residential and occupational locations

    OpenAIRE

    Mandal, J; Brandl, H

    2011-01-01

    Bioaerosols such as bacterial and fungal cells and their spores are - along with non-biological particles - part of indoor airborne particulate matter and have been related since a long time to health issues of human beings as well as flora, and fauna. To identify the different risks and to establish exposure thresholds, microbiology of air samples from a series of indoor environments must be characterized, i.e. the different microorganisms (bacteria and fungi) must be identified and quantifi...

  3. Leadership and management skills of first-line managers of elderly care and their work environment.

    Science.gov (United States)

    Abdelrazek, Fathya; Skytt, Bernice; Aly, Magda; El-Sabour, Mona Abd; Ibrahim, Naglaa; Engström, Maria

    2010-09-01

    To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  4. Intermediate care: for better or worse? Process evaluation of an intermediate care model between a university hospital and a residential home

    Directory of Open Access Journals (Sweden)

    Janmaat Tonnie ACM

    2005-05-01

    Full Text Available Abstract Background Intermediate care was developed in order to bridge acute, primary and social care, primarily for elderly persons with complex care needs. Such bridging initiatives are intended to reduce hospital stays and improve continuity of care. Although many models assume positive effects, it is often ambiguous what the benefits are and whether they can be transferred to other settings. This is due to the heterogeneity of intermediate care models and the variety of collaborating partners that set up such models. Quantitative evaluation captures only a limited series of generic structure, process and outcome parameters. More detailed information is needed to assess the dynamics of intermediate care delivery, and to find ways to improve the quality of care. Against this background, the functioning of a low intensity early discharge model of intermediate care set up in a residential home for patients released from an Amsterdam university hospital has been evaluated. The aim of this study was to produce knowledge for management to improve quality of care, and to provide more generalisable insights into the accumulated impact of such a model. Methods A process evaluation was carried out using quantitative and qualitative methods. Registration forms and patient questionnaires were used to quantify the patient population in the model. Statistical analysis encompassed T-tests and chi-squared test to assess significance. Semi-structured interviews were conducted with 21 staff members representing all disciplines working with the model. Interviews were transcribed and analysed using both 'open' and 'framework' approaches. Results Despite high expectations, there were significant problems. A heterogeneous patient population, a relatively unqualified staff and cultural differences between both collaborating partners impeded implementation and had an impact on the functioning of the model. Conclusion We concluded that setting up a low intensity

  5. Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis

    Directory of Open Access Journals (Sweden)

    Merlyn Teri

    2010-07-01

    Full Text Available Abstract Background The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. Methods Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. Results • Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs. • The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment. • There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills. • Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However

  6. Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis

    Science.gov (United States)

    2010-01-01

    Background The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. Methods Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis) of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. Results • Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs. • The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment). • There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills. • Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However, little is known regarding

  7. Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis.

    Science.gov (United States)

    Jeon, Yun-Hee; Glasgow, Nicholas J; Merlyn, Teri; Sansoni, Emily

    2010-07-06

    The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis) of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. * Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs.* The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment).* There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills.* Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However, little is known regarding how appropriate and effective they are

  8. Improving Oral Hygiene for Veterans With Dementia in Residential Long-term Care.

    Science.gov (United States)

    McConnell, Eleanor S; Lee, Kyung Hee; Galkowski, Lorraine; Downey, Christine; Spainhour, Mary Victoria; Horwitz, Reginaldo

    2017-11-08

    Oral hygiene care is neglected in long-term care (LTC) due to patient-, staff-, and systems-level barriers. A dementia-specific oral hygiene program, implemented and evaluated in a Department of Veterans Affairs LTC unit, addressed barriers to oral care at multiple levels. Improved staff competency, access to oral care supplies, and standardized documentation systems were accompanied by reduced oral plaque and gingivitis, demonstrating the feasibility and benefits of direct care staff providing improved oral hygiene in LTC.

  9. The association of residential mold exposure and adenotonsillar hypertrophy in children living in damp environments.

    Science.gov (United States)

    Atan Sahin, Ozlem; Kececioglu, Nuray; Serdar, Muhittin; Ozpinar, Aysel

    2016-09-01

    There are many consequences of mold exposure related to respiratory system health of children This retrospective cohort study aims to find the association between adenoid hypertrophy and mold exposure in children living in damp environments. Children with history of recurrent respiratory tract infections were enrolled in the study between June 2012 and June 2013 and were followed up for adenoid hypertrophy from June 2013 to June 2016. One hundred and forty two children were residents of moldy houses and 242 were living in normal houses. Skin prick test results for 60 common allergens, vitamin D levels, IgE levels, age, presence of comorbidities such as urticaria, atopic dermatitis, allergic conjunctivitis, allergic rhinitis, asthma, frequency of upper respiratory tract infections and lower respiratory tract infections, were evaluated in both groups. A total of 384 children (mean age ± standard deviation = 53.37 ± 36 months; 198 males and 186 females) were included. The children were classified into 2 groups (1)Children living normal houses (n = 242) (2); Children living in damp houses (n = 142) according to mold exposure. Children with adenoid hypertrophy (p children with mold exposure (p children with recurrent lower respiratory tract infection and upper respiratory tract infection were mainly residents of damp houses (p environment group (p Children with mold exposure had significantly increased adenoid hypertrophy regardless of their atopic nature, however, they may have become more sensitized due to other environmental triggers and genetic factors. In damp environments, sensitization to dermatophagoids, was significantly increased in children with adenoid hypertrophy. During the period of infancy, when children were mostly vitamin D supplemented, they were not sensitized and had normal adenoids. As children with recurrent respiratory tract infections grow, they tend to have lower vitamin D levels, become more atopic and tend to have adenoid

  10. Changing local geographies of private residential care for older people 1983-1999: lessons for social policy in England and Wales.

    Science.gov (United States)

    Andrews, Gavin J; Phillips, David R

    2002-07-01

    The population structures of many developed countries are changing and shifts towards much older age distributions are common. One way of meeting the resulting increasing demand for long-term care is through small business private sector provision allocated through market systems. However, the private residential care sector in England and Wales demonstrates some of the potential problems of leaving long-term care to the market. During the 1980s, the private residential sector for older persons enjoyed substantial state financed support. Since the 1990 National Health Service and Care in the Community Act introduced markets in social care in 1993, homes have had to compete amongst each other for a much smaller number of clients funded by limited local authority budgets. This impacted on their business and caring operations. Based on a three-stage quasi-longitudinal survey of over 100 residential care homes in one county, this paper considers changes in the overall size and structure of a local sector, discusses the specific management strategies that have been adopted by proprietors and the development of a purchasing and providing market culture. The paper also highlights the importance of interdisciplinary perspectives on the topic by illustrating how changes in social policy can influence local and national geographies of long-term care provision and how, in turn, an understanding of these geographies can inform the sensitive implementation of future social policy initiatives.

  11. Developing a theoretical model and questionnaire survey instrument to measure the success of electronic health records in residential aged care

    Science.gov (United States)

    Yu, Ping; Qian, Siyu

    2018-01-01

    Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes. The proposed research model incorporates six variables in the reformulated DeLone and McLean information systems success model: system quality, information quality, service quality, use, user satisfaction and net benefits. Two variables training and self-efficacy were also incorporated into the model. A questionnaire survey instrument was designed to measure the eight variables in the model. After a pilot test, the measurement scale was used to collect data from 243 nursing staff members in 10 residential aged care homes belonging to three management groups in Australia. Partial least squares path modeling was conducted to validate the model. The validated EHR systems success model predicts the impact of the four antecedent variables—training, self-efficacy, system quality and information quality—on the net benefits, the indicator of EHR systems success, through the intermittent variables use and user satisfaction. A 24-item measurement scale was developed to quantitatively evaluate the performance of an EHR system. The parsimonious EHR systems success model and the measurement scale can be used to benchmark EHR systems success across organizations and units and over time. PMID:29315323

  12. Developing a theoretical model and questionnaire survey instrument to measure the success of electronic health records in residential aged care.

    Science.gov (United States)

    Yu, Ping; Qian, Siyu

    2018-01-01

    Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes. The proposed research model incorporates six variables in the reformulated DeLone and McLean information systems success model: system quality, information quality, service quality, use, user satisfaction and net benefits. Two variables training and self-efficacy were also incorporated into the model. A questionnaire survey instrument was designed to measure the eight variables in the model. After a pilot test, the measurement scale was used to collect data from 243 nursing staff members in 10 residential aged care homes belonging to three management groups in Australia. Partial least squares path modeling was conducted to validate the model. The validated EHR systems success model predicts the impact of the four antecedent variables-training, self-efficacy, system quality and information quality-on the net benefits, the indicator of EHR systems success, through the intermittent variables use and user satisfaction. A 24-item measurement scale was developed to quantitatively evaluate the performance of an EHR system. The parsimonious EHR systems success model and the measurement scale can be used to benchmark EHR systems success across organizations and units and over time.

  13. Drug Administration via Enteral Feeding Tube in Residential Care Facilities for Individuals with Intellectual Disability: A Focus Group Study on Guideline Implementation

    Science.gov (United States)

    Joos, Elke; Van Tongelen, Inge; Wijnants, Karen; Mehuys, Els; Van Bocxlaer, Jan; Remon, Jean Paul; Grypdonck, Maria; Van Winckel, Myriam; Boussery, Koen

    2016-01-01

    People with profound intellectual disabilities often receive medication through enteral feeding tube (EFT). In a previous study, we found that current guidelines concerning medication preparation and administration through EFT are often not followed in residential care facilities (RCFs) for individuals with intellectual disabilities. The present…

  14. Longitudinal relation between general well-being and self-esteem : Testing differences for adolescents admitted to secure residential care and after discharge

    NARCIS (Netherlands)

    Barendregt, C.S.; Laan, A.J.; Bongers, I.L.; van Nieuwenhuizen, Ch.

    2016-01-01

    This study investigated the longitudinal relation between general well-being and self-esteem of male adolescents with severe psychiatric disorders. Moreover, the transition out of secure residential care was studied. Adolescents (N = 172) were assessed three times with 6 months between each

  15. An outbreak of severe respiratory tract infection caused by human metapneumovirus in a residential care facility for elderly in Utrecht, the Netherlands, January to March 2010

    NARCIS (Netherlands)

    M.J.T. Wierik (M J Te); D.T. Nguyen (Tien); M.F.C. Beersma (Thijs); S.F. Thijsen (Steven); K.A. Heemstra

    2012-01-01

    textabstractRecognition of infections with human metapneumovirus (HMPV) among institutionalised elderly is rising. When HMPV was found to be the causative agent of an outbreak of pneumonia in a residential care facility for elderly in the Netherlands, an elaborate outbreak investigation was set up,

  16. Family Life and the Impact of Previous and Present Residential and Day Care Support for Children with Major Cognitive and Behavioural Challenges: A Dilemma for Services and Policy

    Science.gov (United States)

    Brown, R. I.; Geider, S.; Primrose, A.; Jokinen, N. S.

    2011-01-01

    Introduction: Since the development of inclusion and integration, parents have increasingly become the major, and sometimes the only, carers of their children with disabilities. Many families speak of stress and frustration with service and community support, and some have turned to residential and specialised day care services to overcome…

  17. A System for Planning and Achieving Comprehensive Health Care in Residential Institutions for the Mentally Retarded.

    Science.gov (United States)

    Decker, Harold A.

    Based on a view of health care intertwining medicine intimately with other components of institutional care, the monograph presents a system of concepts and operating techniques for providing comprehensive health care to institutionalized retardates. Background of the system is explained in terms of its research basis (two studies by the author of…

  18. Chlorpyrifos Exposure and Urban Residential Environment Characteristics as Determinants of Early Childhood Neurodevelopment

    Science.gov (United States)

    Quinn, James W.; Rauh, Virginia A.; Perera, Frederica P.; Andrews, Howard F.; Garfinkel, Robin; Hoepner, Lori; Whyatt, Robin; Rundle, Andrew

    2011-01-01

    Objectives. We evaluated whether neighborhood characteristics correlated with early neurodevelopment and whether these characteristics confounded the previously reported association between exposure to chlorpyrifos (an organophosphate insecticide) and neurodevelopment. Methods. We obtained prenatal addresses, chlorpyrifos exposure data, and 36-month Psychomotor Development Index (PDI) and Mental Development Index (MDI) scores for a birth cohort in New York City (born 1998–2002). We used data from the 2000 US Census to estimate measures of physical infrastructure, socioeconomic status, crowding, demographic composition, and linguistic isolation for 1-kilometer network areas around each child's prenatal address. Generalized estimating equations were adjusted for demographics, maternal education and IQ, prenatal exposure to tobacco smoke, caretaking environment quality, and building dilapidation. Results. Of 266 children included as participants, 47% were male, 59% were Dominican, and 41% were African American. For each standard deviation higher in neighborhood percent poverty, the PDI score was 2.6 points lower (95% confidence interval [CI] = −3.7, −1.5), and the MDI score was 1.7 points lower (95% CI = −2.6, −0.8). Neighborhood-level confounding of the chlorpyrifos-neurodevelopment association was not apparent. Conclusions. Neighborhood context and chlorpyrifos exposure were independently associated with neurodevelopment, thus providing distinct opportunities for health promotion. PMID:20299657

  19. Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets

    Directory of Open Access Journals (Sweden)

    Steventon Adam

    2012-10-01

    Full Text Available Abstract Background Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. Methods We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. Results The largest group of stays (38.9% were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. Conclusions These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.

  20. End-of-life care in residential care homes: a retrospective study of the perspectives of family members using the VOICES questionnaire.

    Science.gov (United States)

    Andersson, Sofia; Lindqvist, Olav; Fürst, Carl-Johan; Brännström, Margareta

    2017-03-01

    In Europe, residential care homes (RCHs) are replacing hospitals as the place where death occurs, and they play an important role in end-of-life (EOL) care. The aim was to describe the quality of care during the last 3 months and last 3 days of life of those who died in RCHs as reported by family members. We also investigated whether there were differences in the EOL care of younger patients (family members. A retrospective survey design. Deaths (n = 189) at 19 RCHs in one municipality in Sweden were included. Family members were sent the VOICES questionnaire 1 month after their elderly relative had died. Descriptive statistics were used. In the last 3 days before death, most family members reported there was enough help with nursing (93%) and personal care (78.5%). Among the family members, 86% were told that the resident was likely to die shortly. Most (94.1%) of residents were reported to have died at their preferred place. No significant difference was found between age groups. Family members also reported that about half of the elderly had pain (46.5%) and 86.4% received treatment; 55.9% had breathlessness and 39.7% received treatment. Breathlessness was significantly (p = 0.01) more common in the younger group, and they were treated more often (p = 0.006) than the oldest old. This study revealed an overall positive picture of personal and nursing care and communication. These findings indicate that the quality of EOL care at RCHs is high. Inadequate management was found for symptom relief the last days of life. This suggests that this subject merits further attention by care professionals. To achieve better quality of EOL care at RCHs, we emphasise the importance of systematically working to improve symptom relief. © 2016 Nordic College of Caring Science.

  1. Multiple dimensions of residential environments, neighborhood experiences, and jogging behavior in the RECORD Study.

    Science.gov (United States)

    Karusisi, Noëlla; Bean, Kathy; Oppert, Jean-Michel; Pannier, Bruno; Chaix, Basile

    2012-07-01

    The purpose of this study was to examine the associations between a broad range of environmental characteristics and jogging behavior while taking into account different complementary outcomes to describe the behavior. Using the RECORD Cohort Study (7290 participants, 2007-2008, Paris region, France), multilevel models were used to investigate individual/neighborhood variables associated with the probability of jogging; the time spent jogging; and the location of the practice. The presence and quality of green and open spaces was associated both with a greater probability of jogging [risk ratio (RR) for the first vs. the fourth quartile=1.22, 95% credible interval (CrI): 1.03-1.44] and with the practice of jogging within rather than outside the neighborhood (RR=1.29; 95% CrI: 1.10-1.53). Moreover, a high social cohesion and the presence of enjoyable places were associated with a higher probability of jogging (RR=1.15; 95% CrI: 1.00-1.31; RR=1.22; 95% CrI: 1.03-1.44) while the presence of parks or a lake increased the probability of jogging inside rather than outside the neighborhood (RR=1.29; 95% CrI: 1.10-1.53; RR=1.14; 95% CrI: 1.03-1.26). Paying attention to physical and social environments, related neighborhood experiences, and attitudes toward health may be an effective approach to promote outdoor physical activity. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Characteristics of indoor/outdoor particulate pollution in urban and rural residential environment of Pakistan

    Energy Technology Data Exchange (ETDEWEB)

    Colbeck, I.; Nasir, Z.A. (Univ. of Essex. Dept. of Biological Sciences, Colchester (United Kingdom)); Ali, Z. (Univ. of Veterinary and Animal Sciences. Dept. of Wildlife and Ecosystem, Lahore (Pakistan))

    2009-09-15

    Particulate pollution has emerged as a serious environmental health concern in Pakistan. The use of biomass fuels in traditional stoves produces high levels of indoor air pollutants. In Pakistan, 94% of rural and 58% of urban households depend on biomass fuel. This study investigates variations in indoor/outdoor concentrations of particulate matter during various activities for three different micro-environments in Pakistan. At a rural site, the average indoor/outdoor ratios for PM{sub 10}, PM{sub 2.5}, and PM{sub 1}, in kitchens using biomass fuels were 3.80, 4.36, and 4.11, respectively. A large variation was recorded in the mass concentration of particulate matter during cooking with concentrations in the range 4000-8555 mug/m3. In a living room at a rural site, the average indoor/outdoor ratios for PM{sub 10}, PM{sub 2.5}, and PM{sub 1} were 1.74, 2.49, and 3.01, respectively. At the urban site, the average indoor/outdoor ratios for the same size fractions were 1.71, 2.88, and 3.47, respectively. Cooking, cleaning and smoking were identified as principal contributors to the high indoor levels of particulate matter. This study showed considerably high concentrations of particulate matter, particularly in kitchens using biomass fuels, as compared to living areas. Thus women and children face the greatest exposure due to the amount of time they spend in the kitchen. (au)

  3. Characteristics of indoor/outdoor particulate pollution in urban and rural residential environment of Pakistan.

    Science.gov (United States)

    Colbeck, I; Nasir, Z A; Ali, Z

    2010-02-01

    Particulate pollution has emerged as a serious environmental health concern in Pakistan. The use of biomass fuels in traditional stoves produces high levels of indoor air pollutants. In Pakistan, 94% of rural and 58% of urban households depend on biomass fuel. This study investigates variations in indoor/outdoor concentrations of particulate matter during various activities for three different micro-environments in Pakistan. At a rural site, the average indoor/outdoor ratios for PM(10), PM(2.5), and PM(1), in kitchens using biomass fuels were 3.80, 4.36, and 4.11, respectively. A large variation was recorded in the mass concentration of particulate matter during cooking with concentrations in the range 4000-8555 microg/m(3). In a living room at a rural site, the average indoor/outdoor ratios for PM(10), PM(2.5), and PM(1) were 1.74, 2.49, and 3.01, respectively. At the urban site, the average indoor/outdoor ratios for the same size fractions were 1.71, 2.88, and 3.47, respectively. Cooking, cleaning and smoking were identified as principal contributors to the high indoor levels of particulate matter. This study showed considerably high concentrations of particulate matter, particularly in kitchens using biomass fuels, as compared to living areas. Thus women and children face the greatest exposure due to the amount of time they spend in the kitchen. In the developing world, particulate air pollution, both indoor and outdoor, is a substantial health hazard to the public. The very high concentrations of particulate matter in both rural and urban sites, particularly in kitchens using biomass fuels, emphasize the severity of this issue in Pakistan. Women and children are extensively at risk due to amount of time spent in kitchens. This state of affairs calls for a large-scale intervention to reduce the exposure to indoor air pollution.

  4. First 2 Years of Experience of "Residential Care" at "Sakalawara Rehabilitation Services," National Institute of Mental Health and Neurosciences, Bengaluru, India.

    Science.gov (United States)

    Manjunatha, Narayana; Agarwal, Preeti Pansari; Shashidhara, Harihara N; Palakode, Mohan; Raj, E Aravind; Mary Kapanee, Aruna Rose; Nattala, Prashanthi; Kumar, C Naveen; Sudhir, Paulomi; Thirthalli, Jagadisha; Bharath, Srikala; Sekar, Kasi; Varghese, Mathew

    2017-01-01

    There is an unmet need for continuity-of-care is well known for those with severe mental disorders (SMDs) after acute care at hospitals in India. The "Sakalawara Rehabilitation Services (SRS)" functioned from March 2014 at "Sakalawara Community Mental Health Centre" (SCMHC) of "National Institute of Mental Health and Neurosciences," Bengaluru, India in the concepts of residential care (half-way-home) with the aim to develop a replicable model. To review the inpatient records after the initial 2 years of experience in residential care at SCMHC. Retrospective file review of inpatients at SCMHC from March 2014 to March 2016 in a semi-structured proforma designed for the study. Ethical committee of NIMHANS Bengaluru has approved the study. The total number of inpatients during this period was 85. It was found that Schizophrenia spectrum disorders were the most common diagnosis among these patients. The activity of daily living and psycho-education were the most common individual interventions. The majority of families underwent structured family psycho-educational interventions. This review also demonstrated the feasibility of tele-aftercare in continuity of care after discharge of patients. SRS kind of residential set-up is feasible and demonstrated effectiveness in maintaining continuity of care of SMDs. There is a need for better structured and customized interventions. There is further a scope for tele (video) aftercare for those with SMDs.

