Alternative regulatory provisions are considered which might permit achievement of the building energy conservation regulatory goals at a lower cost. Major issues, regulatory and legislative options, and cost-benefit analyses are discussed for multi-family and commercial buildings. The following are presented: related government programs, urban and community impact analysis, institutional impacts, energy cost, Residential Conservation Service coverage, methods of analysis, and regional studies. (MHR)
Brown, R. I.; Geider, S.; Primrose, A.; Jokinen, N. S.
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…
Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong
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.
Downey, Liam; Crowder, Kyle; Kemp, Robert J
This study combines micro-level data on families with children from the Panel Study of Income Dynamics with neighborhood-level industrial hazard data from the Environmental Protection Agency and neighborhood-level U.S. census data to examine both the association between family structure and residential proximity to neighborhood pollution and the micro-level, residential mobility processes that contribute to differential pollution proximity across family types. Results indicate the existence of significant family structure differences in household proximity to industrial pollution in U.S. metropolitan areas between 1990 and 1999, with single-mother and single-father families experiencing neighborhood pollution levels that are on average 46% and 26% greater, respectively, than those experienced by two-parent families. Moreover, the pollution gap between single-mother and two-parent families persists with controls for household and neighborhood socioeconomic, sociodemographic, and race/ethnic characteristics. Examination of underlying migration patterns reveals that single-mother, single-father, and two-parent families are equally likely to move in response to pollution. However, mobile single-parent families move into neighborhoods with significantly higher pollution levels than do mobile two-parent families. Thus, family structure differences in pollution proximity are maintained more by these destination neighborhood differences than by family structure variations in the likelihood of moving out of polluted neighborhoods.
Michielin, F.; Mulder, C.H.
Using data from retrospective surveys carried out in the Netherlands during the early 1990s, we describe how the residential mobility of couples—that is, short-distance moves—is affected by family events and how fertility is affected by residential mobility. The results show that residential moves
Kruzich, Jean M.; Friesen, Barbara J.; Williams-Murphy, Tracy; Longley, M. J.
Examines families' perceptions about involvement in residential treatment from the viewpoints of African American and non-African American family members. Focus group interviews found that all family members shared some common positive and negative experiences. However, unique issues remained for African American caregivers. Implications for…
Griffith, Annette K.; Ingram, Stephanie D.; Barth, Richard P.; Trout, Alexandra L.; Hurley, Kristin Duppong; Thompson, Ronald W.; Epstein, Michael H.
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…
Irina R. KANCHEVA
Full Text Available Purchase and consumption behavioral patterns of various family formations in different social and cultural contexts have been subject to intensive investigation over the recent years. Residential real estate as a product category represents one of the most complex household purchases incorporating a wide diversity of attributes to be considered in order to match family members’ needs within available resources. The purpose of this paper is to add some insights into spousal perceptions of gender role specialization throughout a residential real estate purchase family decision-making process. The distribution of influence between husbands and wives across three decision-making stages, three sub-decisions and twelve housing attribute choices and the relative importance of twelve residential real estate characteristics are examined using a convenience sample of both spouses in 127 Bulgarian heterosexual married and cohabiting couples.
Helping poor families increase their residential stability can have direct bearing on school stability and student academic achievement. Discusses the role of housing in child and family wellbeing; residential mobility and school performance; residential mobility and housing problems; housing affordability; (federal housing policy); homeownership;…
Sigurdsson, Halldór Matthias
access providers are implementing service differentiation in their networks where voice and video gets prioritised before data. This paper discusses the role of network access providers in multipurpose packet based networks and the available migration strategies for supporting multimedia services...
Huppé, Vicky; Kestens, Yan; Auger, Nathalie; Daniel, Mark; Smargiassi, Audrey
Preterm birth (PTB) is a growing public health problem potentially associated with ambient air pollution. Gasoline service stations can emit atmospheric pollutants, including volatile organic compounds potentially implicated in PTB. The objective of this study was to evaluate the relationship between residential proximity to gasoline service stations and PTB. Singleton live births on the Island of Montreal from 1994 to 2006 were obtained (n=267,478). Gasoline service station locations, presence of heavy-traffic roads, and neighborhood socioeconomic status (SES) were determined using a geographic information system. Multivariable logistic regression was used to analyze the association between PTB and residential proximity to gasoline service stations (50, 100, 150, 200, 250, and 500 m), accounting for maternal covariates, neighborhood SES, and heavy-traffic roads. For all distance categories beyond 50 m, presence of service stations was associated with a greater odds of PTB. Associations were robust to adjustment for maternal covariates for distance categories of 150 and 200 m but were nullified when adjusting for neighborhood SES. In analyses accounting for the number of service stations, the likelihood of PTB within 250 m was statistically significant in unadjusted models. Associations were, however, nullified in models accounting for maternal covariates or neighborhood SES. Our results suggest that there is no clear association between residential proximity to gasoline service stations in Montreal and PTB. Given the correlation between proximity of gasoline service stations and SES, it is difficult to delineate the role of these factors in PTB.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...
U.S. Environmental Protection Agency — This EnviroAtlas web service includes maps that illustrate population and residential activity in each census block group as well as residential-location-based...
Full Text Available An increasing number of estate agencies are entering the real estate market in South Africa and many are struggling to survive as competition grows stronger. Customer service has become of overriding importance to establish a differential advantage that will ensure long-term survival. This study investigates customer service by estate agencies in the residential property market of South Africa. The results indicate that estate agencies seem to be aware of the importance of providing good customer service and of being service-oriented, but they do not always seem to realise the need to conduct marketing research and test the actual satisfaction of customers with the services provided, leaving a potential gap between what the customer wants and what the estate agency provides.
Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag
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.
... 25 Indians 1 2010-04-01 2010-04-01 false Are there different formulas for different levels of residential services? 39.218 Section 39.218 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR... Verifications Residential Programs § 39.218 Are there different formulas for different levels of residential...
Baker, Kyri; Jin, Xin; Vaidhynathan, Deepthi; Jones, Wesley; Christensen, Dane; Sparn, Bethany; Woods, Jason; Sorensen, Harry; Lunacek, Monte
In this paper, we demonstrate the potential benefits that residential buildings can provide for frequency regulation services in the electric power grid. In a hardware-in-the- loop (HIL) implementation, simulated homes along with a physical laboratory home are coordinated via a grid aggregator, and it is shown that their aggregate response has the potential to follow the regulation signal on a timescale of seconds. Connected (communication-enabled), devices in the National Renewable Energy Laboratory's (NREL's) Energy Systems Integration Facility (ESIF) received demand response (DR) requests from a grid aggregator, and the devices responded accordingly to meet the signal while satisfying user comfort bounds and physical hardware limitations. Future research will address the issues of cybersecurity threats, participation rates, and reducing equipment wear-and-tear while providing grid services.
Heaney, M. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Polly, B. [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
This report presents an analysis of data for residential single-family projects reported by 37 organizations that were awarded federal financial assistance (cooperative agreements or grants) by the U.S. Department of Energy’s Better Buildings Neighborhood Program.1 The report characterizes the energy-efficiency measures installed for single-family residential projects and analyzes energy savings and savings prediction accuracy for measures installed in a subset of those projects.
Ward, Ronald J.
Rhode Islanders Saving Energy (RISE) is a non-profit corporation founded in 1977 to provide Rhode Island residents with a variety of energy conservation services. Since January of 1981, it has been performing energy audits in compliance with the Department of Energy's (DOE) Residential Conservation Service Program (RCS). One aspect of the RCS program is the performance of inspections on energy conservation activities completed according to RCS installation guidelines. This paper will describe both the use and results of thermographic inspections within the RISE program. The primary objective of these inspections has been to assure the quality of the building envelope after completion of retrofit measures. Thermal anamolies have been detected that vary in size, location and probable cause. Approximately 37% of all jobs performed through RISE in conjunction with the RCS program have required remedial work as a result of problems that were identi-fied during the thermographic inspection. This percentage was much higher when infra-red inspections were conducted on "Non-RCS" retrofits. Statistics will be presented that provide an interesting insight on the quality of retrofit work when performed in associa-tion with a constant inspection process.
Coward, Raymond T.; And Others
Examined relationship between place of residence and use of formal services prior to entering nursing home among older persons (n=131) within 30 days of admission. Found no residential differences in percent reporting use of formal services, number of services received, kinds of services used, or average length of time services had been received.…
This dissertation is about post-separation families, their residential arrangements and the organization and practising of their everyday post-separation (family) life. Divorce and separation are common life events in most Western countries. In the Netherlands, 30% of all children under age 18
Coll, Kenneth M.; Powell, Stephanie; Thobro, Patti; Haas, Robin
This study examined relations between family cohesion and adaptability (as measured by the Family Adaptability and Cohesion Scales-III) and the formation of trust and intimacy (assessed with the Measure of Psychosocial Development) among adolescents in residential treatment. Bivariate correlation revealed a significant association between family…
Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen
This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…
Fowler, Cathrine; Schmied, Virginia; Dickinson, Marie; Dahlen, Hannah Grace
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.
Administration for Children, Youth, and Families (DHHS), Washington, DC.
In 1989-90, Full Circle Program's Family Consulting Services (FCS) staff provided family reunification services to 50 children and their families in San Francisco and Marin counties. Staff members developed individualized treatment strategies for each family, acting as advocates for the needs of the child. These services included medical and…
Sergeant, Julie F.; Ekerdt, David J.
This qualitative study delineates motives for residential mobility, describes dynamics between the elder and family members during the move decision process, and locates the move decision within ecological layers of the aging context. Interviews were conducted with 30 individuals and couples (ages 60-87) who experienced a community-based move…
Matthews, Geraldine M.
The directory lists approximately 120 library information service programs in residential facilities for the mentally retarded. Each program is described in terms of its collection (journals, books, films, and tapes), space, services (story hours, reference questions, bibliographies, and translation services), budget, clientele, and program…
Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira
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.
After the revolution, the Islamic Republic of Iran instituted pronatalist policies which included lowering the minimum marriage age for girls to 9 years, abolishing some laws securing women's rights, and limiting availability of family planning (FP) services. By 1983, Iran's population growth rate was 3.9% which was among the highest worldwide. Before the revolution, Iran had 37 million people. About 2 million more people were added each year, resulting in a population size of 60 million by 1992. By the mid-1980s, economic development stood idle, there were not enough houses, children attended schools on 3 shifts, and malnutrition was spreading. In 1989, the government formed a population council and reestablished FP services. It also increased the minimum age of marriage for girls to 13 years, slightly improved women status, and eliminated fertility incentives for couples with at least 4 children. It also significantly increased funding for FP (from 560 million to 13 billion rials between 1990 and 1992). Government spending for FP will likely increase 2% annually until 2011. The government initiated a promotion of FP mass media campaign, emphasizing a 2-child family. Some posters showed a family with 2 girls. The mass media campaign promoted specific contraceptive methods (even tubal occlusion and vasectomy), a practice other Middle Eastern countries not do. 80% of sterilization acceptors claimed to learn about sterilization from the radio or newspapers. The Ministry of Health has invited the Association for Voluntary Surgical Contraception (AVSC) to help with its campaign to update sterilization techniques, including the non scalpel vasectomy technique. AVSC hopes to become even more involved in helping Iran update its national FP program.
K.L. Larson; K.C. Nelson; S.R. Samples; S.J. Hall; N. Bettez; J. Cavender-Bares; P.M. Groffman; M. Grove; J.B. Heffernan; S.E. Hobbie; J. Learned; J.L. Morse; C. Neill; L.A. Ogden; Jarlath O' Neil-Dunne; D.E. Pataki; C. Polsky; R. Roy Chowdhury; M. Steele; T.L.E. Trammell
Although ecosystem services have been intensively examined in certain domains (e.g., forests and wetlands), little research has assessed ecosystem services for the most dominant landscape type in urban ecosystemsânamely, residential yards. In this paper, we report findings of a cross-site survey of homeowners in six U.S. cities to 1) examine how residents subjectively...
Embregts, Petri J. C. M.
In this study, the question was explored whether children with a mild intellectual disability (MID) who were placed in residential treatment following outpatient treatment differ significantly on child and family characteristics from children with MID and not placed in residential treatment following outpatient treatment. The records of the…
Hanna, Andrew; Donnelly, James; Aggar, Christina
Given the social burden and significant cost of dementia care in Australia, finding evidence-based approaches that improve outcomes, maintain independence, and reduce the impact on patients and families is essential. Finding effective ways to train and assist the healthcare staff who support these individuals is also critical, as they are considered to be at risk of workplace stress, burnout, and other psychological disturbances which negatively affects standards of care. The current paper describes a protocol for evaluating the effects of a Montessori-based approach to dementia care, in non-residential respite centres. An 18 month prospective observational, cohort controlled design is suggested that will compare participants from a community respite service that has undergone a Montessori-based workplace culture change and those from a service that provides a person-centred 'care as usual' approach. To achieve this, the protocol includes the assessment of participants across multiple variables on a monthly basis including the cognitive, behavioural, and emotional functioning of clients with dementia, levels of caregiver burden experienced by informal carers, and burnout, compassion satisfaction and workplace engagement among respite staff. The protocol also employs a qualitative evaluation of program fidelity. This approach will provide further insight into the potential benefits of early intervention with Montessori approaches for persons living with dementia in the community, their caregivers, and the staff and volunteers who assist them. Copyright © 2018 Elsevier B.V. All rights reserved.
U.S. Department of Health & Human Services — This locator tool will help you find Title X family planning centers that provide high quality and cost-effective family planning and related preventive health...
Nicholas P. Sisto
Full Text Available Infectious intestinal diseases (IID represent a widespread public health problem in Mexico. The country also faces major challenges with respect to the provision of residential water services (piped water and sewer—an essential input for hygiene and cleanliness in homes. This paper analyzes morbidity rates from several IID associated with unsanitary living conditions along with a series of residential water services indicators for Mexico’s 2,456 municipalities. With data obtained through a special request to the federal epidemiological authority as well as official census data for 2010, we find stark regional contrasts and identify interesting spatial structures for both IID morbidity and residential water services indicators. In particular, municipalities tend to present values similar to neighboring municipalities, forming clusters of relatively high-value (or low-value municipalities. Moreover we find that municipalities with a relatively high level of access to residential water services tend to present relatively low IID morbidity rates. These results have multiple public policy implications. In order to reduce the incidence of IID effectively and efficiently, interventions should explicitly consider the spatial structure of morbidity and target problem spots—which typically spill over state, municipal and other administrative boundaries. Moreover, improvements in the quality of access to piped water (for example, increasing the frequency of supply may be as important for reducing morbidity as the expansion of basic access to this service.
Arcury, Thomas A; Suerken, Cynthia K; Ip, Edward H; Moore, Justin B; Quandt, Sara A
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.
Research purpose: The study sought to examine differences in the relationship between service quality and customer satisfaction because of the type of customer. Motivation for the study: Previous studies have not examined the relationship between service quality and customer satisfaction between residential and business customers. Research design, approach and method: The study used a cross-section of 203 customers (108 residential and 95 business in the fixed-line telecommunications sector in Zimbabwe. Moderated regression analysis was performed to test the research hypotheses. Main findings: It was established that the customer category (residential versus business does not moderate the effect of service quality on customer satisfaction. Practical/managerial implications are, generally, that it is not necessary to segment customers by customer category (residential versus business when managing service quality to achieve customer satisfaction. Contribution/value add: The main theoretical contribution of the study is the comparison of the effect of service quality on customer satisfaction between residential and business customers.
Boyle, Gregory J.; Comer, Peter G.
This paper provides an overview of demographic characteristics of direct-service personnel in Melbourne community residential units for intellectually disabled individuals. Many are found to be relatively inexperienced participants in the workforce, and most are young, single females. Implications of these findings for quality of care and staff…
Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald
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…
Saez-de-Ibarra, Andoni; Martinez-Laserna, Egoitz; Koch-Ciobotaru, Cosmin
The integration of renewable energies and the usage of battery energy storage systems (BESS) into the residential buildings opens the possibility for minimizing the electricity bill for the end-user. This paper proposes the use of batteries that have already been aged while powering electric...... vehicles, during their main first life application, for providing residential demand response service. The paper considers the decayed characteristics of these batteries and optimizes the rating of such a second life battery energy storage system (SLBESS) for maximizing the economic benefits of the user...
Vuorenmaa, M; Perälä, M-L; Halme, N; Kaunonen, M; Åstedt-Kurki, P
Parental empowerment signifies parents' sense of confidence in managing their children, interacting with services that their children use and improving child care services. High empowerment is associated with parents' resilience to demands and their confidence to make decisions and take actions that positively affect their families. Most families with children access various healthcare and education services. Professionals working in these services are therefore ideally placed to reinforce parental empowerment. However, little is known about the characteristics associated with parental empowerment within a generic sample of parents or in the context of basic child care services. The aim of this study was to assess how family characteristics are associated with maternal and paternal empowerment in the family, in service situations and in the service system. Parental empowerment was measured among 955 parents (mothers = 571; fathers = 384) of children aged 0-9 years using the Generic Family Empowerment Scale. Family characteristics were assessed through questions on children, parents and the life situation. Associations between empowerment and family characteristics were evaluated using one-way analysis of variance and t-test. Parental empowerment was predicted by multiple linear regression analysis. Parents' concerns related to their parenting, such as whether they possessed sufficient skills as a parent or losing their temper with children, as well as experiences of stress in everyday life, were negatively associated with all dimensions of maternal and paternal empowerment. Both determinants were more common and more significant in empowerment than child-related problems. Promoting parental self-confidence and providing appropriate emotional and concrete support for everyday functioning may reinforce parental empowerment, thereby enhancing families' well-being and coping, as well as improving their access to required services and timely support. Finally
Warsh, Robin; Pine, Barbara A.; Maluccio, Anthony N.
Whether or not to reunite children in out-of-home care with their families of origin is one of the more complicated decisions that child welfare practitioners and administrators face. Ways in which agencies can assess and improve their service delivery system so as to reunite children and their families effectively and promptly are covered in this…
McConkey, Roy; Gent, Clare; Scowcroft, Emma
Background: Specialist short break services aim to provide enhanced support to family carers as a means of preventing children whose behaviours severely challenge from being placed in full-time residential care. To date, there is limited evidence as to the functioning and effectiveness of such services. Methods: In all, 17 children were selected…
Full Text Available The underlying assumption of this study is that in order to retain the competitiveness while reaching for the EU targets regarding low-energy construction, district heating companies need to develop new business and service models. How district heating companies could broaden their perspective and switch to a more service-oriented way of thinking is a key interest of our research. The used methods in our study are house builder interviews and a questionnaire. With the help of these methods we discussed the potential interest in heating related services acquiring a comprehensive understanding of the customer needs. The results indicate the importance of certain criteria when choosing the heating system in households: easiness, comfort and affordability seem to dominate the house builders’ preferences. Also environmental awareness seems to be for many an important factor when making a decision about the heating of the house. Altogether, based on the results of this study, we suggest that the prospects of district heating could benefit from highlighting certain aspects and strengths in the future. District heating companies need to increase flexibility, readiness to adopt new services, to invest in new marketing strategies and improving the communication skills.
Ancillary services entail controlled modulation of building equipment to maintain a stable balance of generation and load in the power system. Ancillary services include frequency regulation and contingency reserves, whose acting time ranges from several seconds to several minutes. Many pilot studies have been implemented to use industrial loads to provide ancillary services, and some have explored services from commercial building loads or electric vehicle charging loads. Residential loads, such as space conditioning and water heating, represent a largely untapped resource for providing ancillary services. The residential building sector accounts for a significant fraction of the total electricity use in the United States. Many loads in residential buildings are flexible and could potentially be curtailed or shifted at the request of the grid. However, there are many barriers that prevent residential loads being widely used for ancillary services. One of the major technical barriers is the lack of communication capabilities between end-use devices and the grid. End-use devices need to be able to receive the automatic generation control (AGC) signal from the grid operator and supply certain types of telemetry to verify response. With the advance of consumer electronics, communication-enabled, or 'connected,' residential equipment has emerged to overcome the communication barrier. However, these end-use devices have introduced a new interoperability challenge due to the existence of numerous standards and communication protocols among different end devices. In this paper, we present a VOLTTRON-based system that overcomes these technical challenges and provides ancillary services with residential loads. VOLTTRON is an open-source control and sensing platform for building energy management, facilitating interoperability solutions for end devices. We have developed drivers to communicate and control different types of end devices through standard
.... (b) Family work for other than sole proprietor. Work for a corporation is not excluded under this...- ) Employment, Wages, Self-Employment, and Self-Employment Income Work Excluded from Employment § 404.1015 Family services. (a) General. If you work as an employee of a relative, the work is excluded from...
A policy for CO 2 -emission abatement will have to allow for the sectoral energy-conservation potential. The present paper outlines the energy-analysis method applied to the Greek residential and services sectors. The trends in energy requirements for 1990-2000 are forecast and energy-conservation and CO 2 -abatement measures are proposed. A Maximum Action Scenario (MAS) and a Realistic Scenario (RS) are compared with a No-Action Scenario (NAS). (Author)
Wujiang City in south Jiangsu Province is a county-level city, well known for its economic development and effective family planning program. Family planning is practiced voluntarily by the people. The growth rate of the city's population has decreased to 5.47/1000; the proportion of planned births has increased to 98%; and the total fertility rate has declined to 1.5. There are 34 towns (and townships) and 883 administrative villages under the jurisdiction of the city. The living standard has improved significantly. The successful implementation of family planning is largely due to the quality services delivered to farmers, especially women of reproductive age. In an interview, Mme. Ji and Mme. Shen, chiefs of the Wujiang Family Planning Committee, describe the services they deliver. The information, education, and communication (IEC) program is focused on population schools (city, town, township, and village), which deliver information to middle school students, premarital youth, and women who are pregnant, lying-in, or menopausal. Pamphlets on marriage and reproductive health are published by the county population school. Family planning service centers, which deliver contraceptive and technical services, were established in every town and township in 1993. Ultrasound scans are available and have been used to diagnose diseases, including cancer. Over 3000 women have been helped. Misuse of fetal sex identification is banned. The Family Planning Committee and the technical service centers in the city provide counselling services on fewer, healthier births; maternal and child health care; reproductive health; and treatment of infertility. There are several kinds of insurance related to family planning; these include old age support for the parents of only-children, safety insurance for only-children, and old age insurance for newlyweds. The insurance premium is shared by the couple (100 yuan) and the township (400 yuan). Only-child couples, two-daughter families
Hartog, F.T.H. den; Hillen, B.A.G.; Tijmes, M.R.
This document defines the preliminary version of the FIGARO architectural solution for federation within residential networks. The architecture is derived from use cases from the domains of e-health, energy management, domotics and social community services and thus supports requirements from each
Merrick, Joav; Kandel, Isack; Raskas, Mordechai; Caplan, Lee; Morad, Mohammed
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.
Merrick, Joav; Kandel, Isack; Lotan, Meir; Aspler, Shoshana; Fuchs, Brian Seth; Morad, Mohammed
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.
Freado, Mark D.
Provides suggestions for transitioning to family-centered services. Discusses how to establish commitments from schools and agencies, how to bring staff into the process of change, how to develop family-centered initiatives, how to provide appropriate training for staff, ways to overcome resistance, and strategies for matching services to need.…
Field, Clinton E; Nash, Heather M; Handwerk, Michael L; Friman, Patrick C
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.
Alperin, Diane Elias
Surveyed Family Service America member agencies to assess impact of impetus to look to private sector for provision of services. Found that family service agencies experienced tremendous growth in 1980s in both client caseloads and areas of service provision. Family service agency client was likely to be minority person seeking counseling within…
Huebner, Ruth A.; Jones, Blake L.; Miller, Viola P.; Custer, Melba; Critchfield, Becky
Comprehensive Family Services (CFS) is a strengths-based and partnership-oriented approach to casework implemented through multiple initiatives. This study examines the relationship between the practice of CFS and satisfaction of clients, foster parents, and community partners. CFS indicators are paired with statewide customer satisfaction survey…
... 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...
Full Text Available The last Chilean earthquake, occurred on February 27, 2010, allowed establishing important patterns of structural failures in reinforced concrete residential buildings; however, limited progress has been made in the study of basic standards of serviceability, such as obstruction of doors. Thus, this study focused on measuring the influence of design specifications and construction criteria of lintels and columns, in terms of obstruction of doors, considering capacity thresholds for certain levels of displacement. The study consisted of the design and construction of a full-scale prototype of a reinforced concrete frame, designed in accordance with all the ACI-318-08 requirements, taking into account typical aspects of geometry and materiality widely used by the real estate industry, for location and size of doors. In order to quantify the structural capacity of the prototype and to study the serviceability of the door, a quasi-static cyclic test was conducted, according to load and displacement protocols specified in FEMA 356 and FEMA 461, which was adjusted by using virtual models based on a static nonlinear analysis called "Pushover". This research verified that, for displacement levels even five times higher than those established by codes considered, the cracking degree was minimal and fully recoverable. It was also found the door evidenced malfunction when the displacements were greater than those specified by design only, validating a high degree of accomplishment of current codes, in terms of capacity and serviceability, when dealing with obstruction of residential doors.
Huh, Sung-Yoon; Woo, JongRoul; Lim, Sesil; Lee, Yong-Gil; Kim, Chang Seob
Improvements in customer satisfaction as well as product/service quality represent a common objective of all businesses, and electricity services are no exception. Using choice experiments and a mixed logit model, this study quantitatively analyzes customers' preferences and their marginal willingness to pay for improved residential electricity services. The study provides an ex ante evaluation of customers' acceptance of hypothetical electricity services. According to the results, customers consider the electricity bill and the electricity mix as the two most important attributes when choosing their electricity services. Customers are willing to pay 2.2% more in the average electricity bill (an additional monthly electricity bill of KRW 1,064; USD 0.96) for a significant increase in the share of renewable energy, which is far less than the actual cost of achieving this renewable target. Therefore, it is better to maintain the current electricity mix in principle, and the renewable share should be gradually expanded instead of making a sudden change in the electricity mix. In addition, customers are willing to pay KRW 6,793 (USD 6.15) more to reduce blackouts once in a year and KRW 64/year (USD 0.06/year) to reduce a minute of each blackout. -- Highlights: •Customers' preferences for improved residential electricity services are analyzed. •Empirical setting is a sample of residents in South Korea. •The electricity bills and electricity mix are important to customers. •Increase in electricity bill of different electricity mix is considered
Fathalla, M F
The objective of an obstetric service is to ensure a healthy outcome for the mother and her baby. To achieve this objective, maternity care has to extend before the period of pregnancy and after the childbirth, and family planning becomes an integral complement to an obstetric service. The proper planning of pregnancy goes a long way to reducing hazards of childbearing. During postpartum care, ensuring an adequate birth-spacing interval before any subsequent pregnancy can be critical for child survival, apart from its necessity for the mother to build up her nutritional stores. Although obstetric services and contraceptive services may be provided separately, there are several advantages in linking or integrating the 2 services. Breastfeeding is central to any discussion on family planning linked to obstetric services. In addition, a wide array of contraceptive methods is not available. Each method has its merits and suitability to a certain sector of users. Combined oral contraceptives can adversely affect lactation because of their estrogen content. The IUD offers a convenient method of contraception in the postpartum period. Barrier methods do not affect breastfeeding. They can be used safely in the immediate postpartum period. Postpartum abstinence has been an observed tradition in many societies. The objective is to protect the mother from any pregnancy that would interfere with breastfeeding. Where approved for use in the country, the injectable depot can be safely used in breastfeeding women, as they do not affect lactation. Female surgical contraception by tubal occlusion has an important place in postpartum contraception. There is no contraceptive method that can be considered 100% safe. The inherent risks of contraceptive use have to be put in proper perspective. The medical team must be completely aware of the importance of informed choice in contraceptive use. Therefore, counselling is an important component of any family planning service.
Cook, R J; Maine, D
In many countries a spouse, usually the husband, can veto a partner's use of family planning services. Where spousal veto acts as a barrier to family planning services it represents a serious threat to the lives and health of women and children. Removal of spousal authorization requirements has been shown to increase the use of family planning services. The Family Guidance Association of Ethiopia, for example, removed their requirement in 1982 and clinic utilization increased by 26 per cent within a few months. Courts of several countries have held that spousal veto practices violate principles of personal privacy and autonomy and the right to health care. The effect of such judgements has been to reinforce rights to sexual nondiscrimination found, for example, in national constitutions and the Convention on the Elimination of All Forms of Discrimination against Women. This article discusses the nature and application of spousal veto practices, explains how such requirements can violate certain human rights, and explores possible remedies to this problem, including ministerial, legislative, and judicial initiatives. PMID:3812842
... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section 17.81... Federal Agencies § 17.81 Contracts for residential treatment services for veterans with alcohol or drug... “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part II) and the “Confidentiality of Certain...
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
Introduction: 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. Aim: To review the inpatient records after the initial 2 years of experience in residential care at SCMHC. Methodology: 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. Results: 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. Conclusion: 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. PMID:29284806
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
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.
Giné, Climent; Font, Josep; Guàrdia-Olmos, Joan; Balcells-Balcells, Anna; Valls, Judit; Carbó-Carreté, Maria
Resource allocation in social services has become an issue of the utmost importance, especially in these times in which budgets are tight. The aim of this study is to explore whether the SIS allows for the identification of groups of individuals presenting ID with different needs for support living in residential services in Catalonia, Spain, and if so whether or not a more efficient and fairer system of funding could be considered in comparison with the ICAP. The results show that the six categories of need for support resulting from this study could form the basis for better alignment the funding for those who live in this type of residence according to their assessed support needs. Copyright © 2014 Elsevier Ltd. All rights reserved.
Martin, Robyn M; Ridley, Sophie C; Gillieatt, Sue J
Contemporary mental health policies require family inclusion in the design, implementation and evaluation of services. This scoping review considers the factors in mental health practice which either mediate or promote family inclusion. A wide range of factors are reported to obstruct family inclusion, while a smaller number of studies report that meaningful family inclusion rests on a partnership approach which values the input of families and services users. When it comes to family inclusion, there is a gap between policy and service delivery practice. Changes in service delivery attitudes, values and culture are necessary to meaningfully and systematically include families and service users.
Gilman, S E; Kawachi, I; Fitzmaurice, G M; Buka, L
Childhood adversity significantly increases the risk of depression, but it is unclear whether this risk is most pronounced for depression occurring early in life. In the present study, we examine whether three aspects of childhood adversity--low socio-economic status (SES), family disruption, and residential instability--are related to increased risk of depression during specific stages of the life course. We also examine whether these aspects of childhood adversity are related to the severity of depression. A sample of 1089 of the 4140 births enrolled in the Providence, Rhode Island cohort of the National Collaborative Perinatal Project was interviewed between the ages of 18 and 39. Measures of parental SES, childhood family disruption and residential instability were obtained upon mother's enrolment and at age 7. Age at onset of major depressive episode, lifetime number of depressive episodes, and age at last episode were ascertained via structured diagnostic interviews. Survival analysis was used to identify risk factors for depression onset and remission and Poisson regression was used to model the recurrence rate of depressive episodes. Low parental SES, family disruption and a high level of residential instability, defined as three or more family moves, were related to elevated lifetime risks of depression; the effects of family disruption and residential instability were most pronounced on depression onset by age 14. Childhood adversity was also related to increased risk of recurrence and reduced likelihood of remission. Childhood social disadvantage significantly influences risk of depression onset both in childhood and in adulthood. Early childhood adversity is also related to poor prognosis.
O' Neal, D.L.; Jones, J.L.