  5. Human annoyance, acceptability and concern as responses to vibration from the construction of Light Rapid Transit lines in residential environments

    Energy Technology Data Exchange (ETDEWEB)

    Wong-McSweeney, D., E-mail: D.B.C.WongMcSweeney@salford.ac.uk [Acoustics Research Centre, University of Salford, Salford M5 4TW (United Kingdom); Woodcock, J.S.; Peris, E.; Waddington, D.C.; Moorhouse, A.T. [Acoustics Research Centre, University of Salford, Salford M5 4TW (United Kingdom); Redel-Macías, M.D. [Dep. Rural Engineering Campus de Rabanales, University of Córdoba, Córdoba (Spain)

    2016-10-15

    The aim of this paper is to investigate the use of different self-reported measures for assessing the human response to environmental vibration from the construction of an urban LRT (Light Rapid Transit) system. The human response to environmental stressors such as vibration and noise is often expressed in terms of exposure–response relationships that describe annoyance as a function of the magnitude of the vibration. These relationships are often the basis of noise and vibration policy and the setting of limit values. This paper examines measures other than annoyance by expressing exposure–response relationships for vibration in terms of self-reported concern about property damage and acceptability. The exposure–response relationships for concern about property damage and for acceptability are then compared with those for annoyance. It is shown that concern about property damage occurs at vibration levels well below those where there is any risk of damage. Earlier research indicated that concern for damage is an important moderator of the annoyance induced. Acceptability, on the other hand, might be influenced by both annoyance and concern, as well as by other considerations. It is concluded that exposure–response relationships expressing acceptability as a function of vibration exposure could usefully complement existing relationships for annoyance in future policy decisions regarding environmental vibration. The results presented in this paper are derived from data collected through a socio-vibration survey (N = 321) conducted for the construction of an urban LRT in the United Kingdom. - Highlights: • The human response to construction vibration is assessed in residential environments. • Exposure–response relationships are generated based on survey and semi-empirical vibration estimation. • Annoyance, concern and acceptability are compared as response measures. • Concern and acceptability are viable measures complementing annoyance.

  6. Study protocol: a randomised controlled trial testing the effectiveness of 'Op Volle Kracht' in Dutch residential care.

    Science.gov (United States)

    Weeland, Martine M; Nijhof, Karin S; Vermaes, Ignace; Engels, Rutger C M E; Buitelaar, Jan K

    2015-07-21

    Although adolescents are often referred to residential treatment centres because of severe externalizing behaviours, a vast majority demonstrated comorbid symptoms of depression and anxiety. Covert internalizing symptoms in these adolescents might be easily unrecognized and therefore untreated. Adolescents with mild intellectual disability (MID) are overrepresented among youth with both externalizing and internalizing problems. There are yet few treatment programs available for adolescents with both externalizing and internalizing problems. The CBT-based resiliency program, Op Volle Kracht (OVK), which is based on the US Penn Resiliency Program (PRP), was adapted to suit the needs of adolescents with both externalizing and internalizing problems, either with or without MID, in Dutch residential treatment centres. The effectiveness of this group intervention program of eight sessions will be tested in a randomised controlled trial (RCT) with N = 182 adolescents aged 12-16, allocated to either the target intervention plus treatment as usual (OVK + TAU) or treatment as usual only (TAU). The main outcome variables include depressive symptoms (primary), anxiety, behavioural problems, and group therapeutic climate. Cognitive styles and coping styles will be included as possible mediators. Assessments take place at baseline (T1), one week before the start of the program (T2), immediately after the program (T3), and at three months follow-up (T4). The program assets include its wide implementation possibilities due to low costs, the short duration of the program and the delivery by group care workers, and its suitability for adolescents with MID. Further strengths of the present study design include its robust method (RCT), the ecological validity, and the inclusion of possible mediators of treatment effect. The program emphasizes individual risk factors for depression rather than social and family factors. Implications for practice and future research are

  7. A Novel Implementation Strategy in Residential Care Settings to Promote EBP: Direct Care Provider Perceptions and Development of a Conceptual Framework.

    Science.gov (United States)

    Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Jones, C Allyson; Estabrooks, Carole A

    2017-06-01

    Innovative approaches are required to facilitate the adoption and sustainability of evidence-based care practices. We propose a novel implementation strategy, a peer reminder role, which involves offering a brief formal reminder to peers during structured unit meetings. This study aims to (a) identify healthcare aide (HCA) perceptions of a peer reminder role for HCAs, and (b) develop a conceptual framework for the role based on these perceptions. In 2013, a qualitative focus group study was conducted in five purposively sampled residential care facilities in western Canada. A convenience sample of 24 HCAs agreed to participate in five focus groups. Concurrent with data collection, two researchers coded the transcripts and identified themes by consensus. They jointly determined when saturation was achieved and took steps to optimize the trustworthiness of the findings. Five HCAs from the original focus groups commented on the resulting conceptual framework. HCAs were cautious about accepting a role that might alienate them from their co-workers. They emphasized feeling comfortable with the peer reminder role and identified circumstances that would optimize their comfort including: effective implementation strategies, perceptions of the role, role credibility and a supportive context. These intersecting themes formed a peer reminder conceptual framework. We identified HCAs' perspectives of a new peer reminder role designed specifically for them. Based on their perceptions, a conceptual framework was developed to guide the implementation of a peer reminder role for HCAs. This role may be a strategic implementation strategy to optimize the sustainability of new practices in residential care settings, and the related framework could offer guidance on how to implement this role. © 2017 Sigma Theta Tau International.

  8. Residential child and youth care in the Netherlands : Current practices and future perspectives

    NARCIS (Netherlands)

    Ten Brummelaar, Mijntje D.C.; Harder, Annemiek T.; Kalverboer, Margrite E.; Post, Wendy J.; Knorth, Erik J.; Islam, Tuhinul; Fulcher, Leon

    2017-01-01

    Pen picture accounts of four young people in the Netherlands’ care system help to focus attention on the needs of young people and their families. This also highlights issues facing the Dutch care system and how it is organised and funded. In one of the world’s most densely populated countries, the

  9. The Ryan Report (2009. A Practitioner's Perspective on Implications for Residential Child Care

    Directory of Open Access Journals (Sweden)

    Noel Howard

    2012-01-01

    Full Text Available This article suggests that recent abuse reports and the Ryan Report in particular are now warning signs etched in the consciousness of social care workers. Quite rightly, this consciousness will determine how social care workers approach their work with children in the care system. In many care units the incessant, ostensibly plausible, demands of bureaucracy mean that children exist in an artificial, sanitised care bubble where they are bereft of structure, empathy, spontaneity and real relationships – the very things they crave. Written in a personal capacity and based on the author’s background practice experience, some of this article represents points of view rather than evidential conclusions. The article’s purpose is to contribute to debate, so necessary if lessons of the Ryan Report are really to be learned.

  10. Validation of Geriatric Care Environment Scale in Portuguese Nurses

    Directory of Open Access Journals (Sweden)

    João Paulo de Almeida Tavares

    2013-01-01

    Full Text Available The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES among 1,068 Portuguese registered nurses (RNs. Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α=.919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

  11. Validation of geriatric care environment scale in portuguese nurses.

    Science.gov (United States)

    Paulo de Almeida Tavares, João; Leite da Silva, Alcione; Sá-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth

    2013-01-01

    The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α = .919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

  12. A Randomized Controlled Trial of Brain-Activating Rehabilitation for Elderly Participants with Dementia in Residential Care Homes

    Directory of Open Access Journals (Sweden)

    Tetsuya Yamagami

    2012-09-01

    Full Text Available Background/Aims: We aimed to prove the effectiveness of brain-activating rehabilitation for dementia, which consisted of 5 principles: pleasant atmosphere, communication, praising, social role, and supportive care. Methods: The design was a randomized controlled trial that was not blinded. Fifty-four elderly participants with dementia (mean age: 85.2 years were selected. Intervention based on the 5 principles of brain-activating rehabilitation was conducted for 1 h, twice a week, for 12 weeks (24 sessions. The control group had no treatment. Outcome measures consisted of two observation scales, namely sum of boxes in clinical dementia rating (CDR-SB and the multidimensional observation scale for elderly subjects (MOSES, and two cognitive tests: the Hasegawa dementia scale revised (HDS-R and trail making test A. Results: Repeated measure ANCOVA showed a significant interaction for total score of CDR-SB (F = 7.190, p = 0.015 and MOSES (F = 4.525, p = 0.038. There were no significant changes in the two cognitive test scores. Conclusion: Intervention based on the principles of brain-activating rehabilitation was effective in maintaining and improving daily life functions in elderly participants with dementia in residential care homes.

  13. Make a Move: A Comprehensive Effect Evaluation of a Sexual Harassment Prevention Program in Dutch Residential Youth Care.

    Science.gov (United States)

    van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C

    2016-06-27

    Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of sexual harassment. However, in general, there are very few interventions targeting this at-risk group, and no such programs exist in the Netherlands. To this end, a group intervention program-Make a Move-targeting determinants of sexual harassment was developed. This program was implemented and evaluated among boys (N = 177) in Dutch residential youth care (20 institutions). A pre-test, post-test, and 6-month follow-up design including an intervention and a waiting list control group with randomized assignment of institutions (cluster randomized trial) was used to measure the effects of the intervention on determinants of sexual harassment. Multilevel (mixed) regression analysis with Bonferroni correction for multiple testing (α = .005) showed no significant effects of Make a Move on determinants of sexual harassment (ps > .03, Cohen's ds < .44). Results are discussed in light of a three-way explanatory model focusing on intervention content, evaluation, and implementation as potential explanations for not finding any measurable intervention effects. © The Author(s) 2016.

  14. How do community-dwelling LGBT people perceive sexuality in residential aged care? A systematic literature review.

    Science.gov (United States)

    Mahieu, Lieslot; Cavolo, Alice; Gastmans, Chris

    2018-01-22

    To investigate what empirical studies report on the perceptions of community-dwelling LGBT adults regarding sexuality and sexual expression in residential aged care (RAC), and how their sexuality should be addressed in RAC. Relevant papers were identified through electronic searches in databases; and by reference tracking and citation tracking. Data were extracted using a standardized data extraction form and were compared, related, and synthesized using thematic analyses. We evaluated the methodological quality of the studies. Eighteen articles were identified. Three major topics emerged regarding sexuality in RAC: (1) factors affecting LGBT people's perceptions, subdivided into (a) discrimination, (b) loss of sexual identity, (c) failure to acknowledge the same-sex partner, and (d) lack of privacy; (2) LGBT-specific RAC facilities; and (3) characteristics of LGBT friendly RAC facilities and caregivers. LGBT people have clear perceptions about how sexuality and sexual expression is or should be managed in RAC. Despite the general increase in acceptance of sexual minorities, many community-dwelling LGBT people believe older LGBT residents are discriminated against because of their sexual orientation or gender identity. Taking into account these opinions is crucial for increasing accessibility of RAC to LGBT people and to ensure the quality of the provided care.

  15. Training of Residential Social Care Staff to Meet the Needs of Older People with Intellectual Disabilities who Develop Age-Related Health Problems: An Exploratory Study.

    Science.gov (United States)

    Northway, Ruth; Jenkins, Robert; Holland-Hart, Daniella

    2017-09-01

    Despite awareness of the age related health needs of people with intellectual disabilities little is known regarding how residential social care staff are prepared to meet such needs. Data were gathered via semi-structured interviews from 14 managers of supported living settings. Transcripts were thematically analysed. Staff may work in supported living settings with no prior experience of care work, and previous knowledge/experience of supporting people in relation to their health is not required. Whilst health related training is provided there is a lack of specific training regarding healthy ageing, and training seems to be reactive to changing needs of tenants meaning that proactive monitoring for changes in health status may not occur. Whilst some training is provided for residential social care staff in relation to health and ageing a more proactive approach is required which should include a focus on healthy ageing. © 2016 John Wiley & Sons Ltd.

  16. Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

    Directory of Open Access Journals (Sweden)

    Bamford Claire

    2012-10-01

    Full Text Available Abstract Background Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT to understand the barriers and facilitators to implementing the guidelines and inform future implementation. Methods We conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews to explore the views of managers, care staff, catering staff, and domestic staff. Data were analyzed thematically and discussed in data workshops; emerging themes were then mapped to the constructs of NPT. Results Many staff perceived the guidelines as unnecessarily restrictive and irrelevant to older people. In terms of NPT, the guidelines simply did not make sense (coherence, and as a result, relatively few staff invested in the guidelines (cognitive participation. Even where staff supported the guidelines, implementation was hampered by a lack of nutritional knowledge and institutional support (collective action. Finally, the absence of observable benefits to clients confirmed the negative preconceptions of many staff, with limited evidence of reappraisal following implementation (reflexive monitoring. Conclusions The successful implementation of the nutrition guidelines requires that the fundamental issues relating to their perceived value and fit with other priorities and goals be addressed. Specialist support is needed to equip staff with the technical knowledge and skills required for menu analysis and development and to

  17. Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

    Science.gov (United States)

    2012-01-01

    Background Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT) to understand the barriers and facilitators to implementing the guidelines and inform future implementation. Methods We conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews) to explore the views of managers, care staff, catering staff, and domestic staff. Data were analyzed thematically and discussed in data workshops; emerging themes were then mapped to the constructs of NPT. Results Many staff perceived the guidelines as unnecessarily restrictive and irrelevant to older people. In terms of NPT, the guidelines simply did not make sense (coherence), and as a result, relatively few staff invested in the guidelines (cognitive participation). Even where staff supported the guidelines, implementation was hampered by a lack of nutritional knowledge and institutional support (collective action). Finally, the absence of observable benefits to clients confirmed the negative preconceptions of many staff, with limited evidence of reappraisal following implementation (reflexive monitoring). Conclusions The successful implementation of the nutrition guidelines requires that the fundamental issues relating to their perceived value and fit with other priorities and goals be addressed. Specialist support is needed to equip staff with the technical knowledge and skills required for menu analysis and development and to devise ways of evaluating

  18. An evaluation of the impact of flooring types on exposures to fine and coarse particles within the residential micro-environment using CONTAM.

    Science.gov (United States)

    Bramwell, Lisa; Qian, Jing; Howard-Reed, Cynthia; Mondal, Sumona; Ferro, Andrea R

    2016-01-01

    Typical resuspension activities within the home, such as walking, have been estimated to contribute up to 25% of personal exposures to PM10. Chamber studies have shown that for moderate walking intensities, flooring type can impact the rate at which particles are re-entrained into the air. For this study, the impact of residential flooring type on incremental average daily (24 h) time-averaged exposure was investigated. Distributions of incremental time-averaged daily exposures to fine and coarse PM while walking within the residential micro-environment were predicted using CONTAM, the multizone airflow and contaminant transport program of the National Institute of Standards and Technology. Knowledge of when and where a person was walking was determined by randomly selecting 490 daily diaries from the EPA's consolidated human activity database (CHAD). On the basis of the results of this study, residential flooring type can significantly impact incremental time-averaged daily exposures to coarse and fine particles (α=0.05, Pmicro-environment contributed 6-72% of time-averaged daily exposures to PM10.

  19. Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada.

    Science.gov (United States)

    Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita

    2016-08-01

    This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

  20. The Palliative Performance Scale Applied in High-Care Residential Hospice: A Retrospective Study

    NARCIS (Netherlands)

    Jansen, W.J.J.; Buma, S.A.; Gootjes, J.R.G.; Zuurmond, W.W.A.; Perez, R.S.G.M.; Loer, S.A.

    2015-01-01

    Background: The Palliative Performance Scale (PPS) is a tool that is widely used to predict end of life. In Ontario, Canada, the PPS is used to mark the terminal phase of life and eligibility for terminal care.

  1. Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol.

    Science.gov (United States)

    Yi Mohammadi, Joanna Jin; Franks, Kay; Hines, Sonia

    2015-10-01

    The objective of this review is to critically appraise and synthesize evidence on the effectiveness of professional oral health care intervention on the oral health of aged care residents with dementia.More specifically the objectives are to identify the efficacy of professional oral health care interventions on general oral health, the presence of plaque and the number of decayed or missing teeth. Dementia poses a significant challenge for health and social policy in Australia. The quality of life of individuals, their families and friends is impacted by dementia. Older people with dementia often have other health comorbidities resulting in the need for a higher level of care. From 2009 to 2010, 53% of permanent residents in Residential Aged Care Facilities (RACFs) had dementia on admission. Older Australians are retaining more of their natural teeth, therefore residents entering RACFs will have more of their natural teeth and require complex dental work than they did in previous generations. Data from the Australian Institute of Health and Welfare showed that more than half the residents in RACFs are now partially dentate with an average of 12 teeth each. Furthermore, coronal and root caries are significant problems, especially in older Australians who are cognitively impaired.Residents in aged care facilities frequently have poor oral health and hygiene with moderate to high levels of oral disease and overall dental neglect. This is reinforced by aged care staff who acknowledge that the demands of feeding, toileting and behavioral issues amongst residents often take precedence over oral health care regimens. Current literature shows that there is a general reluctance on the part of aged care staff to prioritize oral care due to limited knowledge as well as existing psychological barriers to working on another person's mouth. Although staff routinely deal with residents' urinary and faecal incontinence, deep psychological barriers exist when working on someone

  2. Rethinking the intensive care environment: considering nature in nursing practice.

    Science.gov (United States)

    Minton, Claire; Batten, Lesley

    2016-01-01

    With consideration of an environmental concept, this paper explores evidence related to the negative impacts of the intensive care unit environment on patient outcomes and explores the potential counteracting benefits of 'nature-based' nursing interventions as a way to improve care outcomes. The impact of the environment in which a patient is nursed has long been recognised as one determinant in patient outcomes. Whilst the contemporary intensive care unit environment contains many features that support the provision of the intensive therapies the patient requires, it can also be detrimental, especially for long-stay patients. This narrative review considers theoretical and evidence-based literature that supports the adoption of nature-based nursing interventions in intensive care units. Research and theoretical literature from a diverse range of disciplines including nursing, medicine, psychology, architecture and environmental science were considered in relation to patient outcomes and intensive care nursing practice. There are many nature-based interventions that intensive care unit nurses can implement into their nursing practice to counteract environmental stressors. These interventions can also improve the environment for patients' families and nurses. Intensive care unit nurses must actively consider and manage the environment in which nursing occurs to facilitate the best patient outcomes. © 2015 John Wiley & Sons Ltd.

  3. The Living, Dynamic and Complex Environment Care in Intensive Care Unit.

    Science.gov (United States)

    Backes, Marli Terezinha Stein; Erdmann, Alacoque Lorenzini; Büscher, Andreas

    2015-01-01

    to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care. Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units. built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions); "Providing a suitable environment" and "having relatives with concern" (context); "Mediating facilities and difficulties" (intervenienting conditions); "Organizing the environment and managing the dynamics of the unit" (strategy) and "finding it difficult to accept and deal with death" (consequences). confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

  4. Re-Imagining the Care Home: A Spatially Responsive Approach to Arts Practice with Older People in Residential Care

    Science.gov (United States)

    Hatton, Nicola

    2014-01-01

    This paper considers some of the spatial challenges of doing arts projects with older people in care homes, including those living with dementia. It reflects on the author's own experience of running a performance project with residents with at a care home in North London. Drawing on Lefebvre's concept of socially produced space, it argues that…

  5. Massage, a complementary therapy effectively promoting the health and well-being of older people in residential care settings: a review of the literature.

    Science.gov (United States)

    McFeeters, Sarah; Pront, Leeanne; Cuthbertson, Lesley; King, Lindy

    2016-12-01

    To explore the potential benefits of massage within daily routine care of the older person in residential care settings. Globally, the proportion of people over 65 years is rapidly rising. Increased longevity means older people may experience a rise in physiological and psychological health problems. These issues potentially place an increased demand for quality long-term care for the older person. Complementary approaches such as massage appear to be needed in quality residential care. A critical literature review was undertaken. A literature review pertaining to massage in the older resident was conducted using a range of online databases. Fourteen studies dated 1993-2012 met the inclusion criteria and were critically evaluated as suitable resources for this review. Evidence suggests massage may be advantageous from client and nursing perspectives. Clients' perceive massage to positively influence factors such as pain, sleep, emotional status and psychosocial health. Evidence also demonstrates massage to benefit the client and organisation by reducing the necessity for restraint and pharmacological intervention. Massage may be incorporated into care provision and adopted by care providers and family members as an additional strategy to enhance quality of life for older people. Massage offers a practical activity that can be used to enhance the health and well-being of the older person in residential care. Massage offers benefit for promoting health and well-being of the older person along with potential increased engagement of family in care provision. Integration of massage into daily care activities of the older person requires ongoing promotion and implementation. © 2016 John Wiley & Sons Ltd.

  6. Cost Effectiveness of Falls and Injury Prevention Strategies for Older Adults Living in Residential Aged Care Facilities.

    Science.gov (United States)

    Church, Jody L; Haas, Marion R; Goodall, Stephen

    2015-12-01

    To evaluate the cost effectiveness of interventions designed to prevent falls and fall-related injuries among older people living in residential aged care facilities (RACFs) from an Australian health care perspective. A decision analytic Markov model was developed that stratified individuals according to their risk of falling and accounted for the risk of injury following a fall. The effectiveness of the interventions was derived from two Cochrane reviews of randomized controlled trials for falls/fall-related injury prevention in RACFs. Interventions were considered effective if they reduced the risk of falling or reduced the risk of injury following a fall. The interventions that were modelled included vitamin D supplementation, annual medication review, multifactorial intervention (a combination of risk assessment, medication review, vision assessment and exercise) and hip protectors. The cost effectiveness was calculated as the incremental cost relative to the incremental benefit, in which the benefit was estimated using quality-adjusted life-years (QALYs). Uncertainty was explored using univariate and probabilistic sensitivity analysis. Vitamin D supplementation and medication review both dominated 'no intervention', as these interventions were both more effective and cost saving (because of healthcare costs avoided). Hip protectors are dominated (less effective and more costly) by vitamin D and medication review. The incremental cost-effectiveness ratio (ICER) for medication review relative to vitamin D supplementation is AU$2442 per QALY gained, and the ICER for multifactorial intervention relative to medication review is AU$1,112,500 per QALY gained. The model is most sensitive to the fear of falling and the cost of the interventions. The model suggests that vitamin D supplementation and medication review are cost-effective interventions that reduce falls, provide health benefits and reduce health care costs in older adults living in RACFs.

  7. Promoting student learning and increasing organizational capacity to host students in residential aged care: a mixed method research study.

    Science.gov (United States)

    Grealish, Laurie; Lucas, Nikki; Neill, James; McQuellin, Carmel; Bacon, Rachel; Trede, Franziska

    2013-07-01

    In Australia, the Federal government's agenda to increase clinical training places to address the forecast shortfall of nurses is driving innovation in clinical education. A student leadership model of clinical education, named the Student Nurse Led Ward model, was designed for the aged care context to provide a high number of clinical placements for pre-service Bachelor of Nursing students in an under-utilized clinical education setting. The research aimed to determine the viability of the innovation by (1) developing a preliminary understanding of what students were learning and (2) exploring stakeholders' perceptions about student learning. A mixed methods design included an ageing knowledge test and ageing attitudes survey, both administered before and after the placement, student narratives of a learning event written after the placement, as well as focus group and individual interviews with stakeholders. Three residential aged care facilities partnering with one university in one Australian jurisdiction. Included 35 of the 45 students who began placement in the aged care facilities during one semester, a convenience sample of 15 staff and each of the managers and educators from the three agencies. Descriptive statistical analysis of student pre-post knowledge test and attitude survey, hermeneutic analysis of student narratives, and content analysis of individual and group interview data. There was an increase in student knowledge around sensory changes, delirium, and drug reactions in older people. There was a slight increase in students' expression of ageist attitudes following the clinical experience. The clinical educator position was considered to be critical to the success of the model. This Student Nurse Led Ward model is a viable model to increase clinical placements, with preliminary evidence in this study suggesting that students benefit through increased knowledge, understanding and capacity to work with older people. Copyright © 2012 Elsevier Ltd

  8. Comparison of Four Probabilistic Models (CARES, Calendex, ConsEspo, SHEDS) to Estimate Aggregate Residential Exposures to Pesticides

    Science.gov (United States)

    Two deterministic models (US EPA’s Office of Pesticide Programs Residential Standard Operating Procedures (OPP Residential SOPs) and Draft Protocol for Measuring Children’s Non-Occupational Exposure to Pesticides by all Relevant Pathways (Draft Protocol)) and four probabilistic mo...

  9. Biotechnology: Health care, agriculture, industry, environment

    Energy Technology Data Exchange (ETDEWEB)

    Sikyta, B.; Pavlasova, E.; Stejskalova, E.

    1986-01-01

    New developments in different branches of biotechnology are discussed. The production of peptide hormones, new interferons and other lymphokines by the microbial and cell cultures, and new enzyme inhibitors of microbial origin are the most important for health care and pharmacy. The main direction in research in the agriculture represents the development of the new, very effective methods of nitrogen fixation and the production of animal growth hormones by gene manipulated microorganisms. One of the most important field of application of biotechnology is the chemical industry, c.f. microbial production of polymers and biotransformation of compounds previously produced by chemical methods (acrylamide, adipic acid, naphthalene conversion, etc.). Several novel methods of degradation of the cellulosic materials are mentioned and exploitation of biotechnology in environmental protection is also discussed.

  10. The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial.

    Science.gov (United States)

    Jeon, Yun-Hee; Simpson, Judy M; Chenoweth, Lynn; Cunich, Michelle; Kendig, Hal

    2013-10-25

    A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care--CLiAC) was developed to improve managers' leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be compared by cluster

  11. The Admission of Older People Into Residential Care Homes in Argentina: Coercion and Human Rights Abuse.

    Science.gov (United States)

    Lloyd-Sherlock, Peter; Penhale, Bridget; Redondo, Nelida

    2018-03-23

    There is very little information about the appropriateness of procedures for admitting older people into care homes in low and middle-income countries like Argentina. This study provides the first systematic study of practice and assesses the extent to which current practice respects fundamental human rights. We apply different methods, including document review and national survey analysis. The study also includes a case study of a single city, La Plata, which draws on local key informant interviews, focus group discussions in different neighborhoods, and a clandestine surrogate patient survey led by local pensioners. This innovative design provides a highly triangulated and contextualized data set. Many older people admitted to care homes did not have high levels of care dependency. Care homes did not usually require or even seek the informed consent of older people, regardless of their cognitive status. There were indications of coercive admission by family members, sometimes in order to obtain access to older people's homes and other property and finances. The study indicates the widespread abuse of the fundamental human rights of tens of thousands of older people in Argentina. There is a need for researchers, policy-makers, and civil society to acknowledge the scale of abuse and develop safeguards.

  12. Intergenerational proximity and the residential relocation of older people to care institutions and elsewhere

    NARCIS (Netherlands)

    van der Pers, Marieke; Kibele, Eva; Mulder, Clara H.

    2015-01-01

    We investigated the extent to which the geographic proximity of adult children affected the relocations of older people in the Netherlands in 2008. A major contribution of this study is the examination of the differentiation between relocation to care institutions and elsewhere. Data from the Dutch

  13. A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

    Science.gov (United States)

    Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P

    2011-01-01

    The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. ANZCTR.org.au ACTRN12607000417482.

  14. A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

    Directory of Open Access Journals (Sweden)

    Christopher Beer

    Full Text Available BACKGROUND: The Dementia In Residential care: EduCation intervention Trial (DIRECT was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. METHODOLOGY/PRINCIPAL FINDINGS: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15 higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. CONCLUSION: The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12607000417482.

  15. Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

    Science.gov (United States)

    Francis-Coad, Jacqueline; Etherton-Beer, Christopher; Bulsara, Caroline; Nobre, Debbie; Hill, Anne-Marie

    The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Measuring fall risk and predicting who will fall: clinimetric properties of four fall risk assessment tools for residential aged care.

    Science.gov (United States)

    Barker, Anna L; Nitz, Jennifer C; Low Choy, Nancy L; Haines, Terry

    2009-08-01

    The purpose of this prospective cohort study was to describe the clinimetric evaluation of four fall risk assessment tools (FRATs) recommended in best practice guidelines for use in residential aged care (RAC). Eighty-seven residents, mean age 81.59 years (SD +/-10.69), participated. The Falls Assessment Risk and Management Tool (FARAM), Peninsula Health Fall Risk Assessment Tool (PHFRAT), Queensland Fall Risk Assessment Tool (QFRAT), and Melbourne Fall Risk Assessment Tool (MFRAT) were completed at baseline, and 2 and 4 months, and falls occurring in the 6 months after the baseline assessment were recorded. Interrater agreement (kappa), predictive accuracy (survival analysis and Youden Index), and fit to the Rasch model were examined. Twelve-month fall history formed the predictive accuracy reference. Interrater risk classification agreement was high for the PHFRAT (small ka, Cyrillic = .84) and FARAM (small ka, Cyrillic = .81), and low for the QFRAT (small ka, Cyrillic = .51) and MFRAT (small ka, Cyrillic = .21). Survival analysis identified that 43%-66% of risk factors on each tool had no (p > .10) association with falls. No tool had higher predictive accuracy (Youden index) than the question, "has the resident fallen in past 12 months?" (p > .05). All tools did not exhibit fit to the Rasch model, invalidating summing of risk factor scores to provide an overall risk score. The studied tools have poor clinimetric properties, casting doubt about their usefulness for identifying fall risk factors for those most at risk for falling and measuring fall risk in RAC.

  17. Impacts of the emergency mass evacuation of the elderly from residential care facilities after the 2011 Christchurch earthquake.

    Science.gov (United States)

    Heppenstall, Claire P; Wilkinson, Tim J; Hanger, H Carl; Dhanak, Michelle R; Keeling, Sally

    2013-08-01

    The 2011 earthquake that devastated Christchurch, New Zealand, led to the closure and evacuation of 7 residential care facilities and the partial evacuation of 2 more. Altogether, 516 elderly persons were evacuated. The emergent nature of the disaster was unexpected and largely unplanned for. This study explored the evacuees' experiences and identified lessons learned for future disaster planning. This qualitative study used a general inductive method. Semistructured interviews with evacuees were held in 4 centers throughout New Zealand. Their informal caregivers were also identified and interviewed. Answers were coded and grouped for key themes to provide lessons learned for future disaster planning. We conducted 50 interviews with older people and 34 with informal caregivers. Key themes that emerged were resilience and factors that promoted resilience, including personal attitudes, life experiences, enhanced family support, and social supports. Areas of concern were (1) the mental health of evacuees: 36% reported some symptoms of anxiety, while 32.4% of caregivers reported some cognitive decline; and (2) communication difficulties during the evacuations. Older people were remarkably resilient to the difficult events, and resilience was promoted by family and community support. Anxiety was reported by older people, while informal caregivers reported cognitive issues. Communication difficulties were a major concern.

  18. Measuring the performance of electronic health records: a case study in residential aged care in Australia.

    Science.gov (United States)

    Yu, Ping; Qian, Siyu; Yu, Hui; Lei, Jianbo

    2013-01-01

    Measuring the performance of electronic health records (EHR) is an important, yet un-resolved challenge. Various measurements have addressed different aspects of EHR success, yet a holistic, comprehensive measurement tool needs to be developed to capture the potential EHR success variables completely. A self-administered questionnaire survey instrument was developed based on the theoretical framework of the DeLone and McLean Information Systems Success Model. It measures nigh variables of EHR success: system quality, information quality, service quality, training, self efficacy, intention to use, use, user satisfaction and net benefits. The instrument was used to measure the performance of aged care EHR systems in three aged care organizations. The results suggest that the instrument was reliable.

  19. Nonphysician Care Providers Can Help to Increase Detection of Cognitive Impairment and Encourage Diagnostic Evaluation for Dementia in Community and Residential Care Settings.

    Science.gov (United States)

    Maslow, Katie; Fortinsky, Richard H

    2018-01-18

    In the United States, at least half of older adults living with dementia do not have a diagnosis. Their cognitive impairment may not have been detected, and some older adults whose physician recommends that they obtain a diagnostic evaluation do not follow through on the recommendation. Initiatives to increase detection of cognitive impairment and diagnosis of dementia have focused primarily on physician practices and public information programs to raise awareness about the importance of detection and diagnosis. Nonphysician care providers who work with older adults in community and residential care settings, such as aging network agencies, public health agencies, senior housing, assisted living, and nursing homes, interact frequently with older adults who have cognitive impairment but have not had a diagnostic evaluation. These care providers may be aware of signs of cognitive impairment and older adults' concerns about their cognition that have not been expressed to their physician. Within their scope of practice and training, nonphysician care providers can help to increase detection of cognitive impairment and encourage older adults with cognitive impairment to obtain a diagnostic evaluation to determine the cause of the condition. This article provides seven practice recommendations intended to increase involvement of nonphysician care providers in detecting cognitive impairment and encouraging older adults to obtain a diagnostic evaluation. The Kickstart-Assess-Evaluate-Refer (KAER) framework for physician practice in detection and diagnosis of dementia is used to identify ways to coordinate physician and nonphysician efforts and thereby increase the proportion of older adults living with dementia who have a diagnosis. © The Author(s) 2018. 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.

  20. Invitational rhetoric: Alternative rhetorical strategy for transformation of perception and use of energy in the residential built environment from the Keweenaw to Kerala

    Science.gov (United States)

    Kindred, Merle Niemi

    This dissertation explores the viability of invitational rhetoric as a mode of advocacy for sustainable energy use in the residential built environment. The theoretical foundations for this study join ecofeminist concepts and commitments with the conditions and resources of invitational rhetoric, developing in particular the rhetorical potency of the concepts of re-sourcement and enfoldment. The methodological approach is autoethnography using narrative reflection and journaling, both adapted to and developed within the autoethnographic project. Through narrative reflection, the author explores her lived experiences in advocating for energy-responsible residential construction in the Keweenaw Peninsula of Michigan. The analysis reveals the opportunities for cooperative, collaborative advocacy and the struggle against traditional conventions of persuasive advocacy, particularly the centrality of the rhetor. The author also conducted two field trips to India, primarily the state of Kerala. Drawing on autoethnographic journaling, the analysis highlights the importance of sensory relations in lived advocacy and the resonance of everyday Indian culture to invitational principles. Based on field research, the dissertation proposes autoethnography as a critical development in encouraging invitational rhetoric as an alternative mode of effecting change. The invitational force of autoethnography is evidenced in portraying the material advocacy of the built environment itself, specifically the sensual experience of material arrangements and ambience, as well as revealing the corporeality of advocacy, that is, the body as the site of invitational engagement, emotional encounter, and sensory experience. This study concludes that vulnerability of self in autoethnographic work and the vulnerability of rhetoric as invitational constitute the basis for transformation. The dissertation confirms the potential of an ecofeminist invitational advocacy conveyed autoethnographically for

  1. Can the impact on health of a government policy designed to create more liveable neighbourhoods be evaluated? An overview of the RESIDential Environment Project.

    Science.gov (United States)

    Giles-Corti, Billie; Knuiman, Matthew; Pikora, Terri J; Van Neil, Kimberly; Timperio, Anna; Bull, Fiona C L; Shilton, Trevor; Bulsara, Max

    2007-01-01

    There is growing interest in the impact of community design on the health of residents. In 1998, the Western Australian Government began a trial of new subdivision design codes (i.e. Liveable Neighbourhoods Community Design Code) aimed at creating pedestrian-friendly neighbourhoods to increase walking, cycling and public transport use. The trial provided a unique opportunity for a natural experiment to evaluate the impact of a government planning policy on residents. Nevertheless, evaluations of this kind present a number of methodological challenges in obtaining the highest quality evidence possible. This paper describes the RESIDential Environment Project's study design and discusses how various methodological challenges were overcome.

  2. Interaction Between Physical Environment, Social Environment, and Child Characteristics in Determining Physical Activity at Child Care

    NARCIS (Netherlands)

    Gubbels, J.S.; Kremers, S.P.J.; Kann, D.H.H. van; Stafleu, A.; Candel, M.J.J.M.; Dagnelie, P.C.; Thijs, C.; Vries, N.K.de

    2011-01-01

    Objective: To investigate the association between the child-care environment and physical activity of 2- and 3-year-olds. Based on an ecological view of environmental influences on health behavior, we hypothesized that the social and physical environment, as well as child characteristics (age and

  3. Residential Care Home Unit 5 & Unit 6 (Merlin Park Hospital), Merlin Park, Galway.

    LENUS (Irish Health Repository)

    Boland, Karen

    2016-10-01

    The equitable provision of home enteral nutrition (HEN) in the community can have a transformative effect on patient experience and family life for adults and children alike. While optimising quality of life in HEN patients can be challenging, the initiation of HEN positively impacts this measure of healthcare provision.1 Quality of life scores have been shown to improve in the weeks after hospital discharge, and HEN is physically well tolerated. However, it may be associated with psychological distress, and sometimes reluctance among HEN patients to leave their homes.2 Globally, HEN can attenuate cumulative projected patient care costs through a reduction in hospital admission and complications including hospital acquired infections.3 In an era where the cost of disease related malnutrition and associated prolonged hospital stay is being tackled in our healthcare systems, the role of HEN is set to expand. This is a treatment which has clear clinical and social benefits, and may restore some independence to patients and their families. Rather than the indications for HEN being focused on specific diagnoses, the provision of months of quality life at home for patients is adequate justification for its prescription.4 Previously, a review of HEN service provision in 39 cases demonstrated that patients want structured follow-up after hospital discharge, and in particular, would like one point of contact for HEN education and discharge.5 Management structures, funding challenges and the need for further education, particularly within the primary care setting may limit optimal use of HEN. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) aims to develop a national guideline document, drawing on international best practice, forming a template and standards for local policy development in the area of HEN service provision, training and follow-up. The first step in guideline development was to investigate patient experience for adults and children alike. Care

  4. Pivoting: leveraging opportunities in a turbulent health care environment.

    Science.gov (United States)

    Bandy, Margaret Moylan

    2015-01-01

    The purpose of this lecture is to challenge librarians in clinical settings to leverage the opportunities presented by the current health care environment and to develop collaborative relationships with health care practitioners to provide relevant services. Health care organizations are under financial and regulatory pressures, and many hospital librarians have been downsized or have had their positions eliminated. The lecture briefly reviews hospital librarians' roles in the past but focuses primarily on our current challenges. This environment requires librarians to be opportunity focused and pivot to a new vision that directs their actions. Many librarians are already doing this, and colleagues are encouraging us to embrace these opportunities. Evidence from publications, websites, discussion lists, personal communications, and the author's experience is explored. Developing interdisciplinary and collaborative relationships in our institutions and providing relevant services will mark our progress as vital, contributing members of our health care organizations.

  5. Income statement management in a turbulent health care environment.

    Science.gov (United States)

    Covaleski, M A

    2001-03-01

    This article considers the role of accounting information embedded in the income statement of health care providers in their increasingly difficult economic environment. This turbulent economic environment has resulted from the dramatic shift in power from the seller to the buyer of health care services, with a consequential shift of risks that will mandate that health care providers obtain access to better cost and utilization information. This article looks at the 2 critical components of the income statement--the revenue function and the cost structure-in terms of their importance in the management of enhanced economic performance in both the fee-for-service and the prepaid provision of health care services. Copyright 2001 by W.B. Saunders Company

  6. Infection control assessment after an influenza outbreak in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions.

    Science.gov (United States)

    Azofeifa, Alejandro; Yeung, Lorraine F; Peacock, Georgina; Moore, Cynthia A; Rodgers, Loren; DiOrio, Mary; Page, Shannon L; Fowler, Brian; Stone, Nimalie D; Finelli, Lyn; Jhung, Michael A

    2013-07-01

    To assess the knowledge, attitudes, and practices of infection control among staff in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions. Self-administered survey. Residential care facility (facility A). Facility A staff ([Formula: see text]). We distributed a survey to staff at facility A. We classified staff with direct care responsibilities as clinical (ie, physicians, nurses, and therapists) or nonclinical (ie, habilitation assistants, volunteers, and teachers) and used χ(2) tests to measure differences between staff agreement to questions. Of 248 surveys distributed, 200 (81%) were completed; median respondent age was 36 years; 85% were female; and 151 were direct care staff (50 clinical, 101 nonclinical). Among direct care staff respondents, 86% agreed they could identify residents with respiratory symptoms, 70% stayed home from work when ill with respiratory infection, 64% agreed that facility administration encouraged them to stay home when ill with respiratory infection, and 72% reported that ill residents with respiratory infections were separated from well residents. Clinical and nonclinical staff differed in agreement about using waterless hand gel as a substitute for handwashing (96% vs 78%; [Formula: see text]) and whether handwashing was done after touching residents (92% vs 75%; [Formula: see text]). Respondents' knowledge, attitudes, and practices regarding infection control could be improved, especially among nonclinical staff. Facilities caring for children and young adults with neurologic and neurodevelopmental conditions should encourage adherence to infection control best practices among all staff having direct contact with residents.

  7. Study protocol: a randomised controlled trial testing the effectiveness of 'Op Volle Kracht' in Dutch residential care

    NARCIS (Netherlands)

    Weeland, M.M.; Nijhof, K.S.; Vermaes, I.; Engels, R.C.M.E.; Buitelaar, J.K.

    2015-01-01

    BACKGROUND: Although adolescents are often referred to residential treatment centres because of severe externalizing behaviours, a vast majority demonstrated comorbid symptoms of depression and anxiety. Covert internalizing symptoms in these adolescents might be easily unrecognized and therefore

  8. The effectiveness of an integrated collaborative care model vs. a shifted outpatient collaborative care model on community functioning, residential stability, and health service use among homeless adults with mental illness: a quasi-experimental study.

    Science.gov (United States)

    Stergiopoulos, Vicky; Schuler, Andrée; Nisenbaum, Rosane; deRuiter, Wayne; Guimond, Tim; Wasylenki, Donald; Hoch, Jeffrey S; Hwang, Stephen W; Rouleau, Katherine; Dewa, Carolyn

    2015-08-28

    Although a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model. In total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains. We observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures. Our findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.

  9. Residential age care and domiciliary oral health services: Reach-OHT-The development of a metropolitan oral health programme in Sydney, Australia.

    Science.gov (United States)

    Wright, F A Clive; Law, Garry; Chu, Steven K-Y; Cullen, John S; Le Couteur, David G

    2017-12-01

    To describe an oral health care programme for older people in Residential Aged Care Facilities (RACFs) to improve access to care and support facilities. Different models of residential care have been proposed, but few have been comprehensive (providing on-site health promotion and service delivery) or sustainable. A partnership model of oral health care, with dental services plus oral health education, was integrated into the community outreach services of a metropolitan hospital department of aged care. The programme provided annual oral health education and training to staff, and on-site dental care to 10 (RACFs). None of the RACFs had received organised education or on-site dental service care prior to the programme. At the completion of the third year of the programme, 607 residents (75% of the total bed capacity for the 10 RACFs) had received an annual oral health assessment, and 271 (46.5%) had received on-site dental care. More than 120 nursing and allied health staff had received education and training in oral health support to residents. Oral cleanliness, the proportion not experiencing dental pain and referral for additional care decreased significantly over the period, but dental caries experience and periodontal conditions remained a concern. Sustainable domiciliary oral health services and oral health education are feasible and practical using a partnership model within the Australian health system. Adaptability, continuity and the use of oral health therapists/dental hygienists in the coordination and management of the programme further contribute to viability. © 2017 The Authors. Gerodontology published by The Gerodontology Association and John Wiley & Sons Ltd.

  10. Challenges to neurology residency education in today's health care environment.

    Science.gov (United States)

    Bega, Danny; Krainc, Dimitri

    2016-09-01

    Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

  11. Quality of life among adolescents living in residential youth care: do domain-specific self-esteem and psychopathology contribute?

    Science.gov (United States)

    Jozefiak, Thomas; Kayed, Nanna S; Ranøyen, Ingunn; Greger, Hanne K; Wallander, Jan L; Wichstrøm, Lars

    2017-10-01

    Many adolescents living in residential youth care (RYC) institutions perceive their quality of life (QoL) to be low. Enhancing QoL is thus important, but little is known about the potential contributors to their QoL. Early interpersonal trauma and subsequent removal from home and repeated relocations to new placements are expected to affect mental health and self-esteem. We therefore investigated if domain-specific self-esteem contributed to QoL among adolescents living in RYC institutions over and beyond their levels of psychopathology. All youth in Norwegian RYC institutions between the ages 12-23 years were invited to participate. Of a total of 98 RYC institutions, 86 participated, and 400 of 601 eligible youths were examined. The participants' primary contact completed the Child Behavior Checklist to assess psychopathology. The adolescents completed a revised version of the Self-Perception Profile for Adolescents and the questionnaire for measuring health-related quality of life in children and adolescents (KINDL-R). After adjusting for psychopathology, age, and gender, self-esteem domains uniquely explained 42% of the variance in Qol, where social acceptance (β = 0.57) and physical appearance (β = 0.25) domains significantly predicted concurrent QoL. The self-esteem domains, social acceptance and physical appearance, add substantially to the explained variance in QoL among adolescents living in RYC institutions, over and beyond the levels of psychopathology. These self-esteem domains may be targets of intervention to improve QoL, in addition to treating their psychopathology.