The Energy Production and Conservation Act (EPCA) of 1976 mandated the setting of building energy performance standards (BEPS) for all newly constructed buildings. One of the classes of buildings included in EPCA is single-family residences. These standards cover the energy used for space heating, air conditioning, and water heating. This report describes the evaluation of direct energy and economic impacts of three proposed levels of single-family BEPS: lenient, mid, and strict. The lenient level is the least stringent in requiring improvements in eneryperformance of residence while the strict is the most stringent. Each of the levels and the method of developing them are also described. The ORNL residential energy model is used to calculate energy savings and economic impacts of BEPS to the nation. The model is also used to estimate the sensitivity of the results to several exogenous variables: projected fuel prices, baseline energy codes, capital csts, short-run price elasticities, and discount rates. The Net Present Value (NPV) and cumulative energy savings from 1980 to 2020 are the two measures used to compare the standards. Both the lenient and mid level standards provide a positive economic benefit to the country of 1.24 and 2.58 billion dollars, respectively. Even though the strict standard has the largest energy savings, it has a negative economic cost of 1.5 billion dollars to the nation. The cumulative energy savings of the lenient, mid, and strict level standards are 4.2, 10.2, and 20.1 EJ, respectively.
Bertrand, J T; Proffitt, B J; Bartlett, T L
The health care profession is witnessing a shift in focus from the interests and needs of the service provider to those of the potential consumer in an effort to attract and maintain clients. This study illustrates the role that marketing research can play in the development of program strategies, even for relatively small organizations. The study was conducted for Planned Parenthood of Louisiana, a recently organized affiliate that began offering clinical services in May 1984, to provide information on the four Ps of marketing: product, price, place, and promotion. Data from telephone interviews among a random sample of 1,000 women 15-35 years old in New Orleans before the clinic opened confirmed that the need for family planning services was not entirely satisfied by existing service providers. Moreover, it indicated that clinic hours and the cost of services were in line with client interests. The most useful findings for developing the promotional strategy were the relatively low name recognition of Planned Parenthood and a higher-than-expected level of interest that young, low income blacks expressed in using the service.
Dabiri, O M
Nigerians did not readily accept family planning when Family Health Services (FHS) began in 1988. FHS has made much headway in training, IEC (information, education, and communication), and constituency building and advocacy. Its staff have identified obstacles to implementation, especially program sustainability and management structure. Key limits to sustainability of IEC efforts were inadequately trained personnel and inability of trained personnel to apply what they learned at work stations. The Federal Ministry and Social Services' role in the FHS project was not clearly defined. Some private sector factors contributing to a confused management structure were inadequate method mix, high contraceptive cost, poor monitoring of quality of care, and no coordination of family planning training with the public factor. FHS has since decided to focus its efforts on increasing the demand for and availability of modern contraceptives and improving the quality of family planning services of both the public and private sectors. FHS hopes that accomplishing these activities will reduce fertility, morbidity, and mortality. Strategic plans include a regional focus, quality of care, a variety of methods offered, intensification, hospital and clinics, a management information system, contraceptive logistics, distribution regulations, and addressing social, cultural, and behavioral factors. To effectively implement the strategy, USAID and the Federal Ministry held a workshop in 1993 to effect full integration of Nigerian experience in the 2nd phase of the project (FHS II). Participants reviewed the strengths and weaknesses of the first phase and agreed on implementation. For example, nongovernmental organizations should implement FHS II. FHS II includes training, IEC, and commodities/logistics.
... 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...
... 42 Public Health 4 2010-10-01 2010-10-01 false Family planning services. 441.20 Section 441.20... General Provisions § 441.20 Family planning services. For recipients eligible under the plan for family... free to choose the method of family planning to be used. ...
Chang, Heejun; Bonnette, Matthew Ryan; Stoker, Philip; Crow-Miller, Britt; Wentz, Elizabeth
A growing body of literature examines urban water sustainability with increasing evidence that locally-based physical and social spatial interactions contribute to water use. These studies however are based on single-city analysis and often fail to consider whether these interactions occur more generally. We examine a multi-city comparison using a common set of spatially-explicit water, socioeconomic, and biophysical data. We investigate the relative importance of variables for explaining the variations of single family residential (SFR) water uses at Census Block Group (CBG) and Census Tract (CT) scales in four representative western US cities - Austin, Phoenix, Portland, and Salt Lake City, - which cover a wide range of climate and development density. We used both ordinary least squares regression and spatial error regression models to identify the influence of spatial dependence on water use patterns. Our results show that older downtown areas show lower water use than newer suburban areas in all four cities. Tax assessed value and building age are the main determinants of SFR water use across the four cities regardless of the scale. Impervious surface area becomes an important variable for summer water use in all cities, and it is important in all seasons for arid environments such as Phoenix. CT level analysis shows better model predictability than CBG analysis. In all cities, seasons, and spatial scales, spatial error regression models better explain the variations of SFR water use. Such a spatially-varying relationship of urban water consumption provides additional evidence for the need to integrate urban land use planning and municipal water planning. Copyright © 2017 Elsevier B.V. All rights reserved.
Residential space and water heating accounts for over 90percent of total residential primary gas consumption in the United States. Condensing space and water heating equipment are 10-30percent more energy-efficient than conventional space and water heating. Currently, condensing gas furnaces represent 40 percent of shipments and are common in the Northern U.S. market. Meanwhile, manufacturers are planning to develop condensing gas storage water heaters to qualify for Energy Star? certificati...
These are age, level of education, knowledge about family planning benefits and districts. Conclusion: Women's perception towards family planning services delivered by CHWs in Western region in Kenya is quite low. To improve the demand and supply for family planning services in this region, there is need to invest a ...
Berryman, Doris L.
The suggested standards and evaluative criteria are designed to assist hospitals and other residential institutions in evaluating recreation services provided to residents, primarily children and youth. Described are the development of the standards and the rating instrument, guidelines for using the standards, evaluation and scoring procedures,…
In most parts of the world, family planning and HIV-related services are usually offered separately. Family planning services, especially those that are government-supported, primarily serve married women and couples of reproductive age, while HIV-related services target individuals at higher-risk of exposure to HIV.
Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health ...
Montalto, Michael; Shay, Simon; Le, Andy
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
Belsi, A; Gonzalez-Maffe, J; Jones, K; Wright, D; Gallagher, J E
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.
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.
Lutfi, Khaleeq; Trepka, Mary Jo; Fennie, Kristopher P.; Ibanez, Gladys; Gladwin, Hugh
Sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) have disproportionately affected the non-Hispanic black population in the United States. A person’s community can affect his or her STI risk by the community’s underlying prevalence of STIs, sexual networks, and social influences on individual behaviors. Racial residential segregation—the separation of racial groups in a residential context across physical environments—is a community factor that has been associated with negative health outcomes. The objective of this study was to examine if non-Hispanic blacks living in highly segregated areas were more likely to have risky sexual behavior. Demographic and sexual risk behavior data from non-Hispanic blacks aged 15 – 44 years participating in the National Survey of Family Growth were linked to Core-Based Statistical Area segregation data from the U.S. Census Bureau. Five dimensions measured racial residential segregation, each covering a different concept of spatial variation. Multilevel logistic regressions were performed to test the effect of each dimension on sexual risk behavior controlling for demographics and community poverty. Of the 3,643 participants, 588 (14.5%) reported risky sexual behavior as defined as two or more partners in the last 12 months and no consistent condom use. Multilevel analysis results show that racial residential segregation was associated with risky sexual behavior with the association being stronger for the centralization [aOR (95% CI)][2.07 (2.05 – 2.08)] and concentration [2.05 (2.03 – 2.07)] dimensions. This suggests risky sexual behavior is more strongly associated with neighborhoods with high concentrations of non-Hispanic blacks and an accumulation of non-Hispanic blacks in an urban core. Findings suggest racial residential segregation is associated with risky sexual behavior in non-Hispanic blacks 15 – 44 years of age with magnitudes varying by dimension. Incorporating
Background Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. Methods The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Results Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. Conclusions The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia. PMID:24148155
Schwartz, Sara L; Austin, Michael J
Jewish Family and Children's Services of San Francisco, the Peninsula, Marin, and Sonoma Counties is a pioneering nonprofit human service organization that has delivered services for 157 years. Over the course of its history, the organization has transformed itself from an all-volunteer agency delivering aid to immigrant families during the Gold Rush era to a $30 million nonprofit human service organization offering a full-range of services to adults, children, and families. The history of Jewish Family and Children's Services sheds light on the importance of strong leadership, strategic planning, external relationships, and strong donor support.
Employed an experimental research design in evaluating intensive family preservation services to reunify families after out-of-home placement. Found significant difference between the treatment group and control group in terms of family reunification, and mixed findings in terms of family functioning. Discusses research design with implications…
Mckay, James R.; Gutman, Marjorie; Mclellan, A. Thomas; Lynch, Kevin G.; Ketterlinus, Robert
This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients…
Berg, Insoo Kim
Drawing on the field of family therapy, this step-by-step guide applies principles of brief, solution-focused therapy to family-based services (FBS) in ways that empower clients, increase cooperation, and aid the survival of social workers. Based on the author's experience at the Brief Family Therapy Center in Milwaukee, Wisconsin, the book is…
In logistics regression analysis family planning was significantly lower in the illiterate. Positive husband\\'s attitude had the strongest association (0R 9.3, 95% CI 4.6,18.7) with family planning, in addition to programs that create demand for smaller well-spread children, IEC and family planning services should target men and ...
Hancock, Nancy L; Stuart, Gretchen S; Tang, Jennifer H; Chibwesha, Carla J; Stringer, Jeffrey S A; Chi, Benjamin H
Reducing the global unmet need for contraception is currently a priority for many governments, multi-lateral initiatives, non-governmental organizations, and donors. Evidence strongly suggests that the provision of quality family planning services can increase uptake, prevalence, and continuation of contraception. While an accepted framework to define the components of family planning service quality exists, translating this framework into assessment tools that are accessible, easily utilized, and valid for service providers has remained a challenge. We propose new approaches to improve the standardization and accessibility of family planning service quality assessment tools to simplify family planning service quality evaluation. With easier approaches to program evaluation, quality improvements can be performed more swiftly to help increase uptake and continuation of contraception to improve the health of women and their families.
Gerassi, Lara B
More than 50% of women entering substance use treatment in the U.S. reported having traded sex for money or drugs. Women's participation in addiction treatment and related services is essential to their recovery and increased safety, stabilization, and quality of life. This paper's aim is to explore the barriers related to accessing detox facilities and essential services including substance use treatment and residential services for women impacted by commercial sexual exploitation (CSE). Data are drawn from a larger, community-based, grounded theory study. In-depth interview data were collected from 30 adult women who traded sex as adults (through maximum variation and snowball sampling), as well as 20 service providers who come into contact with adult women who trade sex (through nominations and purposive sampling). Finding suggest that women often encountered sobriety requirements, which created barriers to accessing addiction treatment or residential services. Some organizations' policies required evicting women if they were caught using, which created additional challenges for women who relapsed. Women wanted to avoid becoming "dopesick" on the streets or at home, which partially contributed to them needing to maintain their addiction. Consequently, some returned to sex trading, thus increasing their risk of trafficking. Some women engaged in creative strategies, such as claiming they were suicidal, in order to access the detox facilities in hospitals. Some women indicated they were only able to detox when they were forced to do so in jail or prison, often without medical assistance. Implications to improve health care delivery for this population are discussed.
Xie, Tian; Wang, Meie; Su, Chao; Chen, Weiping
Soils provide the service of attenuating and detoxifying pollutants. Such ability, natural attenuation capacity (NAC), is one of the most important ecosystem services for urban soils. We improved the ecosystem-service performance index (EPX) model by integrating with entropy weight determination method to evaluate the NAC of residential soils in Beijing. Eleven parameters related to the soil process of pollutants fate and transport were selected and 115 residential soil samples were collected. The results showed that bulk density, microbial functional diversity and soil organic matter had high weights in the NAC evaluation. Urban socio-economic indicators of residential communities such as construction age, population density and property & management fee could be employed in kinetic fittings of NAC. It could be concluded urbanization had significant impacts on NAC in residential soils. The improved method revealed reasonable and practical results, and it could be served as a potential measure for application to other quantitative assessment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Richman, Russell; Munroe, Alan James; Siddiqui, Yasmeen
Electromagnetic fields (EMF) permeate the built environment in different forms and come from a number of sources including electrical wiring and devices, wireless communication, 'energy-efficient' lighting, and appliances. It can be present in the indoor environment directly from indoor sources, or can be transmitted through building materials from outside sources. Scientists have identified it as an indoor environmental pollutant or toxin that has ubiquitously plagued developed nations causing a variety of adverse health effects such as sick-building syndrome symptoms, asthma, diabetes, multiple sclerosis, leukemia, electro-hypersensitivity (EHS), behavior disorders, and more. There is currently no international consensus on guidelines and exposure limits. This paper presents the results of 29 EMF field audits in single family residential dwellings located within an urban neighborhood in Toronto (Canada). The following EMF spectra were evaluated: radio frequency, power frequency electric fields, power frequency magnetic fields and high frequency voltage transients. The field audits were conducted in order to provide initial baseline statistics to be used in future studies and in order to be compared to a low-cost EMF reduction design incorporated within the Renovation2050 research house - located within the test neighborhood. The results show the low-cost reduction strategy to be effective, on average reducing exposure by 80% for high-intensity EMF metrics. Research of this nature has not been conducted with relation to the built environment and can be used to spark an industry movement to design for low-exposure to EMF in a residential context. © 2013.
Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D
To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice
Bassuk, Ellen L; DeCandia, Carmela J; Tsertsvadze, Alexander; Richard, Molly K
Family homelessness has become a growing public health problem over the last 3 decades. Despite this trend, few studies have explored the effectiveness of housing interventions and housing and service interventions. The purpose of this systematic review is to appraise and synthesize evidence on effective interventions addressing family homelessness. We searched 10 major electronic databases from 2007 to 2013. Empirical studies investigating effectiveness of housing interventions and housing and service interventions for American homeless families regardless of publication status were eligible for inclusion. Outcomes included housing status, employment, parental trauma and mental health and substance use, children's behavioral and academic status, and family reunification. Study quality was appraised using the Effective Public Health Practice Project tool. Six studies were included in this review. Overall, there was some postintervention improvement in housing and employment, but ongoing residential and work stability were not achieved. Methodological limitations, poor reporting quality, and inconsistent definitions across outcomes hindered between-study comparisons. Substantial limitations in research underscore the insufficiency of our current knowledge base for ending homelessness. Although many families were no longer literally homeless, long-term residential stability and employment at a livable wage were not ensured. Developing and implementing evidence-based approaches for addressing homelessness are long overdue.
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.
Full Text Available In this paper, family social work is constructed through the analysis of social service discourses from the social workers’ perspective. Recent research shows how social workers are dealing with complex and fluid issues, as well as the societal uncertainty in their work with families (e.g., Spratt, 2009; Menéndez et al., 2015. Based on earlier studies, it is vital to analyse family social work in different contextual settings. Societal, political and organisational contexts affect the preconditions of social work, but social work also needs to operate within structures (e.g., Pohjola et al., 2014. This paper provides insights into the Lithuanian family social work. The focus is on what kinds of features construct Socialinis darbas su šeima Roberta Motiečienė, Merja Laitinen 12 family social work by analysing social workers’ discourses. This analysis continues the research of Eidukevičiūtė (2013, who analysed family social work practices in transitional Lithuanian society. This researcher aimed to deepen the knowledge about child protection services in Lithuania, the father’s role in child care and the mother’s performance in it. According to Eidukevičiūtė (2013, social workers are still struggling in the field of family social work. This study continues the research tradition in the field of family social work, paying attention to the different contextual settings where family social work is conducted. The Lithuanian government has stated that family policy is a key component of its mandate where (Social Report, 2014. The Council of Social Work plays a very important role in providing guidance on how to implement the government’s policy in the field of family social work. The European Commission Council (2015 provides recommendations for the implementation of the 2015 National Reform Programme, which should concentrate on the people (30% of the total population who are at risk of poverty. The council recommends working on
Burton, K L O; Bau, K; Lewis, J; Aroyan, K R; Botha, B; Botman, A G M; Stewart, K; Waugh, M-C A; Paget, S P
The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care. Sixteen staff of a BoNT-A service participated in a patient journey mapping exercise. Nine families of the service participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Data from the staff session and interviews were analysed independently using grounded, hermeneutic thematic analysis. Staff sessions revealed 5 core themes that related to impacting on the family experience. Family interviews revealed 4 core themes, with 7 subthemes and 1 latent theme. Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics. © 2017 John Wiley & Sons Ltd.
Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Warland, Andrew; Westbrook, Johanna
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.
AJRH Managing Editor
données tirées du questionnaire de l'enquête sur l'évaluation de la prestation de service en Tanzanie de 2006, basée sur 529 établissements de ... Les établissements publics étaient plus susceptibles de déclarer avoir des conseils ou des protocoles pour les services de ..... DCV participated in study design, participated in.
youth and families as well as Ethnic Resource Team (ERT) Multi faith chaplaincy, a mental health service use the resources of refugees and other ethnic minorities, as they are involved as initiators, professionals and volunteers. However the economic basis is/ has been rather precarious. Intricately......, transnationalism, spirituality, experiences of discrimination. Lastly there are suggestions for further developing organisations which ensure access to equitable psychosocial services for refugee families addressing issues such as refugees’ own resources, resilience, societal exclusion, stigmatisation...
In connection with child raising, we are more and more often hearing words such as feeble parental education, children's indulgence, overprotection, loss of authority, etc. How much are these phenomena present in the family is quite dependent on the parenting style used by parents. Theoretical part of the master's thesis begins with the definition of concepts that help to understand the function of the family and its influence on the child's development. The work focuses primarily on the dysf...
Culhane, Dennis P.; Park, Jung Min; Metraux, Stephen
This study examines families' use of behavioral health hospitalization and foster care placement before, during, and after shelter use, comparing families based on shelter pattern and type of housing exit. Results show that inpatient and foster care services use drops in the homelessness period, but rebounds after exit, regardless of pattern of…
determine the number of children in the family.3. Prevention of fertility could be temporary. (contraception) or permanent (sterilization). However, contraceptive methods are said to be methods that help women avoid unwanted pregnancies. Evaluation of family planning services is usually done for married women or women ...
Roberta Motiečienė; Merja Laitinen
In this paper, family social work is constructed through the analysis of social service discourses from the social workers’ perspective. Recent research shows how social workers are dealing with complex and fluid issues, as well as the societal uncertainty in their work with families (e.g., Spratt, 2009; Menéndez et al., 2015). Based on earlier studies, it is vital to analyse family social work in different contextual settings. Societal, political and organisational contexts affect the pre...
Olanrele O. O.
Full Text Available This study assessed and compared the delivery of Facilities Management (FM services in public and private high rise residential buildings in Lagos, Nigeria. While some facilities or services may not be available in some public estates, the efficiency of the available ones is inadequate in comparison with the adequacy and efficiency of services provided in private estates. The objectives set for the study include identification of services that are provided in the case studies, service delivery method, and an assessment of the residents’ satisfaction of the services. This study adopted questionnaire survey for collection of data. 127 questionnaires were distributed to the residents of the case studies and 93 were returned. Three of which were discarded for incompleteness, thus 90 were analysed. The study found that most but not all of the facilities services expected in high rise buildings are available in the case studies and the services are outsourced under a standard Service Level Agreement. The service delivery in private high rise residential building is better than the public residential high rise buildings as revealed by the study. The study recommends improved standardization of services, customized services and meeting customer’s expectation for improved service delivery.
This paper aims at measuring the social benefits of small CHP distributed generation (DG) in the residential and service sectors. We do this by comparing the social costs of decentralised and centralised supplies, simulating 'ideal' situations in which any source of allocative inefficiencies is eliminated. This comparison focuses on assessing internal and external costs. The internal costs are calculated by simulating the optimal prices of the electricity and gas inputs. The external costs are estimated by using and elaborating the results of the dissemination process of the ExternE project, one of the most recent and accurate methodologies in this field. The analysis takes into account the main sources of uncertainty about the parameter values, including uncertainty about external cost estimations. Despite these sources of uncertainty, the paper concludes that centralised supply is still preferable to small DG. In fact, the overall range of DG social competitiveness is restricted, even considering further remarkable improvements in DG electrical efficiency and investment costs. The results are particularly unfavourable for the residential sector, whereas, in the service sector, the performance of DG technologies is slightly better
To assess the level of awareness of contraceptives and utilisation of family planning services among young women, and barriers that hinder effective use of such services. Methods. In a quantitative descriptive survey, 360 female undergraduate students at the National University of Lesotho responded to a hand-delivered ...
Brown, Jason D.; Moraes, Sabrina; Mayhew, Janet
We examined the service needs of foster families with children who have disabilities. Foster parents in a large Canadian city were asked "What services or supports would be helpful to you?" The responses to this question were edited for clarity and to eliminate redundancies, and sorted into piles of like statements by a group of 15…
Berryman, Mere; Woller, Paul
This paper examines Early Intervention (EI) service provision from within one Ministry of Education region in New Zealand. It does this in order to better understand what works well and what needs to change if children from Maori families, of Early Childhood age, are to be provided with the most effective EI services. By engaging with Maori…
Kahn, Alfred J.; Kamerman, Sheila B.
This report presents a guide to successful contracting of child and family social services during a new era in child welfare. The six chapters focus on: (1) "Privatization, Purchase of Service, Managed Care, and the Child Welfare Reform Agenda" (the continuing crisis, reforming the local child welfare delivery system, and the federal…
Kamerman, Sheila B.; Kahn, Alfred J.
Critical to the success of initiatives to reform and restructure educational and community services to improve the lives of children is the way in which they are financed. This report explores the movement toward privatization through contracting in managing, financing, and delivering child and family social services and provides a conceptual…
Context: Medical audit in healthcare has a goal to monitor and upgrade the standard of health care in a setting. Whether a client will accept, use effectively and continue to practice contraception depends on the quality of services rendered. Objective: To assess the quality of our family planning services as perceived by our ...
Whittaker, James K.; Holmes, Lisa; del Valle, Jorge F.
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...
Nguyen, Mynhi; Pachana, Nancy A; Beattie, Elizabeth; Fielding, Elaine; Ramis, Mary-Anne
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
Jain, Rishee K.; Smith, Kevin M.; Culligan, Patricia J.; Taylor, John E.
Highlights: • We develop a building energy forecasting model using support vector regression. • Model is applied to data from a multi-family residential building in New York City. • We extend sensor based energy forecasting to multi-family residential buildings. • We examine the impact temporal and spatial granularity has on model accuracy. • Optimal granularity occurs at the by floor in hourly temporal intervals. - Abstract: Buildings are the dominant source of energy consumption and environmental emissions in urban areas. Therefore, the ability to forecast and characterize building energy consumption is vital to implementing urban energy management and efficiency initiatives required to curb emissions. Advances in smart metering technology have enabled researchers to develop “sensor based” approaches to forecast building energy consumption that necessitate less input data than traditional methods. Sensor-based forecasting utilizes machine learning techniques to infer the complex relationships between consumption and influencing variables (e.g., weather, time of day, previous consumption). While sensor-based forecasting has been studied extensively for commercial buildings, there is a paucity of research applying this data-driven approach to the multi-family residential sector. In this paper, we build a sensor-based forecasting model using Support Vector Regression (SVR), a commonly used machine learning technique, and apply it to an empirical data-set from a multi-family residential building in New York City. We expand our study to examine the impact of temporal (i.e., daily, hourly, 10 min intervals) and spatial (i.e., whole building, by floor, by unit) granularity have on the predictive power of our single-step model. Results indicate that sensor based forecasting models can be extended to multi-family residential buildings and that the optimal monitoring granularity occurs at the by floor level in hourly intervals. In addition to implications for
Full Text Available Background Mothers with a history of infertility may experience parenting difficulties and challenges. This study was conducted to investigate the role of residential early parenting services in increasing parenting confidence in mothers with a history of infertility. Materials and Methods This was a retrospective chart review study using the quantitative data from the clients attending the Karitane Residential Units and Parenting Services (known as Karitane RUs during 2013. Parenting confidence (using Karitane Parenting Confidence Scale-KPCS, depression, demographics, reproductive and medical history, as well as child’s information were assessed from a sample of 27 mothers who had a history of infertility and who attended the Karitane RUs for support and assistance. The data were analyzed using SPSS version 19. Results More than half of the women (59.3% reported a relatively low level of parenting confidence on the day of admission. The rate of low parenting confidence, however, dropped to 22.2% after receiving 4-5 days support and training in the Karitane RUs. The mean score of the KPCS increased from 36.9 ± 5.6 before the intervention to 41.1 ± 3.4 after the intervention, indicating an improvement in the parenting confidence of the mothers after attending the Karitane RUs (P<0.0001. No statistically significant association was found between maternal low parenting confidence with parental demographics (including age, country of birth, and employment status, a history of help-seeking, symptoms of depression, as well as child’s information [including gender, age, siblings, diagnosis of gastroesophageal reflux disease (GORD and use of medication]. Conclusion Having a child after a period of infertility can be a stressful experience for some mothers. This can result in low parenting confidence and affect parent-child attachment. Our findings emphasized on the role of the residential early parenting services in promoting the level of
This rule will better prevent and protect survivors of family violence, domestic violence, and dating violence, by clarifying that all survivors must have access to services and programs funded under the Family Violence Prevention and Services Act. More specifically, the rule enhances accessibility and non-discrimination provisions, clarifies confidentiality rules, promotes coordination among community-based organizations, State Domestic Violence Coalitions, States, and Tribes, as well as incorporates new discretionary grant programs. Furthermore, the rule updates existing regulations to reflect statutory changes made to the Family Violence Prevention and Services Act, and updates procedures for soliciting and awarding grants. The rule also increases clarity and reduces potential confusion over statutory and regulatory standards. The rule codifies standards already used by the program in the Funding Opportunity Announcements and awards, in technical assistance, in reporting requirements, and in sub-regulatory guidance.
Niniek Lely Pratiwi
Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.
Sushma Dahal; Raj Kumar Subedi
Family planning services in Nepal are provided by government and non-government health facilities. A descriptive cross sectional study was done by secondary data review of eight months from Institutional clinic, District Health Office (DHO) Ilam district. Use of different family planning methods through government health facility was studied in relation to different variables like age, sex, ethnicity, and, number of children. Around 53% of the female users of spacing method and around 47% of ...
The Population Council is responsible for the new USAID-funded Africa OR/TA (operations research/technical assistance) Project II. Project II activities will likely take place in Ghana, Kenya, Mali, and Zimbabwe, and maybe Nigeria and Uganda. The focus of planned OR activities include testing new approaches in reproductive health; sexually transmitted diseases; improving adolescents' access to family planning; documentation of the availability, functioning, and quality of health and family planning service delivery points (SDPs); development of indigenous approaches to community-based distribution; promotion of new and underutilized regulation methods; reduction of septic abortions through greater access to contraceptive services; incorporation of gender concerns in family planning programs; and testing postpartum family planning strategies. Between 1984 and 1998, the project will use OR extensively to examine the efficiency of integrated family planning and reproductive health programs. TA will include providing information and recommendations to program managers and policy decision makers about strategies to improve programs. Some project goals are to develop client-oriented service delivery strategies that are acceptable to different population groups and to improve the operations of programs so they can become more efficient and financially sustainable. Project II staff will use lessons learned from the Africa OR/TA Project I to improve service delivery and quality of care during 1993-1998.
Garg, Suneela; Singh, Ritesh
The family planning programme of India has shown many significant changes since its inception five decades back. The programme has made the contraceptives easily accessible and affordable to the people. Devices with very low failure rate are provided free of cost to those who need it. Despite these significant improvements in service delivery related to family planning the programme cannot be said to achieve success at all levels. There are many issues with the family planning services available through the public health facilities in India. Failure to adopt the latest technology is one of these. But the most serious drawback of the programme is that it has never been able to bridge the gap between the two genders related to contraceptives. The programme gave emphasis to women-centric contraceptive and thus women were seen as their clients. The choice to adopt a contraceptive though is 'cafeteria approach' in family planning lexicon; it is the choice of the husband that is ultimately practiced. There is not enough dialogue between husband and wife and husband and health worker to discuss the use of one contraceptive over another. The male gender needs to be taken in confidence while promoting the family planning practice. The integration of gender equity is to be done carefully so as not to make dominant gender more powerful. Only when there is equity between genders while using family planning services the programme will achieve success.
Karp, Elizabeth A; Dudovitz, Rebecca; Nelson, Bergen B; Shih, Wendy; Gulsrud, Amanda; Orlich, Felice; Colombi, Costanza; Kuo, Alice A
Parents of children with autism spectrum disorder (ASD) face competing demands when caring for their child and fulfilling family commitments. It remains unknown whether family obligations and parental stress might decrease the use of intervention services for young children with ASD. The current study is a secondary analysis of baseline date from a published randomized control trial with 147 low-resourced caregiver-child dyads. Demographic information, data on service use, maternal employment, parent's perception of their child's development, and parental stress were collected for primary caregivers of 2- to 5-year-old children with ASD from 5 sites. Multiple logistic regressions of accessing any intervention services or more than 1 services on familial characteristics were performed, controlling for demographic and contextual variables. Twenty-five percent of children were receiving no intervention service; 26% were receiving 1 service; and 49% were receiving 2 or more services. Perceived developmental delay and not having a sibling in the home were associated with higher odds of receiving intervention services. Children were more likely to receive more than 1 service if their parents had at least a college education and low levels of stress. Factors including perceived developmental level, parental stress, and caring for siblings may play a role in accessing services for children with ASD. Results reveal that competing family needs may be barriers to service use. Mothers of children with ASD with multiple children in the home, low levels of education, and high levels of stress may need additional supports or alternative service delivery models. Copyright © 2018 by the American Academy of Pediatrics.
Carlos Eduardo Leal Vidal
Full Text Available OBJETIVO: Apresentar os principais aspectos da reforma psiquiátrica ocorrida em diversos países e no Brasil, destacar a política de reinserção social dos pacientes e descrever os procedimentos da desospitalização ocorridos em Barbacena, Minas Gerais, com ênfase nas residências terapêuticas e nas intervenções de reabilitação psicossocial. MÉTODO: Pesquisa bibliográfica realizada nas fontes eletrônicas Medline e Lilacs (1990 a 2006, com os seguintes descritores: deinstitutionalization, psychiatric reform, community-based treatment, psychosocial rehabilitation. Descrição do processo de implantação das residências terapêuticas (RT por meio de consulta aos documentos da Prefeitura de Barbacena e de observação direta das residências. RESULTADOS: A maioria dos trabalhos selecionados indicou que pacientes desospitalizados apresentam melhora na autonomia, na interação social, no nível global de funcionamento e na qualidade de vida. A desospitalização implica a existência de serviços comunitários com diversos níveis de atenção e requer a presença de profissionais qualificados e programas de reabilitação efetivos. Em Barbacena, o processo de desospitalização teve início em 2000. Atualmente existem 24 RTs no município. CONCLUSÃO: Apesar das dificuldades na sua implantação, os tratamentos de base comunitária tornaram-se o modelo dominante de cuidados psiquiátricos. Para os pacientes desospitalizados, as RTs têm importante papel no processo de reinserção social.OBJECTIVE: The aim of this article is to show the more relevant aspects of psychiatric reform and the community insert of psychiatric patients around the world and in Brazil. It will be detached the procedures of discharge occurred in the city of Barbacena, emphasizing the residential services and the psychosocial approaches. METHODS: Databases Medline and Lilacs were searched between 1990 and 2006 using the following keywords: deinstitutionalization
... 42 Public Health 1 2010-10-01 2010-10-01 false How does one apply for a family planning services... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does one apply for a family planning services grant? (a) Application for a grant under this subpart shall...
... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply for a family planning... SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.3 Who is eligible to apply for a family planning services grant? Any public or nonprofit private entity in...
Roads in the conventional residential areas serve the purpose of leading to and from the houses in them. Thus, they are essentially traffic routes which may carry all road traffic modes, viz: pedestrians, pedal and motor bicycles, motor cars and trucks, and public service vehicles (buses or trams).
Warsh, Robin; And Others
Each year, many of the children in family foster care, group homes, or residential treatment centers are reunited with their families. This sourcebook is intended to aid the development of well-trained service providers who work with family reunification. The information here, presented in four parts, can be used for agency staff development…
Full Text Available A new human-friendly assistive home environment, Intelligent Sweet Home (ISH, developed at KAIST, Korea for testing advanced concepts for independent living of the elderly/the physically handicapped. The concept of ISH is to consider the home itself as an intelligent robot. ISH always checks the intention or health status of the resident. Therefore, ISH can do actively the most proper services considering the resident's life-style by the detected intention or emergency information. But, when there are more than two residents, ISH cannot consider the residents' characteristics or tastes if ISH cannot identify who he/she is before. To realize a personalized service system in the intelligent residential space like ISH, we deal with a human-friendly user identification method for ubiquitous computing environment, specially focused on dynamic human footprint recognition. And then, we address some case studies of personalized services that have been experienced by Human-friendly Welfare Robot System research center, KAIST.
Shinn, Marybeth; Brown, Scott R; Gubits, Daniel
Family break-up is common in families experiencing homelessness. This paper examines the extent of separations of children from parents and of partners from each other and whether housing and service interventions reduced separations and their precursors among 1,857 families across 12 sites who participated in the Family Options Study. Families in shelters were randomized to offers of one of three interventions: permanent housing subsidies that reduce expenditures for rent to 30% of families' income, temporary rapid re-housing subsidies with some services directed at housing and employment, and transitional housing in supervised facilities with extensive psychosocial services. Each group was compared to usual care families who were eligible for that intervention but received no special offer. Twenty months later, permanent housing subsidies almost halved rates of child separation and more than halved rates of foster care placements; the other interventions did not affect separations significantly. Predictors of separation were primarily homelessness and drug abuse (all comparisons), and alcohol dependence (one comparison). Although housing subsidies reduced homelessness, alcohol dependence, intimate partner violence, and economic stressors, the last three variables had no association with child separations in the subsidy comparison; thus subsidies had indirect effects via reductions in homelessness. No intervention reduced partner separations. © Society for Community Research and Action 2016.
Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster randomized controlled design, we conducted a formative assessment in two districts in Uganda where community health workers, called VHTs, already offered FP. Thirty-six trained VHTs also provided HIV testing and ...
Results: There was a shortage of some medical equipment, trained staffs, and information education and communication materials (IEC) in all of the family planning clinics. The mean waiting time at the service delivery points and consultation duration were 16.4 and 10.5 minutes, respectively. The providers used at least ...
RESULTS: The average levels of perceived informed choice and client provider interaction were 70.0% and 67.6%, respectively. Perceived clinical competence of providers, perceived integration and coordination of care, perceived accessibility of services, perceived participation of families and friends in care delivery, ...
Abstract: This study investigated factors influencing utilization of modern family planning services among women of childbearing age (15-49 years) in the University of Calabar Teaching Hospital, Calabar. Three research questions and three hypotheses were formulated. Descriptive survey design was adopted for it.
Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster randomized controlled design, we conducted a formative assessment in two districts in Uganda where community health workers, called. VHTs, already offered FP. Thirty-six trained VHTs also provided HIV testing and ...
Vidal de Haymes, Maria; Simon, Shirley
The gap between the number of children of color in care and the recruitment of minority foster and adoptive homes has triggered growing support for transracial adoption. This study explored a number of transracial placements and adoptions, with the goal of identifying, from the perspective of the families interviewed, potential services that would…
Background: Utilisation of family planning services in Kenya remains quite low hence, the soaring population which has partly hampered achievement of the fifth Millennium Development Goal (MDG) as well as achievement of overall development goals for the entire country. Current reports indicate that male participation ...
Van Puyenbroeck, Hubert; Loots, Gerrit; Grietens, Hans; Jacquet, Wolfgang; Vanderfaeillie, Johan; Escudero, Valentin
Set up as a one-group pre-test-post-test follow-up design, this study examines the outcomes of intensive family preservation services (IFPS) in Flanders addressing the following research questions: Does IFPS make a significant difference concerning (1) the interaction between parent and child? (2)
Deliberate efforts should be made by the management of UCTH Calabar to train and retrain health services providers to equip them with knowledge, skills and new ideas required for the handling of clients with all types of FP problems. Keywords: Problems, Prospects, Family planning, Calabar Global Journal of Social ...
Cost effectiveness studies of family planning (FP) services are very valuable in providing evidence-based data for decision makers in Egypt. Cost data came from record reviews for all 15 mobile clinics and a matched set of 15 static clinics and interviews with staff members of the selected clinics at Assiut Governorate.
Agustín Huete García
Full Text Available At present, there are several alternatives to support daily life of people with disabilities, which require different resources: human, institutional, technical, material, financial, etc. In addition, these alternatives involve different impacts on both the life of people with disabilites and their immediate environment. This paper presents a case study that compares an user of personal assistance services of the Program for Independent Living (PAVI with an user of a residential service. The study method used is based on the approach of Social Return on Investment (SROI. It also specifies the selection of cases, the partners consulted to gather concepts and values, data collection, variables and formulas for calculating and monetization. Despite its limited scope, it is possible to draw conclusions about the social return on investment in a “standard profile” receiving personal assistance services compared with a “standard profile” in a residential service.
A program described to design, fabricate, and conduct preliminary testing of a prototype solar-powered Rankine cycle turbocompressor heat pump module for a multi-family residential building is presented. A solar system designed to use the turbocompressor heat pump module including all of the subsystems required and the various system operating modes is described in Section I. Section II includes the preliminary design analyses conducted to select the heat pump module components and operating features, working fluid, configuration, size and performance goals, and estimated performance levels in the cooling and heating modes. Section III provides a detailed description of the other subsystems and components required for a complete solar installation. Using realistic performance and cost characteristics for all subsystems, the seasonal performance of the UTC heat pump is described in various US locations. In addition, the estimated energy savings and an assessment of the economic viability of the solar system is presented in Section III. The detailed design of the heat pump module and the arrangement of components and controls selected to conduct the laboratory performance tests are described in Section IV. Section V provides a description of the special laboratory test facility, including the subsystems to simulate the collectors and storage tanks for building load and ambient conditions and the instrumentation, monitoring, and data acquisition equipment. The test results and sample computer analyses and comparisons with predicted performance levels are presented in Section VI. Various appendices provide supplementary and background information concerning working fluid selection (A), configuration selection (B), capacity control concepts (C), building models (D), computer programs used to determine component and system performance and total system economics (E), and weather data (F).
Young, Richard A
The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.
... that consumers in high-cost areas pay some minimum amount to support the cost of the network before turning to the federal support mechanism, which ultimately is borne by consumers across the nation. As the... of service for some consumers that pay local service rates that are significantly lower than the...
Pacheco, Miguel; Lamberts, Roberto
This paper addresses the viability of converting single-family residential buildings in Brazil into zero energy buildings (ZEBs). The European Union and the United States aim ZEBs implementation to address ‘peak oil’ and environmental concerns. However, literature shows no agreement on a consensual definition of ZEB. Seeking a Brazilian ZEB definition, this paper addresses PassivHaus and thermal comfort standards for hot climates, source metrics for ZEB, Brazil′s energy mix, residential energy end uses and Brazilian legal framework for residential photovoltaic (PV) generation. Internal Rate of Return for PV systems in two Brazilian cities is calculated under various scenarios. It shows grid parity was reached from April 2012 to November 2012 assuming residential electric tariffs of that period and the financial conditions given by the Brazilian government for the construction of new dams in the Amazon and the lowest rates offered by Brazilian banks to private individuals. Governmental decision to lower electric residential tariffs in November 2012 reduced the scope of grid parity. Later revocation of a tax exemption in April 2013 ended grid parity in Brazil. It concludes, conversely to developed countries, it is the volatile Brazilian energy policy, instead of economical barriers, the main obstacle for ZEB viability in Brazil. - Highlights: • Critique on super insolated buildings as a good solution for hot climates. • PV parity already reached in some parts of Brazil. • Proposal for a zero energy building definition for Brazil. • Critique of the source metric for energy balance in zero energy buildings. • Average roof area in Brazil enough for PV array to meet average energy consumption
Shinn, Marybeth; Greer, Andrew L; Bainbridge, Jay; Kwon, Jonathan; Zuiderveen, Sara
We developed and evaluated a model to target homelessness prevention services to families more efficiently. We followed 11,105 families who applied for community-based services to prevent homelessness in New York City from October 1, 2004, to June 30, 2008, through administrative records, using Cox regression to predict shelter entry. Over 3 years, 12.8% of applicants entered shelter. Both the complete Cox regression and a short screening model based on 15 risk factors derived from it were superior to worker judgments, with substantially higher hit rates at the same level of false alarms. We found no evidence that some families were too risky to be helped or that specific risk factors were particularly amenable to amelioration. Despite some limitations, an empirical risk model can increase the efficiency of homelessness prevention services. Serving the same proportion of applicants but selecting those at highest risk according to the model would have increased correct targeting of families entering shelter by 26% and reduced misses by almost two thirds. Parallel models could be developed elsewhere.
Vanessa del Pilar Vega Cordova
Full Text Available This study aims to understand the vision and practices of service providers on care provided and its relation to the support and quality of life of institutionalized Chileans with intellectual disabilities. The methodology used consisted of content analysis of the information obtained from three service provider focus groups. The results indicate that while progress is being made in the quality of services offered to these users, it is necessary to take another step to move from the provision of essential services to the promotion, recording and tracking of quality results. This change requires a joint effort at the different levels of the system, including public policies that focus on personal development opportunities and personal outcome, as well as professionals committed to the promotion of best practices.
Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B
We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Full Text Available Research Statement: With an increase in competition within the South African property sector, real estate agencies need to ensure that their channels are as effective as possible. Using the Internet and mobile technologies represents a new means to reach customers and achieve lower operating costs. This study seeks to ascertain which factors potential buyers consider important when perusing residential property in an online environment. Hence, the dimensions of e-service quality, which constitute their online experience, will be explored. In addition, this research explores buyer typologies and probes whether other forms of technology, such as a mobile interface, may be of commercial value to the realtor. Methodology: The empirical analysis was conducted by means of a quantitative survey. A questionnaire was designed to test the application of the e-service quality construct in the South African real-estate sector. Data was obtained from 300 respondents, across the age spectrum, who filled the criteria of being prospective buyers. Convenience sampling was primarily used to collect responses as the researchers were unable to obtain access to a specific database of listed property buyers. Results & Conclusion: As mirrored in other studies of this nature, it was found that trust is paramount when initiating property sales online. All other variables in the construct (site features, information, accessibility, communication, reliability, responsiveness and personalisation also proved significant. A cluster analysis revealed that older respondents preferred a higher level of support - across all attributes of e-service quality - when interacting with online property services. Lastly, the mobile interface appears to appeal to 'students' as well as 'mature workers'. It is surmised that these individuals have access to smart phones capable of being used for accessing property portals. However, the 'young workers' appear less enthusiastic about the
Moeller, D.G.; Wehrberger, R. [Bereich Verkehrstechnik der Siemens AG, Erlangen (Germany); Noack, M. [Siemens AG, Erlangen (Germany)
With the presentation of the Desiro family of railcars and multiple units and the delivery of the first series-built Class-642 DMUs (Fig. 1), the way was opened for a new generation of innovative, flexible, passenger-friendly train sets to operate regional services. This whole new family of trains is intended to provide a response to the changed conditions of regional rail. In addition to passenger comfort, styling, safety, reliability and low life-cycle costs, the Desiro concept caters for the demands for shorter delivery times, smaller series and highly divergent customer desiderata, at a time of ever-increasing pressure to bring down the costs of trains. (orig.)
Mathie, Amy M.; Wood, Nathan
The objective of this research is to document residential and service-population exposure to natural hazards in the rural communities of Clackamas County, Oregon, near Mount Hood. The Mount Hood region of Clackamas County has a long history of natural events that have impacted its small, tourism-based communities. To support preparedness and emergency-management planning in the region, a geospatial analysis of population exposure was used to determine the number and type of residents and service populations in flood-, wildfire-, and volcano-related hazard zones. Service populations are a mix of residents and tourists temporarily benefitting from local services, such as retail, education, or recreation. In this study, service population includes day-use visitors at recreational sites, overnight visitors at hotels and resorts, children at schools, and community-center visitors. Although the heavily-forested, rural landscape suggests few people are in the area, there are seasonal peaks of thousands of visitors to the region. “Intelligent” dasymetric mapping efforts using 30-meter resolution land-cover imagery and U.S. Census Bureau data proved ineffective at adequately capturing either the spatial distribution or magnitude of population at risk. Consequently, an address-point-based hybrid dasymetric methodology of assigning population to the physical location of buildings mapped with a global positioning system was employed. The resulting maps of the population (1) provide more precise spatial distributions for hazard-vulnerability assessments, (2) depict appropriate clustering due to higher density structures, such as apartment complexes and multi-unit commercial buildings, and (3) provide new information on the spatial distribution and temporal variation of people utilizing services within the study area. Estimates of population exposure to flooding, wildfire, and volcanic hazards were determined by using overlay analysis in a geographic information system
Full Text Available Using the City of Roanoke, Virginia as a study site, this paper quantifies the forest structure, ecosystem services and values of vacant and residential land. Single family residential land had more trees (1,683,000 than vacant land (210,000 due largely to the differences in land area (32.44 km2 of vacant land vs. 57.94 km2 residential. While the percentage of tree coverage was almost identical across land uses (30.6% in vacant to 32.3% in residential, the number of trees per ha is greater on residential land (290.3 than on vacant land (63.4. The average healthy leaf surface area on individual trees growing on vacant land was greater than that of individual trees on residential land. The fact that trees in vacant land were found to provide more ecosystem services per tree than residential trees was attributed to this leaf area difference. Trees on vacant land are growing in more natural conditions and there are more large trees per ha. Assessing the forest structure and ecosystem services of Roanoke’s vacant and residential land provides a picture of the current extent and condition of the vacant and residential land. Understanding these characteristics provides the information needed for improved management and utilization of urban vacant land and estimating green infrastructure value.
youth and families as well as Ethnic Resource Team (ERT) Multi faith chaplaincy, a mental health service use the resources of refugees and other ethnic minorities, as they are involved as initiators, professionals and volunteers. However the economic basis is/ has been rather precarious. Intricately...... constructive eclectic theoretical framework invoking local practices is also presented. Despite formal rights to mental healthcare for ethnic minorities including the traumatised refugees, there is no national strategy in Denmark aimed at ensuring that. Still in 1980s as services for treatment of refugees who...
Letschert, Virginie E.; McNeil, Michael A.; Leiva Ibanez, Francisco Humberto; Ruiz, Ana Maria; Pavon, Mariana; Hall, Stephen
Minimum Efficiency Performance Standards (MEPS) have been chosen as part of Chile's national energy efficiency action plan. As a first MEPS, the Ministry of Energy has decided to focus on a regulation for lighting that would ban the sale of inefficient bulbs, effectively phasing out the use of incandescent lamps. Following major economies such as the US (EISA, 2007) , the EU (Ecodesign, 2009) and Australia (AS/NZS, 2008) who planned a phase out based on minimum efficacy requirements, the Ministry of Energy has undertaken the impact analysis of a MEPS on the residential lighting sector. Fundacion Chile (FC) and Lawrence Berkeley National Laboratory (LBNL) collaborated with the Ministry of Energy and the National Energy Efficiency Program (Programa Pais de Eficiencia Energetica, or PPEE) in order to produce a techno-economic analysis of this future policy measure. LBNL has developed for CLASP (CLASP, 2007) a spreadsheet tool called the Policy Analysis Modeling System (PAMS) that allows for evaluation of costs and benefits at the consumer level but also a wide range of impacts at the national level, such as energy savings, net present value of savings, greenhouse gas (CO2) emission reductions and avoided capacity generation due to a specific policy. Because historically Chile has followed European schemes in energy efficiency programs (test procedures, labelling program definitions), we take the Ecodesign commission regulation No 244/2009 as a starting point when defining our phase out program, which means a tiered phase out based on minimum efficacy per lumen category. The following data were collected in order to perform the techno-economic analysis: (1) Retail prices, efficiency and wattage category in the current market, (2) Usage data (hours of lamp use per day), and (3) Stock data, penetration of efficient lamps in the market. Using these data, PAMS calculates the costs and benefits of efficiency standards from two distinct but related perspectives: (1) The
Dolan, Nicola; Sherlock, Catherine
This article is a summary of the research carried out in relation to the experiences of asylum-seeking and refugee families regarding access and participation in local childcare services. Focus groups and interviews were carried out with 16 refugee and asylum-seeking parents, five childcare practitioners, and two support and development staff in a…
Ziviani, Jenny; Feeney, Rachel B.; Khan, Asad
Family-centered early childhood services for children with physical disability and their families can afford developmental advantage for children and avert unnecessary stress for families. This study aimed to determine how characteristics of children and families and perceptions of family-centered practice (FCP) relate to satisfaction with early…
Henderson, Julie; Willis, Eileen; Xiao, Lily; Toffoli, Luisa; Verrall, Claire
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.
Kordheili, Reza Ahmadi; Pourmousavi, Ali; Pillai, Jayakrishnan Radhakrishna
requirements, such as voltage and current limits. This paper proposes an optimization method for determining the number of photovoltaic (PV) panels together with their arrangement in the grid in order to maximize ancillary service, without violating grid operation limits. The proposed optimization method...
Kimla, Katarina; Nathanson, Dania; Woolfenden, Susan; Zwi, Karen
Objective The aims of the present study were to describe the prevalence of vulnerability in a cohort of newborns, identify the factors that increase the risk of vulnerability and examine whether those who are most vulnerable are receiving home visits. Methods A prospective cross-sectional study was performed using data collected from questionnaires completed by child and family health nurses and obstetric discharge summaries for each mother-baby dyad. Descriptive frequencies and percentages are used to describe the proportions of children who were vulnerable, offered services and had risk factors for vulnerability. Categorical data were compared using Pearson's Chi-squared analysis. Results In all, 1517 newborns were included in the present study. Of these, 40.5% were identified as vulnerable and 13.9% had two or more risk factors for vulnerability (95% confidence interval (CI) 12-16%). The most common risk factors were biological. Across all newborns, 33.7% were visited at home, and 74.6% of vulnerable newborns were offered a home visit. Children identified as vulnerable were more likely to have a home visit than those who were not (z for 95% CI=1.96; Prisk needs to be confirmed in further studies, identifying vulnerability allowed the offer of home visiting to be directed towards those most likely to benefit. What is known about the topic? Of the Australian child population, 10-20% are vulnerable to adverse health, developmental and wellbeing outcomes. Vulnerable infants are at a greater risk of becoming vulnerable children, adolescents and adults over the life course. Biological and psychosocial risk factors for vulnerability are well described. Families with the greatest need are often the least likely to access or receive support, and have lower utilisation of preventative health services despite evidence that support in the first few years of life can significantly improve long-term outcomes. What does this paper add? This paper provides a detailed
... financial participation for services provided in FY 1994 and subsequent years may not claim more than 10... property; data processing and computer services; accounting; budgeting; auditing. (3) Program costs are..., family preservation and family support services). 1357.32 Section 1357.32 Public Welfare Regulations...
Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P
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
This study investigated the relationship between families' perceptions of supports and services and family quality of life (FQOL) for families of children with deafblindness, and the potential of satisfaction with family-professional partnerships and child age as moderators of this relationship. The study was guided by the Unified Theory of Family…
Bourke-Taylor, Helen; Cotter, Claire; Stephan, Rebecca
ABSTRACT Families raising a young child with multiple disabilities are charged with significant responsibilities such as learning about their child's condition and navigating mainstream and alternative services. Aim: Describe service choices, costs, out of pocket expenses, and the impact on families. Methods: Survey design using a custom questionnaire was used to collect extensive retrospective and current data. Purposive sampling (N = 29) occurred from one early intervention facility specialized in servicing children with cerebral palsy (CP) and, or multiple disabilities in Australia. Descriptive statistics were used for analysis of data. Results: Twenty-three (79%) families reported caring for a child with CP. Twenty-three families reported using at least one complementary/alternative intervention. Out-of-pocket amounts were reported including: chiropractic services (10 families); naturopathy (9 families); point percussion therapy (7 families), and Chinese medicine (6 families). Expenses resulted in families reporting forgoing clothing items, family entertainment, recreation/hobbies for parents (55%); family holidays (59%); time for parents alone (66%); and health services for parents (38%). Conclusions: Families of young children with multiple disabilities select a wide range of services for their child, with consequential out of pocket expenses. Early intervention professionals can be an important resource for families as they evaluate their choices and select interventions for their child.
... 25 Indians 1 2010-04-01 2010-04-01 false What is included under Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.401 What is included under Services to Children, Elderly, and Families? Services to Children, Elderly, and...
Full Text Available Background and Objective: Many research indicated that adolescents’ residential centers have the high possibility to diagnose with psychological disorders. Therefore, the aim of this study was investigated the mental health, happiness and emotion control among adolescents’ residential centers of state welfare organization.Materials and Methods: This research is a causal –comparative research. The 80 adolescents’ residential centers were chosen through available sampling and 80 adolescents of schools of Alborz city were selected through cluster method. Statistical analysis was conducted by using the independent t-test. The research instruments were Emotion Control Questionnaire (ECQ, General Health Questionnaire (GHQ, Goldenberg, and Oxford Happiness Inventory (OHI.Results: The significantly different was observed in mental health, happiness and emotion control between two adolescents groups (p<0.05.Conclusion: The results indicate that the institutional-reared decrease the level of mental health, happiness and emotion control in adolescents. Thus, counselors should be considered these factors in therapeutic intervention to enhancing the mental health of adolescents’ residential centers.
Hemachidha, C; Rosenfield, A G
The family planning program of Thailand was organized, planned, and implemented by means of the rural health and hospital services of the Ministry of Public Health. Without this integration, the program would not have been allowed by the government. The Thai health system was reasonably well-established, the use of its personnel lessened cost and duplication of efforts, and the resulting integration was successful. The program operated very quietly between 1968 and 1970. No public information was allowed. There were no full-time family planning workers, and no goals and incentives were offered. Only in 1970 when the government announced a national population policy were the restrictions on public information removed. In the development of the program, more than 7600 employees of the Ministry of Public Health received the 1-week training program. After training, family planning clinics were opened in the provincial hospitals and in those rural health centers staffed with a physician. Initially, the auxiliary midwives were expected only to motivate and provide information to those in their areas, referring interested couples to the centers and hospitals for the IUDs, oral contraceptives, and sterilization programs that were available. However, after the successful completion of a pilot study in 1970, the midwives were permitted to prescribe the oral contraceptive. A postpartum program which attempted to motivate women in the use of family planning 2-4 days following delivery revealed that with proper motivation efforts a majority of women will accept family planning services postpartum. A special evaluation section was developed within the Ministry to assess the progress of the program. Many problems continue to require attention, such as the need for high level government support shown by a budget increase and the development of effective supervision for staff within the health system.
Full Text Available Objective: To identify influences on learning for Saudi male students studying Emergency Medical Services at a college in Riyadh, Saudi Arabia. Previous research on influences on student learning in the Kingdom of Saudi Arabia focused on the historical development of education in Saudi Arabia, English language development, and intrinsic motivations of students and excluded a focus on students studying Emergency Medical Services. Methods: Exploratory sequential mixed-methods study was deployed. Results: Family support was an exceptionally strong predictor of student confidence in both skills and post-graduate EMS employment. Concepts involving application, memorization, motivation, and English language did not present as statically significant. The discovery of the strong influences that a family can have on Saudi EMS student’s confidence is noteworthy, as this was not previously discovered in the literature. Conclusion: This discovery holds practical implications for EMS education and training programs as emphasizes the importance of developing practical ways to include a student’s family as a source of support in ensuring student success and confidence.
Thorin, Elizabeth J.; Irvin, Larry K.
Analysis of concerns expressed by 42 members of 19 families of young adults with severe developmental disabilities indicated concerns in such areas as self-care capabilities, sexuality, and quality of residential services. Concerns in the residential domain were most predictive of overall individual and family stress. Effects of questioning…
Full Text Available Family planning services in Nepal are provided by government and non-government health facilities. A descriptive cross sectional study was done by secondary data review of eight months from Institutional clinic, District Health Office (DHO Ilam district. Use of different family planning methods through government health facility was studied in relation to different variables like age, sex, ethnicity, and, number of children. Around 53% of the female users of spacing method and around 47% of female users of permanent method were in age group 20-29 years and 25-29 years respectively. The major reasons for removal of IUCD were husband’s migration and experienced physical problems. Most of the females doing sterilization were from Disadvantaged Janajati group whereas most of the males doing sterilization were from Upper caste ethnic group. Among females doing sterilization, 70% already had their second live birth baby. Out of the total sterilization performed in 8 months, only 15.15% was done among males. So, there is need of increasing male involvement in Family planning. There is also need of programs to encourage spacing methods among the target population. DOI: http://dx.doi.org/10.3126/dsaj.v6i0.8482 Dhaulagiri Journal of Sociology and Anthropology Vol. 6, 2012 125-138
Full Text Available In South Africa, client satisfaction with the quality of health care has received minimal attention; probably due to the lack of locally developed and tested measures. Therefore, we developed and tested a 20-item attitude scale to determine satisfaction with Family Planning (FP services. The objectives of this study were to: ascertain reliability of the scale and confirm, through factor analysis, that satisfaction with the FP service was based on interpersonal and organisational dimensions. The sample comprised 199 black adult interviewees (158 women and 41 men, who had previously used or were currently using contraception, from an informal settlement in Gauteng, South Africa. Three items were removed from the scale due to unacceptable communality estimates. The reliability coefficient of 0.76 for the 17-item scale was satisfactory. The principal components analysis, with orthogonal and oblique rotations, extracted two factors; accounting for 51.8% of the variance. The highest loadings on Factor I involved an interpersonal dimension (friendly, encouraging, competent, informative and communicative. Factor II tended to focus on the organisational elements of the system, such as different methods, choice of methods, service availability and length of waiting time. It was concluded that this scale was a reliable, easily administered and scored measure of satisfaction, with underlying interpersonal and organisational dimensions.
Levitt, Aaron J; Mitchell, Kristen; Pareti, Lauren; DeGenova, Joe; Heller, Anne; Hannigan, Anthony; Gholston, Jennifer
We compared Home to Stay, a pilot of intensive housing placement and community transition services for episodic and recidivist homeless families, with a standard services approach. Using intention-to-treat analyses, we conducted a modified randomized trial of 138 Home to Stay client families and a control group of 192 client families receiving standard shelter services. Home to Stay clients exited shelter more quickly than clients in the control group (Cox regression, P homeless families. Standard shelter services may be able to narrow this performance gap by incentivizing work with all episodic and recidivist homeless families.
The American disability service system is predicated on underlying assumptions and beliefs which are dominant in the majority culture. Consequently, minority families, such as families from India, living in America sometimes experience dissonance with respect to the services provided to their family due to their varying cultural values. As such,…
Fowler, Patrick J.; Taylor, Jeremy J.; Rufa, Anne K.
This study evaluated the impact of housing services among child welfare-involved families using observational data. Propensity score matching with data from the National Survey of Child and Adolescent Well-Being compared intact families (n = 183) who received housing services 12 months after initial investigation to nontreated families balanced on…
Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna
In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.
Andersson, Sofia; Lindqvist, Olav; Fürst, Carl-Johan; Brännström, Margareta
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.
Raghavendra, P; Murchland, S; Bentley, M; Wake-Dyster, W; Lyons, T
For children who have physical disabilities and their families, involvement with a variety of providers of rehabilitation services is the norm rather than the exception. Despite family-centred practice (FCP) being recognized as the 'best practice' model, families experience models of service provision that range from 'expert' to 'collaborative'. After adopting FCP at Novita Children's Services in South Australia, it was imperative to determine the effectiveness of the implementation of FCP. Aim To investigate parents' and staff's perceptions of FCP at Novita as part of ongoing quality assurance activity, and to identify any gaps in the services provided. The Measures of Processes of Care (MPOC) for parents/caregivers and service providers were utilized. A total of 189 families stratified by the three age groups of clients (service providers (MPOC-SP) questionnaire. Parents generally rated the family-centred behaviours of staff as positive. Respectful and supportive care received the highest rating, while providing general information received the lowest. There were significant differences in scores for all five scales of the MPOC between metropolitan and rural families and the age of the child. Service providers also generally rated their family-centred behaviours as positive. There were significant differences among the professions in areas of showing interpersonal sensitivity and providing general information. The findings suggest that parents and service providers perceive FCP as positive at Novita, with some areas for improvement. The MPOC-20 and MPOC-SP can be used to measure FCP and to identify service delivery gaps, which warrant further exploration.
Deng, Jie; Tian, Zhiyong; Fan, Jianhua
A pilot project of the solar water heating system combined with a low temperature air source heat pump (ASHP) unit was established in 2014 in a detached residential house in the rural region of Beijing, in order to investigate the system application prospect for single family houses via system op...... the integrated solar space heating for reducing carbon emission, it is suggested that the Beijing municipal government should offer some financial subsidy to compensate the equivalent solar heat price per kWh....... pilot household on the current electricity price level of 0.5 RMB/kWh, comparing with the reference condition of the fully ASHP space heating. It is further found that the equivalent solar heat price per kWh is too high under the current solar market cost price and collector technology. To put forward...
Soffers, R.; Meijboom, B.R.; van Zaanen, J.; van der Feltz, C.M.
Background The Dutch mental healthcare sector has to decrease costs by reducing intramural capacity with one third by 2020 and treating more patients in outpatient care. This transition necessitates enabling patients to become as self-supporting as possible, by customising the residential care they
Kakoko, D.C.; Ketting, E.; Kamazima, S.R.; Ruben, R.
Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based
Terwiel, M.; Alsem, M. W.; Siebes, R. C.; Bieleman, K.; Verhoef, M.; Ketelaar, M.
BackgroundA family-centred approach to services of children with disabilities is widely accepted as the foundational approach to service delivery in paediatric health care. The 56 items of the Measure of Processes of Care questionnaire (MPOC-56) all reflect elements of family-centred service. In
Daniele Merisio Raimundi
Full Text Available Objective to know the practice of the Family Clinic in Cuiaba and its relationship with the precepts of the expanded clinic, from the perspective of the service nurses. Method qualitative descriptive research, data collection with semi-structured interviews and results analyzed according to the method of thematic content analysis. Results for nurses working in the service, this assumes a differentiated and innovative proposal, which seeks to correlate with shared management in its three spheres. Although most do not know the Enlarged Clinic term in his speech cited its main principles and its tools. The greatest potential described were related to the Support Center for Health and popular participation, and as challenges, the lack of community health worker, the national health establishment registration and the difficulty of operation due to the profile of the professionals technical level arising from secondary care. Conclusions The clinic has positive aspects that can contribute to the advancement of the profession, to train health professionals and an innovative primary care model. Therefore, it emphasizes the need for implementation of continuing education in order to realize its proposal, and further studies on site.