  12. An investigation into thermal comfort and residential thermal environment in an intertropical sub-Saharan Africa region: Field study report during the Harmattan season in Cameroon

    International Nuclear Information System (INIS)

    Djongyang, Noel; Tchinda, Rene

    2010-01-01

    Investigations on thermal comfort have attracted authors for years throughout the world and the most important findings are now the basis of international thermal comfort standards. There is little information available concerning occupant comfort and residential thermal environment in the intertropical sub-Saharan Africa. Thus the purpose for this study is to conduct a field study on comfort and residential thermal environments in a typical intertropical climatic region. A field survey has been conducted during the Harmattan season in two cities from the two climatic regions of Cameroon concerned by that wind. Specific study objectives were to evaluate and characterize some thermal perceptions of occupants in their residence, compare observed and predicted percent of dissatisfied, and discern differences between the study area and other climate zones where similar studies have been performed. It was found that the thermoneutral temperatures in both climatic regions range from 24.69 deg. C to 27.32 deg. C and, in traditional living room, it differs from that of modern living room with approximately 1 deg. C.

  13. A pilot study using "apps" as a novel strategy for the management of challenging behaviors seen in people living in residential care.

    Science.gov (United States)

    Loi, Samantha M; Mazur, Angela; Huppert, David; Hoy, Bernadette; Swan, Jodie; Lautenschlager, Nicola T

    2017-04-01

    Many adults living in residential care will demonstrate challenging behaviors. Non-pharmacological strategies are recommended as first-line treatment. Using applications (apps) is a novel approach to managing these behaviors, and has yet to be assessed in this group. This paper describes a pilot study to test apps as a novel non-pharmacological strategy to manage challenging behaviors in adults living in residential care. A non-blinded, non-randomized crossover trial design was implemented which compared apps to a control situation and usual care to determine whether apps were able to decrease challenging behaviors. The primary outcome measure was the Neuropsychiatric Inventory (NPI) that measures the frequency and severity of these behaviors. Fifteen residents participated whose mean age was 78.5 years. There were a range of diagnoses and comorbidities, including dementia and schizophrenia. IPads were used as the medium for delivering the apps and residential care staff implemented the interventions. There was a significant decrease in the total NPI score using the apps intervention (10.6 points) compared to the control (17.7 points) and to usual care (21.1 points). There was positive qualitative feedback from the staff who were involved in the study, but they also cited barriers such as lack of confidence using the apps and lack of time. Although this was a small and limited study, results suggest that using apps may be a feasible and personalized approach to managing challenging behaviors. A more rigorous study design that includes larger sample sizes and staff training may enable further research and benefits in this area.

  14. Work Environment and Japanese Fathers' Involvement in Child Care

    Science.gov (United States)

    Ishii-Kuntz, Masako

    2013-01-01

    Previous studies mainly examined individual and family factors affecting Japanese fathers' involvement in child care. Along with these factors, we examine how work-related factors such as father-friendly environment at work, workplace's accommodation of parental needs, job stress, and autonomy are associated with Japanese men's participation in…

  15. Perceived nursing work environment of acute care pediatric nurses.

    Science.gov (United States)

    Kotzer, Anne Marie; Koepping, Dianne M; LeDuc, Karen

    2006-01-01

    Nurse job satisfaction is a complex phenomenon and includes elements of the work environment. The purpose of this study was to evaluate nurses' perception of their real (current) and ideal (preferred) work environment in a pediatric tertiary care setting. Using a descriptive survey design, a convenience sample of staff nurses from three inpatient units was surveyed using the Work Environment Scale (WES) by Moos (1994). The WES consists of 10 subscales characterizing three dimensions: Relationship, Personal Growth, and System Maintenance and Change. Overall, nurses affirmed a highly positive and supportive work environment on their units. Non-significant findings between the real and ideal scores for the Involvement and Managerial Control subscales suggest that staff are concerned about and committed to their work, and satisfied with their managers' use of rules and procedures. Statistically significant differences between selected real and ideal subscale scores will help target intervention strategies to enhance the nursing work environment.

  16. Joanna Briggs Collaboration Aged Care Fellowship Project: implementing a smoking cessation program in a young, frail aged residential care facility.

    Science.gov (United States)

    Nicholson, Elayne

    2008-03-01

    Background  The subject site (Ian George Court) caters for clients from a socially disadvantaged background. All clients have been homeless or at risk of homelessness and have a history of alcohol and substance abuse often linked to mental health issues. This project was developed to examine if the site provided best practice in the promotion of smoking cessation. Objectives  The first objective of this project was to improve client knowledge to make informed choice about smoking cessation, ensuring that client advice was given in line with best available evidence and assist the client in accessing community programs. The second objective was to fully review the current assessment tool used in relation to gathering baseline data about smoking habits and act on the information provided. Search strategy  The search strategy sought to find published studies and papers. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract. A second extensive search was then undertaken using all identified keywords. Conclusion  A smoking assessment tool was developed and is now in use across all Anglicare sites in South Australia. This provides staff with consistent baseline information and offers evidence-based health care in a package format to aid clients in smoking cessation. © 2008 The Author.

  17. Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Peisah C

    2014-10-01

    Full Text Available Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NSW, Australia Background: Pain is common in older people, particularly those in residential aged care facilities (RACF and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods: A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results: While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation. Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and nonpharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief.Conclusion: A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings

  18. What are effective strategies for implementing trauma-informed care in youth inpatient psychiatric and residential treatment settings? A realist systematic review.

    Science.gov (United States)

    Bryson, Stephanie A; Gauvin, Emma; Jamieson, Ally; Rathgeber, Melanie; Faulkner-Gibson, Lorelei; Bell, Sarah; Davidson, Jana; Russel, Jennifer; Burke, Sharlynne

    2017-01-01

    Many young people who receive psychiatric care in inpatient or residential settings in North America have experienced various forms of emotional trauma. Moreover, these settings can exacerbate trauma sequelae. Common practices, such as seclusion and restraint, put young people at risk of retraumatization, development of comorbid psychopathology, injury, and even death. In response, psychiatric and residential facilities have embraced trauma-informed care (TIC), an organizational change strategy which aligns service delivery with treatment principles and discrete interventions designed to reduce rates of retraumatization through responsive and non-coercive staff-client interactions. After more than two decades, a number of TIC frameworks and approaches have shown favorable results. Largely unexamined, however, are the features that lead to successful implementation of TIC, especially in child and adolescent inpatient psychiatric and residential settings. Using methods proposed by Pawson et al. (J Health Serv Res Policy 10:21-34, 2005), we conducted a modified five-stage realist systematic review of peer-reviewed TIC literature. We rigorously searched ten electronic databases for peer reviewed publications appearing between 2000 and 2015 linking terms "trauma-informed" and "child*" or "youth," plus "inpatient" or "residential" plus "psych*" or "mental." After screening 693 unique abstracts, we selected 13 articles which described TIC interventions in youth psychiatric or residential settings. We designed a theoretically-based evaluative framework using the active implementation cycles of the National Implementation Research Network (NIRN) to discern which foci were associated with effective TIC implementation. Excluded were statewide mental health initiatives and TIC implementations in outpatient mental health, child welfare, and education settings. Interventions examined included: Attachment, Self-Regulation, and Competency Framework; Six Core Strategies

  19. Nursing care in a high-technological environment: Experiences of critical care nurses.

    Science.gov (United States)

    Tunlind, Adam; Granström, John; Engström, Åsa

    2015-04-01

    Management of technical equipment, such as ventilators, infusion pumps, monitors and dialysis, makes health care in an intensive care setting more complex. Technology can be defined as items, machinery and equipment that are connected to knowledge and management to maximise efficiency. Technology is not only the equipment itself, but also the knowledge of how to use it and the ability to convert it into nursing care. The aim of this study is to describe critical care nurses' experience of performing nursing care in a high technology healthcare environment. Qualitative, personal interviews were conducted during 2012 with eight critical care nurses in the northern part of Sweden. Interview transcripts were analysed using qualitative content analysis. Three themes with six categories emerged. The technology was described as a security that could facilitate nursing care, but also one that could sometimes present obstacles. The importance of using the clinical gaze was highlighted. Nursing care in a high technological environment must be seen as multi-faceted when it comes to how it affects CCNs' experience. The advanced care conducted in an ICU could not function without high-tech equipment, nor could care operate without skilled interpersonal interaction and maintenance of basal nursing. That technology is seen as a major tool and simultaneously as a barrier to patient-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Use of Color in Child Care Environments: Application of Color for Wayfinding and Space Definition in Alabama Child Care Environments.

    Science.gov (United States)

    Read, Marilyn A.

    2003-01-01

    Compared the use of color in physical design features associated with the exterior and interior designs of 101 child care centers in Alabama. Found that color was evidenced on the exterior of the centers at just over half of the sample. The interior environments had warm colors and bright accents in the setting; however, the majority of centers…

  1. The impact of unconfined mine tailings in residential areas from a mining town in a semi-arid environment: Nacozari, Sonora, Mexico.

    Science.gov (United States)

    Meza-Figueroa, Diana; Maier, Raina M; de la O-Villanueva, Margarita; Gómez-Alvarez, Agustín; Moreno-Zazueta, Alan; Rivera, Jacinto; Campillo, Alberto; Grandlic, Christopher J; Anaya, Ricardo; Palafox-Reyes, Juan

    2009-09-01

    Past mining activities in northern Mexico left a legacy of delerict landscapes devoid of vegetation and seasonal formation of salt efflorescence. Metal content was measured in mine tailings, efflorescent salts, soils, road dust, and residential soils to investigate contamination. Climatic effects such as heavy wind and rainfall events can have great impact on the dispersion of metals in semi-arid areas, since soils are typically sparsely vegetated. Geochemical analysis of this site revealed that even though total metal content in mine tailings was relatively low (e.g. Cu= 1000 mg kg(-1)), metals including Mn, Ba, Zn, and Cu were all found at significantly higher levels in efflorescence salts formed by evaporation on the tailings impoundment surface following the rainy season (e.g. Cu= 68,000 mg kg(-1)). Such efflorescent fine-grained salts are susceptible to wind erosion resulting in increased metal spread to nearby residential soils. Our results highlight the importance of seasonally dependent salt-formation and wind erosion in determining risk levels associated with potential inhalation or ingestion of airborne particulates originating from contaminated sites such as tailings impoundments. In low metal-content mine tailings located in arid and semi-arid environments, efflorescence salts could represent a human health risk and a challenge for plant establishment in mine tailings.

  2. The impact of unconfined mine tailings in residential areas from a mining town in a semi-arid environment: Nacozari, Sonora, Mexico

    Science.gov (United States)

    Meza-Figueroa, Diana; Maier, Raina M.; de la O-Villanueva, Margarita; Gómez-Alvarez, Agustín; Moreno-Zazueta, Alan; Rivera, Jacinto; Campillo, Alberto; Grandlic, Christopher; Anaya, Ricardo; Palafox-Reyes, Juan

    2009-01-01

    Past mining activities in northern Mexico left a legacy of delerict landscapes devoid of vegetation and seasonal formation of salt efflorescence. Metal content was measured in mine tailings, efflorescent salts, soils, road dust and residential soils to investigate contamination. Climatic effects such as heavy wind and rainfall events can have great impact on the dispersion of metals in semi-arid areas, since soils are typically sparsely vegetated. Geochemical analysis of this site revealed that even though total metal content in mine tailings was relatively low (e.g. Cu = 1000 mg kg-1), metals including Mn, Ba, Zn, and Cu were all found at significantly higher levels in efflorescence salts formed by evaporation on the tailings impoundment surface following the rainy season (e.g. Cu=68000 mg kg-1). Such efflorescent fine-grained salts are susceptible to wind erosion resulting in increased metal spread to nearby residential soils. Our results highlight the importance of seasonally dependent salt-formation and wind erosion in determining risk levels associated with potential inhalation or ingestion of airborne particulates originating from contaminated sites such as tailings impoundments. In low metal-content mine tailings located in arid and semi-arid environments, efflorescence salts could represent a human health risk and a challenge for plant establishment in mine tailings. PMID:19500816

  3. Residential child care

    DEFF Research Database (Denmark)

    Jensen, Niels Rosendal

    2013-01-01

    Anmeldelsen gennemgår Connelly og Milligans præsentation af skotske døgninstitutioner ved at placere dette tema inden for rammerne af socialpolitikken og ved at pege på spændingen mellem børns hhv. unges ønsker og de muligheder, stederne kan tilbyde....

  4. Self-help memory training for healthy older adults in a residential care center: specific and transfer effects on performance and beliefs.

    Science.gov (United States)

    Cavallini, Elena; Bottiroli, Sara; Capotosto, Emanuela; De Beni, Rossana; Pavan, Giorgio; Vecchi, Tomaso; Borella, Erika

    2015-08-01

    Cognitive flexibility has repeatedly been shown to improve after training programs in community-dwelling older adults, but few studies have focused on healthy older adults living in other settings. This study investigated the efficacy of self-help training for healthy older adults in a residential care center on memory tasks they practiced (associative and object list learning tasks) and any transfer to other tasks (grocery lists, face-name learning, figure-word pairing, word lists, and text learning). Transfer effects on everyday life (using a problem-solving task) and on participants' beliefs regarding their memory (efficacy and control) were also examined. With the aid of a manual, the training adopted a learner-oriented approach that directly encouraged learners to generalize strategic behavior to new tasks. The maintenance of any training benefits was assessed after 6 months. The study involved 34 residential care center residents (aged 70-99 years old) with no cognitive impairments who were randomly assigned to two programs: the experimental group followed the self-help training program, whereas the active control group was involved in general cognitive stimulation activities. Training benefits emerged in the trained group for the tasks that were practiced. Transfer effects were found in memory and everyday problem-solving tasks and on memory beliefs. The effects of training were generally maintained in both practiced and unpracticed memory tasks. These results demonstrate that learner-oriented self-help training enhances memory performance and memory beliefs, in the short term at least, even in residential care center residents. Copyright © 2014 John Wiley & Sons, Ltd.

  5. Impact of the severity of distance and near-vision impairment on depression and vision-specific quality of life in older people living in residential care.

    Science.gov (United States)

    Lamoureux, Ecosse L; Fenwick, Eva; Moore, Kirsten; Klaic, Marlena; Borschmann, Karen; Hill, Keith

    2009-09-01

    To determine the relationship between the severity of distance and near-vision impairment on vision-specific quality of life (QoL) and depression in residential care residents. Residents from three low-level residential care facilities in Victoria (Australia) were recruited. All participants were assessed for cognitive impairment, distance and near-vision impairment (VI), and depression. Sociodemographic and other clinical data were also collected. The subscales of the Nursing Home Vision-Targeted Health-Related Quality-of-Life questionnaire (NHVQoL) were the main outcome measures and were validated by Rasch Analysis. Seventy-six residents were enrolled. The mean +/- SD of the participants' age was 83.9 +/- 9.9 years, and most were women (n = 44; 60%); 46.4% (n = 35) had binocular presenting VI (worse than N8); 16% (n = 14) recorded depression symptoms, although depression was not associated with VI (P > 0.05). In linear regression models, distance and near VI was independently associated with poorer QoL on seven of the eight subscales of the NHVQoL scale (P vision loss had poorer QoL, ranging between 12 and 80 points (scale range: 0-100) than did those with no VI. The QoL aspects most affected by vision loss were related to general vision, reading, hobbies, emotional well-being, and social interaction. VI remains a major form of disability in individuals living in residential care facilities and affects vision-specific functioning and socioemotional aspects of daily living. A larger study is needed to confirm these findings.

  6. A demand response modeling for residential consumers in smart grid environment using game theory based energy scheduling algorithm

    Directory of Open Access Journals (Sweden)

    S. Sofana Reka

    2016-06-01

    Full Text Available In this paper, demand response modeling scheme is proposed for residential consumers using game theory algorithm as Generalized Tit for Tat (GTFT Dominant Game based Energy Scheduler. The methodology is established as a work flow domain model between the utility and the user considering the smart grid framework. It exhibits an algorithm which schedules load usage by creating several possible tariffs for consumers such that demand is never raised. This can be done both individually and among multiple users of a community. The uniqueness behind the demand response proposed is that, the tariff is calculated for all hours and the load during the peak hours which can be rescheduled is shifted based on the Peak Average Ratio. To enable the vitality of the work simulation results of a general case of three domestic consumers are modeled extended to a comparative performance and evaluation with other algorithms and inference is analyzed.

  7. Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities.

    Science.gov (United States)

    Peisah, Carmelle; Weaver, Judith; Wong, Lisa; Strukovski, Julie-Anne

    2014-01-01

    Pain is common in older people, particularly those in residential aged care facilities (RACF) and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation). Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and non-pharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief. A laborious "pain communication chain" exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as "needs interpreters"; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings.

  8. Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program.

    Science.gov (United States)

    Hwang, Stephen W; Gogosis, Evie; Chambers, Catharine; Dunn, James R; Hoch, Jeffrey S; Aubry, Tim

    2011-12-01

    Supportive housing, defined as subsidized housing in conjunction with site-based social services, may help improve the health and residential stability of highly disadvantaged individuals. This study examined changes in health status, quality of life, substance use, health care utilization, and residential stability among 112 homeless and vulnerably housed individuals who applied to a supportive housing program in Toronto, Canada, from December 2005 to June 2007. Follow-up interviews were conducted every 6 months for 18 months. Comparisons were made between individuals who were accepted into the program (intervention) and those who were wait-listed (usual care) using repeated-measures analyses. Individuals who were accepted into the housing program experienced significantly greater improvements in satisfaction with living situation compared with individuals in the usual care group (time, F(3,3,261) = 47.68, p homeless individuals was limited by the small number of participants who were literally homeless at baseline and by the large number of participants who gained stable housing during the study period regardless of their assigned housing status. Nonetheless, this study shows that highly disadvantaged individuals with a high prevalence of poor physical and mental health and substance use can achieve stable housing.

  9. Identification of high risk fallers among older people living in residential care facilities: a simple screen based on easily collectable measures.

    Science.gov (United States)

    Whitney, Julie; Close, Jacqueline C T; Lord, Stephen R; Jackson, Stephen H D

    2012-01-01

    To develop a simple screen based on easily collectable measures to identify older people living in residential care facilities at high risk of falls. This prospective study was conducted in seven residential care facilities in the U.K. Residents aged>60 years who were not bedbound or terminally ill participated. Demographics, medical history, medication use, cognition (mini mental state examination (MMSE)), function (Barthel, balance and sit-to-stand ability) and behavior (neuro-psychiatric inventory (NPI) and impulsivity) were recorded at baseline. Falls and injuries were prospectively recorded over 6 months. Data were analyzed for differences between fallers and non-fallers and significant variables entered into logistic regression analysis. Two hundred and forty residents completed the study. In the follow-up period, 50% fell ≥1 times. Fallers had worse function, cognition, behavior and balance and took more medications. Falling in the past year, walking frame and hypnotic/anxiolytic and anti-depressant medication use were also associated with increased likelihood of falling. Logistic regression identified MMSEfactorial measures provides a simple way of quantifying the probability with which a care home resident will fall over a 6-month period. The tool may also assist in guiding the development and targeting of interventions to prevent falls in this group. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  10. The applicability of SERVQUAL in different health care environments.

    Science.gov (United States)

    Dean, A M

    1999-01-01

    This paper reports on a study that investigates the applicability of a modified SERVQUAL instrument as a means of measuring service quality in two types of health service environments; medical care and health care (incorporating medical, social, cognitive and emotional elements). The research confirms a four factor structure that is stable for both environments, and similar to the service quality dimensions recognised in the literature. However, the relative importance of the dimensions of quality is inconsistent for the two types of health services. These results confirm the suggestion that importance values should be part of the measurement tool. Finally, the extra diagnostic advantage achieved by the use of gap scores to measure service quality, when compared to perception only scores is demonstrated.

  11. Trust: key to acculturation in corporatized health care environments.

    Science.gov (United States)

    Johns, J

    1996-01-01

    Widespread restructuring of health care organizations often results in corporatization and associated cultures to which nurse administrators must adapt. Acculturation may be facilitated through understanding key aspects of traditional and emerging corporate cultures. One of these aspects is trust, which is requisite for persistently successful organizational performance in dynamic environments. This article defines trust, assesses its significance within organizational settings, delineates specific ways in which it affects organizations, and discusses the implications for nurse administrators of varying levels of trust associated with organizations.

  12. Abnormal environmental light exposure in the intensive care environment.

    Science.gov (United States)

    Fan, Emily P; Abbott, Sabra M; Reid, Kathryn J; Zee, Phyllis C; Maas, Matthew B

    2017-08-01

    We sought to characterize ambient light exposure in the intensive care unit (ICU) environment to identify patterns of light exposure relevant to circadian regulation. A light monitor was affixed to subjects' bed at eye level in a modern intensive care unit and continuously recorded illuminescence for at least 24h per subject. Blood was sampled hourly and measured for plasma melatonin. Subjects underwent hourly vital sign and bedside neurologic assessments. Care protocols and the ICU environment were not modified for the study. A total of 67,324 30-second epochs of light data were collected from 17 subjects. Light intensity peaked in the late morning, median 64.1 (interquartile range 19.7-138.7) lux. The 75th percentile of light intensity exceeded 100lx only between 9AM and noon, and never exceeded 150lx. There was no correlation between melatonin amplitude and daytime, nighttime or total light exposure (Spearman's correlation coefficients all 0.5). Patients' environmental light exposure in the intensive care unit is consistently low and follows a diurnal pattern. No effect of nighttime light exposure was observed on melatonin secretion. Inadequate daytime light exposure in the ICU may contribute to abnormal circadian rhythms. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?