Kiwi, Mahin; Hydén, Lars-Christer; Antelius, Eleonor
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.
Marlowe, Stephanie L.
The present study investigated within a substance abuse treatment center the influence of family therapy on flexibility and cohesion among family members. Past studies have suggested adolescents who abuse substances exist in families who have a lack of balance of flexibility and cohesion. Unfortunately, few studies have examined the influence of…
Apsche, Jack A.; Bass, Christopher K.; Zeiter, J. Scott; Houston, Marsha Ann
Mode Deactivation Therapy (MDT) has been shown to be an effective treatment for a variety of adolescent disorders including emotional dysregulation, behavioral dysregulation, physical aggression, sexual aggression, and many harmful symptoms of anxiety and traumatic stress. MDT Family Therapy has been effective in reducing family disharmony in case…
Karsten, L.; Paddison, R.; Ostendorf, W.
Housing studies show an overwhelming preference by middle-class families for suburban living locations. In this paper an atypical category, middle-class families living in the city, is addressed. The aim is to understand why these households disconnect the seemingly natural relationship between
Rodriguez, Aubrey J; Margolin, Gayla
Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. (c) 2015 APA, all rights reserved).
McDermott, Garret L
This study aimed to highlight the experiences and perceptions of rehabilitation services among families of people with Acquired Brain Injury (ABI) and among professionals working in ABI rehabilitation services in Ireland.
Aziz, Mirette; Ahmed, Sabra; Ahmed, Boshra
To assess the attitudes of physicians providing family planning services at the public sector in Egypt about recommending intrauterine device (IUD) for family planning clients, and to identify the factors that could affect their attitudes. A descriptive cross sectional study, in which all the physicians providing family planning services in Assiut Governorate were invited to complete self-administered questionnaires. The study participants were recruited at the family planning sector monthly meetings of the 13 health directorates of Assiut Governorate, Upper Egypt. 250 physicians accepted to participate in the study. Bivariate and Multivariate regression analyses were performed to identify the most important predictors of recommending IUD to family planning clients when appropriate. Less than 50% of physicians would recommend IUD for clients with proper eligibility criteria; women younger than 20 years old (49.2%), women with history of ectopic pregnancy (34%), history of pelvic inflammatory diseases (40%) or sexually transmitted diseases (18.4%) and nulliparous women (22.8%). Receiving family planning formal training within the year preceding data collection and working in urban areas were the significant predictors of recommending IUD insertion for appropriate clients. Physicians providing family planning services in Upper Egypt have negative attitudes about recommending IUD for family planning clients. Continuous education and in-service training about the updated medical eligibility criteria, especially for physicians working in rural areas may reduce the unfounded medical restrictions for IUD use. Copyright © 2017 Elsevier B.V. All rights reserved.
Wright, F A Clive; Law, Garry; Chu, Steven K-Y; Cullen, John S; Le Couteur, David G
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.
Nunez, Ralph da Costa
This book discusses homeless families in the United States and advocates the efforts of residential educational and employment training centers--American Family Inns--which provide comprehensive services education, job training, and parenting and life skills to address the poverty-related conditions that contribute to homelessness. Chapters of the…
Pangaribuan, A. B.; Rahmat, R. F.; Lidya, M. S.; Zálešák, M.
The paper describes improvisation mode of energy supply source by collaboration between national utility grid as represented by fossil fuels and PV as independent renewable power resource in order to aim the energy consumptions efficiently in retrofit single family house. In this case, one existing single family house model in Medan, Indonesia was observed for the possibility of future refurbishment. The eco-design version of the house model and prediction analyses regarding nearby potential renewable energy resource (solar system) had been made using Autodesk Revit MEP 2015, Climate Consultant 6.0 and Green Building Studio Analysis. Economical evaluation of using hybrid power supply is discussed as well.
...] Hazard Mitigation Assistance for Wind Retrofit Projects for Existing Residential Buildings AGENCY... for Wind Retrofit Projects for Existing Residential Buildings. DATES: Comments must be received by... to protect existing one- and two-family residential buildings (not including manufactured housing...
... insurance (UI) tax account under the name American Home Mortgage Servicing, Inc. Accordingly, the Department... mortgage servicing customer services from India. The amended notice applicable to TA-W-82,568, TA-W-82,568A...
.../Tribal/local accountability? 3. What role should the child welfare case management information system or... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families 45 CFR Parts 1355, 1356 and 1357 Federal Monitoring of Child and Family Service Programs; Request for Public Comment and...
... GENERAL § 1355.31 Elements of the child and family services review system. Scope. Sections 1355.32 through... 45 Public Welfare 4 2010-10-01 2010-10-01 false Elements of the child and family services review system. 1355.31 Section 1355.31 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE...
Corr, Catherine; Santos, Rosa Milagros; Fowler, Susan A.
The Individuals With Disabilities Education Act mandates that very young children with disabilities be served through Part C services. Families of young children with disabilities who are also living in poverty are often the primary recipients of these services. To better understand the experiences of families, particularly those living in…
Underwood, Kathryn; Trent-Kratz, Marion
Increasingly, governments are seeking ways to integrate early childhood education and care services as a social policy strategy to maximize child and family outcomes. This study examines the role of a school-based parenting and family literacy program to a system of services in one community in Ontario, Canada. Using an appreciative inquiry…
Lara A. Roman; John J. Battles; Joe R. McBride
Urban forests can provide ecosystem services that motivate tree planting campaigns, and tree survival is a key element of program success and projected benefits. We studied survival in a shade tree give-away program in Sacramento, CA, monitoring a cohort of young trees for five years on single-family residential properties. We used conditional inference trees to...
Christensen, Thomas Højlund; Fruergaard, Thilde; Matsufuji, Y.
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...
Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara
Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…
... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL... permanency for all children and help prepare youth emancipating from the foster care system for self... identified, enhanced, respected, and mobilized to help families solve the problems which compromise their...
Kyzar, Kathleen B.; Brady, Sara E.; Summers, Jean Ann; Haines, Shana J.; Turnbull, Ann P.
In this study, the authors examined the moderating effects of partnership on the relationship between services and supports adequacy and family quality of life (FQOL) for families of children with deaf-blindness ages birth to 21. A social-ecological approach enabled examining the impact of disability on the family system. A survey, consisting of…
rand 2011 www.rand.org Assessing the Needs of Service Members and Their Families A New Approach S ince the advent of the all-volunteer force in...programs to be responsive to the needs of service members and their families. Unfortunately, DoD does not have a systematic way to determine what those...needs are. Traditional program evaluation focuses on the use of specific programs rather than the needs of DoD families. This shortfall is remedied
Goldberg, Debora Goetz; Wood, Susan F; Johnson, Kay; Mead, Katherine Holly; Beeson, Tishra; Lewis, Julie; Rosenbaum, Sara
Family planning and related reproductive health services are essential primary care services for women. Access is limited for women with low incomes and those living in medically underserved areas. Little information is available on how federally funded health centers organize and provide family planning services. This was a mixed methods study of the organization and delivery of family planning services in federally funded health centers across the United States. A national survey was developed and administered (n = 423) and in-depth case studies were conducted of nine health centers to obtain detailed information on their approach to family planning. Study findings indicate that health centers utilize a variety of organizational models and staffing arrangements to deliver family planning services. Health centers' family planning offerings are organized in one of two ways, either a separate service with specific providers and clinic times or fully integrated with primary care. Health centers experience difficulties in providing a full range of family planning services. Major challenges include funding limitations; hiring obstetricians/gynecologists, counselors, and advanced practice clinicians; and connecting patients to specialized services not offered by the health center. Health centers play an integral role in delivering primary care and family planning services to women in medically underserved communities. Improving the accessibility and comprehensiveness of family planning services will require a combination of additional direct funding, technical assistance, and policies that emphasize how health centers can incorporate quality family planning as a fundamental element of primary care. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Borbasi, Sally; Galvin, Kathleen T; Adams, Trevor; Todres, Les; Farrelly, Brona
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.
Toy libraries have become a favoured way of providing a service to families in which there is a mentally handicapped child. The purpose of this study was to gain information about how parents valued the service provided by the toy library at Honeylands Family Support Unit. Parents expressed a great deal of satisfaction with the service. Suggestions are made as to how it could be further improved and about the desirability of it being extended to school-aged children.
Context: Family planning is an integral part of maternal health as its uptake is a significant factor in the reduction of maternal mortality and in ensuring positive child health outcomes. Objectives: To describe prevalence and pattern of contraceptive use, and identify reasons for discontinuation among women accessing family ...
Hess, Peg McCartt; And Others
Describes implementation of Professional Review Action Group (PRAG) model for reviewing cases of disrupted family reunification. Notes that model provides for care review, periodic reporting of review findings, and recommendations for and documentation of corrective actions. Explains how, in first 62 cases reviewed, both family and service…
Zingale, Marinella; Belfiore, Giovanni; Mongelli, Vita; Trubia, Grazia; Buono, Serafino
The authors present the outcomes of three parent training experiences carried out at the Research Institute "OASI MARIA SS" in Troina, Italy, which were designed to facilitate the acquisition of specific competencies and to promote educational effectiveness within the family. Some 30 families (all with a member with autistic disorder or…
and income generating activities with positive outcome in increasing contraceptive prevalence in rural areas9. Even though literature on uptake as well as methods used for family planning at community level in develop- ing countries is available, literature on perceptions and attitudes of women towards the use of family ...
Africa.1-4 Family planning can reduce the number of deaths among women by preventing unintended pregnancies, which account for about 30% of all births in sub-Saharan. Africa.5,6 In Lesotho almost one-third of currently married women have an unmet need for family planning, 11% for spacing their children and 20% for ...
Hoagwood, Kimberly Eaton; Olin, Su-Chin Serene; Wang, Nicole M; Pollock, Michele; Acri, Mary; Glaeser, Elizabeth; Whitmyre, Emma D; Storfer-Isser, Amy; Horwitz, Sarah McCue
This paper describes a systematic approach to assessing community services post-Sandy Hook shooting. An evaluation team was invited to develop a sustainability plan for community services in Newtown. Service organizations, providers and families were interviewed. Descriptive statistics were used to characterize the range of services; respondent perspectives were coded using content analysis. We found that Newtown has a broad array of community services, but respondent groups varied in their perceptions of service adequacy. Consensus existed about core components of an ideal service system, including centralizing access; coordinating care; personalizing and tailoring services for families; and providing evidence-based care. The strategic community assessment approach developed here may inform how communities examine their service capacity and develop sustainability plans post-disaster.
Rr Dian Tristiana
Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.
Daatland, Svein Olav
Examined the use of public services by 1,080 Norwegian older adults. Results showed more than one-third use public services for the aged (i.e., are institutionalized or receive home help or home nursing). The use of services is affected by both need and demand factors. The family's role is discussed. (JAC)
This article presents a Relational Goal-Oriented Model of Service Delivery to Children with physical or mental health difficulties and their families. This research-informed and practice-relevant model provides a broad understanding of what effective service provision entails and requires from practitioners and service organizations. The model…
The Department of Defense's (DOD) Exceptional Family Member Program (EFMP) is a mandatory enrollment program for active duty servicemembers who have family members with special medical needs. The Ronald W...
MacNeil, Jessica R; Liu, Chia-Ling; Stone, Sarah; Farrell, Janet
To determine levels of families' satisfaction and anxiety associated with the early hearing detection and intervention (EHDI) process in Massachusetts, and to assess the relationship between a child's hearing status and levels of family satisfaction. Surveys were mailed to families whose infants (a) passed their initial hearing screening (Group 1), (b) did not pass their initial screening but subsequently passed an outpatient rescreen or diagnostic evaluation (Group 2), or (c) were identified with permanent hearing loss (Group 3). Survey instruments measured families' satisfaction and anxiety associated with each stage of the EHDI process. Of the 4,138 families surveyed, 1,106 (27%) responded. Families reported satisfaction with screening services (Group 1 = 88%; Group 2 = 86%; Group 3 = 75%), and few reported anxiety prior to the hearing screening (Group 1= 4%; Group 2 = 15%; Group 3 = 19%). Among families requiring retesting services, 97% of Group 2 and 87% of Group 3 families were satisfied. Among Group 3 families, 94% reported satisfaction with the care their audiologist was providing, and 79% were satisfied with their early intervention services overall. Families reported satisfaction with the EHDI services they received in Massachusetts and expressed strong support for the universal newborn hearing screening initiative.
Ingólfsdóttir, Jóna G; Egilson, Snæfrídur Thóra; Traustadóttir, Rannveig
This paper outlines the reported discrepancies between the aims of the welfare services in Iceland and the experiences of parents raising young children with intellectual disabilities. Prevailing views on disability and service delivery were also considered. A multi case study design was employed to reflect the situation in different parts of the country. Families of eight children with intellectual disabilities and professionals in three different municipalities formed the cases. The findings reveal a high convergence between the three cases with variations based on individual experiences rather than geographical location. Overall, parents praised the preschools but experienced support services often as fragmented and uncompromising. Particular components of the services were consistently regarded as hard to reach and not in accordance with the needs of the family. Cultural-historical activity theory is introduced as a beneficial framework for further study and system improvement.
Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel
Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable
Full Text Available Post-abortion family planning (PAFP has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes
Muñoz-Guzmán, Carolina; Fischer, Candice; Chia, Enrique; LaBrenz, Catherine
Poor outcomes and several complaints to the judicial system against residential services for children have triggered a deep review of the Chilean child welfare services, particularly in relation to family reunification. This paper offers strategic guidelines to improve alternative care for children younger than six years of age, who are under protective measures. To define such guidelines, a case study was developed based on current models of residential services and foster home programs, whi...
Full Text Available Abstract Background Both availability and quality of family planning services are believed to have contributed to increasing contraceptive use and declining fertility rates in developing countries. Yet, there is limited empirical evidence to show the relationship between the quality of family planning services and the population based prevalence of contraceptive methods. This study examined the relationship between quality of family planning services and use of intrauterine devices (IUD in Egypt. Methods The analysis used data from the 2003 Egypt Interim Demographic and Health Survey (EIDHS that included 8,445 married women aged 15–49, and the 2002 Egypt Service Provision Assessment (ESPA survey that included 602 facilities offering family planning services. The EIDHS collected latitude and longitude coordinates of all sampled clusters, and the ESPA collected these coordinates for all sampled facilities. Using Geographic Information System (GIS methods, individual women were linked to a facility located within 10 km of their community. A facility-level index was constructed to reflect the quality of family planning services. Four dimensions of quality of care were examined: counseling, examination room, supply of contraceptive methods, and management. Effects of quality of family planning services on the use of IUD and other contraceptive methods were estimated using multinomial logistic regression. Results are presented as relative risk ratios (RRR with significance levels (p-values. Results IUD use among women who obtained their method from public sources was significantly positively associated with quality of family planning services (RRR = 1.36, p Conclusion This study is one among the few that used geographic information to link data from a population-based survey with an independently sampled health facility survey. The findings demonstrate that service quality is an important determinant of use of clinical contraceptive methods in Egypt
Roelands, Marc; Van Oost, Paulette; Depoorter, AnneMarie
This study aims to investigate whether selected social and psychological characteristics of family caregivers of persons with dementia are related to community-based service use in Belgium. Two aspects were distinguished in service utilisation: volume (number of contacts) and diversity (number of services). Within a selected region, dementia caregivers were traced via the detection of persons with dementia known to community health or social services. A probability diagnosis was made with the Geriatric Mental State and the computer algorithm AGECAT. Family caregivers of persons with dementia (N = 168) were interviewed at home by means of a structured questionnaire. Data were analysed with multiple regression analysis. Co-residence, a positive attitude towards home service use, and increased problem-solving coping were found to be direct predictors of increased diversity of services used, whereas a lower burden of behaviour problems, living apart, and increased avoidance coping were found to be direct predictors of increased volume of service use. Care recipients' behaviour problems and functional status were not found to be related to service use. The results suggest that social and psychological factors have a larger impact on service use in family caregivers of persons with dementia, compared to objective or subjective burden. Interventions to increase awareness of relevant services, to improve attitudes towards their use and support problem-solving coping in family caregivers may be considered to increase the use of appropriate services.
BACKGROUND: The important role of families and other caregivers in the lives of adults with schizophrenia is well documented. Persons with schizophrenia frequently live with their families of origin, and the vast majority have regular family contact. Families of persons with schizophrenia have also been demonstrated to have significant needs. Families most frequently cite the need for education and support in helping them to cope with their family member's illness. Further, numerous studies have documented the benefits of interventions designed to meet the needs of family members. AIMS OF THE STUDY: This paper identifies critical issues and challenges in the provision of services to families of persons with schizophrenia and other serious and persistent mental illnesses. METHODS: This study draws from both a literature review and a summary of pertinent data from the Schizophrenia Patient Outcomes Research Team (PORT). RESULTS: Recent best practices standards and treatment recommendations specify that families should be given education and support. One of the PORT treatment recommendations states that "Patients who have on-going contact with their families should be offered a family psychosocial intervention which spans at least nine months and which provides combinations of: Education about the illness; Family support; Crisis intervention; and, Problem solving skills training". The PORT treatment recommendations are based on well designed and rigorous research on family psychoeducation programs that demonstrate reduced relapse rates and improved patient and family well-being for persons whose families receive psychoeducation. While family psychoeducation programs have been the subject of extensive treatment trials, family members and family organizations have endorsed a variety of other models of services such as family education and consultation models. These models have not been as rigorously researched as family psychoeducation. Control groups are generally
Kim, Jun-Hyun; Gu, Donghwan; Sohn, Wonmin; Kil, Sung-Ho; Kim, Hwanyong; Lee, Dong-Kun
Rapid urbanization has accelerated land use and land cover changes, and generated the urban heat island effect (UHI). Previous studies have reported positive effects of neighborhood landscapes on mitigating urban surface temperatures. However, the influence of neighborhood landscape spatial patterns on enhancing cooling effects has not yet been fully investigated. The main objective of this study was to assess the relationships between neighborhood landscape spatial patterns and land surface temperatures (LST) by using multi-regression models considering spatial autocorrelation issues. To measure the influence of neighborhood landscape spatial patterns on LST, this study analyzed neighborhood environments of 15,862 single-family houses in Austin, Texas, USA. Using aerial photos, geographic information systems (GIS), and remote sensing, FRAGSTATS was employed to calculate values of several landscape indices used to measure neighborhood landscape spatial patterns. After controlling for the spatial autocorrelation effect, results showed that larger and better-connected landscape spatial patterns were positively correlated with lower LST values in neighborhoods, while more fragmented and isolated neighborhood landscape patterns were negatively related to the reduction of LST. PMID:27598186
Full Text Available Rapid urbanization has accelerated land use and land cover changes, and generated the urban heat island effect (UHI. Previous studies have reported positive effects of neighborhood landscapes on mitigating urban surface temperatures. However, the influence of neighborhood landscape spatial patterns on enhancing cooling effects has not yet been fully investigated. The main objective of this study was to assess the relationships between neighborhood landscape spatial patterns and land surface temperatures (LST by using multi-regression models considering spatial autocorrelation issues. To measure the influence of neighborhood landscape spatial patterns on LST, this study analyzed neighborhood environments of 15,862 single-family houses in Austin, Texas, USA. Using aerial photos, geographic information systems (GIS, and remote sensing, FRAGSTATS was employed to calculate values of several landscape indices used to measure neighborhood landscape spatial patterns. After controlling for the spatial autocorrelation effect, results showed that larger and better-connected landscape spatial patterns were positively correlated with lower LST values in neighborhoods, while more fragmented and isolated neighborhood landscape patterns were negatively related to the reduction of LST.
Kim, Jun-Hyun; Gu, Donghwan; Sohn, Wonmin; Kil, Sung-Ho; Kim, Hwanyong; Lee, Dong-Kun
Rapid urbanization has accelerated land use and land cover changes, and generated the urban heat island effect (UHI). Previous studies have reported positive effects of neighborhood landscapes on mitigating urban surface temperatures. However, the influence of neighborhood landscape spatial patterns on enhancing cooling effects has not yet been fully investigated. The main objective of this study was to assess the relationships between neighborhood landscape spatial patterns and land surface temperatures (LST) by using multi-regression models considering spatial autocorrelation issues. To measure the influence of neighborhood landscape spatial patterns on LST, this study analyzed neighborhood environments of 15,862 single-family houses in Austin, Texas, USA. Using aerial photos, geographic information systems (GIS), and remote sensing, FRAGSTATS was employed to calculate values of several landscape indices used to measure neighborhood landscape spatial patterns. After controlling for the spatial autocorrelation effect, results showed that larger and better-connected landscape spatial patterns were positively correlated with lower LST values in neighborhoods, while more fragmented and isolated neighborhood landscape patterns were negatively related to the reduction of LST.
... 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 ...
Jones, Sean; Bremer, Emily; Lloyd, Meghann
Families of children with autism spectrum disorder (ASD) often experience high levels of stress; it is important to investigate the family quality of life (FQOL) to understand how to serve the entire family, not just the child. The purpose of this investigation was to determine: (a) how families with a child with ASD view their overall FQOL and (b) what aspects of everyday life have the greatest influence on the FQOL? A survey designed to asses FQOL was mailed to all families (n = 454) of children with ASD (0-18 years) waiting for government-funded services. Results from 151 surveys were examined (31 % response rate). Descriptive on all variables, ordinal logistic regression, and t tests were used to analyze the data. The most influential factors on FQOL were whether the child with ASD had a major health concern, whether the family's needs were met by disability-related services, and whether there were opportunities to engage in leisure and recreation activities. Families on waitlists experience challenges in FQOL influenced by the health of the family members; this is implicitly important for service agencies and providers. Future research should continue to explore how access to disability-related services impacts FQOL; and how these associations may be moderated by contextual factors such as socioeconomic status, health of child and family members, access and engagement in recreation, and severity of the child's needs.
Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N
When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Bradley, H; Bedada, A; Tsui, A; Brahmbhatt, H; Gillespie, D; Kidanu, A
Integrating voluntary HIV counselling and testing (VCT) with family planning and other reproductive health services may be one effective strategy for expanding VCT service delivery in resource poor settings. Using 30,257 VCT client records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between HIV and family planning service integration modality and three outcomes: VCT client composition, client-initiated HIV testing and client HIV status. Associations between facility HIV and family planning integration level and the likelihood of VCT clients being atypical family planning client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating services in the same compound, those offering family planning and HIV services in the same rooms were 2-13 times more likely to serve atypical family planning client-types than older, ever-married women. Facilities where counsellors jointly offered HIV and family planning services and served many repeat family planning clients were significantly less likely to serve single clients relative to older, married women. Younger, single men and older, married women were most likely to self-initiate HIV testing (78.2 and 80.6% respectively), while the highest HIV prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located services, those integrating services at room- and counsellor-levels were 1.9-7.2 times more likely to serve clients initiating HIV testing. These health facilities attract both standard material and child health (MCH) clients, who are at high risk for HIV in these data, and young, single people to VCT. This analysis suggests that client types may be differentially attracted to these facilities depending on service integration modality and other facility
Jonson-Reid, Melissa; Drake, Brett; Zhou, Pan
Recent child maltreatment research has highlighted the very different context of poverty for Black and White children. Neglect is the most common form of maltreatment and strongly associated with poverty. Neglect is, however, not a unitary construct. We lack an understanding of whether reporting of and responding to different types of neglect may vary by poverty, race, or the intersection of the two. Administrative census, child welfare, welfare, health, and education data were used to examine how family and community poverty factors associate with various subtypes of neglect and subsequent case dispositions for Black and White children. Black children reported to child welfare reside in far poorer communities than Whites, even after taking into account family income (Aid to Families with Dependent Children [AFDC]/Temporary Aid to Needy Families [TANF]). Black children were more commonly reported and substantiated for severe and basic needs neglect. Community poverty indicators had a different relationship to report disposition for Black as compared to White children after controlling for neglect subtypes, child and family characteristics. Implications for practice and policy are discussed. PMID:23109353
Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.
Bendixen, Bente E; Kirkevold, Marit; Graue, Marit; Haltbakk, Johannes
To describe family members' experiences of attending to an old person with diabetes receiving home care services, including their interaction with the formal caregivers. The study has a qualitative descriptive design. From May to August 2015, eight family members were interviewed. Interviews were analysed using qualitative content analysis. To describe family members' experiences, the following four themes were identified: Security through patients' self-management skills and diabetes knowledge; Perceived burden due to the old persons' deteriorated health; Security through competent home care services; and Doubt due to personnel's inadequate approach and interaction. It is important for personnel in home care services to consider patients' self-management skills and the family members' diabetes knowledge as key aspects in order to limit experiences of burden when the older person with diabetes has deteriorating health. The findings underscore that interaction with home care personnel skilled in managing diabetes helps family members feel secure. © 2017 Nordic College of Caring Science.
Mandak, Kelsey; Light, Janice
Although family-centered services have long been discussed as essential in providing successful services to families of children with autism spectrum disorder (ASD), ideal implementation is often lacking. This study aimed to increase understanding of how families with children with ASD and limited speech receive services from speech-language…
Loeste de Arruda-Barbosa
Full Text Available Objective: To assess the evaluation of the users regarding the family health services and identify the main reasons that led them to seek such services. Methods: A descriptive study with qualitative approach, carried out in 5 Family Health Units with 25 users of theFamily Health Strategy (FHS of the city of Crato-CE, Brazil. The study took place from March to April 2009. Semi-structured interview was applied and recorded. We used thetechnique of thematic content analysis. Results: We found that the users of the FHS have great dissatisfaction, especially on the organization and access to health services, evaluating the family health as inefficient, although bringing care closer to the population, primarily through home visits. It was clear also that there is a search to the service mainly supported by curative vision and the acquisition of medicines. Conclusions: The subjects evaluate the organization and access to healthcare services as unsatisfactory, but value the actions, when there is a bond with the health team. However, there is still demand for health services, based on the search for medicines and medical consultation. Thus, it is necessary to improve services of the Family Health Strategy in Crato, with a view to ensure quality, accessibilityand greater resolution of health services.
Hodgetts, Sandra; Zwaigenbaum, Lonnie; Nicholas, David
Increasing demand for autism services is straining service systems. Tailoring services to best meet families' needs could improve their quality of life and decrease burden on the system. We explored overall, best, and worst met service needs, and predictors of those needs, for families of children with autism spectrum disorders. Parents of 143 children with autism spectrum disorders (2-18 years) completed a survey including demographic and descriptive information, the Family Needs Survey-Revised, and an open-ended question about service needs. Descriptive statistics characterize the sample and determine the degree to which items were identified and met as needs. Predictors of total and unmet needs were modeled with regression or generalized linear model. Qualitative responses were thematically analyzed. The most frequently identified overall and unmet service needs were information on services, family support, and respite care. The funding and quality of professional support available were viewed positively. Decreased child's age and income and being an older mother predicted more total needs. Having an older child or mother, lower income, and disruptive behaviors predicted more total unmet needs, yet only disruptive behaviors predicted proportional unmet need. Child's language or intellectual abilities did not predict needs. Findings can help professionals, funders, and policy-makers tailor services to best meet families' needs. © The Author(s) 2014.
Appleby, Lawrence; Desai, Prakash
In an exploration of residential instability and recidivism in chronic mental patients, 215 psychiatric admissions were followed for a year after the initial episode. In addition to an unusually high incidence of residential mobility, a relationship between mobility and number of hospitalizations was evident, as were isolation, disruptive family situations, and homelessness. The needed response of the mental health system is discussed.
Stancliffe, Roger J.; Lakin, K. Charlie; Larson, Sheryl A.; Engler, Joshua; Taub, Sarah; Fortune, Jon; Bershadsky, Julie
This study describes service users with Down syndrome (N = 1,199) and a comparative sample with intellectual and developmental disabilities but not Down syndrome (N = 11,182), drawn from National Core Indicator surveys of adult service users in 25 U.S. states. Individuals with Down syndrome were younger than were individuals without Down syndrome.…
It is the view of the Planned Parenthood Federation of America that the new Title 20 regulations of the Social Security Act could have an adverse effect on the progress that has been made in family planning services. Under the proposed regulations family planning services would exclude abortion. The regulations fail to specify that sexually active minors should be served on their own initiative and consent; that outreach, transportation, and child care should be cited as allowable family planning expenses; that a choice of method and of source of service should be provided; and that medical standards should be maintained. Planned Parenthood believes that the proposed regulations do not expand the availability of family planning services for low-income persons, which was the congressional intent.
Esposito, Tonino; Delaye, Ashleigh; Chabot, Martin; Trocmé, Nico; Rothwell, David; Hélie, Sonia; Robichaud, Marie-Joelle
Socio-environmental factors such as poverty, psychosocial services, and social services spending all could influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts the reunification for children placed in out-of-home care. This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec's child protection agencies; (2) 2006 and 2011 Canadian Census data; and, (3) intra-province health and social services data. The final data set included all children ( N = 39,882) placed in out-of-home care for the first time between 1 April 2002 and 31 March 2013, and followed from their initial out-of-home placement. Multilevel hazard results indicate that socioeconomic vulnerability, controlling for psychosocial services and social services spending, contributes to the decreased likelihood of reunification. Specifically, socioeconomic vulnerability, psychosocial services, and social services spending account for 24.0% of the variation in jurisdictional reunification for younger children less than 5 years of age, 12.5% for children age 5 to 11 years and 21.4% for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socioeconomic vulnerabilities of reunifying families.
Sep 15, 2017 ... This study aimed to assess the degree of clients' satisfaction with family planning (FP) ... But, as the quality is multidimensional, other aspects especially significant funding investment and quality-assurance interventions must be taken into .... all, elementary or college education level. Perception of FP ...
Dembo, Richard; Schmeidler, James
This book provides a detailed review of a National Institute on Drug Abuse-funded, long-term clinical trial of the Family Empowerment Intervention (FEI). FEI is a systems-oriented, low-cost intervention delivered in the home by trained nontherapists for high-risk youths who have been arrested and their families. The subjects were a group of over…
Popp, Tierney K.; You, Hyun-Kyung
The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…
Degeneffe, Charles Edmund; Green, Richard; Jones, Clair
Purpose: The study aimed to understand how use and satisfaction with services following discharge from an acquired brain injury (ABI) acute-care facility related to family caregiver outcomes. Methods: A correlational and descriptive study design was used. Nineteen primary family caregivers of persons recently discharged from an ABI acute-care…
Cavallini, Adriane Q.; Erekson, David M.; Steinberg, Rachel M.; Clayson, Rachelle A.; Albright, Dallin D.
Family history events have been shown to be reliable predictors of eating and body image concerns; however, little is known regarding how family history events compare in a clinical sample, or if these events differ by gender. The current study addresses this paucity, focusing on 3,129 university students seeking clinical services. Having a family…
Huang, Gary G.; Van Horn, Patricia
Analysis of data from the 1991 National Household Education Survey examined usage of various child care services by families with disabled children in rural and urban areas. Type of child care used was related to locale, parent educational attainment, poverty status, child age, maternal employment, and one-parent family structure. Contains 36…
Ayala-Nunes, Lara; Jiménez, Lucía; Hidalgo, Victoria; Dekovic, Maja; Jesus, Saul
Objective: The measurement of Family Feedback on Child Welfare Services (FF-CWS) is gaining prominence as an efficacy indicator and is coherent with concerns about family-centered practice and empowerment. The aim of this study was to develop and validate an instrument that would overcome the scarcity of psychometrically sound measures in this…
Bhopti, Anoo; Brown, Ted; Lentin, Primrose
A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…
Urbanowicz, Anna; Downs, Jenny; Bebbington, Ami; Jacoby, Peter; Girdler, Sonya; Leonard, Helen
This study assessed factors that could influence equipment and respite services use among Australian families caring for a girl/woman with Rett syndrome and examined relationships between use of these resources and the health of female caregivers. Data was sourced from questionnaires completed by families (n=170) contributing to the Australian…
Defense Lodging System Epitome Epitome, Defense Lodging System Financial/reporting Business Warehouse Food and beverage , clubs and dining facilities...has not been any impetus from the military services to collaborate, and it has been challenging to ensure top managerial support. In order to...Sustaining Service Members and Their Families • improve the effectiveness, efficiency, and economy in the delivery of programs within the purview of
Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R
To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.