    Directory of Open Access Journals (Sweden)

    Conradsson M

    2013-11-01

    Full Text Available Mia Conradsson,1 Håkan Littbrand,1,2 Gustaf Boström,1 Nina Lindelöf,1 Yngve Gustafson,1 Erik Rosendahl1,2 1Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; 2Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden Aim: Functional capacity and dependency in activities of daily living (ADL could be important mediators for an association between physical exercise and mental health. The aim of this study was to investigate whether a change in functional capacity or dependency in ADL is associated with a change in depressive symptoms and psychological well-being among older people living in residential care facilities, and whether dementia can be a moderating factor for this association. Methods: A prospective cohort study was undertaken. Participants were 206 older people, dependent in ADL, living in residential care facilities, 115 (56% of whom had diagnosed dementia. Multivariate linear regression, with comprehensive adjustment for potential confounders, was used to investigate associations between differences over 3 months in Berg Balance Scale (BBS and Geriatric Depression Scale (GDS-15 scores, and in BBS and Philadelphia Geriatric Center Morale Scale (PGCMS scores. Associations were also investigated between differences in Barthel ADL Index and GDS-15 scores, and in Barthel ADL Index and PGCMS scores. Results: There were no significant associations between changes in scores over 3 months; the unstandardized β for associations between BBS and GDS-15 was 0.026 (P=0.31, BBS and PGCMS 0.045 (P=0.14, Barthel ADL Index and GDS-15 0.123 (P=0.06, and Barthel ADL Index and PGCMS -0.013 (P=0.86. There were no interaction effects for dementia. Conclusion: A change in functional capacity or dependency in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people living in residential care

  14. Successful ingredients in the SMILE study: resident, staff, and management factors influence the effects of humor therapy in residential aged care.

    Science.gov (United States)

    Brodaty, Henry; Low, Lee-Fay; Liu, Zhixin; Fletcher, Jennifer; Roast, Joel; Goodenough, Belinda; Chenoweth, Lynn

    2014-12-01

    To test the hypothesis that individual and institutional-level factors influence the effects of a humor therapy intervention on aged care residents. Data were from the humor therapy group of the Sydney Multisite Intervention of LaughterBosses and ElderClowns, or SMILE, study, a single-blind cluster randomized controlled trial of humor therapy conducted over 12 weeks; assessments were performed at baseline, week 13, and week 26. One hundred eighty-nine individuals from 17 Sydney residential aged care facilities were randomly allocated to the humor therapy intervention. Professional performers called "ElderClowns" provided 9-12 weekly humor therapy 2-hour sessions, augmented by trained staff, called "LaughterBosses." Outcome measures were as follows: Cornell Scale for Depression in Dementia, Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, the withdrawal subscale of Multidimensional Observation Scale for Elderly Subjects, and proxy-rated quality of life in dementia population scale. Facility-level measures were as follows: support of the management for the intervention, commitment levels of LaughterBosses, Environmental Audit Tool scores, and facility level of care provided (high/low). Resident-level measures were engagement, functional ability, disease severity, and time-in-care. Multilevel path analyses simultaneously modeled resident engagement at the individual level (repeated measures) and the effects of management support and staff commitment to humor therapy at the cluster level. Models indicated flow-on effects, whereby management support had positive effects on LaughterBoss commitment, and LaughterBoss commitment increased resident engagement. Higher resident engagement was associated with reduced depression, agitation, and neuropsychiatric scores. Effectiveness of psychosocial programs in residential aged care can be enhanced by management support, staff commitment, and active resident engagement. Copyright © 2014 American Association for

  15. Effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review.

    Science.gov (United States)

    Travers, Catherine; Brooks, Deborah; Hines, Sonia; O'Reilly, Maria; McMaster, Mitchell; He, Wei; MacAndrew, Margaret; Fielding, Elaine; Karlsson, Lina; Beattie, Elizabeth

    2016-12-01

    The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored. However, the effectiveness of individualizing interventions or activities for this population is not known. In response to consumer feedback by the Consumer Dementia Research Network that this question ought to be addressed, this review was undertaken, the aim of which was to determine the effectiveness of meaningful occupation interventions for people living with dementia in residential aged care facilities (RACFs). People living with dementia in RACFs (nursing homes).Any intervention that was individualized to be meaningful to the participant, versus any active control condition or usual care.Experimental and observational studies. Quality of life, BPSD (such as agitation, aggression, depression, wandering and apathy), mood, function, cognition and sleep. The search strategy aimed to identify both published and unpublished studies, with the following 12 databases extensively searched: PubMed, CINAHL, PsycINFO, ISI Web of Science, OTSeeker, Embase, Cochrane CENTRAL, clinicaltrials.gov, Mednar, OpenSIGLE, New York Academy of Medicine Library Gray Literature Report, ProQuest Dissertations and Theses. The search strategy was limited to papers published in English between 2004 and January 31, 2015. All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality. Data from included papers were extracted using a

  16. Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis.

    Science.gov (United States)

    Mac Giolla Phadraig, Caoimhin; Nunn, June; Guerin, Suzanne; Normand, Charles

    2016-04-01

    Oral health training is often introduced into community-based residential settings to improve the oral health of people with intellectual disabilities (ID). There is a lack of appropriate evaluation of such programs, leading to difficulty in deciding how best to allocate scarce resources to achieve maximum effect. This article reports an economic analysis of one such oral health program, undertaken as part of a cluster randomized controlled trial. Firstly, we report a cost-effectiveness analysis of training care-staff compared to no training, using incremental cost-effectiveness ratios (ICERs). Effectiveness was measured as change in knowledge, reported behaviors, attitude and self-efficacy, using validated scales (K&BAS). Secondly, we costed training as it was scaled up to include all staff within the service provider in question. Data were collected in Dublin, Ireland in 2009. It cost between €7000 and €10,000 more to achieve modest improvement in K&BAS scores among a subsample of 162 care-staff, in comparison to doing nothing. Considering scaled up first round training, it cost between €58,000 and €64,000 to train the whole population of staff, from a combined dental and disability service perspective. Less than €15,000-€20,000 of this was additional to the cost of doing nothing (incremental cost). From a dental perspective, a further, second training cycle including all staff would cost between €561 and €3484 (capital costs) and €5815 (operating costs) on a two yearly basis. This study indicates that the program was a cost-effective means of improving self-reported measures and possibly oral health, relative to doing nothing. This was mainly due to low cost, rather than the large effect. In this instance, the use of cost effectiveness analysis has produced evidence, which may be more useful to decision makers than that arising from traditional methods of evaluation. There is a need for CEAs of effective interventions to allow comparison

  17. [Evaluation of the nurse working environment in health and social care intermediate care units in Catalonia].

    Science.gov (United States)

    Bullich-Marín, Ingrid; Miralles Basseda, Ramón; Torres Egea, Pilar; Planas-Campmany, Carme; Juvé-Udina, María Eulalia

    A favourable work environment contributes to greater job satisfaction and improved working conditions for nurses, a fact that could influence the quality of patient outcomes. The aim of the study is two-fold: Identifying types of centres, according to the working environment assessment made by nurses in intermediate care units, and describing the individual characteristics of nurses related to this assessment. An observational, descriptive, prospective, cross-sectional, and multicentre study was conducted in the last quarter of 2014. Nurses in intermediate care units were given a questionnaire containing the Practice Environment Scale of the Nursing Work Index (PES-NWI) which assesses five factors of the work environment using 31 items. Sociodemographic, employment conditions, professional and educational variables were also collected. From a sample of 501 nurses from 14 centres, 388 nurses participated (77% response). The mean score on the PES-NWI was 84.75. Nine centres scored a "favourable" working environment and five "mixed". The best valued factor was "work relations" and the worst was "resource provision/adaptation". Rotating shift work, working in several units at the same time, having management responsibilities, and having a master degree were the characteristics related to a better perception of the nursing work environment. In most centres, the working environment was perceived as favourable. Some employment conditions, professional, and educational characteristics of nurses were related to the work environment assessment. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme.

    Science.gov (United States)

    Scerri, Anthony; Scerri, Charles

    2017-11-08

    Dementia training programmes for staff working in long-term care settings have been found to be effective in improving staff outcomes. This study investigated the impact of a dementia training programme for all Maltese nursing staff working in public nursing/residential homes on their knowledge, attitudes and confidence. Additionally, we identified the predictors of these domains before and after the programme. A 14-hour training programme focusing on dementia management, care and policy was developed for all nursing staff working in public nursing and residential homes in Malta. A pretest-posttest design was used to evaluate the participants' knowledge of dementia, attitudes and confidence in working with residents with dementia using validated tools. Demographic variables were measured and compared with each staff domain. The majority of nursing staff attended the training programme with 261 fully completed questionnaires being collected pre-training and 214 post-training. The programme significantly improved nursing staff knowledge, attitudes and confidence. Stepwise regression analysis of each staff domain showed that the strongest predictor in all models at pre-training was the intensity of previous training programmes. Furthermore, staff who attended previous training continued to improve in their attitudes and confidence following programme completion. The study continues to shed further evidence on the impact of dementia training programs on staff outcomes. It also indicated that the intensity of previous participation in dementia training programmes was related to the participants' knowledge, attitudes and confidence and that continual exposure to training had a cumulative effect.

  19. Leadership and the psychosocial work environment in old age care.

    Science.gov (United States)

    Lundgren, Dan; Ernsth-Bravell, Marie; Kåreholt, Ingemar

    2016-03-01

    To study leadership factors and their associations with psychosocial work environmental among nursing assistants who are engaged in old age care and to analyse (i) differences in the assessment of leadership factors and the assessment of psychosocial work environmental in nursing homes and home help services and (ii) the association between the psychosocial work environment and factors that are related to leadership in nursing homes and home help services. Leadership factors are an important element of the psychosocial work environment in old age care. The physical distance between leaders and nursing assistants is larger in home help services than in nursing homes. Therefore, it is important to study leadership separately in nursing homes and home help services. Assessments from 844 nursing assistants in nursing homes and 288 in home help services (45 nursing homes and 21 home help service units) were analysed. The data were analysed using linear regression. Age, gender, number of staff at the unit, number of years at the current working unit and educational level were controlled in Model 1. Summarised indexes that were based on all independent variables except the main independent variable were additionally controlled in Model 2. Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. Empowering leadership, support from superiors, the primacy of human resources and control over decisions were associated with higher assessments on all the variables that were related to the psychosocial work environment in both the nursing homes and home help services. Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better prerequisites for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services. Due to the differences in

  20. Effects of child care policy and environment on physical activity.

    Science.gov (United States)

    Trost, Stewart G; Ward, Dianne S; Senso, Meghan

    2010-03-01

    Child care centers differ systematically with respect to the quality and quantity of physical activity they provide, suggesting that center-level policies and practices, as well as the center's physical environment, are important influences on children's physical activity behavior. To summarize and critically evaluate the extant peer-reviewed literature on the influence of child care policy and environment on physical activity in preschool-aged children. A computer database search identified seven relevant studies that were categorized into three broad areas: cross-sectional studies investigating the impact of selected center-level policies and practices on moderate-to-vigorous physical activity (MVPA), studies correlating specific attributes of the outdoor play environment with the level and intensity of MVPA, and studies in which a specific center-level policy or environmental attribute was experimentally manipulated and evaluated for changes in MVPA. Staff education and training, as well as staff behavior on the playground, seem to be salient influences on MVPA in preschoolers. Lower playground density (less children per square meter) and the presence of vegetation and open play areas also seem to be positive influences on MVPA. However, not all studies found these attributes to be significant. The availability and quality of portable play equipment, not the amount or type of fixed play equipment, significantly influenced MVPA levels. Emerging evidence suggests that several policy and environmental factors contribute to the marked between-center variability in physical activity and sedentary behavior. Intervention studies targeting these factors are thus warranted.

  1. Developing networks between residential aged care facilities as a result of engagement in a falls prevention project: an action research study.

    Science.gov (United States)

    Lea, Emma; Andrews, Sharon; Haines, Terry; Nitz, Jennifer; Haralambous, Betty; Moore, Kirsten; Hill, Keith; Robinson, Andrew

    2016-01-01

    Residential aged care facility (RACF) staff often operate in isolation. Research is lacking on networking between facilities. To explore outcomes associated with network formation between two RACFs as part of an action research approach to reducing falls. Action research approach with qualitative data collected. Twelve RACF staff from two facilities in regional Tasmania, Australia, formed a falls prevention action research group. Thematic analysis was undertaken of 22 audio-recorded fortnightly group meetings. This was the first opportunity for participants to meet colleagues from another facility in a professional context. The formation of an inter-facility network enabled the sharing of ideas and systems related to evidence-based falls prevention activities and other issues and galvanised a collaborative focus for action. An action research process can be used to create an inter-facility network. Such networks can decrease staff isolation and facilitate best resident care.

  2. Comparison of cleaning efficacy between in-use disinfectant and electrolysed water in an English residential care home.

    Science.gov (United States)

    Meakin, N S; Bowman, C; Lewis, M R; Dancer, S J

    2012-02-01

    Infection control in hospitals and care homes remains a key issue. They are regularly inspected regarding standards of hygiene, but visual assessment does not necessarily correlate with microbial cleanliness. Pathogens can persist in the inanimate environment for extended periods of time. This prospective study compared the effectiveness of a novel sanitizer containing electrolysed water, in which the active ingredient is stabilized hypochlorous acid (Aqualution™), with the effectiveness of the quaternary ammonium disinfectant in current use for microbial removal from hand-touch surfaces in a care home. The study had a two-period crossover design. Five surfaces were cleaned daily over a four-week period, with screening swabs taken before and after cleaning. Swabs were cultured in order to compare levels of surface microbial contamination [colony-forming units (cfu)/cm(2)] before and after cleaning with each product. Cleaning with electrolysed water reduced the mean surface bacterial load from 2.6 [interquartile range (IQR) 0.30-30.40] cfu/cm(2) to 0.10 (IQR 0.10-1.40) cfu/cm(2) [mean log(10) reduction factor 1.042, 95% confidence interval (CI) 0.79-1.30]. Cleaning with the in-use quaternary ammonium disinfectant increased the bacterial load from 0.90 (IQR 0.10-8.50) cfu/cm(2) to 93.30 (IQR 9.85-363.65) cfu/cm(2) (mean log(10) reduction -1.499, 95% CI -1.87 to -1.12) (P care homes. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  3. Caring for people with dementia in residential aged care: successes with a composite person-centered care model featuring Montessori-based activities.

    Science.gov (United States)

    Roberts, Gail; Morley, Catherine; Walters, Wendy; Malta, Sue; Doyle, Colleen

    2015-01-01

    Person-centered models of dementia care commonly merge aspects of existing models with additional influences from published and unpublished evidence and existing government policy. This study reports on the development and evaluation of one such composite model of person-centered dementia care, the ABLE model. The model was based on building the capacity and ability of residents living with dementia, using environmental changes, staff education and organizational and community engagement. Montessori principles were also used. The evaluation of the model employed mixed methods. Significant behavior changes were evident among residents of the dementia care Unit after the model was introduced, as were reductions in anti-psychotic and sedative medication. Staff reported increased knowledge about meeting the needs of people with dementia, and experienced organizational culture change that supported the ABLE model of care. Families were very satisfied with the changes. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Creating collaborative learning environments for transforming primary care practices now.

    Science.gov (United States)

    Miller, William L; Cohen-Katz, Joanne

    2010-12-01

    The renewal of primary care waits just ahead. The patient-centered medical home (PCMH) movement and a refreshing breeze of collaboration signal its arrival with demonstration projects and pilots appearing across the country. An early message from this work suggests that the development of collaborative, cross-disciplinary teams may be essential for the success of the PCMH. Our focus in this article is on training existing health care professionals toward being thriving members of this transformed clinical care team in a relationship-centered PCMH. Our description of the optimal conditions for collaborative training begins with delineating three types of teams and how they relate to levels of collaboration. We then describe how to create a supportive, safe learning environment for this type of training, using a different model of professional socialization, and tools for building culture. Critical skills related to practice development and the cross-disciplinary collaborative processes are also included. Despite significant obstacles in readying current clinicians to be members of thriving collaborative teams, a few next steps toward implementing collaborative training programs for existing professionals are possible using competency-based and adult learning approaches. Grasping the long awaited arrival of collaborative primary health care will also require delivery system and payment reform. Until that happens, there is an abundance of work to be done envisioning new collaborative training programs and initiating a nation-wide effort to motivate and reeducate our colleagues. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  5. The challenges of caring in a technological environment: critical care nurses' experiences.

    Science.gov (United States)

    McGrath, Mary

    2008-04-01

    This paper presents and discusses the findings from a phenomenological study which illuminated the lived experiences of experienced critical care nurses caring within a technological environment. While nursing practice is interwoven with technology, much of the literature in this area is speculative. Moreover, there is a debate as to whether and how 'high tech' and 'high touch' are reconcilable; this orientation is referred to as the optimism vs. pessimism debate. On a personal level, the motivation for this study came from the author's 13 years' experience in the critical care area. Following ethical approval, 10 experienced nurses from two cardiothoracic critical care units in Ireland participated in the study. A Heideggerian phenomenological methodology was used. Data collection consisted of unstructured interviews. A method of data analysis described by Walters was used. The findings provide research-based evidence to illuminate further the optimistic/pessimistic debate on technology in nursing. While the study demonstrates that the debate is far from resolved, it reveals a new finding: life-saving technology that supports the lives of critically ill patients can bring experienced nurses very close to their patients/families. The three main themes that emerged: 'alien environment', 'pulling together' and 'sharing the journey' were linked by a common thread of caring. Experienced critical care nurses are able to transcend the obtrusive nature of technology to deliver expert caring to their patients. However, the journey to proficiency in technology is very demanding and novice nurses have difficulty in caring with technology. Relevance to clinical practice. It is recommended that more emphasis be placed on supporting, assisting and educating inexperienced nurses in the critical care area and that the use of technology in nursing be given serious consideration.

  6. Comparative Analysis of a MOOC and a Residential Community Using Introductory College Physics: Documenting How Learning Environments Are Created, Lessons Learned in the Process, and Measurable Outcomes

    Science.gov (United States)

    Olsen, Jack Ryan

    Higher education institutions, such as the University of Colorado Boulder (CU-Boulder), have as a core mission to advance their students' academic performance. On the frontier of education technologies that hold the promise to address our educational mission are Massively Open Online Courses (MOOCs) which are new enough to not be fully understood or well-researched. MOOCs, in theory, have vast potential for being cost-effective and for reaching diverse audiences across the world. This thesis examines the implementation of one MOOC, Physics 1 for Physical Science Majors, implemented in the augural round of institutionally sanctioned MOOCs in Fall 2013. While comparatively inexpensive to a brick-and-mortar course and while it initially enrolled audience of nearly 16,000 students, this MOOC was found to be time-consuming to implement, and only roughly 1.5% of those who enrolled completed the course---approximately 1/4 of those who completed the standard brick and mortar course that the MOOC was designed around. An established education technology, residential communities, contrast the MOOCs by being high-touch and highly humanized, but by being expensive and locally-based. The Andrews Hall Residential College (AHRC) on the CU campus fosters academic success and retention by engaging and networking students outside of the standard brick and mortar courses and enculturating students into an environment with vertical integration through the different classes: freshman, sophomore, junior, etc. The physics MOOC and the AHRC were studied to determine how the environments were made and what lessons were learned in the process. Also, student performance was compared for the physics MOOC, a subset of the AHRC students enrolled in a special physics course, and the standard CU Physics 1 brick and mortar course. All yielded similar learning gains for physics 1 performance, for those who completed the courses. These environments are presented together to compare and contrast their

  7. Setting the Scene for a Healthier Indoor Living Environment: Citizens’ Knowledge, Awareness, and Habits Related to Residential Radon Exposure in Romania

    Directory of Open Access Journals (Sweden)

    Dacinia Crina Petrescu

    2017-11-01

    Full Text Available The present research is based on the premise that people perceive radiation risks in different ways, depending on their cultural background, information exposure, economic level, and educational status, which are specific to each country. The main objective was to assess and report, for the first time, the Romanians’ attitude (perceptions, knowledge, and behaviors related to residential radon, in order to contribute to the creation of a healthier living environment. A convenience sample of 229 people from different parts of Romania, including radon prone areas, was used. Results profiled a population vulnerable to radon threats from the perspective of their awareness and perceptions. Thus, study results showed that most participants did not perceive the risk generated by radon exposure as significant to their health; only 13.1% of interviewed people considered the danger to their health as “high” or “very high”. Additionally, it was found that awareness of radon itself was low: 62.4% of the sample did not know what radon was. From a practical perspective, the study shows that in Romania, increasing awareness, through the provision of valid information, should be a major objective of strategies that aim to reduce radon exposure. The present study takes a bottom-up perspective by assessing Romanian citizens’ attitudes toward radon. Therefore, it compensates for a gap in the behavioral studies literature by providing practical support for radon risk mitigation and creating the premises for a healthier living environment.

  8. Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

    Science.gov (United States)

    Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

    2015-01-01

    In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

  9. Finishes and furnishings: considerations for critical care environments.

    Science.gov (United States)

    Chambers, Misty; Bowman, Ken L

    2011-01-01

    When selecting finishes and furnishings within a critical care unit, multiple factors can ultimately affect patient outcomes, impact costs, and contribute to operational efficiencies. First, consider the culture of the regional location, operations of the specific facility, and the recent focus on patient-centered care. The intention is to create an appropriate familiarity and comfort level with the environment for the patient and family. Second, safety and infection control are of utmost concern, particularly for the critical care patient with limited mobility. The planning and design team must be acutely aware of the regulations and guidelines of various governing agencies, local codes, and best design practices that can directly affect choices of finishes and furnishings. Flooring, wall, and window finishes, lighting, art and color, as well as furniture and fabric selection should be considered. Issues to address include maintenance, durability, sustainability, infection control, aesthetics, safety, wayfinding, and acoustics. Balancing these issues with comfort, patient and staff satisfaction, accommodations for an aging population, increasing bariatric needs, efficient operations, and avoidance of "never events" requires team collaboration and communication, knowledge of product advancements, a keen awareness of how environmental stimuli are perceived, and utilization of the best available evidence to make informed design decisions.

  10. Dental Education Required for the Changing Health Care Environment.

    Science.gov (United States)

    Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

    2017-08-01

    To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  11. Saving water to save the environment: Contrasting the effectiveness of environmental and monetary appeals in a residential water saving intervention

    NARCIS (Netherlands)

    Tijs, M.S.; Karremans, J.C.T.M.; Veling, H.P.; Lange, M.A. de; Meegeren, P. van; Lion, R.

    2017-01-01

    To convince people to reduce their energy consumption, two types of persuasive appeals often are used by environmental organizations: Monetary appeals (i.e., 'conserving energy will save you money') and environmental appeals (i.e., 'conserving energy will protect the environment'). In this field

  12. How Does the Neighborhood "Come through the Door?" Concentrated Disadvantage, Residential Instability, and the Home Environment for Preschoolers

    Science.gov (United States)

    May, Emily M.; Azar, Sandra T.; Matthews, Stephen A.

    2018-01-01

    Living in a disadvantaged neighborhood is associated with heightened risk for poor school readiness and health outcomes in early childhood, and the home environment is thought to be a primary mechanism by which neighborhood context impacts preschoolers. This study examined the effects of neighborhood concentrated disadvantage and neighborhood…

  13. Space and crime in Dutch built environments : Macro and micro scale spatial conditions for residential burglaries and thefts from cars

    NARCIS (Netherlands)

    Lopez, M.J.J.; Van Nes, A.

    2007-01-01

    At this moment, more knowledge is available on the physical characteristics of the built environment and their relationship to criminal opportunity rather than the spatial characteristics of potential targets and the public and private space between them. To improve this situation, a research

  14. Healthy cities as catalysts for caring and supportive environments.

    Science.gov (United States)

    Green, Geoff; Jackisch, Josephine; Zamaro, Gianna

    2015-06-01

    'Caring and Supportive Environments' are fundamental to a social model of health and were a core theme of Phase V (2009-13) of the WHO European Healthy Cities Network. Deploying the methodology of realist evaluation, this article synthesizes qualitative evidence from 112 highly structured case studies from 68 Network cities and 71 responses to a General Evaluation Questionnaire, which asked cities to analyze city attributes and trends. A schematic model was developed to describe the interaction between action targeted toward children, migrants, older people and action on social and health services, health literacy and active citizenship-the six subtopics clustered within the theme Caring and Supportive Environments. Four hypotheses were tested: (i) there are prerequisites and processes of local governance that increase city capacity for creating supportive environments; (ii) investing in health and social services, active citizenship and health literacy enhance the social inclusion of vulnerable population groups; (iii) there are synergies between social investment and healthy urban planning; and (iv) these investments promote greater equity in health. The evaluation revealed many innovative practices. Providers of health and social services have developed partnerships with agencies influencing wider determinants of health. Health literacy campaigns address the wider context of people's lives. In a period of economic austerity, cities have utilized the social assets of their citizens. Realist evaluation can help illuminate the pathways from case study interventions to health outcomes, and the prerequisites and processes required to initiate and sustain such investments. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Insights into the impact and use of research results in a residential long-term care facility: a case study

    Directory of Open Access Journals (Sweden)

    Cranley Lisa A

    2012-09-01

    Full Text Available Abstract Background Engaging end-users of research in the process of disseminating findings may increase the relevance of findings and their impact for users. We report findings from a case study that explored how involvement with the Translating Research in Elder Care (TREC study influenced management and staff at one of 36 TREC facilities. We conducted the study at ‘Restwood’ (pseudonym nursing home because the Director of Care engaged actively in the study and TREC data showed that this site differed on some areas from other nursing homes in the province. The aims of the case study were two-fold: to gain a better understanding of how frontline staff engage with the research process, and to gain a better understanding of how to share more detailed research results with management. Methods We developed an Expanded Feedback Report for use during this study. In it, we presented survey results that compared Restwood to the best performing site on all variables and participating sites in the province. Data were collected regarding the Expanded Feedback Report through interviews with management. Data from staff were collected through interviews and observation. We used content analysis to derive themes to describe key aspects related to the study aims. Results We observed the importance of understanding organizational routines and the impact of key events in the facility’s environment. We gleaned additional information that validated findings from prior feedback mechanisms within TREC. Another predominant theme was the sense that the opportunity to engage in a research process was reaffirming for staff (particularly healthcare aides—what they did and said mattered, and TREC provided a means of having one’s voice heard. We gained valuable insight from the Director of Care about how to structure and format more detailed findings to assist with interpretation and use of results. Conclusions Four themes emerged regarding staff engagement with

  16. Insights into the impact and use of research results in a residential long-term care facility: a case study

    Science.gov (United States)

    2012-01-01

    Background Engaging end-users of research in the process of disseminating findings may increase the relevance of findings and their impact for users. We report findings from a case study that explored how involvement with the Translating Research in Elder Care (TREC) study influenced management and staff at one of 36 TREC facilities. We conducted the study at ‘Restwood’ (pseudonym) nursing home because the Director of Care engaged actively in the study and TREC data showed that this site differed on some areas from other nursing homes in the province. The aims of the case study were two-fold: to gain a better understanding of how frontline staff engage with the research process, and to gain a better understanding of how to share more detailed research results with management. Methods We developed an Expanded Feedback Report for use during this study. In it, we presented survey results that compared Restwood to the best performing site on all variables and participating sites in the province. Data were collected regarding the Expanded Feedback Report through interviews with management. Data from staff were collected through interviews and observation. We used content analysis to derive themes to describe key aspects related to the study aims. Results We observed the importance of understanding organizational routines and the impact of key events in the facility’s environment. We gleaned additional information that validated findings from prior feedback mechanisms within TREC. Another predominant theme was the sense that the opportunity to engage in a research process was reaffirming for staff (particularly healthcare aides)—what they did and said mattered, and TREC provided a means of having one’s voice heard. We gained valuable insight from the Director of Care about how to structure and format more detailed findings to assist with interpretation and use of results. Conclusions Four themes emerged regarding staff engagement with the research process

  17. Residential environments, alcohol advertising, and initiation and continuation of alcohol consumption among adolescents in urban Taiwan: A prospective multilevel study

    OpenAIRE

    Chen, Yen-Tyng; Cooper, Hannah L.F.; Windle, Michael; Haardörfer, Regine; Crawford, Natalie D.; Chen, Wei J.; Chen, Chuan-Yu

    2016-01-01

    Background Research indicates that place characteristics and the media environment are important contextual determinants of underage drinking behaviors in Western countries, but it is unknown whether these exposures influence adolescent alcohol consumption outside Western contexts, including in Asia׳s emerging global alcohol markets. Guided by the social ecological framework, we prospectively investigated the influences of place characteristics and alcohol advertising on initiation and contin...

  18. Residential Racial Composition and Black-White Obesity Risks: Differential Effects of Neighborhood Social and Built Environment

    Directory of Open Access Journals (Sweden)

    Kelin Li

    2014-01-01

    Full Text Available This study investigates the association between neighborhood racial composition and adult obesity risks by race and gender, and explores whether neighborhood social and built environment mediates the observed protective or detrimental effects of racial composition on obesity risks. Cross-sectional data from the 2006 and 2008 Southeastern Pennsylvania Household Health Survey are merged with census-tract profiles from 2005–2009 American Community Survey and Geographic Information System-based built-environment data. The analytical sample includes 12,730 whites and 4,290 blacks residing in 953 census tracts. Results from multilevel analysis suggest that black concentration is associated with higher obesity risks only for white women, and this association is mediated by lower neighborhood social cohesion and socioeconomic status (SES in black-concentrated neighborhoods. After controlling for neighborhood SES, black concentration and street connectivity are associated with lower obesity risks for white men. No association between black concentration and obesity is found for blacks. The findings point to the intersections of race and gender in neighborhood effects on obesity risks, and highlight the importance of various aspects of neighborhood social and built environment and their complex roles in obesity prevention by socio-demographic groups.

  19. Deciding upon Transition to Residential Care for Persons Living with Dementia: why Do Iranian Family Caregivers Living in Sweden Cease Caregiving at Home?

    Science.gov (United States)

    Kiwi, Mahin; Hydén, Lars-Christer; Antelius, Eleonor

    2018-03-01

    Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families' preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of 'sheer exhaustion' that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon 'being too tired' must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.

  20. Creating learning environments for compassionate care: a programme to promote compassionate care by health and social care teams.

    Science.gov (United States)

    Bridges, Jackie; Fuller, Alison

    2015-03-01

    The consistent delivery of compassionate health and social care to older people is a matter of global concern to the nursing profession and the public it serves. The development and evaluation of effective interventions to address this concern is of prime importance. This paper draws on findings from previous research to propose the use of a novel implementation programme designed to improve and support the delivery of compassionate care by health and social care teams. Creating Learning Environments for Compassionate Care (CLECC) is a 4-month implementation programme designed for hospital ward nursing teams caring for older people, but relevant to other teams working with other client groups. The programme focuses on using workplace learning to promote change at unit/ward/team level by enabling the development of leadership and team relational practices which are also designed to enhance the capacity of individual team members to relate to older people. Existing research evidence suggests that optimising relational capacity in this way will support the delivery of compassionate care. This evidence-based intervention is designed to develop and sustain the relational work required by managers and team members to support care delivery and has the potential to address widely documented variations in care quality. Attention should now be paid to establishing the feasibility of the intervention in practice. © 2014 John Wiley & Sons Ltd.

  1. The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines.

    Science.gov (United States)

    White, L C J; Lanza, S; Middleton, J; Hewitt, K; Freire-Moran, L; Edge, C; Nicholls, M; Rajan-Iyer, J; Cassell, J A

    2016-11-01

    Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.

  2. American Organization of Nurse Executives Care Innovation and Transformation program: improving care and practice environments.

    Science.gov (United States)

    Oberlies, Amanda Stefancyk

    2014-09-01

    The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.

  3. Adolescents in secure residential care: the role of active and passive coping on general well-being and self-esteem.

    Science.gov (United States)

    Barendregt, Charlotte S; Van der Laan, André M; Bongers, Ilja L; Van Nieuwenhuizen, Chijs

    2015-07-01

    Coping, general well-being and self-esteem play an important role during the process of adaptation to turning points in life-course. This study aimed to investigate the effect of coping on both the development of general well-being and self-esteem of adolescents with severe psychiatric problems in secure residential care. In addition, risk and protective factors were taken into account. Adolescents between the age of 16 and 18 (N = 172) were followed for 1.5 years. General well-being and self-esteem were assessed with the Lancashire Quality of Life Profile and the Self-Perception Profile for Adolescents, respectively. In addition, the Utrecht Coping List for Adolescents and the Structured Assessment of Violence Risk in Youth were administered. Results showed that the longitudinal relation between general well-being and self-esteem is no longer significant after adding active and passive coping to the model. The use of active coping strategies was associated with a higher self-esteem. The use of passive coping strategies was associated with a lower self-esteem and also a lower perceived general well-being. Having multiple risks in the individual and/or social/contextual domain affected the developmental pattern of general well-being. During treatment of adolescents with severe psychiatric problems in secure residential care, attention should be paid for enhancing those capabilities and skills, like coping, which help adolescents to fulfill their needs and consequently enhance their well-being. Enhancing the well-being of adolescents might in the long run decrease the chance of reoffending and/or psychiatric relapse.

  4. The social responsibility commitment to the community and care environment

    Directory of Open Access Journals (Sweden)

    Martha Elena López Regalado

    2015-12-01

    Full Text Available The concept of csr has evolved in recent years, currently the main objective of the Company cannot lie only meet the monetary needs of the shareholders, but to seek the participation of all stakeholders in the company, with the different stakeholders that interact with the environment either customers, suppliers, employees and society at large, impacting the community with socially responsible actions. Because the concept has acquired new shades as social, economic and environmental responsibility among others, being on the great responsibility of the actions of companies to make social or common good acts to achieve their objectives without harming their economies community, the next job is presented focusing especially on two major indicators of social responsibility such as environmental care, and welfare of the community.

  5. Residential Environment Induced Preference Heterogeneity for River Ecosystem Service Improvements: A Comparison between Urban and Rural Households in the Wei River Basin, China

    Directory of Open Access Journals (Sweden)

    Hengtong Shi

    2016-01-01

    Full Text Available This paper assesses residential environment induced preference heterogeneity regarding ecosystem services improvements of a river basin by comparing urban and rural residents’ welfare estimates. In a choice experiment, the ecological improvements are described in terms of several observable ecological indicators set in an experimental design. Given the fact that economic and environmental conditions differ for urban and rural residents in China, the utility they derive from ecological restoration is hypothesized to differ. The urban and rural residents’ survey data were modeled separately using mixed logit models. The results reveal that water quality and water quantity, measured by unit of level improvement and percentage improvement, respectively, hold the highest marginal utility values in all respondents’ models. Urban and rural residents have the same preference regarding expanding soil erosion control areas and landscape improvement. However, they have statistically significant different utility for water quality, water quantity, forest coverage, ecotourism improvements, and reducing soil erosion intensity. Generally, urban residents express a higher implicit price for most of the ecological indicators. The findings imply that policy makers should take existing preference heterogeneity into account in designing ecosystem payment schemes and allocating resources.

  6. Intra- and inter-individual variability of Aspergillus fumigatus reactive T-cell frequencies in healthy volunteers in dependency of mould exposure in residential and working environment.

    Science.gov (United States)

    Wurster, Sebastian; Weis, Philipp; Page, Lukas; Helm, Johanna; Lazariotou, Maria; Einsele, Hermann; Ullmann, Andrew J

    2017-10-01

    Invasive aspergillosis remains a deadly disease in immunocompromised patients, whereas the combination of an exaggerated immune response and continuous exposure lead to various hyperinflammatory diseases. This pilot study aimed to gain an overview of the intra- and inter-individual variability in Aspergillus fumigatus reactive T-helper cells in healthy adults and the correlation with environmental mould exposure. In this flow cytometric study, the frequencies of CD154 + A. fumigatus reactive T cells were evaluated in 70 healthy volunteers. All subjects completed a standardised questionnaire addressing their mould exposure. Subjects with intensive mould exposure in their professional or residential surrounding demonstrated considerably higher mean frequencies of A. fumigatus reactive T-helper and T-memory cells. Comparative evaluation of multiple measurements over time demonstrated relatively conserved reactive T-cell frequencies in the absence of major changes to the exposure profile, whereas those frequently exposed in professional environment or with changes to their risk score demonstrated a marked dependency of antigen reactive T-cell frequencies on recent mould exposure. This pilot study was the first to provide data on the intra-individual variability in A. fumigatus reactive T-cell frequencies and its linkage to mould encounter. Fungus reactive T cells are to be considered a valued tool for the assessment of environmental mould exposure. © 2017 Blackwell Verlag GmbH.

  7. Health symptoms in relation to temperature, humidity, and self-reported perceptions of climate in New York City residential environments

    Science.gov (United States)

    Quinn, Ashlinn; Shaman, Jeffrey

    2017-07-01

    Little monitoring has been conducted of temperature and humidity inside homes despite the fact that these conditions may be relevant to health outcomes. Previous studies have observed associations between self-reported perceptions of the indoor environment and health. Here, we investigate associations between measured temperature and humidity, perceptions of indoor environmental conditions, and health symptoms in a sample of New York City apartments. We measured temperature and humidity in 40 New York City apartments during summer and winter seasons and collected survey data from the households' residents. Health outcomes of interest were (1) sleep quality, (2) symptoms of heat illness (summer season), and (3) symptoms of respiratory viral infection (winter season). Using mixed-effects logistic regression models, we investigated associations between the perceptions, symptoms, and measured conditions in each season. Perceptions of indoor temperature were significantly associated with measured temperature in both the summer and the winter, with a stronger association in the summer season. Sleep quality was inversely related to measured and perceived indoor temperature in the summer season only. Heat illness symptoms were associated with perceived, but not measured, temperature in the summer season. We did not find an association between any measured or perceived condition and cases of respiratory infection in the winter season. Although limited in size, the results of this study reveal that indoor temperature may impact sleep quality, and that thermal perceptions of the indoor environment may indicate vulnerability to heat illness. These are both important avenues for further investigation.

  8. Understanding the optimal learning environment in palliative care.

    Science.gov (United States)

    Connell, Shirley E; Yates, Patsy; Barrett, Linda

    2011-07-01

    The learning experiences of student nurses undertaking clinical placement are reported widely, however little is known about the learning experiences of health professionals undertaking continuing professional development (CPD) in a clinical setting, especially in palliative care. The aim of this study, which was conducted as part of the national evaluation of a professional development program involving clinical attachments with palliative care services (The Program of Experience in the Palliative Approach [PEPA]), was to explore factors influencing the learning experiences of participants over time. Thirteen semi-structured, one-to-one telephone interviews were conducted with five participants throughout their PEPA experience. The analysis was informed by the traditions of adult, social and psychological learning theories and relevant literature. The participants' learning was enhanced by engaging interactively with host site staff and patients, and by the validation of their personal and professional life experiences together with the reciprocation of their knowledge with host site staff. Self-directed learning strategies maximised the participants' learning outcomes. Inclusion in team activities aided the participants to feel accepted within the host site. Personal interactions with host site staff and patients shaped this social/cultural environment of the host site. Optimal learning was promoted when participants were actively engaged, felt accepted and supported by, and experienced positive interpersonal interactions with, the host site staff. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Decision-making experiences of family members of older adults with moderate dementia towards community and residential care home services: a grounded theory study protocol.

    Science.gov (United States)

    Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong

    2017-06-05

    Caring and supporting older people with dementia have become a major public health priority. Recent reports have also revealed a diminishing number of family carers to provide dementia care in the future. Carers who are engaged in the caring role are known to bear significant psychological, practical and economic challenges as the disease advances over time. Seemingly, evidence indicates that the burden of care can be relieved by formal services. This study aims to explore decision-making experiences of family members of older adults with moderate dementia towards the use of community support (CS) and residential care home (RCH) services. A large multi-site constructivist grounded theory in a range of non-government organizations and a private aged home will frame this Hong Kong study. Purposive sampling will begin the recruitment of family members, followed by theoretical sampling. It is estimated that more than 100 family members using CS and RCH services will participate in an interview. The process of successive constant comparative analysis will be undertaken. The final product, a theory, will generate an integrated and comprehensive conceptual understanding which will explain the processes associated with decision-making of family members for dementia sufferers. Deeper understanding of issues including, but not exclusive to, service needs, expectations and hopes among family carers for improving service support to serve dementia sufferers in CS and RCH services will also be revealed. Importantly, this study seeks to illustrate the practical and strategic aspects of the theory and how it may be useful to transfer its applicability to various service settings to better support those who deliver formal and informal care to the dementia population.

  10. [Virtual environment: assistance in nursing care for the deaf based on the protocol of primary care].

    Science.gov (United States)

    Rodrigues, Silvia Cristina Martini; Damião, Gardênia Costa

    2014-08-01

    Presenting a Virtual Environment (VE) based on the Protocol of Treatment of Hypertension and Diabetes Mellitus type 2, used in Primary Care for evaluation of dietary habits in nursing consultations. An experimental study applied by two nurses and a nurse manager, in a sample of 30 deaf patients aged between 30 and 60 years. The environment was built in Visual Basic NET and offered eight screens about feeding containing food pictures, videos in Libras (Brazilian sign language) and audio. The analysis of the VE was done through questionnaires applied to patients and professionals by the Poisson statistical test. The VE shows the possible diagnostics in red, yellow, green and blue colors, depending on the degree of patients' need. The environment obtained excellent acceptance by patients and nurses, allowing great interaction between them, even without an interpreter. The time in consultation was reduced to 15 minutes, with the preservation of patient privacy.

  11. Association of the Nurse Work Environment, Collective Efficacy, and Missed Care.

    Science.gov (United States)

    Smith, Jessica G; Morin, Karen H; Wallace, Leigh E; Lake, Eileen T

    2017-10-01

    Missed nursing care is a significant threat to quality patient care. Promoting collective efficacy within nurse work environments could decrease missed care. The purpose was to understand how missed care is associated with nurse work environments and collective efficacy of hospital staff nurses. A cross-sectional, convenience sample was obtained through online surveys from registered nurses working at five southwestern U.S. hospitals. Descriptive, correlational, regression, and path analyses were conducted ( N = 233). The percentage of nurses who reported that at least one care activity was missed frequently or always was 94%. Mouth care (36.0% of nurses) and ambulation (35.3%) were missed frequently or always. Nurse work environments and collective efficacy were moderately, positively correlated. Nurse work environments and collective efficacy were associated with less missed care (χ 2 = 10.714, p = .0054). Fostering collective efficacy in the nurse work environment could reduce missed care and improve patient outcomes.

  12. ASHRAE and residential ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max H.

    2003-10-01

    In the last quarter of a century, the western world has become increasingly aware of environmental threats to health and safety. During this period, people psychologically retreated away from outdoors hazards such as pesticides, smog, lead, oil spills, and dioxin to the seeming security of their homes. However, the indoor environment may not be healthier than the outdoor environment, as has become more apparent over the past few years with issues such as mold, formaldehyde, and sick-building syndrome. While the built human environment has changed substantially over the past 10,000 years, human biology has not; poor indoor air quality creates health risks and can be uncomfortable. The human race has found, over time, that it is essential to manage the indoor environments of their homes. ASHRAE has long been in the business of ventilation, but most of the focus of that effort has been in the area of commercial and institutional buildings. Residential ventilation was traditionally not a major concern because it was felt that, between operable windows and envelope leakage, people were getting enough outside air in their homes. In the quarter of a century since the first oil shock, houses have gotten much more energy efficient. At the same time, the kinds of materials and functions in houses changed in character in response to people's needs. People became more environmentally conscious and aware not only about the resources they were consuming but about the environment in which they lived. All of these factors contributed to an increasing level of public concern about residential indoor air quality and ventilation. Where once there was an easy feeling about the residential indoor environment, there is now a desire to define levels of acceptability and performance. Many institutions--both public and private--have interests in Indoor Air Quality (IAQ), but ASHRAE, as the professional society that has had ventilation as part of its mission for over 100 years, is the

  13. Global inequality and care of the environment: a political and ethical ...

    African Journals Online (AJOL)

    At the end, theresearch makes a clarion call to the society for global equality in the consumption of the goods of the environment and also for all men and women to love, cherishes and cares for the environment--- as political and ethical duties. Keywords: Global inequality, Care, Environment, Ethics, Environmental, Rights ...