...) and characteristics (e.g., self-esteem, relationship skills) can moderate the impacts of past and... to States for Domestic Violence Shelters and Support Services AGENCY: Family and Youth Services... Act (FVPSA) to States (including territories and insular areas). The purpose of these grants is to: (1...
... relatives, involvement in after-school activities) and characteristics (e.g., self-esteem, relationship... Prevention and Services/Grants to State Domestic Violence Coalitions AGENCY: Family and Youth Services Bureau... and coordinate with States, tribes, localities, cities, and the private sector to be involved in State...
Staff, Ilene; Fein, Edith
Describes a three-month study of a family reunification program for abused and neglected children that explored the process and outcomes of service delivery. The coding scheme measured both the time used in and purposes of activities of the service workers. Discusses the implications of this method for practice, planning, and research. (TM)
Wansink, H.J.; Janssens, J.M.A.M.; Hoencamp, E.; Middelkoop, B.J.C.; Hosman, C.M.H.
Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as
... that employed exit interviews with clients, service - provider interviews, observations of client- provider interactions and an assessment of the availability of the necessary resources was conducted in one hospital, two health centers, two health stations, and one non-governmental clinic operating in north west Ethiopia.
Frensch, Karen; Cameron, Gary; Preyde, Michele
Caregivers of 210 youth receiving residential treatment (RT) or intensive family services (IFS) in Ontario were interviewed about the long term community adaptation of youth after leaving these programs. School attendance and academic functioning data at admission, discharge, and 12-18 months post-discharge were analyzed to explore predictors of…
Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M
Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/str...
Muganyizi, Projestine S; Ishengoma, Joyce; Kanama, Joseph; Kikumbih, Nassoro; Mwanga, Feddy; Killian, Richard; McGinn, Erin
Background Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study s...
Meadows, Carl; Camus, Susann; Fraser, Julie
This article describes how one provincial health region adopted a client- and family-centred approach to improve access to community health services. Transition best practices and the "Triple Aim" supplied a framework for the transformation of transition of clients needing home healthcare services (Berwick et al. 2008). The need to improve the patient and family experience, establish and streamline professional practice standards, strengthen interprofessional collaborations, increase efficiency, create a critical mass of experts in the clinical domain of care transitions and program access, and evaluate customer experience were the organizational drivers for this transformation. The new framework identifies clients' needs and assigns a priority code. It also identifies which family member provides what support to the client and offers a one-stop service number staffed by individuals trained to provide client- and family-centred homecare services. This transformation of home healthcare transitions has improved the client and family experience, strengthened service provider satisfaction and generated efficiencies in prioritizing and delivering community healthcare services. Copyright © 2015 Longwoods Publishing.
Hopkins, Kristine; Aiken, Abigail R. A.; Stevenson, Amanda; Hubert, Celia; Grossman, Daniel; Potter, Joseph E.
We examined the impact of legislation in Texas that dramatically cut and restricted participation in the state’s family planning program in 2011 using surveys and interviews with leaders at organizations that received family planning funding. Overall, 25% of family planning clinics in Texas closed. In 2011, 71% of organizations widely offered long-acting reversible contraception; in 2012–2013, only 46% did so. Organizations served 54% fewer clients than they had in the previous period. Specialized family planning providers, which were the targets of the legislation, experienced the largest reductions in services, but other agencies were also adversely affected. The Texas experience provides valuable insight into the potential effects that legislation proposed in other states may have on low-income women’s access to family planning services. PMID:25790404
Vanhoutteghem, Lies; Tommerup, Henrik M.; Svendsen, Svend
existing single-family houses in the Nordic countries are to have competitive power compared to new buildings on the future housing market. Good technical solutions exist but need to be combined based on the full range of (standard) solutions in order to reach the low primary energy level of new...... the solutions. Such one-stop-shops in the form of full-service providers of energy efficient renovation of single-family house are missing in the Nordic countries, although this service is vital to open up the market. As part of the Nordic research project `SuccesFamilies´ with the purpose to change...... the business environment in order to speed up the implementation of sustainable renovation of single-family houses –a sustainable renovation concept suitable for different categories of single-family houses with regard to type and age has been proposed in this article. The sustainable renovation concept...
Biswas, Kamal K; Pearson, Erin; Shahidullah, S M; Sultana, Sharmin; Chowdhury, Rezwana; Andersen, Kathryn L
In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual
Porta, C. Rees; Anderson, Michael R.; Steele, Scott R.
Over 1,500 years ago, the St. Benedictine Monks used planning and strict schedules to increase their productivity. Since then, surgeons have developed several different strategies to manage our time effectively. Finding a balance among career, family, and hobbies is essential for maintaining satisfaction and optimizing productivity. Several recurring themes throughout the medical literature offer potential solutions to help maximize the little time surgeons possess. In this article, we will explore some of the methods and strategies available to help surgeons minimize waste and make the most of the most precious commodity we have—our time. PMID:24436684
Hamann, Darla J
This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.
Gibson, Allison K; Anderson, Keith A; Acocks, Sara
Although often cast as a disease of later life, a growing number of people are being diagnosed with Alzheimer's disease in their 50s and 60s. Early-onset Alzheimer's disease (EOAD) poses special challenges and needs for individuals and their caregivers, such as employment and access to services. In this cross-sectional study, the researchers surveyed 81 (N = 81) family caregivers to individuals with EOAD to identify service and support usage and need. Descriptive analyses revealed that families utilized a range of formal services (eg, adult day) and informal support from family and friends. In terms of challenges and needs, participants indicated that they struggled most with employment, benefits, and financial issues. Although most caregivers felt that they were coping well, they also indicated that their needs were not well understood by service providers and the public. These findings highlight the need to better understand and respond to the specific issues surrounding EOAD. © The Author(s) 2014.
The author describes the Del Paso Model, a neighborhood-based integrated services effort underway in Sacramento County, California. Del Paso Heights is a community made up of African American, Asian, and white families on the northern side of the City of Sacramento. The County of Sacramento selected Del Paso Heights as a location to pilot a new family-centered holistic way to serve families under county human services programs in a Neighborhood Services Agency. The Del Paso Heights model demonstrates the power of the neighborhood as a focal point of integration of services and how the neighborhood can be used as a concept to overcome bureaucratic turf. Like many other community initiatives, measuring the outcomes of the Del Paso Heights Model remains an elusive goal.
This mixed research methods study explores whether project-based service-learning projects promote greater learning than standard project-based projects and whether introduced earlier into the curriculum promotes a greater student understanding of the world issues affecting their community. The present study focused on comparing sophomore and…
Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.
Thompson, Ronald W.; Duppong Hurley, Kristin; Trout, Alexandra L.; Huefner, Jonathan C.; Daly, Daniel L.
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…
Sufrin, Carolyn; Baird, Sara; Clarke, Jennifer; Feldman, Elizabeth
Purpose Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues. Design/methodology/approach The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement. Findings Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment. Practical implications Family planning services for incarcerated women benefits individuals, facilities, and the community. Social implications Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women - including reproductive life goals counseling and contraceptive method provision - promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services. Originality/value This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of
Wang, Jing; Xiao, Lily Dongxia; He, Guo-Ping; De Bellis, Anita
To examine socially, culturally and politically constructed factors affecting family caregiver practice in dementia care, and to identify possible changes in a country with undeveloped dementia services. In China and many other low- and middle-income countries, social transformations are weakening the family care model, which has an impact on the population with dementia. Exploring the challenges that caregivers face may help the international healthcare community to improve dementia services. A double hermeneutic approach informed by Giddens' Structuration Theory was used. In-depth semi-structured interviews with 23 family caregivers of people with dementia were conducted in 2012. The interviews were audiotaped, transcribed and analysed. Analyses revealed three consequences of socially constructed factors in dementia care, which constrained caregiver practice. First, caregivers were unable to manage behavioural and psychological symptoms of dementia. Untreated aggressive behaviours caused harm to the person with dementia and endangered the caregiver and the public. Second, the burden on the primary caregiver was evident and caregivers received limited support. Third, there was little coordination between primary and specialist care services for people with dementia. On critical reflection of potential changes that could improve dementia services, caregivers suggested that community nurses have a leading role in coordinating dementia services and supporting caregivers. Relying on family caregivers to care for people with dementia without the prevision of dementia services by the public healthcare system generates negative health outcomes for both care recipients and caregivers. The nursing workforce should be developed to support dementia services. © 2013 John Wiley & Sons Ltd.
Full Text Available The family’s role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.
Phoenix, Michelle; Rosenbaum, Peter
Several concepts - risk, resilience, disability and hard-to-reach families in early intervention services - are talked and written about in many ways. Family Stress Theory can be usefully applied to explore these issues systematically. The relationship between risk and disability is complex, and the role of resilience is not fully understood. The idea of "hard-to-reach families" is not well defined, thus presenting challenges to service providers and policy makers. Reflection: This paper presents the Model of Risk, Disability and Hard-to-Reach Families and uses the model to: (1) define the groups of high risk families and families of children with disabilities and explore the concept of resilience within these groups; (2) describe services offered to these groups; and (3) reflect on service use and so-called "hard-to-reach families". Each section includes suggested applications for service providers that may inform the work done with young children and their families who experience risk or disability. Service providers can apply the Model of Risk, Disability and Hard-to-Reach Families to consider each family's unique strengths and challenges, and use those individual elements to influence service recommendations and anticipate service use. Implications for rehabilitation The concepts of risk, resilience, and hard-to-reach families are poorly defined in the literatures, but have important implications with respect to early childhood intervention services. Family Stress Theory can help to identify high-risk families and account for family resilience It is important for clinicians, researchers and policy makers to consider the relationship between disability and risk with respect to services offered to families and the potential barriers to service use. Clinicians and policy makers have a role in promoting accessible early childhood services.
Pavlov, Georgi Krasimiroy; Olesen, Bjarne W.
In the future there will be an increased demand for energy efficient cooling of residential buildings. Therefore it is essential to develop cooling concepts that are passive and/or using very little primary energy. A possible solution is a ground source heat pump combined with a low-temperature h......In the future there will be an increased demand for energy efficient cooling of residential buildings. Therefore it is essential to develop cooling concepts that are passive and/or using very little primary energy. A possible solution is a ground source heat pump combined with a low......-temperature heating and high-temperature cooling system. The present work evaluates the performance in relation to thermal comfort and energy consumption of a GSHP with different GHE concepts. The different configurations are analyzed being part of the energy supply system of a low-energy residential house...
Tischler, Victoria; Karim, Khalid; Rustall, Sue; Gregory, Peter; Vostanis, Panos
The objective of the present study was to establish the psychosocial characteristics and perspectives of 49 consecutive homeless families who received input from a new designated family support worker (FSW) post at a large statutory hostel for homeless parents and children. The FSW provided: assessment of social, educational and health needs; support and parent training; and liaison with and referral to specialist services. Measures included quantitative questionnaires (i.e. the Hospital Anxiety and Depression Scale, the Parenting Daily Hassles Scale, the Eyberg Child Behaviour Inventory, and the Health of the Nation Outcome Scales for Children and Adolescents), and a qualitative (semistructured) interview on service experiences and satisfaction. The psychosocial measures indicated high rates of parenting difficulties, mental health and related needs among children and their parents. Parenting difficulties were associated with child behaviour problems. Parents expressed satisfaction with the service whilst they were residents at the hostel, but they were often not clear about the objectives of agencies and interventions. Family support interventions have a key role in service provision for homeless and other vulnerable families by providing direct parenting interventions and ensuring that specialist agencies are appropriately involved. Family support worker involvement needs to continue when families are re-housed in the community.
Full Text Available In Sweden, municipal social services provide help and support for vulnerable people with a variety of needs. Although the family has long been understood to be a focus of social work interventions, it is unclear how it is brought into the casework process in the highly individualised and specialised municipal social services. Therefore, in this study we investigated processes of client-making and role assignment in five service sectors: social assistance, child welfare, substance abuse, disability, and elderly care. We carried out focus group interviews with social workers in each of these sectors in a mid-sized community in central Sweden. Findings showed that clienthood and the family are interpreted in different ways. The family is brought into or kept out of service provisions in ways that are connected to social workers’ construction of the family either as expert, client or non-client. However, the role of the family may also change during the casework process. Findings are examined in relation to theories of the welfare state and implications for family-focused practice are discussed.
Fordham, L; Gibson, F; Bowes, J
Much has been written on the principles of family-centred practice and on the service delivery methods and skills required of its practitioners. Far less has been written from the perspective of families whose children have a disability. The aims of this study were twofold: firstly to understand families' experiences of family-centred early childhood intervention services and secondly to explore other factors that might impact on these experiences. One hundred and thirty families attending two established early childhood intervention services in New South Wales, Australia completed a survey incorporating the Measure of Processes of Care-56, the Family Empowerment Scale, the Family Support Scale and the Parenting Daily Hassles Scale. Consistent with previous research using the Measure of Processes of Care-56, 'respectful and supportive care' was the domain of care families rated to occur most and 'provision of general information' was the domain they rated to occur least. Significant positive relationships existed between families' ratings of family-centred care and feelings of empowerment. Being provided with general information was strongly correlated with family empowerment. Families' social support networks played an important role but support from professionals was most strongly correlated with families' experiences of family-centred care. Finally, families whose children's early intervention services were co-ordinated by a professional experienced significantly better care. The provision of general information and professional support are key components of family-centred early childhood intervention services. © 2011 Blackwell Publishing Ltd.
Terwiel, M; Alsem, M W; Siebes, R C; Bieleman, K; Verhoef, M; Ketelaar, M
A family-centred approach to services of children with disabilities is widely accepted as the foundational approach to service delivery in paediatric health care. The 56 items of the Measure of Processes of Care questionnaire (MPOC-56) all reflect elements of family-centred service. In this study, we investigated which elements of family-centred service are rated important by parents of children with cerebral palsy by adding a question on importance to each item of the MPOC-56 (MPOC-56-I). In total, 175 parents of children with cerebral palsy completed the MPOC-56-I. For each MPOC item, parents were asked to rate the importance on a 5-point scale ranging from 0 (not important at all) up to and including 4 (very important). We used Spearman's rank correlation coefficient to further explore the variation in parents' importance ratings. Parents' importance ratings of the MPOC-56 items varied. The percentage of parents rating an item important (importance rating 3 or 4) varied between 43.8% and 96.8%. The percentage of parents rating an item unimportant (rating 0 or 1) varied between 0.0% and 20.3%, and the percentage of parents rating an item neutral (rating 2) varied between 3.0% and 36.0%. Most diverse importance ratings were found for five items concerning the provision of general information. Three correlations between these items and child and parent characteristics were found. Six items were rated important by almost all (≥95%) parents. These items concern elements of specific information about the child, co-ordinated and comprehensive care for child and family and enabling and partnership. Parents rate the importance of family-centred services for their situation in various ways. These findings endorse that family-centred services should recognize the uniqueness of families and should be tailored to what parents find important. © 2017 John Wiley & Sons Ltd.
Efron, D; Sewell, J R; Horn, M; Jewell, F
To determine the prevalence of health and behaviour problems in a sample of children in homeless families and of psychological problems in their parents, and to assess the use of health services by homeless families. A cross-sectional, questionnaire-based prevalence survey. Supported accommodation provided by a welfare service in Melbourne between May 1994 and June 1995. 51 children from 31 families soon after housing crises. More than one-third of all children had total behaviour problems scores in the "deviant" range (i.e., requiring mental health referral). Intellectual disability/developmental delay, skin problems, vision problems, recurrent headache, and asthma or other breathing problems were more prevalent in these homeless children than in a large Australian normative population. Their mothers scored higher than a large normative sample on the mental health questionnaire, most markedly for "anxiety-insomnia", "severe depression" and total score. Cost of treatment and transport difficulties were seen as barriers to using health care services. Australian health-care practitioners should be aware of the health and health service access problems of children in homeless families, and work to minimise their physical, emotional, developmental and academic disadvantages. Psychological support services should be available for homeless families, particularly for mothers.
Yang, Xueyan; Li, Shuzhuo; Feldman, Marcus W
The objectives of this study are to develop a scale of gender role ideology appropriate for assessing Quality of Care in family planning services for rural China. Literature review, focus-group discussions and in-depth interviews with service providers and clients from two counties in eastern and western China, as well as experts' assessments, were used to develop a scale for family planning services. Psychometric methodologies were applied to samples of 601 service clients and 541 service providers from a survey in a district in central China to validate its internal consistency, reliability, and construct validity with realistic and strategic dimensions. This scale is found to be reliable and valid, and has prospects for application both academically and practically in the field.
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.
Michael, Jennifer, Ed.
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);…
Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho
Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.
Melton, Gary B
Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Jozefiak, Thomas; Sønnichsen Kayed, Nanna
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.
West, Lucy; Isotta-Day, Harriet; Ba-Break, Maryam; Morgan, Rosemary
The Syrian conflict presents the fastest growing refugee crisis in the world today, with over four million people now displaced outside the country. Existing literature suggests that family planning services are often still neglected in crisis response efforts. A small-scale qualitative study conducted in May 2013, interviewing Syrian women residing in a Jordanian refugee camp about use and barriers to accessing family planning services. The study shows that significant barriers remain, and suggests that international attempts to address refugees' family planning needs remain inconsistent. Several practical measures are identified to address barriers to access, making the article of both practical and academic relevance. 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/
Family outcomes are important to the provision of services because families are increasingly considered as the primarily support unit for children with developmental disabilities. With emphasis on positivity and multidimensionality of the life of families who have children with disabilities, this study aimed to expand the applicability of the…
Pavlov, Georgi Krasimiroy; Olesen, Bjarne W.
In the future there will be an increased demand for energy efficient cooling of residential buildings. Therefore it is essential to develop cooling concepts that are passive and/or using very little primary energy. A possible solution is a ground source heat pump combined with a low-temperature h...
Full Text Available Background: The way that health care systems in developing countries like India care for dying patients, has an impact on the expectations of such care for those who migrate to other countries faces. At the end of life, cultural issues may impact on the quality of life remaining and for that reason, it is important that particular cultural practices are understood. This paper describes a study that investigated the cultural issues of access to palliative care services for Indian migrants in Australia. Purpose of the Study: To investigate the experiences of the family members of terminally ill Indian migrants in Victoria, Australia. Objective of the Study: To explore the issues related to accessing palliative care services for Indian migrants; to identify the effectiveness of palliative care in supporting the patient and family and to recommend strategies for improving this care. Materials and Methods: A qualitative descriptive design was utilized. Up to 6 family members were selected for in-depth interviews in understanding cultural issues related to the palliative care services for a family member. Results: Analysis of the interviews revealed that families of Indian patients experience difficulties whilst receiving palliative care services, which fell into three main categories: Indian support systems, cultural issues, and caring experiences. Although each of these issues had a direct influence on the experience of terminal care that their family member received, cultural issues and support systems also influenced the caring experiences. Conclusion: Despite the successful implementation of palliative care services across Australia, there are still problems in accessing and receiving the services among minority and disadvantaged groups like various cultural groups.
Martinussen, Monica; Kaiser, Sabine; Adolfsen, Frode; Patras, Joshua; Richardsen, Astrid M
This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T 1 ) and after (T 2 , T 3 ) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T 1 to T 2 . No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T 3 ) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.
Full Text Available Teachers’ beliefs about family-school relationship vary in a continuum according to the role that parents and teachers have, and the power that they hold. Pre-service teachers also have beliefs about this relationship and their own competence to develop it. Two groups of pre-service teachers (second year students participated in this study. One group received specific training on family-school relationship and its improvement (116 students attending a degree in Early Childhood Education, who constituted the experimental group, EG. The other group was not trained (92 students attending a degree in Primary Education, who made up the control group, CG. The Beliefs about family-school Questionnaire (CCR was developed and applied before and after the EG was trained. Results show that students in the EG increased their beliefs about family-school collaboration in the post-test and decreased their beliefs about parental subordination to teachers’ authority and parents’ carelessness. Students in the CG kept their beliefs unchanged, which were significantly more prone to support teachers’ authority and parental subordination and parents’ carelessness compared to the EG.. Perceived competence for family-school relationship did not change significantly in either group. However, significant correlations between beliefs and perceived competence were found, pointing out the importance of working pre-service teachers’ beliefs about family-school collaboration.
Christiaens, Wendy; Bracke, Piet
Combination pressure or work-life imbalance is linked to adverse health. However, it remains unclear how work-family conflict is related to healthcare utilisation. Does work-family conflict function as a barrier or as a facilitator in relation to the use of health services and prescription medication? Lack of time may prevent people from visiting a doctor when they feel unwell. However, combination pressure can also be expected to intensify the use of health services, as the need for a quick fix is prioritised. Further, do women and men differ in their susceptibility to medicalisation and time pressure resulting from work-life imbalance? This article investigates the use of health services and prescription medication of dual-income couples with children, based on data from 23 countries in the European Social Survey round 2 (N(women) = 3755; N(men) = 3142). It was found that medical services and prescription medications are used more frequently in dual-income couples experiencing work-to-family spillover, but for women only this is irrespective of their self-reported health. Family-to-work spillover does not result in increased health service or medication use for either men or women. While women opt for a medical response to work-life imbalance, men's reluctance to seek formal health support is confirmed. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.
Full Text Available Despite that there is an operating social support system for families, social workers are affected by factors that limit effectiveness of their activities in working with families whose children are taken into temporary custody. The article aims to uncover what hinders social worker to carry out effective work in providing social services for families whose children are in temporary custody. Qualitative research data shows that the research participants’ awareness of social work effectiveness is limited to its individual components. Putting together these components one can get a broad definition of effectivenessof social work though the research participants themselves donot use such a concept. The research data reveals that micro level factors influencing effectiveness of social workers’ activities working with families whose children are in temporary custody are as follows: absence of parental motivation to seek changes and unfavourable environment as well as negative community approach to social risk families. Macro level factors limiting social work effectiveness working with the families at social risk lie in the system of social services. Inadequate management of social work, limited social workers’ access to resources necessary to restore family functions; too high workload for social workers are essential factors limiting social work effectiveness.
Tafese, Fikru; Woldie, Mirkuzie; Megerssa, Berhane
Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted to assess the quality of family planning services in primary health centers of Jimma Zone, Southwest Ethiopia. A cross-sectional facility based study was conducted from March 1(st)-25(th), 2011 among family planning clients of government primary health care centers in southwest Ethiopia. Exit interview of 301 family planning clients identified through systematic random sampling technique was carried out using a pre-tested structured questionnaire. Availability of resources was checked using provider interview and inventory checklist. Moreover, a total of 150 consultation sessions were observed using checklist. Descriptive statistics and linear regression coefficients were generated to meet the objective of the study. There was a shortage of some medical equipment, trained staffs, and information education and communication materials (IEC) in all of the family planning clinics. The mean waiting time at the service delivery points and consultation duration were 16.4 and 10.5 minutes, respectively. The providers used at least one information education and communication material in 33.3% of the consultation sessions. The overall satisfaction score was 8.64. Clients' perception on adequacy of information during consultation (β=0.24; ( 95%CI=0.02-0.16) ease of getting the clinic site, short waiting time (β=0.17; 95%CI=0.15-029) and educational level (β=0.09; 95%CI =0.09-0.29) were significantly associated with overall satisfaction. The findings of this study showed that there was lack of critical resources for the provision of quality family planning services in all of the primary health care centers included in the study. This has affected important aspects of
Borrero, Sonya; Schwarz, Eleanor B; Creinin, Mitchell; Ibrahim, Said
This study sought to examine the independent effect of patient race or ethnicity on the use of family planning services and on the likelihood of receiving counseling for sterilization and other birth control methods. This study used national, cross-sectional data collected by the 2002 National Survey of Family Growth (NSFG). Our analysis included women aged 18-44 years who had heterosexual intercourse within the past 12 months, who were not actively seeking to get pregnant, and who had not undergone surgical sterilization. The primary outcome was receipt of family planning services within the past 12 months. Specific services we examined were (1) provision of or prescription for a method of birth control, (2) checkup related to using birth control, (3) counseling about sterilization, and (4) counseling about birth control. Although we found no racial/ethnic differences in the overall use of family planning services, there were racial/ethnic differences in the specific type of service received. Hispanic and black women were more likely than white women to receive counseling for birth control (adjusted OR 1.5, 95% confidence interval [CI] 1.2, 1.8, and adjusted OR 1.3, 95% CI 1.1, 1.7, respectively). Hispanic women were more likely than white women to report having been counseled about sterilization (adjusted OR 1.5, 95% CI 1.0, 2.3). Minority women were more likely to receive counseling about sterilization and other birth control methods. However, there were no differences in access to family planning services by race or ethnicity. Future studies are needed to examine the quality and content of contraceptive counseling received by minority compared with nonminority women.
Whiston, Lucy; Barry, Joe M; Darker, Catherine D
Identify the current amount and intensity of patient and family participation at the patient, service and national levels from a diabetes and a psychiatric service perspective. Establish the current level of support for greater participation and related characteristics. Researcher-administered questionnaires were conducted with 738 patients and family members in an outpatient type 2 diabetes service and an outpatient psychiatric service, both in Dublin, Ireland. Patient and family participation at the service and national levels are restricted to the provision of information. Typically no involvement in discussions or the decision -making process is reported. The majority of participants favour greater patient participation at the service level (537/669; 80.3%) and the national level (561/651; 86.2%). Greater support for patient and family member participation is significantly associated with participant's age, service satisfaction and level of education. Patient and family participation is greatest at the patient level. The majority of patients and family members support greater participation at the service and national levels. The best way to implement participation needs to be identified. There needs to be a greater focus on participation at the service level. The role of family members also needs to be investigated further. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
...) and characteristics (e.g., self-esteem, relationship skills) can moderate the impacts of past and... to State Domestic Violence Coalitions AGENCY: Family and Youth Services Bureau (FYSB), Administration..., domestic violence, and dating violence; to provide for Coalitions to collaborate and coordinate with States...
... homelessness, VA announces that grantees are permitted to utilize a maximum of 50 percent of supportive... INFORMATION CONTACT: John Kuhn, Supportive Services for Veteran Families Program Office, National Center on Homelessness Among Veterans, 4100 Chester Avenue, Suite 201, Philadelphia, PA 19104; (877) 737-0111 (this is a...
Children who experience homelessness have an increased risk for negative outcomes in several developmental areas (Bucker, 2008). While there are numerous programs that hope to mediate these and other risks by offering services to families experiencing homelessness, there is a paucity of research that addresses how children's psychosocial needs are…
The paper draws on a study aiming to work with practitioners' perspectives to support involvement through family services. Data were collected from a cluster sample of practitioners conducting father groups in south-west England. The paper focuses upon working with their perspectives. Two issues in their perspectives were associated with…
... the definition of “State agency” in 45 CFR 1355.20.) (2) The CFSP must include a description of the... and external consultation process used to obtain broad and active involvement of major actors across... the active involvement of major actors providing child and family services within the Tribe's area of...
...: Supportive Services for Veteran Families Program Office, National Center on Homelessness Among Veterans, 4100... Homelessness Among Veterans, 4100 Chester Avenue, Suite 201, Philadelphia, PA 19104; ((877) 737-0111 (this is a... steps to end homelessness and prevent a return to homelessness.'') The aim of the provision of...
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.
Stergiopoulos, Vicky; Schuler, Andrée; Nisenbaum, Rosane; deRuiter, Wayne; Guimond, Tim; Wasylenki, Donald; Hoch, Jeffrey S; Hwang, Stephen W; Rouleau, Katherine; Dewa, Carolyn
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.
Issues and trends in relation to substance misuse normally develop in the transitional phase of adolescence, as young people begin looking towards their peers for direction and are less subject to parental authority. In relation to substance misuse it is observed that risk and protection factors exist in equal measure within different contexts, including within the individual, family, peer group, school and community settings. In response to problems relating to illicit drug use in Ireland the first adult treatment service was established in Dublin in 1969. As an approach to meeting the complex needs of an adolescent drug using population two designated out-patient treatment adolescent services were established in Dublin during the mid-1990s. Working closely with families, carers and significant others improves communication and mobilises resources in ways that enhances protection for young people especially in circumstances where there are a number of family members engaging in substance misuse.
Kim, Jiyeon; Kim, Hongsoo
The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.
Phillips, Julie; Peterson, Lars E; Fang, Bo; Kovar-Gough, Iris; Phillips, Robert L
New family physicians have opportunities to avoid accruing educational debt or have loans repaid by making a commitment to public service. Little information is available about the numbers of early career family physicians who have made service commitments to fund their education. The purpose of this study is to describe the proportion of graduating family medicine residents who have enrolled in US military and National Health Service Corps (NHSC) scholarship and loan repayment programs, thus obligating them to future public service. The study was a secondary analysis of de-identified data from the 2014 and 2015 American Board of Family Medicine examination registration questionnaire, which is required of all residents applying for board certification. Descriptive statistics were used to indicate the numbers and proportions of respondents who indicated military or NHSC financial support. Chi square analyses were used to analyze differences between groups. Of the 6,231 residents studied, 271 (4.4%) had either obtained military support (n=191, 3.1%) or enrolled in the NHSC (n=80, 1.3%). More men had enrolled in the military than women (4.2% vs 2.2%, P<0.01), but there was no significant NHSC gender difference. Underrepresented minorities (URM) were twice as likely to have enrolled in NHSC as non-URM residents (2.5% vs 1.0%, P<0.01). Only a small fraction of graduating family medicine residents have used either military enrollment or NHSC scholarships to fund their education. Family medicine should advocate strongly for expansion of the NHSC scholarship program, which receives many more applications than it can support.
cases where physical injuries are minimal, or in sexual assualt and rape cases when victims reports the incident days after the attack. In the latter case...Military Family Advocacy; Child Abuse; Spouse Abuse; Sexual Assault; Rape 20. ABSTRACT (Contnue on reverse If neeoery and Identify by block number...child abuse, spouse abuse, and sexual assault or rape. The report also identifies program needs and recommendations for program inmrovement. Findings
Hancock, Nancy L; Vwalika, Bellington; Sitali, Elizabeth Siyama; Mbwili-Muleya, Clara; Chi, Benjamin H; Stuart, Gretchen S
To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach. We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up. Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%). This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability. Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement. Copyright © 2015
Magnani, Robert J; Ross, John; Williamson, Jessica; Weinberger, Michelle
The need for annual family planning program tracking data under the Family Planning 2020 (FP2020) initiative has contributed to renewed interest in family planning service statistics as a potential data source for annual estimates of the modern contraceptive prevalence rate (mCPR). We sought to assess (1) how well a set of commonly recorded data elements in routine service statistics systems could, with some fairly simple adjustments, track key population-level outcome indicators, and (2) whether some data elements performed better than others. We used data from 22 countries in Africa and Asia to analyze 3 data elements collected from service statistics: (1) number of contraceptive commodities distributed to clients, (2) number of family planning service visits, and (3) number of current contraceptive users. Data quality was assessed via analysis of mean square errors, using the United Nations Population Division World Contraceptive Use annual mCPR estimates as the "gold standard." We also examined the magnitude of several components of measurement error: (1) variance, (2) level bias, and (3) slope (or trend) bias. Our results indicate modest levels of tracking error for data on commodities to clients (7%) and service visits (10%), and somewhat higher error rates for data on current users (19%). Variance and slope bias were relatively small for all data elements. Level bias was by far the largest contributor to tracking error. Paired comparisons of data elements in countries that collected at least 2 of the 3 data elements indicated a modest advantage of data on commodities to clients. None of the data elements considered was sufficiently accurate to be used to produce reliable stand-alone annual estimates of mCPR. However, the relatively low levels of variance and slope bias indicate that trends calculated from these 3 data elements can be productively used in conjunction with the Family Planning Estimation Tool (FPET) currently used to produce annual m
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services. PMID:25945160
Full Text Available The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services. Keywords: Telerehabilitation, Occupational Therapy, Rural, Early Intervention, Children, Program Evaluation, Cost Analysis
The enTECH Telerehabilitation Program explored the use of telerehabilitation as an alternative service delivery model for early intervention therapy services. Utilizing the Kentucky Telehealth Network, two families living in rural Kentucky received occupational therapy services over a 12-week period. Following program implementation, qualitative data was collected using participant journals and interviews. Data analysis identified three thematic categories related to the program: benefits/strengths, challenges/weaknesses, and recommendations for program improvement. Results of the program evaluation indicated that telerehabilitation has the potential to cost-effectively meet the therapeutic needs of children living in rural areas where provider shortages exist. The enTECH Telerehabilitation Program serves as a model for how telerehabilitation can be used to deliver early intervention services to ameliorate health disparities and improve access to rehabilitation services.