  14. Residential environments, alcohol advertising, and initiation and continuation of alcohol consumption among adolescents in urban Taiwan: A prospective multilevel study.

    Science.gov (United States)

    Chen, Yen-Tyng; Cooper, Hannah L F; Windle, Michael; Haardörfer, Regine; Crawford, Natalie D; Chen, Wei J; Chen, Chuan-Yu

    2016-12-01

    Research indicates that place characteristics and the media environment are important contextual determinants of underage drinking behaviors in Western countries, but it is unknown whether these exposures influence adolescent alcohol consumption outside Western contexts, including in Asia׳s emerging global alcohol markets. Guided by the social ecological framework, we prospectively investigated the influences of place characteristics and alcohol advertising on initiation and continuation of alcohol consumption among adolescents in Taipei, Taiwan. Data on individual-level characteristics, including alcohol use behaviors and perceived exposure to alcohol advertising, were obtained from two waves of a longitudinal school-based study through a stratified probability sampling method in 2010 (Grade 7/Grade 8, aged 13-14 years old) and 2011-2012 (Grade 9, aged 15 years old) from 1795 adolescents residing in 22 of 41 districts in Taipei. Data on district-level characteristics were drawn from administrative sources and Google Street View virtual audit to describe districts where adolescents lived at baseline. Hierarchical generalized linear models tested hypotheses about the associations of place characteristics and perceived alcohol advertising with underage drinking, with stratification by baseline lifetime alcohol consumption. Among alcohol-naïve adolescents, lower district-level economic disadvantage, a higher proportion of betel nut kiosks (a relatively unregulated alcohol source) compared to off-premises alcohol outlets, and exposure to television-based alcohol advertising predicted increased likelihood of alcohol initiation at one-year follow-up. Among alcohol-experienced adolescents, greater spatial access to off-premises alcohol outlets, and lower access to metro rapid transportation (MRT) and to temples were found to predict a subsequent increased likelihood of continued alcohol use. Parental drinking moderated the relationship between district-level violent

  15. Nurse-perceived quality of care in intensive care units and associations with work environment characteristics : a multicentre survey study

    NARCIS (Netherlands)

    Stalpers, Dewi; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2017-01-01

    Aims: To examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics. Background: Nurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes

  16. Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program

    Directory of Open Access Journals (Sweden)

    Hewitt J

    2014-02-01

    Full Text Available Jennifer Hewitt,1 Kathryn M Refshauge,1 Stephen Goodall,2 Timothy Henwood,3 Lindy Clemson1 1Faculty of Health Sciences, University of Sydney, 2Centre for Health Economic Research and Evaluation, University of Technology, Sydney, NSW, 3University of Queensland/Blue Care Research and Practice Development Centre, The University of Queensland, Brisbane, QLD, Australia Introduction: Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care reduces falls in residents of aged care facilities. Research question: Is the program more effective and cost-effective than usual care for the prevention of falls? Design: Single-blinded, two group, cluster randomized trial. Participants and setting: 300 residents, living in 20 aged care facilities. Intervention: Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Control: Usual care. Measurements: Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. Analysis: The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. Discussion: This study addresses a significant shortcoming in aged care research, and has potential to impact

  17. Supporting the long-term residential care needs of older homeless people with severe alcohol-related brain injury in Australia: the Wicking Project.

    Science.gov (United States)

    Rota-Bartelink, Alice; Lipmann, Bryan

    2007-01-01

    For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model ofcare to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham's capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.

  18. An intervention strategy for improving residential environment and positive mental health among public housing tenants: rationale, design and methods of Flash on my neighborhood!

    Science.gov (United States)

    Houle, Janie; Coulombe, Simon; Radziszewski, Stephanie; Leloup, Xavier; Saïas, Thomas; Torres, Juan; Morin, Paul

    2017-09-25

    In Canada, public housing programs are an important part of governmental strategies to fight poverty and public exclusion. The Flash on my neighborhood! project is a four-year multiphase community-based participatory action research strategy currently implemented in six public housing developments (n = 1009 households) across the province of Québec, Canada. The goal is to reduce the mental health disparities faced by these public housing tenants compared to the general population, while identifying which environmental and policy changes are needed to turn public housing settings into healthier environments. The protocol involves three successive, interconnected phases: 1) Strengths and needs assessment, including community outreach and recruitment of tenants to collaborate as peer researchers, an exploratory qualitative component (photovoice), a systematic neighborhood observation, and a household survey; 2) Action plan development, including a community forum and interactive capacity-building and discussion sessions; 3) Action plan implementation and monitoring. The entire intervention is evaluated using a mixed-method design, framed within a multiple case study perspective. Throughout the project and particularly in the evaluation phase, data will be collected to record a) contextual factors (tenants' previous experience of participation, history of public housing development, etc.); b) activities that took place and elements from the action plan that were implemented; and c) short- and medium-term outcomes (objective and perceived improvements in the quality of the residential setting, both physically and in terms of mental health and social capital). The study will provide unprecedented evidence-based information on the key ingredients of a collective intervention process associated with the increased collective empowerment and positive mental health of public housing tenants.

  19. Implications of Cost Effectiveness Screening Practices in a Low Natural Gas Price Environment: Case Study of a Midwestern Residential Energy Upgrade Program

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Borgeson, Merrian Goggio [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Zimring, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-04-12

    With the proliferation of statewide energy savings targets and other policies favorable to energy efficiency, savings from utility customer-funded energy efficiency programs could rise to offset much of annual load growth by 2025 (Barbose et al 2013). For these increased savings to occur, however, nearly all of these programs must pass screening for cost effectiveness. Some program administrators and state regulators are finding that conventional analyses, which only consider a narrow set of energy-savings related efficiency program benefits, are now resulting in some natural gas efficiency programs failing their cost-effectiveness criteria in the new low natural gas price environment. Regulators are considering whether to scale back or terminate gas portfolios in at least four states (WA, OR, ID, NM) because of cost-effectiveness concerns. Stakeholders in several regions of the country have asked LBNL to help assess alternatives to reducing the pursuit of energy savings in their regions. We address these requests by producing two working papers: one exploring cost-effectiveness screening policy implications of low to moderate natural gas prices, and a second assessing some of the values that policymakers may take into account in weighing the pros and cons of ending natural gas efficiency programs. In this policy brief, we lay out the challenges that low gas prices pose for cost effectiveness of an electric-gas efficiency program and portfolio. We then quantify options available to regulators and administrators who want to evaluate the tradeoffs among multiple policy objectives. A multi-measure, residential energy upgrade program in the Midwest is used as a lens to explore the implications of common and emerging cost-effectiveness policies in the context of low prices for natural gas. We illustrate the results across a range of cost-effectiveness screening options, including different discount rates, levels of test application, various benefit-cost tests, and the

  20. An intervention strategy for improving residential environment and positive mental health among public housing tenants: rationale, design and methods of Flash on my neighborhood!

    Directory of Open Access Journals (Sweden)

    Janie Houle

    2017-09-01

    Full Text Available Abstract Background In Canada, public housing programs are an important part of governmental strategies to fight poverty and public exclusion. The Flash on my neighborhood! project is a four-year multiphase community-based participatory action research strategy currently implemented in six public housing developments (n = 1009 households across the province of Québec, Canada. The goal is to reduce the mental health disparities faced by these public housing tenants compared to the general population, while identifying which environmental and policy changes are needed to turn public housing settings into healthier environments. Methods The protocol involves three successive, interconnected phases: 1 Strengths and needs assessment, including community outreach and recruitment of tenants to collaborate as peer researchers, an exploratory qualitative component (photovoice, a systematic neighborhood observation, and a household survey; 2 Action plan development, including a community forum and interactive capacity-building and discussion sessions; 3 Action plan implementation and monitoring. The entire intervention is evaluated using a mixed-method design, framed within a multiple case study perspective. Throughout the project and particularly in the evaluation phase, data will be collected to record a contextual factors (tenants’ previous experience of participation, history of public housing development, etc.; b activities that took place and elements from the action plan that were implemented; and c short- and medium-term outcomes (objective and perceived improvements in the quality of the residential setting, both physically and in terms of mental health and social capital. Discussion The study will provide unprecedented evidence-based information on the key ingredients of a collective intervention process associated with the increased collective empowerment and positive mental health of public housing tenants.

  1. Cluster Randomized Controlled Trial of An Aged Care Specific Leadership and Management Program to Improve Work Environment, Staff Turnover, and Care Quality.

    Science.gov (United States)

    Jeon, Yun-Hee; Simpson, Judy M; Li, Zhicheng; Cunich, Michelle M; Thomas, Tamsin H; Chenoweth, Lynn; Kendig, Hal L

    2015-07-01

    To evaluate the effectiveness of a leadership and management program in aged care. Double-blind cluster randomized controlled trial. Twelve residential and community-aged care sites in Australia. All care staff employed for 6 months or longer at the aged care sites were invited to participate in the surveys at 3 time points: baseline (time 1), 9 months from baseline (time 2), and 9 months after completion of time 2 (time 3) from 2011 to 2013. At each time point, at least 500 care staff completed a survey. At baseline (N = 503) the largest age group was 45 to 54 years (37%), and the majority of care staff were born in Australia (70%), spoke English (94%), and had at least completed secondary education (57%). A 12-month Clinical Leadership in Aged Care (CLiAC) program for middle managers, which aimed to further develop their leadership and management skills in creating positive workplace relationships and in enabling person-centered, evidence-based care. The primary outcomes were care staff ratings of the work environment, care quality and safety, and staff turnover rates. Secondary outcomes were care staff's intention to leave their employer and profession, workplace stress, job satisfaction, and cost-effectiveness of implementing the program. Absenteeism was excluded due to difficulty in obtaining reliable data. Managers' self-rated knowledge and skills in leadership and management are not included in this article, which focuses on care staff perceptions only. At 6 months after its completion, the CLiAC program was effective in improving care staff's perception of management support [mean difference 0.61, 95% confidence interval (CI) 0.04-1.18; P = .04]. Compared with the control sites, care staff at the intervention sites perceived their managers' leadership styles as more transformational (mean difference 0.30, 95% CI 0.09-0.51; P = .005), transactional (mean difference 0.22, 95% CI 0.05-0.39; P = .01), and less passive avoidant (mean difference 0.30, 95% CI 0

  2. Homeowner attitudes and practices towards residential landscape management in Ohio, USA.

    Science.gov (United States)

    Blaine, Thomas W; Clayton, Susan; Robbins, Paul; Grewal, Parwinder S

    2012-08-01

    This study describes the results of a survey of 432 homeowners in Ohio, USA concerning their perceptions and practices regarding management of residential landscapes. The results reveal that outdoor residential environments are extremely important to homeowners, who tend to view their yards as serving multiple functions: a place to observe nature and to socialize as well as a place of beauty and recreation. Use of a lawn care company to apply chemicals is reported by 22 % of respondents, while 40 % either apply chemicals themselves or have someone other than a lawn care company do it. Logistic regressions reveal that factors influencing a homeowner's decision to employ a lawn care company or to apply chemicals themselves include: household income (+), perceived impacts on the environment (-), whether the next door neighbor does it (+), and type of residential environment (rural -, suburban and urban +). A theme that emerges throughout the study is the perceived importance of the role of the lawn in residents' sense of social status or acceptance in the neighborhood. This perception can be viewed as a positive in ensuring that residential environments are well maintained, but also as a negative resulting in environmental degradation or presenting a barrier to creativity in the development of alternative residential environments. Specific policy implications of these findings are that efforts aimed at educating homeowners about the environmental impacts of their lawn care choices are likely to have more success if they are directed at neighborhood groups rather than individuals, show that alternatives are easy to adopt, affordable, and can produce the characteristics of lawns that homeowners seek.

  3. Early skin-to-skin care in extremely preterm infants: thermal balance and care environment.

    Science.gov (United States)

    Karlsson, Victoria; Heinemann, Ann-Britt; Sjörs, Gunnar; Nykvist, Kerstin Hedberg; Agren, Johan

    2012-09-01

    To evaluate infant thermal balance and the physical environment in extremely preterm infants during skin-to-skin care (SSC). Measurements were performed in 26 extremely preterm infants (gestational age 22-26 weeks; postnatal age, 2-9 days) during pretest (in incubator), test (during SSC), and posttest (in incubator) periods. Infants' skin temperature and body temperature, ambient temperature, and relative humidity were measured. Evaporimetry was used to determine transepidermal water loss, and insensible water loss through the skin was calculated. The infants maintained a normal body temperature during SSC. Transfer to and from SSC was associated with a drop in skin temperature, which increased during SSC. Ambient humidity and temperature were lower during SSC than during incubator care. Insensible water loss through the skin was higher during SSC. SSC can be safely used in extremely preterm infants. SSC can be initiated during the first week of life and is feasible in infants requiring neonatal intensive care, including ventilator treatment. During SSC, the conduction of heat from parent to infant is sufficiently high to compensate for the increase in evaporative and convective heat loss. The increased water loss through the skin during SSC is small and should not affect the infant's fluid balance. Copyright © 2012 Mosby, Inc. All rights reserved.

  4. Studying feasibility and effects of a two-stage nursing staff training in residential geriatric care using a 30 month mixed-methods design [ISRCTN24344776

    Directory of Open Access Journals (Sweden)

    Hantikainen Virpi

    2011-05-01

    Full Text Available Abstract Background Transfer techniques and lifting weights often cause back pain and disorders for nurses in geriatric care. The Kinaesthetics care conception claims to be an alternative, yielding benefits for nurses as well as for clients. Starting a multi-step research program on the effects of Kinaesthetics, we assess the feasibility of a two-stage nursing staff training and a pre-post research design. Using quantitative and qualitative success criteria, we address mobilisation from the bed to a chair and backwards, walking with aid and positioning in bed on the staff level as well as on the resident level. In addition, effect estimates should help to decide on and to prepare a controlled trial. Methods/Design Standard basic and advanced Kinaesthetics courses (each comprising four subsequent days and an additional counselling day during the following four months are offered to n = 36 out of 60 nurses in a residential geriatric care home, who are in charge of 76 residents. N = 22 residents needing movement support are participating to this study. On the staff level, measurements include focus group discussions, questionnaires, physical strain self-assessment (Borg scale, video recordings and external observation of patient assistance skills using a specialised instrument (SOPMAS. Questionnaires used on the resident level include safety, comfort, pain, and level of own participation during mobilisation. A functional mobility profile is assessed using a specialised test procedure (MOTPA. Measurements will take place at baseline (T0, after basic training (T1, and after the advanced course (T2. Follow-up focus groups will be offered at T1 and 10 months later (T3. Discussion Ten criteria for feasibility success are established before the trial, assigned to resources (missing data, processes (drop-out of nurses and residents and science (minimum effects criteria. This will help to make rational decision on entering the next stage of the research

  5. The relationship between physical activity, and physical performance and psycho-cognitive functioning in older adults living in residential aged care facilities.

    Science.gov (United States)

    Bootsman, Natalia J M; Skinner, Tina L; Lal, Ravin; Glindemann, Delma; Lagasca, Carmela; Peeters, G M E E Geeske

    2018-02-01

    Insight into modifiable factors related to falls risk in older adults living in residential aged care facilities (RACFs) is necessary to tailor preventive strategies for this high-risk population. Associations between physical activity (PA), physical performance and psycho-cognitive functioning have been understudied in aged care residents. This study investigated associations between PA, and both physical performance and psycho-cognitive functioning in older adults living in RACFs. Cross-sectional study. Forty-four residents aged 85±8years were recruited from four RACFs located in Southeast Queensland. PA was assessed as the average time spent walking in hours/day using activPAL3™. Physical performance tests included balance, gait speed, dual-task ability, reaction time, coordination, grip strength, and leg strength and power. Psycho-cognitive questionnaires included quality of life, balance confidence, fear of falling and cognitive functioning. Associations between PA and each outcome measure were analysed using linear or ordinal regression models. The average time spent walking was 0.5±0.4h/day. Higher levels of PA were significantly associated with better balance (compared with low PA, medium: B=1.6; high: B=1.3) and dual-task ability (OR=7.9 per 0.5h/day increase). No statistically significant associations were found between PA and the other physical and psycho-cognitive measures. More physically active residents scored higher on balance and dual-task ability, which are key predictors of falls risk. This suggests that physical activity programs targeting balance and dual-task ability could help prevent falls in aged care residents. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. Performance-Based Contracting in Residential Care and Treatment: Driving Policy and Practice Change through Public-Private Partnership in Illinois

    Science.gov (United States)

    Kearney, Kathleen A.; McEwen, Erwin; Bloom-Ellis, Brice; Jordan, Neil

    2010-01-01

    The National Quality Improvement Center on the Privatization of Child Welfare Services selected Illinois as a demonstration site in 2007 to evaluate performance-based contracting in residential treatment services. This article discusses the first two years of project implementation including developing residential treatment performance indicators,…

  7. The SNAQ(RC), an easy traffic light system as a first step in the recognition of undernutrition in residential care

    NARCIS (Netherlands)

    Kruizenga, H M; de Vet, H.C.W.; van Marissing, C.M.E.; Stassen, E.E.P.M.; Strijk, J.E.; van Bokhorst-de van der Schueren, M.A.E.; Horman, J.C.H.; Schols, J.M.G.A.; van Binsbergen, J.J.; Eliens, A; Knol, D L; Visser, M

    OBJECTIVE: Development and validation of a quick and easy screening tool for the early detection of undernourished residents in nursing homes and residential homes. DESIGN: Multi-center, cross sectional observational study. SETTING: Nursing homes and residential homes. PARTICIPANTS: The screening

  8. Make a move : A comprehensive effect evaluation of a sexual harassment prevention program in Dutch residential youth care

    NARCIS (Netherlands)

    van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C

    2016-01-01

    Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of

  9. Sources of Job Stress and Job Satisfaction Reported by Direct-Care Staff of Large Residential Mental Retardation Facilities.

    Science.gov (United States)

    Buckhalt, Joseph A.; And Others

    1990-01-01

    An instrument measuring ratings of sources of job stress and satisfaction resulting from characteristics of residents and work conditions was completed by 136 direct-care staff members in 4 regional state mental retardation facilities. Differences by facility were noted. The instrument offers some unique information appropriate for studies of job…

  10. The place of surveillance technology in residential care for people with intellectual disabilities: is there an ideal model of application

    NARCIS (Netherlands)

    Niemeijer, A.R.; Frederiks, B.J.M.; Depla, M.F.I.A.; Eefsting, J.A.; Hertogh, C.M.P.M.

    2013-01-01

    Background The demand for (care) services for people with intellectual disabilities (ID) is on the rise, because of an expanding population of people with ID as resources are concurrently diminishing. As a result, service providers are increasingly turning to technology as a potential answer to this

  11. Essential elements of professional nursing environments in Primary Care and their influence on the quality of care.

    Science.gov (United States)

    Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón

    Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  12. The relationship between the nursing environment and delivering culturally sensitive perinatal hospice care.

    Science.gov (United States)

    Mixer, Sandra J; Lindley, Lisa; Wallace, Heather; Fornehed, Mary Lou; Wool, Charlotte

    2015-09-01

    Wide variations exist among perinatal hospices, and barriers to perinatal palliative care exist at the healthcare level. Research in the area of culturally sensitive perinatal palliative care has been scarce, a gap which this study addresses. To evaluate the relationship between the nurse work environment and the delivery of culturally sensitive perinatal hospice care. This retrospective, correlational study used data from the National Home and Hospice Care Survey, which includes a nationally representative sample of hospice care providers. A multivariate logistic regression model was used to estimate the relationship between the delivery of culturally sensitive care and the nurse work environment. Accreditation, teaching status, and baccalaureate-prepared registered nurse staff had an impact on the provision of culturally sensitive perinatal care Conclusions: The hospice and nursing unit environments, specifically in regards to education and technology, may be important contributors to the delivery of culturally sensitive care.

  13. Patterns of emergency ambulance use, 2009-13: a comparison of older people living in Residential Aged Care Facilities and the Community.

    Science.gov (United States)

    Dwyer, R; Gabbe, B; Tran, T D; Smith, K; Lowthian, J A

    2018-04-24

    to examine demand for emergency ambulances by older people. retrospective cohort study using secondary analysis of routinely collected clinical and administrative data from Ambulance Victoria, and population data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. Victoria, Australia. people aged 65 years and over, living in Residential Aged Care Facilities (RACF) and the community, attended by emergency ambulance paramedics, 2009-13. rates of emergency ambulance attendance. older people living in RACF experienced high rates of emergency ambulance attendance, up to four times those for age- and sex-matched people living in the community. Rates remained constant during the study period equating to a consistent, 1.45% average annual increase in absolute demand. Rates peak among the 80-84-year group where the number of attendances equates to greater than one for every RACF-dwelling person each year. Increased demand was associated with winter months, increasing age and being male. these data provide strong evidence of high rates of emergency ambulance use by people aged 65 years and over living in RACF. These results demonstrate a clear relationship between increased rate of ambulance use among this vulnerable group of older Australians and residence, sex, age and season. Overall, absolute demand continues to increase each year adding to strain on health resources. Additional research is needed to elucidate individual characteristics, illness and health system contributors to ambulance use to inform strategies to appropriately reduce demand.

  14. Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study.

    Science.gov (United States)

    Fan, Lijun; Hou, Xiang-Yu; Zhao, Jingzhou; Sun, Jiandong; Dingle, Kaeleen; Purtill, Rhonda; Tapp, Sam; Lukin, Bill

    2016-02-09

    There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67-0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50-0.76); p Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

  15. Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

    Science.gov (United States)

    Lofton, Kristi L.; Carr, Deborah H.

    2010-01-01

    Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

  16. The Nature of Relationships in Alternative Dementia Care Environments

    Science.gov (United States)

    Wiersma, Elaine C.; Pedlar, Alison

    2008-01-01

    The purpose of this exploratory study was to examine the experiences of older adults with dementia while they were in long-term care and while they were in a summer-camp setting. Participant observation and interviews took place in both settings to gain an understanding of the experiences of seven residents of the long-term care facility. In the…

  17. Self- and proxy reports of quality of life among adolescents living in residential youth care compared to adolescents in the general population and mental health services.

    Science.gov (United States)

    Jozefiak, Thomas; Sønnichsen Kayed, Nanna

    2015-07-22

    Child welfare services are aimed at providing care and protection, fostering well-being and prosocial behaviour. Thus, Quality of Life (QoL) should be an important outcome measure in Residential Youth Care (RYC) institutions. However, the dearth of research in this area gives rise to serious concern. The present study is the first large scale, nationwide study assessing QoL among adolescents living in RYC. To provide a reference frame, adolescent self- and primary contact proxy reports were compared to the general population and to adolescent outpatients in Child and Adolescent Mental Health Service (CAMHS). Also, we investigated the association between self-report of QoL in adolescents living in RYC and proxy reports of their primary contacts at the institution. All residents between the ages of 12-23 years living in RYC in Norway were the inclusion criteria. Eighty-six RYC institutions (with 601 eligible youths) were included, 201 youths/ parents did not give their consent. Finally, 400 youths aged 12-20 years participated, yielding a response rate of 67%. As a reference frame for comparison, a general population (N = 1444) and an outpatient sample of adolescents in CAMHS (N = 68) were available. We used the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). General Linear Model analyses (ANCOVA) were conducted with five KINDL life domains as dependent variables and group as independent variable. Self- and proxy reports of QoL in adolescents living in RYC revealed a significantly (p proxy reports in RYC differed significantly on two of five life domains, but correlated low to moderate with each other. The results in this study raise major concerns about the poor QoL of the adolescents living in RYC, thereby challenging the child welfare system and decision makers to take action to improve the QoL of this group. The use of QoL as outcome measures is highly recommended.

  18. Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme

    Directory of Open Access Journals (Sweden)

    Samantha Fien

    2016-05-01

    Full Text Available The objective of the study was to examine the feasibility and benefits of a group resistance training exercise programme for improving muscle function in institutionalised older adults. A feasibility and acceptability study was designed for a residential aged care (RAC facility, based on the Gold Coast, Australia. Thirty-seven adults, mean age 86.8 ± 6.1 years (30 females living in a RAC facility. Participants were allocated into an exercise (n = 20 or control (n = 17 group. The exercise group, the Group Aged Care Exercise (GrACE programme, performed 12 weeks of twice weekly resistance exercises. Feasibility was measured via recruitment rate, measurement (physiological and surveys completion rate, loss-to-follow-up, exercise session adherence, adverse events, and ratings of burden and acceptability. Muscle function was assessed using gait speed, sit-to-stand and handgrip strength assessments. All intervention participants completed pre- and post-assessments, and the exercise intervention, with 85% (n = 17 of the group attending ≥ 18 of the 24 sessions and 15% (n = 3 attending all sessions. Acceptability was 100% with exercise participants, and staff who had been involved with the programme strongly agreed that the participants “Benefited from the programme.” There were no adverse events reported by any participants during the exercise sessions. When compared to the control group, the exercise group experienced significant improvements in gait speed (F(4.078 = 8.265, p = 0.007, sit to stand performance (F(3.24 = 11.033, p = 0.002 and handgrip strength (F(3.697 = 26.359, p < 0.001. Resistance training via the GrACE programme is feasible, safe and significantly improves gait speed, sit-to-stand performance and handgrip strength in RAC adults.

  19. Developing inclusive residential care for older lesbian, gay, bisexual and trans (LGBT) people: An evaluation of the Care Home Challenge action research project.

    Science.gov (United States)

    Hafford-Letchfield, Trish; Simpson, Paul; Willis, Paul B; Almack, Kathryn

    2018-03-01

    There have been substantial achievements in legislative and human rights for lesbian, gay, bisexual and transgender (LGBT) older people and their visibility in health and social care has equally increased. These appear to have surpassed the ability of care services to meet their needs given documented concerns about the accessibility, inclusiveness and safety of care services particularly institutionalised care. This requires systemic change not easy to operationalise. This paper describes an action research initiative where six care homes belonging to a national care provider, collaborated to assess and develop their services with the support of local LGBT "Community Advisors" and academic partners. Framed within Rogers' (2003) change management framework and combined with a participatory leadership approach, a programme of intervention was implemented comprising structured activities around seven key areas thought to promote LGBT inclusion. A formal evaluation was conducted involving 35 pre- and post-intervention qualitative interviews with 18 people (community advisors; care home managers and senior managers). The findings are presented across three key themes (1) starting points on the journey; (2) challenges encountered along the journey (organisational and interpersonal); and (3) making change happen; opportunities, initiatives and gains. We make recommendations on the value of a programme approach for achieving tangible outcomes that demonstrate increased inclusion for older LGBT people living in long-term care settings. © 2017 John Wiley & Sons Ltd.

  20. Supervised versus non-supervised implementation of an oral health care guideline in (residential) care homes: a cluster randomized controlled clinical trial.

    NARCIS (Netherlands)

    Putten, G.J. van der; Visschere, L. De; Schols, J.; Baat, C. de; Vanobbergen, J.

    2010-01-01

    BACKGROUND: The increase of the proportion of elderly people has implications for health care services. Advances in oral health care and treatment have resulted in a reduced number of edentulous individuals. An increasing number of dentate elderly people have tooth wear, periodontal disease, oral

  1. How do health care education and training professionals learn about the environment?

    Science.gov (United States)

    Glazer, H R; Stein, D S; Schafer, D S

    1993-01-01

    Preparing for the health care system of the future includes the ability to abstract information from relevant sectors of the environment. This study looked at the way health care educators scan the environment and the relationship of scanning behavior to management style. Results indicate that education and training professionals focus on the regulatory and customer sectors of the environment more than the technological and sociopolitical sectors.

  2. Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-10-01

    To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  3. Does job satisfaction mediate the relationship between healthy work environment and care quality?

    Science.gov (United States)

    Bai, Jinbing

    2016-01-01

    A healthy work environment can increase nurse-reported job satisfaction and patient care outcomes. Yet the associations between healthy work environment, nurse job satisfaction and QC have not been comprehensively examined in Chinese ICUs. To investigate the mediating effect of nurse job satisfaction on the relationship between healthy work environment and nurse-reported quality of care (QC) in Chinese intensive care units (ICUs). A total of 706 nurses were recruited from 28 ICUs of 14 tertiary hospitals. The nurses completed self-reported questionnaires to evaluate healthy work environment, job satisfaction and quality of patient care. Mediation analysis was conducted to explore the mediating effect between nurse-reported healthy work environment and QC. Nurse work environment showed positive correlations with nurse-reported QC in the ICUs. Nurse-reported job satisfaction showed full mediating effects between healthy work environment and QC in the medical-surgical ICUs, surgical ICUs and neonatal/paediatric ICUs and indicated a partial mediating effect in the medical ICUs. Significant mediating effects of nurse job satisfaction provide more support for thinking about how to use this mediator to increase nurse and patient care outcomes. Nurse administrators can design interventions to increase nurse work environment and patient care outcomes with this mediating factor addressed. © 2015 British Association of Critical Care Nurses.

  4. Factor Structure, Reliability and Measurement Invariance of the Alberta Context Tool and the Conceptual Research Utilization Scale, for German Residential Long Term Care

    Science.gov (United States)

    Hoben, Matthias; Estabrooks, Carole A.; Squires, Janet E.; Behrens, Johann

    2016-01-01

    We translated the Canadian residential long term care versions of the Alberta Context Tool (ACT) and the Conceptual Research Utilization (CRU) Scale into German, to study the association between organizational context factors and research utilization in German nursing homes. The rigorous translation process was based on best practice guidelines for tool translation, and we previously published methods and results of this process in two papers. Both instruments are self-report questionnaires used with care providers working in nursing homes. The aim of this study was to assess the factor structure, reliability, and measurement invariance (MI) between care provider groups responding to these instruments. In a stratified random sample of 38 nursing homes in one German region (Metropolregion Rhein-Neckar), we collected questionnaires from 273 care aides, 196 regulated nurses, 152 allied health providers, 6 quality improvement specialists, 129 clinical leaders, and 65 nursing students. The factor structure was assessed using confirmatory factor models. The first model included all 10 ACT concepts. We also decided a priori to run two separate models for the scale-based and the count-based ACT concepts as suggested by the instrument developers. The fourth model included the five CRU Scale items. Reliability scores were calculated based on the parameters of the best-fitting factor models. Multiple-group confirmatory factor models were used to assess MI between provider groups. Rather than the hypothesized ten-factor structure of the ACT, confirmatory factor models suggested 13 factors. The one-factor solution of the CRU Scale was confirmed. The reliability was acceptable (>0.7 in the entire sample and in all provider groups) for 10 of 13 ACT concepts, and high (0.90–0.96) for the CRU Scale. We could demonstrate partial strong MI for both ACT models and partial strict MI for the CRU Scale. Our results suggest that the scores of the German ACT and the CRU Scale for nursing

  5. Factor Structure, Reliability and Measurement Invariance of the Alberta Context Tool and the Conceptual Research Utilization Scale, for German Residential Long Term Care.

    Science.gov (United States)

    Hoben, Matthias; Estabrooks, Carole A; Squires, Janet E; Behrens, Johann

    2016-01-01

    We translated the Canadian residential long term care versions of the Alberta Context Tool (ACT) and the Conceptual Research Utilization (CRU) Scale into German, to study the association between organizational context factors and research utilization in German nursing homes. The rigorous translation process was based on best practice guidelines for tool translation, and we previously published methods and results of this process in two papers. Both instruments are self-report questionnaires used with care providers working in nursing homes. The aim of this study was to assess the factor structure, reliability, and measurement invariance (MI) between care provider groups responding to these instruments. In a stratified random sample of 38 nursing homes in one German region (Metropolregion Rhein-Neckar), we collected questionnaires from 273 care aides, 196 regulated nurses, 152 allied health providers, 6 quality improvement specialists, 129 clinical leaders, and 65 nursing students. The factor structure was assessed using confirmatory factor models. The first model included all 10 ACT concepts. We also decided a priori to run two separate models for the scale-based and the count-based ACT concepts as suggested by the instrument developers. The fourth model included the five CRU Scale items. Reliability scores were calculated based on the parameters of the best-fitting factor models. Multiple-group confirmatory factor models were used to assess MI between provider groups. Rather than the hypothesized ten-factor structure of the ACT, confirmatory factor models suggested 13 factors. The one-factor solution of the CRU Scale was confirmed. The reliability was acceptable (>0.7 in the entire sample and in all provider groups) for 10 of 13 ACT concepts, and high (0.90-0.96) for the CRU Scale. We could demonstrate partial strong MI for both ACT models and partial strict MI for the CRU Scale. Our results suggest that the scores of the German ACT and the CRU Scale for nursing

  6. Nurse work environment and quality of care by unit types: A cross-sectional study.

    Science.gov (United States)

    Ma, Chenjuan; Olds, Danielle M; Dunton, Nancy E

    2015-10-01

    Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. Unit

  7. Nursing in family environment: caring for person in mental suffering

    Directory of Open Access Journals (Sweden)

    Lucas Amaral Martins

    2013-01-01

    Full Text Available The study aims to describe the experience of nursing care to person in mental suffering (PMS in the family context. Developed by nursing academic during home attendance, in the 2008.2 semester. The results showed that: is undeniable the family function of the PMS care, becoming the main partner of the heath teams, the care in the perspective of psychosocial rehabilitation influences the attitudes, patterns of response and participation in treatment, resulting in the empowerment of PMS and family. It’s concluded that home attendance contributes to the process of psychosocial rehabilitation of the PMS and assessment of mental health services, subsidizing the formulation of public policies for the sector, especially, in regard to care in perspective of the whole human life.

  8. Homeless veterans' satisfaction with residential treatment.

    Science.gov (United States)

    Kasprow, W J; Frisman, L; Rosenheck, R A

    1999-04-01

    Because little is known about homeless individuals' satisfaction with mental health services or the association between satisfaction and measures of treatment outcome, the study examined those issues in a group of homeless veterans. Demographic and clinical data were obtained from intake assessments conducted before veterans' admission to residential treatment facilities under contract with the Department of Veterans Affairs Health Care for Homeless Veterans program, a national outreach and case management program. Clients completed a satisfaction survey and the Community-Oriented Programs Environment Scale, which asks them to rate dimensions of the treatment environment. Outcome data came from discharge outcome summaries completed by VA case managers. Overall satisfaction with residential treatment services was high among the 1,048 veterans surveyed. Greater satisfaction was associated with more days of drug abuse and more days spent institutionalized in the month before intake and with an intake diagnosis of drug abuse. Regression analyses indicated that satisfaction was most strongly related to clients' perceptions of several factors in the treatment environment. Policy clarity, clients' involvement in the program, an emphasis on order, a practical orientation, and peer support were positively related to satisfaction; staff control and clients' expression of anger were negatively related. Satisfaction was significantly associated with case managers' discharge ratings of clinical improvement of drug problems and psychiatric problems. Homeless veterans are more satisfied in environments they perceive to be supportive, orderly, and focused on practical solutions. The results indicate that client satisfaction is not related to treatment outcomes strongly enough to serve as a substitute for other outcome measures.

  9. New 'patent accelerated care environment' aims to facilitate work flow, free up ED for acute care needs.

    Science.gov (United States)

    2012-02-01

    Faced with rising acuity levels and surging demand, Virginia Mason Medical Center modified the Clinical Decision Unit concept used in many EDs, and developed a new Patient Accelerated Care Environment (PACE) to care for observation patients, process patients for discharge, and to prepare patients for admission.The approach is designed to utilize ED beds for initial processing of patients, allowing resuscitative care if needed, and treating and releasing the patients with quick care needs. Using the Virginia Mason Production System, a methodology that is modeled after Toyota production techniques, developers designed an optimal work flow pattern and then built infrastructure to facilitate that process. All patients who present to the ED for care are seen by the ED team through a "team greet" approach. Approximately 35% to 40% of patients who come to the ED for care are transferred to the PACE unit. Patients assigned to the PACE unit typically remain there for 4 to 48 hours, depending on their care needs.

  10. Interaction and common ground in dementia: Communication across linguistic and cultural diversity in a residential dementia care setting.

    Science.gov (United States)

    Strandroos, Lisa; Antelius, Eleonor

    2017-09-01

    Previous research concerning bilingual people with a dementia disease has mainly focused on the importance of sharing a spoken language with caregivers. While acknowledging this, this article addresses the multidimensional character of communication and interaction. As using spoken language is made difficult as a consequence of the dementia disease, this multidimensionality becomes particularly important. The article is based on a qualitative analysis of ethnographic fieldwork at a dementia care facility. It presents ethnographic examples of different communicative forms, with particular focus on bilingual interactions. Interaction is understood as a collective and collaborative activity. The text finds that a shared spoken language is advantageous, but is not the only source of, nor a guarantee for, creating common ground and understanding. Communicative resources other than spoken language are for example body language, embodiment, artefacts and time. Furthermore, forms of communication are not static but develop, change and are created over time. Ability to communicate is thus not something that one has or has not, but is situationally and collaboratively created. To facilitate this, time and familiarity are central resources, and the results indicate the importance of continuity in interpersonal relations.

  11. An assessment of risk posed by a Campylobacter-positive puppy living in an Australian residential aged-care facility.

    Science.gov (United States)

    Moffatt, Cameron; Appuhamy, Ranil; Andrew, Will; Wynn, Sandy; Roberts, Jan; Kennedy, Karina

    2014-01-01

    In April and June 2012, two outbreaks of Campylobacter gastroenteritis were investigated in an Australian aged-care facility (ACF); a Campylobacter-positive puppy was identified as a potential source of infection. An expert panel was convened to assess transmission risk from the puppy to elderly residents and to guide further public health action. Criteria considered as part of the panel's assessment included the puppy's infectivity, the bacterium's transmissibility, puppy-resident contact, infection control and cleaning practices and animal management at the facility. A literature review was used to assist the panel, with a final risk being determined using a likelihood and consequence matrix. The panel determined that the setting and low infective dose made transmission likely despite varying degrees of contact between the puppy and cases. While infection control practices were generally appropriate, the facility's animal policy did not adequately address potential zoonotic risk. In summary, puppies should not be considered as companion animals in ACFs due to high rates of Campylobacter carriage and the underlying susceptibility of the elderly. Infection control and animal policies in ACFs should reflect an awareness of zoonotic disease potential.

  12. [Chronic home-care patients and their primary health care environment].

    Science.gov (United States)

    Bilbao Curiel, I; Gastaminza Santacoloma, A M; García García, J A; Quindimil Vázquez, J A; López Rivas, J L; Huidobro Fernández, L

    1994-03-15

    Describing the primary level of attention to chronic home patients (CHP), their quality or life and the one of their home carers. Descriptive transverse study. Teaching Unit of Family of Sestao (Vizcaya) urban environment. 197 CHP patients with subacute, chronic illnesses or in terminal stages or handicapped, that is to say, people who cannot attend the Medical Centre and needing constant home care (longer than 4 weeks) although they do not need to be in hospital at the moment. A questionnaire made up by the researching group. April-June 1992. The clinical histories and home interviews. Mean age (78 +/- 23) years old; 70% were women; average of health problems of patients (4.2 +/- 4); average of drug consumption by patients (3.6 +/- 4); average of one visit to each patient per two months; 75% did not need derivation. The average age of people looking after them was (58 +/- 28) years old and 77.3% of them were women. Their average QL index was (9 +/- 2.4) out of 10, 9.2% had a QL index between 4 and 7 although there was nobody under 3. We have found an old population, mostly women with an average of health problems of (4.24 +/- 4) and who are polymedicated. 9.4 of them are not looked after by anybody. Generally their homes are habitable enough. In 77.3% of the cases the carers are women and 65.6% do not receive any domiciliary help.

  13. Designing and evaluating an electronic patient falls reporting system: perspectives for the implementation of health information technology in long-term residential care facilities.

    Science.gov (United States)

    Mei, Yi You; Marquard, Jenna; Jacelon, Cynthia; DeFeo, Audrey L

    2013-11-01

    Patient falls are the leading cause of unintentional injury and death among older adults. In 2000, falls resulted in over 10,300 elderly deaths, costing the United States approximately $179 million in incidence and medical costs. Furthermore, non-fatal injuries caused by falls cost the United States $19 billion annually. Health information technology (IT) applications, specifically electronic falls reporting systems, can aid quality improvement efforts to prevent patient falls. Yet, long-term residential care facilities (LTRCFs) often do not have the financial resources to implement health IT, and workers in these settings are often not ready to adopt such systems. Additionally, most health IT evaluations are conducted in large acute-care settings, so LTRCF administrators currently lack evidence to support the value of health IT. In this paper, we detail the development of a novel, easy-to-use system to facilitate electronic patient falls reporting within a LTRCF using off-the-shelf technology that can be inexpensively implemented in a wide variety of settings. We report the results of four complimentary system evaluation measures that take into consideration varied organizational stakeholders' perspectives: (1) System-level benefits and costs, (2) system usability, via scenario-based use cases, (3) a holistic assessment of users' physical, cognitive, and marcoergonomic (work system) challenges in using the system, and (4) user technology acceptance. We report the viability of collecting and analyzing data specific to each evaluation measure and detail the relative merits of each measure in judging whether the system is acceptable to each stakeholder. The electronic falls reporting system was successfully implemented, with 100% reporting at 3-months post-implementation. The system-level benefits and costs approach showed that the electronic system required no initial investment costs aside from personnel costs and significant benefits accrued from user time savings

  14. Differences in nursing practice environment among US acute care unit types: a descriptive study.

    Science.gov (United States)

    Choi, JiSun; Boyle, Diane K

    2014-11-01

    The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered

  15. Another link to improving the working environment in acute care hospitals: registered nurses' spirit at work.

    Science.gov (United States)

    Urban, Ann-Marie; Wagner, Joan I

    2013-12-01

    Hospitals are situated within historical and socio-political contexts; these influence the provision of patient care and the work of registered nurses (RNs). Since the early 1990s, restructuring and the increasing pressure to save money and improve efficiency have plagued acute care hospitals. These changes have affected both the work environment and the work of nurses. After recognizing this impact, healthcare leaders have dedicated many efforts to improving the work environment in hospitals. Admirable in their intent, these initiatives have made little change for RNs and their work environment, and thus, an opportunity exists for other efforts. Research indicates that spirit at work (SAW) not only improves the work environment but also strengthens the nurse's power to improve patient outcomes and contribute to a high-quality workplace. In this paper, we present findings from our research that suggest SAW be considered an important component in improving the work environment in acute care hospitals.

  16. Architectural design of passive solar residential building

    Directory of Open Access Journals (Sweden)

    Ma Jing

    2015-01-01

    Full Text Available This paper studies thermal environment of closed balconies that commonly exist in residential buildings, and designs a passive solar residential building. The design optimizes the architectural details of the house and passive utilization of solar energy to provide auxiliary heating for house in winter and cooling in summer. This design might provide a more sufficient and reasonable modification for microclimate in the house.

  17. Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study.

    Science.gov (United States)

    Heutmekers, Marloes; Naaldenberg, Jenneken; Verheggen, Sabine A; Assendelft, Willem J J; Lantman-de Valk, Henny M J van Schrojenstein; Tobi, Hilde; Leusink, Geraline L

    2017-11-03

    To investigate whether people with intellectual disabilities (ID) in residential setting were more likely than people from the general population to request out-of-hours general practitioner (GP) care and whether these requests had a similar level of urgency. Cross-sectional routine data-based study. Two GP cooperatives providing out-of-hours primary care in an area in the Netherlands. 432 582 persons living in the out-of-hours service areas, of which 1448 could be identified as having an ID. GP cooperative records of all contacts in 2014 for people with and without ID were used to calculate the relative risk of requesting care and the associated level of urgency. Of the people with ID (448/1448), 30.9% requested out-of-hours GP care, whereas for the general population this was 18.4% (79 206/431 134), resulting in a relative risk of 1.7 (95% CI 1.6 to 1.8). We found a different distribution of urgency level for people with and without ID. Generally, requests for people with ID