Despite access to a comprehensive administrative database that would allow for timely data retrieval and utilization, regular use of data to inform service provision remained infrequent at one children and family services agency. To address this issue, a research and evaluation manager was hired to facilitate regular data use and evidence-informed service provision. This led to a shift in agency culture that moved from viewing data collection as a burden and threat, to now valuing data as a powerful tool for improving programs and outcomes for children and families. This case study presents the experiences of this agency, describing the process by which the research and evaluation manager was hired, how data are now used by the agency, significant changes resulting from the agency's new data use practices, and perspectives of the evaluator and staff on data use and changes in agency culture. Copyright © Taylor & Francis Group, LLC
Thatte, Nandita; Choi, Yoonjoung
Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be
... responsible for PTSD, related injuries, and neurological disorders following TBI; foster development of new... link performance to meeting mental health service demand. Sec. 5. Improved Research and Development. (a) The lack of full understanding of the underlying mechanisms of Post-Traumatic Stress Disorder (PTSD...
Vafaee-Najar, Ali; Nejatzadegan, Zohreh; Pourtaleb, Arefeh; Kaffashi, Shahnaz; Vejdani, Marjan; Molavi-Taleghani, Yasamin; Ebrahimipour, Hosein
Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients' expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference (P≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services (P≤ 0.05). There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients' expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employees.
Abbas, Khadija; Khan, Adnan Ahmad; Khan, Ayesha
The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector. We used overall budgets and time allocation by health and population departments to estimate the total costs of FP by these departments, costs per woman served, and costs per couple-year of protection (CYP). The public sector is the predominant provider of FP to the poorest and is the main provider of female sterilization services. The overall costs of FP in the public sector are USD 55 per woman served, annually (USD 17 per CYP). Within the public sector, the population welfare departments provide services at USD 72 per woman served, annually (USD 17 per CYP) and the health departments at USD 39 per woman per year (USD 29 per CYP). While the public sector has a critical niche in serving the poor and providing female sterilization, its services are considerably more expensive compared to international and even some Pakistani non-government organization (NGO) costs. This reflects inefficiencies in services provided, client mistrust in the quality of services provided, and inadequate referrals, and will require specific actions for improving referrals and the quality of services.
Compton, Scott; Madgy, Alexander; Goldstein, Mark; Sandhu, Jaswinder; Dunne, Robert; Swor, Robert
To describe emergency medical service providers' experiences with family member presence during resuscitation, and to determine whether those experiences are similar within urban and suburban settings. We conducted a personally distributed survey of a convenience sample of urban and suburban emergency medical service (EMS) providers presenting to two Midwestern Emergency Departments. Providers were questioned as to their experiences with resuscitating patients in the presence of family members. There were 128 respondents to the survey (59 urban and 69 suburban), of which 70.1% were EMT-Paramedics. No provider who was approached refused participation. Nearly all (122) had performed CPR in the presence of family members, with most (77%) performing greater than 20. Subjects averaged 12.3 years of experience. The majority of urban and suburban providers felt it was inappropriate for family to witness resuscitations (75.9% versus 60.3%, respectively; p=0.068). Many providers reported feeling uncomfortable with family presence (31.5% urban versus 44.8% suburban; p=0.136), and few preferred that family witness the resuscitation (13.2% urban versus 15.4 suburban; p=0.738). A minority of providers believed that family were better prepared to accept the death of the patient (37.0% urban versus 37.6% suburban; p=0.939). Approximately half felt comfortable providing emotional support (66.0% urban versus 53.7% suburban; p=0.173). Many felt that family caused a negative impact during resuscitation (53.7% urban and 36.8% suburban; p=0.061). Urban providers more often reported feeling threatened by family members during resuscitation (66.7% versus 39.7%; p=0.003), and felt that family often interfered with their ability to perform resuscitations (35.6% versus 16.4%, p=0.014). EMS providers have substantial experience with family witnessed resuscitations, are uncomfortable about their presence, and often must provide support for families. While urban providers tended to report more
Wegner in the Department of Healthcare Operations for helping me access and understand the data used for this study. I would also like to extend a...social well-being and not merely the absence of disease or infirmity" (1946). WHO further describes health care as all the goods and services designed...outpatient treatment and consultation related to the management of psychological issues associated with medical treatment and disease management, with a
Walling, Teresa; Potts, Bridget; Fortune, Jon; Cobb, Ginny L.; Fortune, Barbara
This report describes the outcomes of a Wyoming program that provides host families for individuals with developmental disabilities. Host families work with certified Medicaid providers of home and community-based services for people with developmental disabilities and provide residential habilitation to an adult who is accepted as a member of…
Köhler, M; Emmelin, M; Hjern, A; Rosvall, M
This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS). Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups. The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care. Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high-quality preventive health care for this particularly vulnerable group of children. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan
To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.
Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan
Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689
Full Text Available Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed.Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twenty-two patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages.Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for
Johnson, Katherine M; Dodge, Laura E; Hacker, Michele R; Ricciotti, Hope A
The aim of this project was to investigate adolescent perspectives on family planning services at a community-health center, with the intent to inform health center programs aimed at stemming the adolescent pregnancy rate. This project was cross-sectional and employed mixed methods, including surveys and interviews, for the purposes of quality improvement. The project was conducted in the obstetrics and gynecology clinic at an urban community health center in Boston. Twenty adolescent females (age 16-20) who used services at the health center. Participants were individually interviewed to assess perspectives on family planning services and to identify major influences on methods of pregnancy prevention. Major themes were categorized into contraceptive usage, reproductive health knowledge, adult influence and communication, barriers to contraceptive care and expectations of a family planning clinic. All participants were sexually active and 80% had experienced pregnancy. Reproductive health knowledge was variable and in many cases limited. Concern about disapproval was a prominent barrier to going to a clinician for contraception or advice and parents were not often involved in the initial contraception discussion. Other barriers to use of contraception included forgetting to use the methods and fear of side effects. We identified several potentially modifiable factors, including lack of knowledge, concern for provider disapproval and fear of side effects that may limit effective use of family planning services by adolescents. Further attention should be paid to these factors in designing and improving youth-friendly services in ob-gyn clinics. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Substance Abuse and Mental Health Services Administration, 2010
This report to Congress provides critical information about the Comprehensive Community Mental Health Services for Children and their Families Program (CMHI), including the characteristics of children, youth, and families as they enter the CMHI; the outcomes attained for children and youth, and their caregivers and families after entry into the…
Mayberry, Lindsay Satterwhite; Heflinger, Craig Anne
Family involvement in the planning and execution of mental health treatment has been shown to positively influence child outcomes; however, there is wide variability in the levels of involvement by families. The current study investigated the influence of child, family caregiver, service system, and community factors on the level of family…
Kassa, Mihretie; Abajobir, Amanuel Alemu; Gedefaw, Molla
Men's participation is crucial to the success of family planning programs and women's empowerment and associated with better outcomes in reproductive health such as contraceptive acceptance and continuation, and safer sexual behaviors. Limited choice and access to methods, attitudes of men towards family planning, perceived fear of side-effects, poor quality of available services, cultural or religious oppositions and gender-based barriers are some of the reasons for low utilization of family planning. Hence, this study assessed the level of male involvement in family planning services utilization and its associated factors in Debremarkos town, Northwest Ethiopia. A community-based cross-sectional study was conducted from October to November, 2013. Multi-stage sampling technique was used to select 524 eligible samples. Data were collected by using semi-structured questionnaires. Epi Info and SPSS were used to enter and analyze the data; univariate, bivariate and logistic regression analyses were performed to display the outputs. Only 44 (8.4%) respondents were using or directly participating in the use of family planning services mainly male condoms. The reasons mentioned for the low participation were the desire to have more children, wife or partner refusal, fear of side effects, religious prohibition, lack of awareness about contraceptives and the thinking that it is the only issue for women. Opinion about family planning services, men approval and current use of family planning methods were associated with male involvement in the services utilization. In this study, the level of male involvement was low. Lack of information, inaccessibility to the services and the desire to have more children were found to be the reasons for low male involvement in family planning services utilization. Governmental and nongovernmental organizations, donors and relevant stakeholders should ensure availability, accessibility and sustained advocacy for use of family planning
Yarger, Jennifer; Decker, Martha J; Campa, Mary I; Brindis, Claire D
The purpose of this study was to compare awareness and use of family planning services by rural and urban program site among a sample of adolescent women before participation in the federal Personal Responsibility Education Program in California. We conducted a secondary analysis of survey data collected from youth before participation in California's Personal Responsibility Education Program. Bivariate and multivariate analyses were conducted for a sample of 4,614 females ages 14-18 years to compare awareness and use of family planning services between participants at rural and urban program sites, controlling for the program setting and participant demographic, sexual, and reproductive characteristics. Overall, 61% of participants had heard of a family planning provider in their community, and 24% had visited a family planning provider. Awareness and use of family planning services were lower among rural participants than urban participants. After adjusting for the program setting and participant characteristics, rural participants were less likely to know about a family planning provider in their community (odds ratio, .64; 95% confidence interval, .50-.81) or receive family planning services (odds ratio, .76; 95% confidence interval, .58-.99) than urban participants. Findings suggest that adolescents in rural areas face greater barriers to accessing family planning services than adolescents in urban areas. Targeted efforts to increase awareness and use of family planning services among adolescents in rural areas and among other underserved populations are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Levonorgestrel emergency contraception and other contraceptive methods are available over-the-counter (OTC; however youth continue to face a number of barriers in accessing healthcare services, including lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. A descriptive, nonexperimental, cross-sectional study of a sample of 112 community pharmacies in San Diego, California was conducted between December 2009 and January 2010 to assess community pharmacy practices related to the availability and accessibility of family planning health pharmacy services and products, particularly to youth. A majority (n = 79/112, 70.5% of the pharmacies carried a wide selection of male condoms; however, the other OTC nonhormonal contraceptive products were either not available or available with limited selection. A majority of the pharmacies sold emergency contraception (n = 88/111, 78.6%. Most patient counseling areas consisted of either a public or a semi-private area. A majority of the pharmacy sites did not provide materials or services targeting youth. Significant gaps exist in providing family planning products and services in the majority of community pharmacies in San Diego, California. Education and outreach efforts are needed to promote provision of products and services, particularly to the adolescent population.
Vedsted, Peter; Olesen, Frede
of this reorganization on the use of services by frequent attenders (FAs). METHODS: From 1990 to 1994, methods of contact and annual costs per attender were analyzed in an ecological time-trend study based on aggregated administrative data collected from the database of the Public Health Insurance, Aarhus County......, Denmark (600,000 inhabitants). The study only included attenders ages 18 and over. FAs were defined as the group that, within each calendar year (12 months), had 4 or more contacts with the after-hours family practice service. RESULTS: FAs made up 9.5% of the attenders and accounted for more than 40...
Johnson, Michelle; Stone, Susan; Lou, Christine; Ling, Jennifer; Claassen, Jennette; Austin, Michael J
Parent education programs may be offered or mandated at various stages of the child welfare services continuum. However, little is known regarding their efficacy in addressing the parenting problems that bring families to the attention of child welfare services. This article synthesizes outcome data generated from 58 parenting programs with families determined to be at-risk of child maltreatment and/or abusive or neglectful. It places parent education programs within the broader context of research on effective parenting as well as the leading etiological models of child maltreatment to assess the evaluations of these programs with regard to methodological rigor as well as theoretical salience. Practical and theoretical implications are presented along with recommendations for future research.
Meehan, Elaine M; Reid, Susan M; Williams, Katrina J; Freed, Gary L; Sewell, Jillian R; Reddihough, Dinah S
The aim of the study was to investigate the patterns of medical service use in children with cerebral palsy (CP), taking into account child and family characteristics. Nine hundred and one parents and carers of children registered with the Victorian CP Register were invited to complete a survey. Participants were asked about their child's appointments with general practitioners and public and private paediatric medical specialists over the preceding 12 months. Information on family characteristics and finances was also collected. Data on CP severity and complexity were extracted from the CP Register. Three hundred and fifty parents and carers (39%) participated. Of these, 83% reported that their child had ≥1 appointment with a general practitioner over the preceding 12 months, while 84% had ≥1 appointment with a public or private paediatric medical specialist. Overall, 58% of children saw 2-5 different paediatric medical specialists, while 9% had appointments with ≥6 clinicians. Children with severe and complex CP were more likely to have had ≥1 appointment with a publically funded paediatric medical specialist and had seen a greater number of different clinicians over the study period. Family characteristics were not associated with service use. Children with CP are managed by a number of paediatric medical specialists, and they continue to see a range of specialists throughout adolescence. In Victoria, differences in service use are not based on family characteristics; instead the highest service users are those with severe and complex CP. For this group, care co-ordination and information sharing between treating clinicians are important, if gaps in care are to be avoided. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Mattioni, Violaine; Micaëlli, Delphine
When the mobile emergency and intensive care service (Smur) intervenes with a child, the parents are in a completely unknown and anxiety-generating situation. The care team helps families to find their place, depending on the medical context and health status of the child. The intervention of the Smur therefore represents a place of transition for the parents. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Thomas, James C; Reynolds, Heidi; Bevc, Christine; Tsegaye, Ademe
Public health resources are often deployed in developing countries by foreign governments, national governments, civil society and the private health clinics, but seldom in ways that are coordinated within a particular community or population. The lack of coordination results in inefficiencies and suboptimal results. Organizational network analysis can reveal how organizations interact with each other and provide insights into means of realizing better public health results from the resources already deployed. Our objective in this study was to identify the missed opportunities for the integration of HIV care and family planning services and to inform future network strengthening. In two sub-cities of Addis Ababa, we identified each organization providing either HIV care or family planning services. We interviewed representatives of each of them about exchanges of clients with each of the others. With network analysis, we identified network characteristics in each sub-city network, such as referral density and centrality; and gaps in the referral patterns. The results were shared with representatives from the organizations. The two networks were of similar size (25 and 26 organizations) and had referral densities of 0.115 and 0.155 out of a possible range from 0 (none) to 1.0 (all possible connections). Two organizations in one sub-city did not refer HIV clients to a family planning organization. One organization in one sub-city and seven in the other offered few HIV services and did not refer clients to any other HIV service provider. Representatives from the networks confirmed the results reflected their experience and expressed an interest in establishing more links between organizations. Because of organizations not working together, women in the two sub-cities were at risk of not receiving needed family planning or HIV care services. Facilitating referrals among a few organizations that are most often working in isolation could remediate the problem, but the
Mankowski, Mariann; Everett, Joyce E
The purpose of this paper is to highlight what we know now about female service members, veterans, and their families. The experiences of U.S. female service members and veterans are more complex than previous eras and significant demographic changes have taken place. U.S. female veterans are more likely to be younger, come from ethnic and racial minority groups, have children, and combat exposure. U.S. female service members report high rates of sexual violence and they are more vulnerable to homelessness and unemployment when compared to previous female military cohorts. U.S. female service members and veterans are also at higher risk for significant mental and health issues. Children and adolescents of women service members and veterans may also carry a heavy burden as a result of lengthy deployments. A majority of female service members and veterans will utilize community based healthcare and social services, therefore, it is essential that all healthcare providers understand the unique needs of this cohort of women. Practice implications at the micro, mezzo, and macro levels are discussed. Qualitative and quantitative studies that expand our understanding of women's experience in the military and as veterans are encouraged. Copyright © 2016 Elsevier Ltd. All rights reserved.
White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia
Cervical cancer is a leading cause of mortality in Sub-Saharan Africa-in large part because of inadequate coverage of screening and preventive treatment services. A number of programs have begun integrating cervical cancer prevention services into existing family planning or HIV/AIDS service delivery platforms, to rapidly expand "screen and treat" programs and mitigate cervical cancer burden. Drawing upon a review of literature and our experiences, we consider benefits and challenges associated with such programs in Sub-Saharan Africa. We then outline steps that can optimize uptake and sustainability of integrated sexual and reproductive health services. These include increasing coordination among implementing organizations for efficient use of resources; task shifting for services that can be provided by nonphysicians; mobilizing communities via trusted frontline health workers; strengthening management information systems to allow for monitoring of multiple services; and prioritizing an operational research agenda to provide further evidence on the cost-effectiveness and benefits of integrated service delivery. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet
Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.
Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N
LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.
Rhodes, Ramona L; Mitchell, Susan L; Miller, Susan C; Connor, Stephen R; Teno, Joan M
As patients near the end of life, bereaved family members provide an important source of evaluation of the care they receive. A study was conducted to identify which processes of care were associated with greater satisfaction with hospice services from the perception of bereaved family members. A total of 116,974 surveys from 819 hospices in the United States were obtained via the 2005 Family Evaluation of Hospice Care, an online repository of surveys of bereaved family members' perceptions of the quality of hospice care maintained by the National Hospice and Palliative Care Organization. Overall satisfaction was dichotomized as "excellent" vs. "other" (very good, good, fair, and poor). Using multivariate logistic regression, the association between overall satisfaction and the individual item problem scores that compose the Family Evaluation of Hospice Care were examined. Bereaved family members were more likely to rate overall satisfaction with hospice services as "excellent" if they were regularly informed about their loved one's condition (adjusted odds ratio [AOR]=3.76, 95% confidence interval [CI]=3.61-3.91), they felt the hospice team provided the right amount of emotional support to them (AOR=2.21, 95% CI=2.07-2.38), they felt that the hospice team provided them with accurate information about the patient's medical treatment (AOR=2.16, 95% CI=2.06-2.27), and they could identify one nurse as being in charge of their loved one's care (AOR=2.02, CI=1.92-2.13). These four key processes of care appear to significantly influence an "excellent" rating of overall satisfaction with hospice care.
This paper explores the pre- and in-service preparation of service providers on family and inter-professional coordination issues. It particularly looks at the service providers affiliated with seven occupation groups and who work with 48 children with hearing impairment in a specific geographical region of Cyprus. The research study from which…
Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh
In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization
Kossoff, Eric H; Sutter, Lindsay; Doerrer, Sarah C; Haney, Courtney A; Turner, Zahava
Traditionally the ketogenic diet is started as an inpatient admission to the hospital. Starting in January 2015, child life services were made formally available during ketogenic diet admissions to help families cope. One-page surveys were then provided to 15 parents on the day of discharge and again after 3 months. Every family believed that the child life services were helpful. Children who were developmentally appropriate/mildly delayed had higher parent-reported anxiety scores than those who were moderate to severely delayed (4.4 vs 1.0, P = .02). At 3 months, child life services were deemed very helpful for the parents (mean score: 8.9, range: 5-10), and were more helpful for the parent than the child (mean 6.2, range 1-10, P = .047). One of the most helpful services was a prior phone call to parents 1 week prior. In this small pilot study, child life involvement during the start of the ketogenic diet was highly useful.
Radon concentrations have been studied extensively in single-family residential buildings, but relatively little work has been done in large buildings, including multistory residential buildings. The phenomena of radon transport in multistory residential buildings is made more complicated by the multizone nature of the airflow system and the numerous interzone airflow paths that must be characterized in such a system. This paper presents the results of a computer simulation of airflow and radon transport in a twelve-story residential building. Interzone airflow rates and radon concentrations were predicted using the multizone airflow and contaminant dispersal program (CON-TAM88). Limited simulations were conducted to study the influence of two different radon source terms, indoor-outdoor temperature difference and exterior wall leakage values on radon transport and radon concentration distributions
Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M
Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.
Javier Pérez Padilla
Full Text Available In this study parenting stress and coping strategies in a sample of 109 mothers from at-risk families were analyzed. Results obtained show over half of these women experienced clinical levels of parenting stress, and problem focused coping strategies were the most commonly used. Moreover, the main characteristics of these families and their trajectories in Child and Family Protection Services were correlated with parenting stress and coping strategies. The global valuation of family risk informed by professionals was significantly related to parenting stress.
Wolchik, Sharlene A.; And Others
Examined visitation problems from the perspectives of residential and nonresidential parents through interviews. Subjects were 341 fathers and 271 mothers from 378 divorcing families. Residential parents perceptions of visitation problems were correlated with concerns about their ex-spouse's parenting abilities. Anger and hurt about the divorce…
Wansink, Henny J; Janssens, Jan M A M; Hoencamp, Erik; Middelkoop, Barend J C; Hosman, Clemens M H
Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as developed in the Preventive Basic Care Management (PBCM) program, improve parenting and prevent child behavioral problems? This randomized controlled clinical trial (RCT) compared the effectiveness of PBCM with a control condition. Ninety-nine outpatients of a community mental health center were randomized to intervention or control. Primary outcomes included parenting quality (assessed by the HOME instrument), parenting skills (parenting skills subscale of FFQ), and parenting stress (PDH). Secondary outcomes are child behavioral problems (SDQ). Outcomes were assessed at baseline and after 9 and 18 months. Effects were analyzed by Repeated Measures Analysis of Variance. Most families were single-parent families belonging to ethnic minorities. The results of the first RCT on effects of PBCM suggest that this intervention is feasible and has a positive effect on parenting skills. There was no evidence for effects on the quality of parenting and parenting stress, nor preventive effects on child behavioral problems. Replication studies in other sites, with more power, including monitoring of the implementation quality and studying a broader palette of child outcomes are needed to confirm the positive effects of PBCM. Long-term prospective studies are needed to investigate if improved parenting skills lead to positive effects in the children in the long run. (c) 2015 APA, all rights reserved).
Full Text Available Background and Aim: Iran′s health sector has been engaging the services of physicians and midwives in healthcare centers since 2005, with the hope of improving the quantity and quality of family planning services. The aim of this study was to assess the effect of serving physicians and midwives on the quantity and quality of family planning services in the healthcare centers of Iran. Materials and Methods: The present cross-sectional study (Jan 2010 until Sep 2011 was carried out on 600 eligible families who were clients of healthcare centers of Tabriz, Azarshahr and Osku, cities of Northwest Iran from 2006 until 2011, in two groups (before and after. Some of the characteristics of the participants and the data on the quality and quantity of family planning services provided were grouped in a checklist of 16 variables by comparing the patients′ past medical histories. Results: In comparison with 3 years prior to engaging physician and midwife services in health care centers, the Couple Year Protection (CYP and the quantity of family planning service indexes significantly increased among eligible families. The family size of participants declined significantly after family physicians and midwives became available in the healthcare centers (P < 0.005. Conclusion: Our findings showed some improvement in the quantity of services without any noticeable changes in the quality of services provided as a consequence of this huge intervention. Therefore, it is suggested that there should be proper oversight of the duties of the health team in order to keep a close watch on primary healthcare, design of proper mechanisms for collecting and maintaining performance reports and statistics, and continuously monitor and control the quality of services.
Merrick, Melissa T; Henly, Megan; Turner, Heather A; David-Ferdon, Corinne; Hamby, Sherry; Kacha-Ochana, Akadia; Simon, Thomas R; Finkelhor, David
Predictability in a child's environment is a critical quality of safe, stable, nurturing relationships and environments, which promote wellbeing and protect against maltreatment. Research has focused on residential mobility's effect on this predictability. This study augments such research by analyzing the impact of an instability index-including the lifetime destabilization factors (LDFs) of natural disasters, homelessness, child home removal, multiple moves, parental incarceration, unemployment, deployment, and multiple marriages--on childhood victimizations. The cross-sectional, nationally representative sample of 12,935 cases (mean age = 8.6 years) was pooled from 2008, 2011, and 2014 National Surveys of Children's Exposure to Violence (NatSCEV). Logistic regression models controlling for demographics, socio-economic status, and family structure tested the association between excessive residential mobility, alone, and with LDFs, and past year childhood victimizations (sexual victimization, witnessing community or family violence, maltreatment, physical assault, property crime, and polyvictimization). Nearly 40% of the sample reported at least one LDF. Excessive residential mobility was significantly predictive of increased odds of all but two victimizations; almost all associations were no longer significant after other destabilizing factors were included. The LDF index without residential mobility was significantly predictive of increased odds of all victimizations (AOR's ranged from 1.36 to 1.69), and the adjusted odds ratio indicated a 69% increased odds of polyvictimization for each additional LDF a child experienced. The LDF index thus provides a useful alternative to using residential moves as the sole indicator of instability. These findings underscore the need for comprehensive supports and services to support stability for children and families. Copyright © 2018. Published by Elsevier Ltd.
Norton, Joanna; Engberink, Agnès Oude; Gandubert, Catherine; Ritchie, Karen; Mann, Anthony; David, Michel; Capdevielle, Delphine
Provide up-to-date detection rates for common mental disorders (CMD) and examine patient service-use since the Preferred Doctor scheme was introduced to France in 2005, with patients encouraged to register with and consult a family practitioner (FP) of their choice. Study of 1133 consecutive patients consulting 38 FPs in the Montpellier region, replicating a study performed before the scheme. Patients in the waiting room completed the self-report Patient Health Questionnaire (PHQ) and Client Service-Receipt Inventory with questions on registration with a Preferred Doctor and doctor-shopping. CMD was defined as reaching PHQ criteria for depression, somatoform, panic or anxiety disorder. For each patient, FPs completed a questionnaire capturing psychiatric caseness. 81.2% of patients were seeing their Preferred Doctor on the survey-day. Of those with a CMD, 52.6% were detected by the FP. This increased with CMD severity and comorbidity. Detected cases were more likely to be consulting their Preferred Doctor (84.7% versus 79.4% for non-detected cases, p = 0.05) rather than another FP. They declared more visits to psychiatrists (17.2% versus 6.7%, p = 0.002). There was no association with consultation frequency or doctor-shopping, which both declined between the two studies. The CMD detection rate is relatively high, with no increase compared to our previous study, despite a decline in doctor-shopping. An explanation is the same high proportion of patients visiting their usual FP on the survey-day at both periods, suggesting a limited impact of the scheme on care continuity. FP action taken highlights the importance of improving detection for providing care to patients with CMDs.
Full Text Available This cross-sectional study aimed to identify the profile of morbidity and use of health services by the elderly in the Family Health Program Antonio Estevão de Carvalho, from São Paulo, Brazil. The information of 92 seniors from the database of the project "Family Health - assessment of the new assistance strategy in the setting of public policies" were used. A descriptive data analysis showed the elderly with an average age of 70.6 years old; 64.1%, females: 93.5% reported any kind of health problems, especially hypertension (67.4% and diabetes mellitus (19.6%, 77.3% looked for health care; public hospitals (42.4% were the most sought after services. The reasons for the choice of services were ease of access (18.5% and need of care (7.6%. The main reason of satisfaction was the interpersonal care and of dissatisfaction the lack of medicines and the long wait to set appointments.
Modeling and off-design performance of a 1 kWe HT-PEMFC (high temperature-proton exchange membrane fuel cell)-based residential micro-CHP (combined-heat-and-power) system for Danish single-family households
Arsalis, Alexandros; Nielsen, Mads Pagh; Kær, Søren Knudsen
temperatures, as compared to Nafion-based PEMFCs and therefore can be a significant candidate for cogeneration residential systems. The proposed system can provide electric power, hot water, and space heating for a typical Danish single-family household. A complete fuel processing subsystem, with all necessary......A novel proposal for the modeling and operation of a micro-CHP (combined-heat-and-power) residential system based on HT-PEMFC (High Temperature-Proton Exchange Membrane Fuel Cell) technology is described and analyzed to investigate its commercialization prospects. An HT-PEMFC operates at elevated...
Msovela, Judith; Tengia-Kessy, Anna
Men as the main decision makers in most of African families have an important role to play towards acceptance of family planning methods. This study sought to identify strategies used to engage men in family planning services and determine the extent to which men in Kibaha district in Tanzania accept these interventions. We conducted a cross sectional study using both quantitative and qualitative techniques. We used a questionnaire to interview a random sample of 365 of currently married or cohabiting men who had at least one child under the age of five years. We further conducted in-depth interviews with health workers involved in delivering reproductive health services as well as community dispensers of family planning commodities. Descriptive analysis was used to determine the extent to which men were engaged in family planning services. The data from the indepth interviews were analysed manually according to the predetermined themes, guided by the grounded theory to identify the existing strategies used to encourage male involvement in family planning services. According to the key informants, strategies that are used to encourage men to engage in family planning services include invitations through their spouses, either verbally or by using partner notification cards, incorporating family planning messages during monthly meetings and community outreach reproductive health programs. Of 365 men responding to the questionnaire, only 31 (8.4%) said they were invited to accompany their spouses to family planning clinics. Among them, 71% (22/31) visited family planning clinics. A third (32%) of the respondents had heard of community health meetings and only 20.7% of them attended these meetings. More than a third (12/34) of men who attended these meeting asserted that family planning messages targeting men featured in the agenda and subsequently half of them visited health facilities for family planning services. Existing strategies such as invitations to clinics
Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha
Background Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., ?service users?), especially those with co-occurring issues, as well as their family members. Methods We conducted structured interviews with 73 service users and 41 family members of serv...
Becker, Davida; Díaz-Olavarrieta, Claudia; Garcia, Sandra G.; Harper, Cynthia C.
Objective First trimester abortion was decriminalized in Mexico City in 2007. We studied client views of family planning services provided during abortion care at public facilities and acceptance of postabortion contraception. Methods We surveyed 402 clients seeking first trimester abortion care in Mexico City. We used logistic regression to test whether postabortion contraception varied by abortion visit characteristics or client sociodemographics. Results Most participants (81.6%) reported being offered contraception at their visit and 89.5% selected a contraceptive method postabortion, with 58.9% selecting the IUD. Surgical abortion clients were more likely to report being offered contraception than medical abortion clients (p<.001), as were clients attended by a female physician (p<.05). Clients at the general hospital were less likely to report being offered contraception (p<.001). Conclusion Public sector facilities in Mexico City are providing a generally high level of postabortion family planning care and uptake of postabortion contraception is high. PMID:23499047
Ibnouf, A H; van den Borne, H W; Maarse, J A M
To explore differences in utilization of family planning services and predisposing factors, we surveyed 601 women from urban and rural areas of Khartoum state. About half were using modern family planning techniques; there were no significant differences in utilization rates between urban and rural settings. Contraceptive pills were the most frequently used modern method (47.7%) followed by intrauterine devices (10.2%) and injections (7.5%). Breastfeeding was used by around 33% of both groups. The rhythm method and withdrawal were more often used by urban women (22.2% and 8.6% respectively) than rural women (16.1% and 3.6% respectively). Use of male methods (condom; sterilization) was extremely low. Socioeconomic status, knowledge and education level were the most important determinants of using modern methods.
Tumlinson, Katherine; Speizer, Ilene S; Curtis, Siân L; Pence, Brian W
In the field of international family planning, quality of care as a reproductive right is widely endorsed, yet we lack validated data-collection instruments that can accurately assess quality in terms of its public health importance. This study, conducted within 19 public and private facilities in Kisumu, Kenya, used the simulated client method to test the validity of three standard data-collection instruments used in large-scale facility surveys: provider interviews, client interviews, and observation of client-provider interactions. Results found low specificity and low positive predictive values in each of the three instruments for a number of quality indicators, suggesting that the quality of care provided may be overestimated by traditional methods of measurement. Revised approaches to measuring family planning service quality may be needed to ensure accurate assessment of programs and to better inform quality-improvement interventions. © 2014 The Population Council, Inc.
Liu, Yin; Kim, Kyungmin; Zarit, Steven H
The study examines family caregivers' health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers' trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives' placement. Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. © The Author(s) 2014.
Cianetti, S; Lombardo, G; Lupatelli, E; Rossi, G; Abraha, I; Pagano, S; Paglia, L
The aim of this study was to verify whether socioeconomic determinants, such as parents' educational level, family income and dental service attendance by children, are associated with the presence of caries among an Italian population of children. An observational retrospective study was carried out in a population of children aged 4-14 years who visited the Paediatric Dentistry Department of the University of Perugia, Italy. Children were stratified according to familial socioeconomic level (father's and mother's educational level, family income) and dental service attendance of children. Age- and sex- adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by means of multivariate logistic regression models. A sample of 231 children (mean age 8.1 yrs, SD 2.6; 127 males, 104 females) was recruited. One hundred and sixty three (70.46%) children in the study had caries. Caries presence in children was higher in children where the mothers' educational level was lower (OR =6.1; 95% CI = 3.1 to 12.7), in children where the fathers' educational level was lower (OR =2.9; 95% CI =1.6 to 5.5) and in children with lower family income (OR = 9.9; 95% 95% CI = 5.1 to 20.1). No statistically significant difference were observed in terms of caries presence between the children who were visited at least once by a dentist and children who were not previously seen by a dental practitioner (OR = 0.8; 95% CI = 0.4 to 1.6). Socioeconomic level was an important predictor of caries presence among children. Both low income and low parental educational level were related to an increased presence of caries, whereas previous dental visits experience did not affect caries presence in children.
Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan
Referrals to other medical services are central to healthcare, including family planning service providers; however, little information exists on the nature of referral practices among health centers that offer family planning. We used a nationally representative survey of administrators from 1,615 publicly funded health centers that offered family planning in 2013-14 to describe the use of six referral practices. We focused on associations between various health center characteristics and frequent use of three active referral practices. In the prior 3 months, a majority of health centers (73%) frequently asked clients about referrals at clients' next visit. Under half (43%) reported frequently following up with referral sources to find out if their clients had been seen. A third (32%) of all health centers reported frequently using three active referral practices. In adjusted analysis, Planned Parenthood clinics (adjusted odds ratio 0.55) and hospital-based clinics (AOR 0.39) had lower odds of using the three active referral practices compared with health departments, and Title X funding status was not associated with the outcome. The outcome was positively associated with serving rural areas (AOR 1.39), having a larger client volume (AOR 3.16), being a part of an insurance network (AOR 1.42), and using electronic health records (AOR 1.62). Publicly funded family planning providers were heavily engaged in referrals. Specific referral practices varied widely and by type of care. More assessment of these and other aspects of referral systems and practices is needed to better characterize the quality of care.
Phipps, Maureen G; Matteson, Kristen A; Fernandez, Gema E; Chiaverini, Leanne; Weitzen, Sherry
The purpose of this study was to compare the demographic characteristics and sexual risk behaviors of women who seek emergency contraception (EC) and general family planning (FP) services. This cross-sectional study included 227 women aged 17-43 years who were being evaluated for either EC or FP in an outpatient setting from 2003-2004. Descriptive statistics and odds ratios were included. The EC group, compared with the FP group, had higher proportions of women with education beyond high school (62% vs 52%; P = .02), and not married (79% vs 42%; P providers.
Darrah, J; Magil-Evans, J; Adkins, R
The satisfaction of families of adolescents and young adults with a diagnosis of cerebral palsy with the service delivery they had experienced in the areas of health, education, recreation, employment, housing and transportation was examined. Common themes across the six service areas were identified. Forty-nine adolescents (13-15 years) and 39 young adults (19-23 years) and their families rated their satisfaction with services and then participated in semi-structured interviews to discuss their experiences. Using a constant comparative method of analysis, common themes were identified from the transcribed interviews. Four themes were identified and named: caring and supportive people; fighting and fatigue; communication/information; and disability awareness. Families continue to experience dissatisfaction and frustration with service delivery in the six areas examined. Both bureaucratic structure and attitudes of service providers contribute to their dissatisfaction.
Eleweke, C. Jonah; Gilbert, Sharon; Bays, Debbie; Austin, Ellen
This paper is concerned with reviewing some useful effects of information about support services provided to families of young children with hearing loss and the challenges of providing this information to families. Evidence indicates that 95 percent of young children with hearing loss have hearing parents. With no previous experience of hearing…
Puig, Victoria I.
This study was designed to gain insight into how early intervention (EI) services incorporate the cultural and linguistic resources of families and how EI professionals and families build partnerships with each other. Through observation and interview, the author looked deeply at the experiences of a small group of culturally and linguistically…
Shope, Jean T.; And Others
Surveyed 244 Michigan agencies providing geriatric information and referral (I&R) to determine service availability, families' needs, and problems providing I&R for persons with dementia and their families. Home-delivered meals, nursing, and social work assessments were considered most available. Medical assessment was considered "very available"…
Zhang, Ling; Xue, Chengbing; Wang, Youjie; Zhang, Liuyi; Liang, Yuan
Despite the benefits of maternal health services, these services are often underutilized, especially in the developing countries. The aim of the present study is to provide insight regarding factors affecting maternal health services use from the family perspective. We use data from the fourth National Health Services Survey in Jiangsu province of Eastern China to investigate the effect of family characteristics on the use of maternal health services. Family characteristics included whether or not living with parents, age of husband, husband's education, and husband's work status as well as family economic status. Demographic variables, social and environmental factors, and previous reproductive history were taken as potential confounders. Multiple logistic regression models were used to examine the independent effects of the family characteristic variables on maternal health service utilization. The data indicate that the percentages of prenatal care, postnatal visits and hospital delivery were 85.44, 65.12 and 99.59 % respectively. Living with parents was associated with less use of prenatal care and husband's age, education and employment status had no effect on the use of prenatal care after adjusting for potential confounding variables. Our findings suggest that maternal health education (especially the role of prenatal care) needs to be extended beyond the expectant mothers themselves to their parents and husbands. The difference of health care delivery as a result of traditional family culture may highlight the differences in factors influencing the use of postnatal visits and those influencing the use of prenatal care; which may be worthy of further study.
Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia
This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported
Muganyizi, Projestine S; Ishengoma, Joyce; Kanama, Joseph; Kikumbih, Nassoro; Mwanga, Feddy; Killian, Richard; McGinn, Erin
Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n = 7) of schools had skills laboratories, 76% (n = 22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital
Amoon, A T; Oksuzyan, S; Crespi, C M; Arah, O A; Cockburn, M; Vergara, X; Kheifets, L
Studies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the effect of mobility. We analyzed data from a population-based case-control study of childhood leukemia using cases who were born in California and diagnosed between 1988 and 2008 and birth certificate controls. We used stratified logistic regression, case-only analysis, and propensity-score adjustments to assess predictors of residential mobility between birth and diagnosis, and account for potential confounding due to residential mobility. Children who moved tended to be older, lived in housing other than single-family homes, had younger mothers and fewer siblings, and were of lower socioeconomic status. Odds ratios for leukemia among non-movers living mobility, including dwelling type, increased odds ratios for leukemia to 2.61 (95% CI: 1.76-3.86) for living mobility of childhood leukemia cases varied by several sociodemographic characteristics, but not by the distance to the nearest power line or calculated magnetic fields. Mobility appears to be an unlikely explanation for the associations observed between power lines exposure and childhood leukemia. Copyright © 2018 Elsevier Inc. All rights reserved.
Rodriguez Lien, Elizabeth; Shattuck, Karen
Breastfeeding education is known to be insufficient in pediatric (PEDS) training and is, in part, responsible for suboptimal rates of breastfeeding. No recent studies about the level of education provided to family medicine (FM) and obstetrics-gynecology (OB) residency trainees are available. This study was conducted to investigate breastfeeding education and support services provided to FM and OB residents in the United States. The results were compared with a 2011 study of PEDS residents. A cross-sectional study was conducted using a web-based survey emailed to program directors (PDs) of FM and OB residency programs in the United States. Eighteen percent of PDs (95 of 515) completed the survey. Of these, 88% answered questions regarding education and support services provided. A median of 23 hours of breastfeeding education is provided to OB residents (4-year program) and 8 hours provided to FM residents (3-year program). In comparison, PEDS programs reported a median of 9 hours. The most commonly used settings included lectures with faculty and lactation consultants, similar to the PEDS study. Approximately 75% of respondents cited barriers to educating residents, with limited resident time being the most common. Eighty-one percent of respondents identified breastfeeding rooms as the service most frequently provided to residents who breastfeed. FM and PEDS residents are provided similar amounts of breastfeeding education, while OB programs provide more education, but in different settings. Reported barriers to this education are similar in all specialties. Support services are more commonly provided in PEDS programs.
Amin, Maryam S; Perez, Arnaldo; Nyachhyon, Pawan
To explore reasons for underutilization of dental services covered by a governmental funded program in Alberta. A survey questionnaire was sent to 4,000 randomly selected clients of Alberta Health Benefit program. Only respondents with children were included in the analysis. Reasons were explored among those who indicated that their children did not receive any dental services in the year prior to the survey (non-users). Difficulties faced by those who reported receiving at least one dental service (users) were also collected. Among 795 returned surveys, 597 had at least one child. A total of 1,303 children aged 1 to 19 years (mean age = 11.79 years, SD = 4.2) were included in the analysis. Of the 1,303 children, 443 (34%) did not receive any covered dental services (non-users); the most common reason (50.7%) was 'no perceived need' labeled for the replies 'my child was too young or had no dental problems' followed by perceived insufficient coverage (38.6%). The most common challenge reported by the dental care users was also insufficient coverage (44.9%). About 57% of parents were aware of the covered yearly fluoride application; however, only 34.3% of their children received fluoride and 14.2% had sealants. Low-income families underutilized available dental benefits for children. Perceived need seemed to be the primary determinant of utilization. Parental awareness about the coverage did not seem to promote the utilization of preventive measures for young children.
Dulli, Lisa S; Eichleay, Marga; Rademacher, Kate; Sortijas, Steve; Nsengiyumva, Théophile
ABSTRACT Objective The primary objective of this study was to test the effectiveness of integrating family planning service components into infant immunization services to increase modern contraceptive method use among postpartum women. Methods The study was a separate sample, parallel, cluster-randomized controlled trial. Fourteen randomly selected primary health facilities were equally allocated to intervention (integrated family planning and immunization services at the same time and location) and control groups (standard immunization services only). At baseline (May–June 2010), we interviewed postpartum women attending immunization services for their infant aged 6 to 12 months using a structured questionnaire. A separate sample of postpartum women was interviewed 16 months later after implementation of the experimental health service intervention. We used linear mixed regression models to test the study hypothesis that postpartum women attending immunization services for their infants aged 6–12 months in the intervention facilities will be more likely to use a modern contraceptive method than postpartum women attending immunization services for their infants aged 6–12 months in control group facilities. Results We interviewed and analyzed data for 825 women from the intervention group and 829 women from the control group. Results showed the intervention had a statistically significant, positive effect on modern contraceptive method use among intervention group participants compared with control group participants (regression coefficient, 0.15; 90% confidence interval [CI], 0.04 to 0.26). Although we conducted a 1-sided significance test, this effect was also significant at the 2-sided test with alpha = .05. Among those women who did not initiate a contraceptive method, awaiting the return of menses was the most common reason cited for non-use of a method. Women in both study groups overwhelmingly supported the concept of integrating family planning
Koomey, J.G.; McMahon, J.E.; Wodley, C.
This report summarizes the costs and space-conditioning load savings from improving new single-family building shells. It relies on survey data from the National Association of Home-builders (NAHB) to assess current insulation practices for these new buildings, and NAHB cost data (aggregated to the Federal region level) to estimate the costs of improving new single-family buildings beyond current practice. Space-conditioning load savings are estimated using a database of loads for prototype buildings developed at Lawrence Berkeley Laboratory, adjusted to reflect population-weighted average weather in each of the ten federal regions and for the nation as a whole
Children and Families in the Midwest: Employment, Family Services and the Rural Economy. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, Ninety-Ninth Congress, Second Session (Galesburg, IL, August 11, 1986).
Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.
The House select committee met to hear testimony from parents, children, service providers, and researchers concerning the effects of job and income loss on families in central Illinois. The testimony of the first panel consisted of personal narratives. A high school student whose parents may move the family in order to find better paying jobs…
Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C
Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs
Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff
Service learning is often used in teacher education as a way to challenge social bias and provide teacher candidates with skills needed to work in partnership with diverse families. Although some literature suggests that service learning could reinforce cultural bias, there is little documentation. In a study of 21 early childhood teacher…
Sinanan, Allison N.
This study identified selected child factors (e.g., age, gender, race/ethnicity, disabilities, prior victimization, and relationship to perpetrator of abuse), family risk factors (e.g., substance abuse, domestic violence, inadequate housing, and financial problems), and services provided by child protective services that likely increased reports…
The potable water use recorded by 3 579 residential consumer water meters in Cape Town, South Africa, was analysed as part of this research. The focus was on selected residential properties in serviced areas, with additional private access to groundwater as a supplementary household water source. Private consumers ...
Fisher, Peter S.
Using multiple regression analysis for each county and a case study of selected services in Johnson County, Iowa, the study estimated the impacts of rural non-farm development in Iowa on the demand for local public services, on the cost of providing these services, and on the distribution of service benefits and tax burdens among population…
This issue of Population Briefs contains articles on researches conducted by the Population Council concerning the delivery of quality of care, contraceptive development, safe abortion, family planning, demography, and medical anthropology. The cover story focuses on a systematic data collection tool called Situation Analysis that helps managers in program evaluation. This tool has a handbook entitled "The Situation Analysis Approach to Assessing Family Planning and Reproductive Health Services" that contains all the information needed to conduct a Situation Analysis study. The second article reports about a new contraceptive method, the two-rod levonorgestrel, which was developed at the Population Council and was recently approved by the US Food and Drug Administration. The third article reports on a medical abortion procedure that was proven to be safe, effective, and acceptable to women in developing countries. Moreover, the fourth article presents initial findings of the Community Health and Family Planning Project conducted in Northern Ghana. The fifth article discusses the paper written by the Population Council demographer, Mark Montgomery entitled "Learning and lags in mortality perceptions". Finally, the sixth article deals with another paper that reports on women's health perceptions and reproductive health in the Middle East.
Kilmer, Ryan P; Cook, James R; Crusto, Cindy; Strater, Katherine P; Haber, Mason G
The experience of homelessness can pervade multiple levels and facets of a child and family's world. In view of the historical risks in the lives of children who are experiencing homelessness (e.g., growing up under conditions of poverty, exposure to family violence), it is clear that interventions, services, and supports need to be equally comprehensive to have a positive influence on child functioning and development. Consequently, service systems, providers, and community supports need to address the circumstances of children and families experiencing homelessness and, more specifically, better attend to their ecologies and the diverse factors that can affect their well-being and adjustment trajectories. Such an approach is needed to better understand the range of factors and influences on the development and adaptation of these youngsters at home, at school, and with their peers as well as to guide the identification and implementation of adequate family-centered services and supports. © 2012 American Orthopsychiatric Association.
Straub, Christine; Krüger, Marcus; Bode, Sebastian
Interprofessional collaboration between different professional groups in the health care system is essential to efficient and effective patient care. Especially in pediatrics, in the field of child protection, and family services it is mandatory to involve experts from different health-care professions to optimize support for children and their families. Interprofessional education in medical schools and specifically in pediatrics is rare in Germany, but is called for by the German National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). We developed an interprofessional course aimed at bringing medical students together with students of psychology, social work, clinical education, and educational science to learn from, about and with each other in the context of child protection and family services. This offers opportunities for all participants to understand profession-specific competencies, roles, attitudes, and limits of their professional roles. The course is led by an interprofessional teaching tandem (social scientist & physician); further input is provided by other health and social care professionals. After the students get a brief overview about the requirements for a successful interprofessional cooperation they solve case studies in interprofessional teams with online support by the teaching tandem. We assess the feasibility and acceptability of this interprofessional course and describe challenges encountered when conducting this kind of learning concept for health care professions. All conducted courses over five consecutive terms were evaluated with an arithmetic mean of AM=1.32 on a 6-point scale (1="excellent", 6="insufficient"), the teaching tandem was evaluated with AM=1.1. All participants (N=85 complete evaluations) voted for the course to be continued in the following terms. Especially the opportunity to discuss cases with students from different degree programs was highly valued as were
Kong, Anthony Pak-Hin
This study investigates (a) the provision of speech-language pathology (SLP) services and community resources in Hong Kong for persons with aphasia (PWA) and their families and (b) family members' perception of the service quality. A self-administered 42-item questionnaire was distributed in two community support groups. The questions included information on the demography data of the PWAs, details of the SLP services and family members' perception of PWAs' satisfaction with the hospital-based services and resources in community support groups. Results from 37 completed questionnaires indicated most inpatient and outpatient SLP sessions were delivered weekly and monthly, respectively, in fewer than 30 min. The primary foci of these sessions were assessment and treatment of aphasia. While professional SLP services were unavailable in support groups, the activities attended most frequently by the PWAs and their families were communication groups and social gatherings, respectively. Overall satisfaction was highest with support groups, followed by hospital-based inpatient and outpatient services. The results provide commentary on the existing practices of post-stroke aphasia management in Hong Kong, and will provide new insights into the clinical care of the PWAs and their families. Such knowledge can allow better planning of resource and manpower allocation for aphasia rehabilitation.
Umar Aminu Kaoje
Full Text Available Introduction: Satisfaction evaluation is an excellent opportunity to involve clients in the process of assessing programs from users′ perspective and is recognized as a component of quality of care. This study aimed to identify determinants of client satisfaction with the family planning (FP services provided in government health facilities in Sokoto metropolis. Materials and Methods: A descriptive cross-sectional study was conducted among FP clients that patronized the FP commodity delivery point in selected health facility in Sokoto, Northern Nigeria. A multi-stage sampling technique was used to select the study respondents. List of the clients that attended each clinic was compiled and used as a sampling frame. A set of pretested exit interviewer-administered questionnaire was used to collect data from the clients. Ethical approval was granted for the conduct of the study, and individual informed consent was obtained from each client. Thereafter, the exit questionnaire was administered. Results: All the respondents were females and those aged 25-29 years constituted a larger proportion of 26%. Overall mean age was 30.8 ± 7.0 years. Large proportion (85% expressed satisfaction with FP services provided. About 49% of the respondents reported waiting for 30 min before being attended to by service providers while 13% waited for more than 2 h. Average waiting time was 60.3 ± 21.3 min with clients mean desired waiting time of 35.2 ± 11.1 min. Clinic waiting time, being examined during the visit, and attitude of both service providers and other clinic staffs were found to be the key determinants of client satisfaction. Conclusion: Although, most of the clients waited for more than 30 min, majority were satisfied with the services offered. There is a need to reduce waiting time of FP clients at the clinic and ensure clients are appropriately examined.
Thomas, James C; Reynolds, Heidi W; Alterescu, Xavier; Bevc, Christine; Tsegaye, Ademe
The service needs of people with human immunodeficiency virus (HIV) in low-income settings are wide-ranging. Service provision in a community is often disjointed among a variety of providers. We sought to reduce unmet patient needs by increasing referral coordination for HIV and family planning, measured as network density, with an organizational network approach. We conducted organizational network analysis on two networks in sub-cities of Addis Ababa, Ethiopia. There were 25 organizations in one sub-city network and 26 in the other. In one of them we sought to increase referrals through three network strengthening meetings. We then conducted the network analysis again in both sub-cities to measure any changes since baseline. We also quantitatively measured reported client service needs in both sub-cities before and after the intervention with two cross-sectional samples of face-to-face interviews with clients (459 at baseline and 587 at follow-up). In the sub-city with the intervention, the number of referral connections between organizations, measured as network density, increased 55%. In the control community, the density decreased over the same period. Reported unmet client service needs declined more consistently across services in the intervention community. This quasi experiment demonstrated that (1) an organizational network analysis can inform an intervention, (2) a modest network strengthening intervention can enhance client referrals in the network, (3) improvement in client referrals was accompanied by a decrease in atient-reported unmet needs and (4) a series of network analyses can be a useful evaluation tool. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Leijten, Patty; Shaw, Daniel S.; Gardner, Frances; Wilson, Melvin N.; Matthys, Walter; Dishion, Thomas J.
Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide
Leijten, P.; Shaw, D.S.; Gardner, F.; Wilson, M.N.; Matthys, W.; Dishion, T.J.
Integration of empirically supported prevention programs into existing community services is a critical step toward effecting sustainable change for the highest-risk members in a community. We examined if the Family Check-Up—known to reduce disruptive behavior problems in young children—can provide
Gebreselassie, Tesfayi; Stephens, Robert L.; Maples, Connie J.; Johnson, Stacy F.; Tucker, Alyce L.
Predictors of retention of participants in a longitudinal study and heterogeneity between communities were investigated using a multilevel logistic regression model. Data from the longitudinal outcome study of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families program and information on…
Describes the Elma School District (Washington) birth-to-kindergarten program. One-fourth of the 100 students in the program are developmentally delayed. Family-focus elements include parent volunteers, home visits, class visitations, parenting information dissemination, parent-teacher conferences, referral to social services, and intervention.…
Mpunga, Dieudonné; Lumbayi, J P; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert
To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as "high" if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or "low" if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services ( P family planning services in health facilities in the DRC remain low, with inequitable distribution of services throughout the country. To improve access to and use of family planning, efforts should focus on improving availability and quality at lower health system levels
Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin
Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.
McNall, Laurel A; Scott, Lindsay D; Nicklin, Jessica M
More individuals than ever are managing work and family roles, but relatively little research has been done exploring whether boundary preferences help individuals benefit from multiple role memberships. Drawing on Greenhaus and Powell's (2006) work-family enrichment theory, along with Boundary Theory (Ashforth, Kreiner, & Fugate, 2000) and Conservation of Resources Theory (Hobfoll, 2002), we explore the impact of personal characteristics as enablers of work-family enrichment, and in turn, work outcomes relevant to human service workers: turnover intentions and emotional exhaustion. In a 2-wave study of 161 human service employees, we found that individuals high in positive affectivity were more likely to experience both work-to-family and family to-work enrichment, whereas those with preferences toward integration were more likely to experience work-to-family enrichment (but not family to-work enrichment). In turn, work-to-family enrichment (but not family to-work enrichment) was related to lower turnover intentions and emotional exhaustion. Enrichment served as a mediating mechanism for only some of the hypothesized relationships. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Curry, Dora Ward; Rattan, Jesse; Huang, Shuyuan; Noznesky, Elizabeth
An estimated 43 million women of reproductive age experienced the effects of conflict in 2012. Already vulnerable from the insecurity of the emergency, women must also face the continuing risk of unwanted pregnancy but often are unable to obtain family planning services. The ongoing Supporting Access to Family Planning and Post-Abortion Care (SAFPAC) initiative, led by CARE, has provided contraceptives, including long-acting reversible contraceptives (LARCs), to refugees, internally displaced persons, and conflict-affected resident populations in Chad, the Democratic Republic of the Congo (DRC), Djibouti, Mali, and Pakistan. The project works through the Ministry of Health in 4 key areas: (1) competency-based training, (2) supply chain management, (3) systematic supervision, and (4) community mobilization to raise awareness and shift norms related to family planning. This article presents data on program results from July 2011 to December 2013 from the 5 countries. Project staff summarized monthly data from client registers using hard-copy forms and recorded the data electronically in Microsoft Excel for compilation and analysis. The initiative reached 52,616 new users of modern contraceptive methods across the 5 countries, ranging from 575 in Djibouti to 21,191 in Chad. LARCs have predominated overall, representing 61% of new modern method users. The percentage of new users choosing LARCs varied by country: 78% in the DRC, 72% in Chad, and 51% in Mali, but only 29% in Pakistan. In Djibouti, those methods were not offered in the country through SAFPAC during the period discussed here. In Chad, the DRC, and Mali, implants have been the most popular LARC method, while in Pakistan the IUD has been more popular. Use of IUDs, however, has comprised a larger share of the method mix over time in all 4 of these countries. These results to date suggest that it is feasible to work with the public sector in fragile, crisis-affected states to deliver a wide range of quality
Amo-Adjei, Joshua; Mutua, Michael; Athero, Sherine; Izugbara, Chimaraoke; Ezeh, Alex
In this paper, we reflect on our experiences of implementing a multipronged intervention to improve sexual and reproductive health outcomes. The project used family planning as its entry point and was implemented in two high fertility counties-Busia and Siaya in Kenya. The intervention, implemented by a seven-member consortium, involved: family planning services delivery; regular training of service providers to deliver high quality services; monitoring and evaluation; strengthening of commodity chain delivery and forecasting; school-based and out-of-school based sexuality education; and advocacy and stakeholder engagements at the community, county and national levels. Over a 5-year period, the project contributed to raising demand for family planning considerably, evidenced in fertility decline. It also improved the capacity of family planning services providers, increased commitment and awareness of county government and other community stakeholders on the importance of investments in family planning. Our collaborations with organisations interested in sexual and reproductive health issues substantially enhanced the consortium's ability to increase demand for, and supply of family planning commodities. These collaborations are proving useful in the continuity and sustainability of project achievements.
Blusi, Madeleine; Asplund, Kenneth; Jong, Mats
The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion . The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.
Bintabara, Deogratius; Nakamura, Keiko; Seino, Kaoruko
Global policy reports, national frameworks, and programmatic tools and guidance emphasize the integration of family planning and HIV testing and counseling services to ensure universal access to reproductive health care and HIV prevention. However, the status of integration between these two services in Tanzanian health facilities is unclear. This study examined determinants of facility readiness for integration of family planning with HIV testing and counseling services in Tanzania. Data from the 2014-2015 Tanzania Service Provision Assessment Survey were analyzed. Facilities were considered ready for integration of family planning with HIV testing and counseling services if they scored ≥ 50% on both family planning and HIV testing and counseling service readiness indices as identified by the World Health Organization. All analyses were adjusted for clustering effects, and estimates were weighted to correct for non-responses and disproportionate sampling. Descriptive, bivariate, and multivariate logistic regression analyses were performed. A total of 1188 health facilities were included in the study. Of all of the health facilities, 915 (77%) reported offering both family planning and HIV testing and counseling services, while only 536 (45%) were considered ready to integrate these two services. Significant determinants of facility readiness for integrating these two services were being government owned [AOR = 3.2; 95%CI, 1.9-5.6], having routine management meetings [AOR = 1.9; 95%CI, 1.1-3.3], availability of guidelines [AOR = 3.8; 95%CI, 2.4-5.8], in-service training of staff [AOR = 2.6; 95%CI, 1.3-5.2], and availability of laboratories for HIV testing [AOR = 17.1; 95%CI, 8.2-35.6]. The proportion of facility readiness for the integration of family planning with HIV testing and counseling in Tanzania is unsatisfactory. The Ministry of Health should distribute and ensure constant availability of guidelines, availability of rapid diagnostic
Qureshi, Asma M
To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.
Qureshi Asma M
Full Text Available Abstract Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00 relative to private non-franchises. Service use was significantly associated with training (P = 0.00, franchise affiliation (P = 0.01, providers' years of family planning experience (P = 0.02 and the number of trained staff working at government owned clinics (P = 0.00. In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00. Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.
O'Connor, Meredith; Rosema, Stefanie; Quach, Jon; Kvalsvig, Amanda; Goldfeld, Sharon
A fifth of children enter school with special health care needs (SHCN), many of whom have difficulties that are milder or not yet formally diagnosed (emerging SHCN). This study aimed to investigate how differing perceptions of children's emerging SHCN across the family and school contexts relates to service utilization. Sample: The nationally representative birth cohort of the Longitudinal Study of Australian Children, which includes parent reports on the abbreviated Children with Special Health Care Needs Screener. For a subsample of 2459 children teachers also completed the Australian Early Development Census, a measure of early childhood development at school entry that includes SHCN. Logistic regression analyses were conducted adjusting for severity of condition, gender, language background, and disadvantage. Overall 24.1% of children were identified by their parent and/or teacher as experiencing emerging SHCN. Compared with those with consistent reports, children with parent-only identified needs had lower odds of accessing school services (odds ratio [OR], 0.29; 95% confidence interval [CI], 0.10-0.81). Similarly, children with parent-only (OR, 0.39; 95% CI, 0.20-0.75) and teacher-only (OR, 0.25; 95% CI, 0.14-0.46) identified needs had significantly lower odds of accessing services in the community. When parent and teacher perceptions of children's emerging SHCN were inconsistent, service use was lower at school and in the community. Further efforts are needed by health and education providers to ensure that common understandings about a child's needs at school are established early in children's educational careers. Copyright © 2017. Published by Elsevier Inc.
DeVoe, Ellen R; Paris, Ruth; Emmert-Aronson, Ben; Ross, Abigail; Acker, Michelle
Parenting through the deployment cycle presents unique stressors for military families. To date, few evidence-based and military-specific parenting programs are available to support parenting through cycles of deployment separation and reintegration, especially for National Guard/Reserve members. The purpose of this research was to test the efficacy of a parenting program developed specifically to support military families during reintegration. Within 1 year of returning from deployment to Afghanistan or Iraq, 115 service members with very young children were randomly assigned to receive either the Strong Families Strong Forces Parenting Program at baseline or after a 12-week waiting period. Using a home-based modality, service members, at-home parents, and their young child were assessed at baseline, 3 months posttreatment/wait period, and 6 months from baseline. Service member parents in Strong Families evidenced greater reductions in parenting stress and mental health distress relative to those in the waitlist comparison group. Service members with more posttraumatic stress symptoms reported higher levels of perceived parental efficacy in the intervention group than service members in the comparison group. Intervention also resulted in enhanced parental reflective capacity, including increased curiosity and interest in the young child among those in the intervention group relative to comparison. Service member parents and their spouses demonstrated high interest in participating in a postdeployment parenting program targeting families with very young children. Findings point to the feasibility, appeal, and efficacy of Strong Families in this initial trial and suggest promise for implementation in broader military and community service systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Walshe, Margaret; Moran, Robert; Boyle, Marie; Cretu, Ion; Galvin, Zita; Swan, Victoria; Trikovic, Jason; Farrell, Michael P; Foy, Sinéad; O'Brien, Loretta; Leyden, Jan; Mulligan, Niall; Fenlon, Helen; Gallagher, David J; MacMathúna, Padraic
We present the 15-year experience of a family colorectal cancer screening service in Ireland with emphasis on real life experience and outcomes. Questionnaires were used to assess family cancer history and assign patients to risk categories; 'Moderate Risk', HNPCC, (suspected) genetic syndrome (non-HNPCC), 'Low Risk'. Screening was by full colonoscopy. We report neoplastic yield, examining effect of risk category, age, gender, and index colonoscopy findings. Between 1998 and 2013, 2242 individuals were referred; 57.3% female, 42.7% male, median age 46 years (range9-85yrs). Median follow up time was 7.9yrs (range 0.5-15.3yrs). Follow up data after exclusion (non-compliance, known CRC) was available in 1496 (66.7%): 'Moderate risk' 785 (52.5%), HNPCC 256 (17.1%), (suspected) genetic syndrome (non-HNPCC) 85 (5.7%), 'Low Risk' 370 (24.7%). Screening was performed in 1025(68.5%) patients; colonoscopy data available for 993 (96.9%); total 1914 colonoscopies. At index colonoscopy, 178 (18.0%) patients had adenomas; 56 (5.5%) advanced adenoma. During the entire study period, 240 (24.2%) had an adenoma; 69 (7.0%) advanced adenoma. Cancers were diagnosed on screening in 2 patients. Older age and male gender were associated with higher adenoma detection rate; p50) were the core identifiable risk factors for neoplasia at screening colonoscopy in this family screening setting. Our results would support less intensive surveillance in younger patients (<50), particularly where index colonoscopy is normal. Copyright © 2017 Elsevier Ltd. All rights reserved.
Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O
Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client's waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as 'pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers' behaviour. There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive
Gizachew Assefa Tessema
Full Text Available Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa.Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings.From 4334 records, 11 studies (eight quantitative, three qualitative met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client's waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as 'pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers' behaviour.There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking
Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony
Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…
Lindsay, Sally; King, Gillian; Klassen, Anne F; Esses, Victoria; Stachel, Melissa
Although providing culturally sensitive care is an important element of family-centered rehabilitation very is little known about providers' experiences working with immigrant families in pediatric settings. The purpose of this study is to develop a better understanding of the experiences of service providers working with immigrant families raising a child with a physical disability. We draw on a qualitative approach involving in-depth interviews and focus groups with healthcare and community service providers (n = 13) in two multi-cultural Canadian cities. The findings indicate that healthcare and community service providers encounter several challenges in providing care to immigrant families raising a child with a disability. Such challenges include the following: (1) lack of training in providing culturally sensitive care; (2) language and communication issues; (3) discrepancies in conceptualizations of disability between healthcare providers and immigrant parents; (4) building rapport; and (5) helping parents to advocate for themselves and their children. Service providers also have several recommendations for improving services to better meet the needs of immigrant families. Clinicians should be cognizant of how culture influences the care they provide to clients. More training opportunities are needed for enhancing culturally sensitive care. • Pediatric rehabilitation providers working with immigrant families raising a child with a disability should engage in training and education around culturally sensitive care to better meet the needs of these clients. • More time is needed when working with immigrant families to build trust and rapport. • Clinicians need to be sensitive around gender issues and try to involve both parents in the decision making around the care for their child. • Healthcare providers should help clients to become more aware of the resources available to them in the hospital and in the community.
Azami-Aghdash, Saber; Ghojazadeh, Morteza; Aghaei, Mir Hossein; Naghavi-Behzad, Mohammad; Asgarlo, Zoleikha
In view of the recent surge in chronic disease rates and elderly population in the developing countries, there is an urgent felt need for palliative and hospice care services. The present study investigates the views and attitudes of patients and their families, physicians, nurses, healthcare administrators, and insurers regarding designing and delivering hospice care service in a middle income country. In this qualitative study, the required data was collected using semi structured interviews and was analyzed using thematic analysis. Totally 65 participants from hospitals and Tabriz University of Medical Sciences were selected purposively to achieve data saturation. Analyzing the data, five main themes (barriers, facilitators, strategies, attitudes, and service provider) were extracted. Barriers included financial issues, cultural-religious beliefs, patient and family-related obstacles, and barriers related to healthcare system. Facilitators included family-related issues, cultural-religious beliefs, as well as facilitators associated with patients, healthcare status, and benefits of hospice service. Most participants (79%) had positive attitude towards hospice care service. Participant suggested 10 ways to design and deliver effective and efficient hospice care service. They thought the presence of physicians, nurses, and psychologists and other specialists and clergy were necessary in the hospice care team. Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.
Skiles, Martha Priedeman; Cunningham, Marc; Inglis, Andrew; Wilkes, Becky; Hatch, Ben; Bock, Ariella; Barden-O'Fallon, Janine
Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance. Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations. Access to services was an important predictor of injectable use. The probability of injectable use among rural women with the most access by both measures was 7‒8 percentage points higher than among rural dwellers with the least access. The probability of wanting to space or limit births among urban women who had access to the most reliable supplies was 18 percentage points higher than among their counterparts with the least access. Product availability in the local service environment plays a critical role in women's demand for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments provides a refined approach to linking women with services and accounts for both distance to facilities and supply reliability. Urban and rural differences should be considered when seeking to improve contraceptive access.
Goswami, Kiran; Salve, H; Malhotra, S; Kumar, Y
Family Health Advisory Services (FHAS) posting as well as its assessment is resource demanding but fails to enjoy priority. Study focuses on a holistic overview of the assessment process to understand need for change. The aim of this study is to identify perceived gaps in current assessment practices related to FHAS posting. A cross-sectional mixed method study among all the V semester students currently undergoing assessment for the posting, past students (selected VII semester students and interns), preceptors (supervising residents - postgraduate students in department and senior resident, health assistants, medical social service officer), and involved faculty. Self-administered questionnaire, in-depth interview, focus group discussions (two) as well as observations using checklist were used for data collection and triangulation. Quantitative data used in this study were statistical measures of central tendency and dispersion. Qualitative data transcript repeatedly read to identify underlying common themes, compared to draw inference. There was a lack of guidelines and communication regarding assessment. Formative assessment was not performed and replaced by one time end assessment. All components of learning were not assessed. End-posting assessment was not standardized and unrelated to learning objectives. Award of scores was skewed toward right for intervention and toward left for analysis and community diagnosis. There is a need to focus on proper implementation of programme to strengthen formative assessment. Assessment should be relevant to learning objectives of posting. Faculty has to lead by example.
Whittaker, Karen A; Cox, Pat; Thomas, Nigel; Cocker, Karen
United Kingdom policy and practice endorses family support for child well-being. Achieving such support requires multi-agency approaches that consider all aspects of parents' and children's lives and which offer practical, social and emotional help. The potential for services to make a positive impact on parents and their families will depend in part on the level and nature of engagement. In this paper, a case is made for the application of the two-part surface and depth concept for understanding how practitioners engage with families and how they might improve the chances of supporting sustainable differences for parents and families. To illustrate, qualitative data from a review of family centre support provided by a north of England local authority are presented. The review was commissioned to explore why families often need to re-engage with intensive support services. Data were drawn from interviews with parents (n = 18, recruited following a survey of all those registered with the service during April-May 2009) and discussions with family centre support workers (n = 4), and following thematic analysis, three dominant themes emerged--resources available, staff approach and real life--which were appraised in the light of the surface and depth concept. Much of the work with parents effectively dealt with pressing needs. This felt gratifying for both parent and worker and supported immediate service engagement. However, each noted that the more complex issues in parents' lives went unchallenged and thus the sustainability of progress in terms of parenting practice was questionable. A strengths focused approach by staff that understood needs in the context of parents' real-life circumstances was important to parent engagement. Thus, longer term benefits from family support require practitioners to work with parents to problem solve immediate issues while also digging deeper to acknowledge and seek to resolve the more complex challenges parents face in their real
Chacko, Anil; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Jackson, Jerrold; Marcus, Sue; Hoagwood, Kimberly; McKay, Mary
The purpose of this study was to determine the benefits of a multiple family group (MFG) service delivery model compared with services as usual (SAU) in improving the functioning of youth with oppositional defiant/conduct disorder in families residing in socioeconomically disadvantaged communities. Participants included 320 youth aged 7 to 11 and their families who were referred to participating outpatient clinics. Participants were assigned to the MFG or the SAU condition, with parent report of child oppositional behavior, social competence, and level of youth impairment as primary outcomes at post-treatment. Family engagement to MFG was measured by attendance to each group session. Caregivers of youth in the MFG service delivery model condition reported significant improvement in youth oppositional behavior and social competence compared with youth in the SAU condition. Impairment improved over time for both groups with no difference between treatment conditions. The MFG led to greater percentage of youth with clinically significant improvements in oppositional behavior. Attendance to the MFG was high, given the high-risk nature of the study population. The MFG service delivery model offers an efficient and engaging format to implement evidence-based approaches to improving functioning of youth with oppositional defiant and/or conduct disorder in families from socioeconomically disadvantaged communities.
Shlay, Judith C; McEwen, Dean; Bell, Deborah; Maravi, Moises; Rinehart, Deborah; Fang, Hai; Devine, Sharon; Mickiewicz, Theresa; Dreisbach, Susan
Sexually transmitted diseases (STDs) and unintended pregnancy are significant and costly public health concerns. Integrating family planning services (FPS) into STD visits provides an opportunity to address both concerns simultaneously. Our objectives were to create an electronic eligibility reminder to identify male and female patients eligible for FPS during an STD clinic visit and measure FPS use, additional cost of integrated services, and patient/provider satisfaction and to explore the impact on incident pregnancy and STDs. Quasi-experimental design compared enrollment and patient/provider satisfaction before (2008) and after implementation (2010). Incident pregnancy and STD 12 months after the initial visit before and after were explored. Time and cost were calculated. Quantitative and qualitative analyses were performed. A total of 9695 clients (male, 5842; female, 3853) in 2008 and 10,021 clients (male, 5852; female, 4169) in 2010 were eligible for FPS. Enrollment in FPS increased (2008: 51.6%, 2010: 95.3%; P < 0.01). Total additional cost was US$29.25/visit, and additional staff time was 4.01 minutes for integrated visits. Staff satisfaction increased and client satisfaction remained high. Among women returning within 12 months (39.6% in 2008, 37.1% in 2010), pregnancies were lower among enrolled versus nonenrolled women for 2008 (7.7% vs. 19.5%, P < 0.01) and 2010 (13.1% vs. 25.9%, P = 0.05). Incident STDs did not differ. An electronic eligibility reminder of FPS increased FPS use. Integration of FPS with STD services is feasible, is well accepted, and increases costs minimally. Integration may reduce pregnancy rates without increasing STD rates.
Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana
Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.
Walakira, Eddy J; Ochen, Eric A; Bukuluki, Paul; Alllan, Sue
This article describes a model of care for abandoned and neglected infants in need of urgent physical, social, and medical support as implemented by the Child's i Foundation, an international, nongovernmental organization operating in Uganda. The model discounts the need for long-term care of young children within institutions and challenges the basis for intercountry adoption. Underpinned by the essentials of care continuum provided under the Uganda National Alternative Care Framework (Ministry of Gender, Labour and Social Development, 2012), the model emphasizes the need to effect the reintegration of the separated child within the family of his or her birth, or locally organize foster care or adoption. Highlighting policy and programming lessons, the model showcases a holistic approach to the problem and puts emphasis on interventions that are protective, promotional, and transformational and the use of a community-oriented approach. The model offers guidance to both government and nongovernment actors in addressing the problems of child neglect and abandonment through the implementation of the alternative care framework. © 2014 Michigan Association for Infant Mental Health.
Full Text Available The paper presents energy use for heating and ventilation (one of the energy performance components determined in three ways. A case of a single family building located near Wroclaw in Poland is analyzed. The first and the second variant are both computational and the third presents actual measured energy consumption. Computational variants are based on the Polish methodology for the EPC (the Energy Performance Certificate. This methodology is based on ‘the Energy Performance of Buildings Directive 2010/31/EU’. Energy use for heating and ventilation is calculated using monthly method presented in EN ISO 13790. In the first computational option standard input data (parameters such as indoor and outdoor air temperature etc. are taken from standards and regulations are implemented. In the second variant this input data are partially taken from measurements. The results of energy use from both computational variants are compared to the actual measured energy consumption. On the basis of this comparison the influence of three factors: solar radiation heat gains, building air tightness and the SCOP of the heat pump on energy use calculations are analyzed. Conclusions aim to point the differences between them and the actual energy consumption.
Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna
Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the
Antunes C. H.
Full Text Available The increasing deployment of distributed generation systems based on renewables in the residential sector, the development of information and communication technologies and the expected evolution of traditional power systems towards smart grids are inducing changes in the passive role of end-users, namely with stimuli to change residential demand patterns. The residential user should be able to make decisions and efficiently manage his energy resources by taking advantages from his flexibility in load usage with the aim to minimize the electricity bill without depreciating the quality of energy services provided. The aim of this paper is characterizing electricity consumption in the residential sector and categorizing the different loads according to their typical usage, working cycles, technical constraints and possible degree of control. This categorization of end-use loads contributes to ascertain the availability of controllable loads to be managed as well as the different direct management actions that can be implemented. The ability to implement different management actions over diverse end-use load will increase the responsiveness of demand and potentially raises the willingness of end-users to accept such activities. The impacts on the aggregated national demand of large-scale dissemination of management systems that would help the end-user to make decisions regarding electricity consumption are predicted using a simulator that generates the aggregated residential sector electricity consumption under variable prices.
Assaf, Shireen; Wang, Wenjuan; Mallick, Lindsay
High quality of care in family planning (FP) services has been found to be associated with increased and continued use of contraceptive methods. The interpersonal skills and technical competence of the provider is one of the main components of quality of care. To study the process component of quality of care, the distribution of the FP counseling topics was examined by client, provider and facility characteristics. To assess the outcomes of quality of care, client satisfaction and their knowledge of their method's protection from STIs were used. This study examined the factors associated with these outcomes with a focus on provider counseling and training. Data from the 2012-2013 Senegal Service Provision Assessment survey was used for the analysis. The survey included a representative sample of the health facilities in Senegal and collects data by observing the clients' FP visits and conducting exit interviews. The main outcomes of interest were provider's counseling in FP, client's satisfaction with FP services and client's knowledge of their method's protection from STIs. Several covariates were used in the analysis which represent client, provider and facility characteristics. The level of counseling was inadequate-- very low proportions of providers that performed different types of counseling. Counseling was more likely to be provided to new than returning clients. Approximately 84% of the clients were very satisfied with services but only 58% had correct knowledge of their method's protection from STIs. Clients were significantly less likely to be very satisfied when their providers counseled on side effects and when to return, and counseling provided on method's protection from STIs did not significantly improve knowledge in this area. Clients seen by a provider with FP training had almost twice the odds of having correct knowledge about their method's protection from STIs compared with clients seen by a provider with no recent training. The percentage of
Hovdestad, W; Shields, M; Williams, G; Tonmyr, L
Young mothers' families are at increased risk of child maltreatment and other poor health and social outcomes. Chi-square analyses of pooled child welfare services data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003; CIS-2008) were used to compare 284 teen mothers (18 years or younger) and 800 young mothers (19-21 years) and their families with 5752 families where the mother was 22 years or older. Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother) received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10%) and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18%) and few social supports (46% and 41% vs. 37%). Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%). All were equally likely to be victims of domestic violence and to have mental health issues. Within this sample of high-risk families, young mothers' families were more at risk than comparison families. Mothers' youth may be a useful criterion to identify families for targeted interventions.
Asai, Masayuki O.; Kameoka, Velma A.
The Asian family is regarded as a close-knit social unit in which elderly people are believed to occupy a highly respected position. Family members are thought to provide care for elderly parents gratefully because of filial piety. This stereotypic portrayal of Asian families, however, may not apply fully to Japanese families. This article points…
The use of crisis nursery care as a viable alternative for the consumer experiencing chronic and ongoing family crises calls for consideration of various programmatic and staffing issues. Combinations of family problems, including homelessness, substance abuse, incarceration, family violence, and chronic illness of a family member, may precipitate…
Many low-income families are at risk for food insecurity. In addition, with the aging of America, multigenerational families are becoming more prevalent, resulting in excessive strain and burden on the resources of low-income families. Family and consumer sciences educators need to teach their students about factors that contribute to food…
The 1999 Active Duty Surveys (ADS) gather information on current location, spouse's military assignment, military life, programs and services, spouse employment, family information, economic issues, and background...
Full Text Available Background: With high unmet need for family planning in postpartum period new methods like postpartum intrauterine contraceptive device (PPIUCD can reduce the gap between demand and supply. Role of providers is critical in facilitating a client’s decision to choose an appropriate contraceptive method during her postpartum status. Aims & Objectives: To assess the role of providers in facilitating client’s decision to choose an appropriate contraceptive method during her postpartum status. Material & Methods: This descriptive study was conducted as a multi-centric post-training PPIUCD follow up study of providers in eight states of India. From February 2012 to July 2012, 124 PPIUCD trained providers of sixteen hospitals were interviewed with a standardized questionnaire after informed consent. The providers were interviewed for their perceptions on timing and benefits of family planning counseling, procedure ease, side effects and complications of PPIUCD and their perception of client satisfaction of the method. Proportions and mean (SD were calculated. Results: 66 doctors, 42 nurses and 16 counselors were interviewed. 95% providers felt IUCD is a suitable method for postpartum women. According to 94% doctors, 55% nurses and 88% counselors, antenatal period was the most preferred period for counselling clients. 89% doctors and 69% nurses felt that ideal time of insertion was immediately after delivery of placenta and most preferred Kelly’s placental forceps for insertion. Expulsion was the commonest perceived complication. More than 70% providers felt that clients were satisfied with their decision of choosing PPIUCD as a method with reasons. Conclusions: The results of this descriptive study on providers’ perceptions for IUCD use during the postpartum period showed a positive inclination of the interviewed PPIUCD trained doctors, nurses and counselors towards the method which will help improve access and availability to this service
Tuffrey-Wijne, I; Rose, T
Most staff working in intellectual disability services will be confronted with people with intellectual disabilities who need support around death, dying and bereavement. Previous studies suggest that intellectual disability staff tend to protect clients from knowing about death and avoid communication about death. The aims of this study were to gain further insight into the individual, organisational and contextual factors that affect the communication of death-related bad news to people with intellectual disabilities by intellectual disability staff and to develop guidelines for services to enable appropriate communication with clients about death and dying. Semi-structured interviews were held with 20 social care staff working in intellectual disability residential or supported living services in London, who had supported a client affected by death-related bad news in the past 6 months. Staff found supporting people with intellectual disabilities around death and dying extremely difficult and tended to avoid communication about death. The following factors had a particularly strong influence on staff practice around communicating death-related bad news: fear and distress around death; life and work experience; and organisational culture. Staff attitudes to death communication had a stronger influence than their client's level of cognitive or communicative abilities. Managers were important role models. Service managers should ensure not only that all their staff receive training in death, loss and communication but also that staff are enabled to reflect on their practice, through emotional support, supervision and team discussions. Future work should focus on the development and testing of strategies to enable intellectual disability staff to support their clients in the areas of dying, death and bereavement. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Guterman, Neil B; Bellamy, Jennifer L; Banman, Aaron
Despite mounting evidence on the importance of fathers in children's development, evidence-based perinatal home visitation programs have largely overlooked fathers in the design and delivery of services. This paper describes the design, development, and pilot testing of the "Dads Matter" enhancement to standard home visiting services. Dads Matter is a manualized intervention package designed to fully incorporate fathers into perinatal home visiting services. Twenty-four families were enrolled in a pilot study to assess the feasibility, acceptability, and preliminary outcomes of the intervention. Using a quasi-experimental time-lagged design, 12 families received standard home visiting services and completed baseline and four-month post-tests. Home visitor staff were then trained and supervised to implement the Dads Matter enhancement in addition to standard services. Twelve additional families were then enrolled and completed baseline and four-month post-tests. Implementation data indicated that Dads Matter was implemented as planned. Cohen's d scores on outcome measures indicate positive trends associated with Dads Matter in the quality of the mother-father relationship, perceived stress reported by both parents, fathers' involvement with the child, maltreatment indicators, and fathers' verbalizations toward the infant. Effect sizes generally ranged from moderate to large in magnitude and were larger than overall effect sizes of home visitation services alone reported in prior meta-analyses. Dads Matter appears to be a feasible, acceptable, and promising approach to improving fathers' engagement in home visiting services and promoting family and child well-being. Copyright © 2017. Published by Elsevier Ltd.
Burrows, Kristen E; Adams, Cindy L; Spiers, Jude
Children with autism might display unpredictable and volatile behavior that places them in considerable physical danger and creates stress for the family. Families of autistic children often have limited freedom and experience difficulty with everyday activities. In this qualitative ethology study, we examined the effect of integrating service dogs into ten families with an autistic child. Data included participant observation, video recordings of family-parent-dog interaction, and semistructured interviews with the parents. The themes were (a) the dog as a sentinel of safety, (b) gaining freedom through enhanced safety, facilitating public outings and family activities, and (c) improving social recognition and status, in which the presence of the dog promoted awareness of autism and affected social interaction. The triadic relationship between parent, autistic child, and service dog constantly evolves. This research provides valuable information for parents interested in having a service dog for their autistic child, and has implications for long-term human-animal companionship for children with special needs and their caregivers.
Linden Services for Children is part of Extern, which is a charity within the voluntary sector. The organisation's mission is to promote social inclusion and help reduce the incidence of offending behaviour. Extern operates in both the North and South of Ireland and works with children, families, adults and communities. It aims, through assessment…
Barrueco, Sandra; Wall, Shavaun M.; Mayer, Lynn M.; Blinka, Marcela
Nationally, focus is increasing on the developmental experiences of young children (birth to age 8). Twenty four (arch)dioceses in large metropolitan areas participated in a survey identifying the extent and nature of services provided by Catholic schools and Catholic Charities programs to young children and their families. Six hundred and seventy…
Bigras, Nathalie; Bouchard, Caroline; Cantin, Gilles; Brunson, Liesette; Coutu, Sylvain; Lemay, Lise; Tremblay, Melissa; Japel, Christa; Charron, Annie
This study seeks to determine whether center-based and family-based child care services differ with respect to process quality, as measured by the Educative Quality Observation Scales ("EQOS", Bourgon and Lavallee 2004a, b, c), for groups of children 18 months old and younger. It also seeks to identify structural variables associated…
Dogba, Maman Joyce; Dahan-Oliel, Noémi; Snider, Laurie; Glorieux, Francis H; Durigova, Michaela; Palomo, Telma; Cordey, Michel; Bédard, Marie-Hélène; Bedos, Christophe; Rauch, Frank
Despite the growing interest in understanding the psycho-social impact of rare genetic diseases, few studies examine this concept and even fewer seek to obtain feedback from families who have lived the experience. The aim of this project was to involve families of children living with osteogenesis imperfecta (OI) in the development of a tool to assess the impact of OI on the lives of patients and their families. This project used an integrated knowledge translation approach in which knowledge users (clinicians and people living with OI and their families) were consulted throughout the four steps of development, that is: content mapping, item generation, tool appraisal and pre-testing of the questionnaires. The International Classification of Functioning and Health was used as a framework for content mapping. Based on a scoping review we selected two validated tools to use as a basis for developing the questionnaire. The final parent self-report version measured six domains: experience of diagnosis; use of health services; use of social and psychological support services; expectations about tertiary specialized centers; and socio-demographic information. A total of 27 out of 40 families receiving care at the Shriners Hospital for Children-Canada and invited to participate in the pre-test returned the completed questionnaires. In more than two-thirds of families (69%; n = 18) OI was suspected either at or within the first 3 months after birth. Up to 46% of families consulted between 3 and 5 doctors (46%; n = 12) prior to final diagnosis. The use of services by families varied from 0 to 16 consultations, 0 to 9 exploratory examinations and 1 to 10 types of allied health services. In the 12 months prior to the study, fewer than a quarter of children had been admitted, for treatment, for hospital stays of longer than 8 hours or to an emergency department (24% and 9% respectively). Only 29% of parents received psychological support. This joint development process
Maman Joyce Dogba
Full Text Available Despite the growing interest in understanding the psycho-social impact of rare genetic diseases, few studies examine this concept and even fewer seek to obtain feedback from families who have lived the experience. The aim of this project was to involve families of children living with osteogenesis imperfecta (OI in the development of a tool to assess the impact of OI on the lives of patients and their families.This project used an integrated knowledge translation approach in which knowledge users (clinicians and people living with OI and their families were consulted throughout the four steps of development, that is: content mapping, item generation, tool appraisal and pre-testing of the questionnaires. The International Classification of Functioning and Health was used as a framework for content mapping. Based on a scoping review we selected two validated tools to use as a basis for developing the questionnaire. The final parent self-report version measured six domains: experience of diagnosis; use of health services; use of social and psychological support services; expectations about tertiary specialized centers; and socio-demographic information.A total of 27 out of 40 families receiving care at the Shriners Hospital for Children-Canada and invited to participate in the pre-test returned the completed questionnaires. In more than two-thirds of families (69%; n = 18 OI was suspected either at or within the first 3 months after birth. Up to 46% of families consulted between 3 and 5 doctors (46%; n = 12 prior to final diagnosis. The use of services by families varied from 0 to 16 consultations, 0 to 9 exploratory examinations and 1 to 10 types of allied health services. In the 12 months prior to the study, fewer than a quarter of children had been admitted, for treatment, for hospital stays of longer than 8 hours or to an emergency department (24% and 9% respectively. Only 29% of parents received psychological support.This joint development
Lukasczik, Matthias; Ahnert, Jutta; Ströbl, Veronika; Vogel, Heiner; Donath, Carolin; Enger, Ilka; Gräßel, Elmar; Heyelmann, Lena; Lux, Heidemarie; Maurer, Jochen; Özbe, Dominik; Spieckenbaum, Stefanie; Voigtländer, Elzbieta; Wildner, Manfred; Zapf, Andreas; Zellner, Angela; Hollederer, Alfons
Background Healthcare professionals are confronted with specific work-related demands that influence work-family relations and might indirectly affect the quality of healthcare. This paper seeks to provide an overview of the current state of research on this topic of relevance to health services research. The overview may serve as a starting point for modifying structures in the healthcare system (especially in rural regions) with the aim of improving work-family compatibility. Methods A systematic national and international literature search was conducted in terms of a scoping review. The following criteria/contents to be covered in publications were defined: work-family compatibility; work-family interface and work-family conflict in employees working in healthcare; healthcare professions in rural areas and links with work-family issues; interventions to improve work-family compatibility. 145 publications were included in the overview. Results The available literature focuses on physicians and nursing staff while publications on other professions are largely lacking. The methodological quality of existing studies is mostly low, including a lack of meta-analyses. Several studies document dissatisfaction in physicians and nursing staff regarding reconciliation of work and family life. Only few intervention studies were found that seek to improve work-life compatibility; few of them focus on employees in healthcare. There are also deficits with respect to linking work-family issues with aspects of healthcare in rural areas. Conclusions There is a shortage of systematic national and international research regarding work-family compatibility, especially when it comes to the evaluation of interventions. The overview provides starting points for improving work-family compatibility in healthcare. © Georg Thieme Verlag KG Stuttgart · New York.
Atuahene, Margaret Duah; Afari, Esther Oku; Adjuik, Martin; Obed, Samuel
Family planning services help save lives by reducing women's exposure to risks of child birth and abortion. While family planning services provide measures to prevent unintended pregnancies and time the formation of families, the acceptability and coverage is still very low worldwide. Some of the reasons for this include poor quality of service, unavailability of range of methods, fear of opposition from partners, side effects and health concerns among others.About 40 % of the world's 215,000 annual deaths in childbirth occur in the Sub-Saharan region. In Ghana, urban-rural fertility differences range from two to three children. The acceptability and coverage of family planning are still low and in the study area in particular. We sought to examine factors that contribute to low acceptability and coverage of family planning services in a sub-urban community with a design of quantitative cross-sectional. Ethical approval was given by the Ghana Health Service. Midwives and community health nurses who provide family planning services were interviewed. Exit-interview was also conducted with women receiving a variety of outpatient services. Most of the women in this study (48.7 %) were in the 25-34 age range and were either married (42.8 %) or cohabiting (40.5 %). Majority of these women (67.7 %) have middle/Junior high level of formal education with a modal parity of two. Sixty eight (68) clients were identified as current family planning users. About 6.0 % and 4.5 % were dissatisfied about auditory and visual privacy during counselling respectively. This was confirmed by providers who attributed it to inappropriate facility layout. Most of the clients (79.1 %) were not given educational materials although 88.8 % were talked to about family planning and this could be due to unavailability of these hand-outs.Though clients show satisfaction of services received, providers did not follow standard protocols with as much as 73.7 % faced with challenges in
Shah, N.A.; Nisar, N.
To assess level of awareness and pattern of utilizing family planning services among women (15-49 years) of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a pre tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child (3%), 2-3 children (11%), 4-5 (37.5%), more than five children (36%), 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area. (author)
Rahman, M M; Islam, M N
In order to foster the successful implementation of the strategies of the Voluntary Surgical Contraception program, a study was undertaken in 1990 in Bangladesh to examine the role of service providers and family planning (FP) program personnel in providing quality services to enhance client satisfaction. An assessment was also made of existing facilities and the difficulties they face in providing quality services. The reasons for deterioration in the quality of services were probed, and the suggestions of service providers and managers for improving the quality of services were noted. Data were collected from interviews with 1348 sterilized clients (360 men and 988 women) and from service providers in the districts where the respondents lived (16 medical officers, 67 family welfare visitors, 12 nurses, 33 program managers, and 190 field workers). Results were tabulated by type of service provider (medical officers, family welfare visitors and nurses) for 1) the selection criteria for client suitability, 2) means of sterilizing instruments, 3) the availability of necessary equipment, 4) process used to confirm sterilization of instruments, 5) availability of surgical supplies, and 6) postoperative advice given to clients. Medical officers and program managers answered queries on the adequacy of the supply of materials and suggestions for improving the quality of services. The role of the FP Assistants and the Family Welfare Assistants was assessed by determining the topics each category of worker discussed with potential clients and by asking clients who most influenced their decision to undergo the procedure (more than 50% were motivated by the field workers). Suggestions for improved services from these field workers included enhancing the rate of compensation, increasing the quality of services in the clinics, providing free medical treatment for the clients' children, and giving preferential treatment to sterilized clients. It was concluded that FP field
Ando, Noriko; Iwamitsu, Yumi; Takemura, Kazuhisa; Saito, Yukiko; Takada, Fumio
Our objectives were to investigate: (1) relationships between perceptions of various terms regarding mutation and the depth of knowledge regarding mutation among family members of patients receiving genetic outpatient services, and (2) differences in perceptions of the term "gene mutation" for family members versus university students. Fifty-eight family members and 178 university students responded to two questionnaires: Impressions regarding the term, and Knowledge about the concept of mutation. Factor analyses were conducted to determine the factor structure of ratings of the terms, and two-way analyses of variance [(1)Term, (2)Group x Knowledge] were conducted to examine differences in perceptions of the terms as measured by scores for each extracted factor. Family members had a significantly more negative perception of the term "gene mutation" than "gene change" and a less negative perception of the term "gene mutation" than "gene lesion"; they had significantly more negative perceptions of the term "gene mutation" than did university students.
S Haghighi; B Movahedzadeh; M Malekzadeh
Background and aim: Psychological consequences of addiction, such as major depression regardless of physical problems, economic, cultural and social is cause problems for both families and society. The aim of this study was to evaluate the effectiveness of group cognitive hypnotherapy on major depression in residential and semi-residential addiction recovery centers in the city of Yasuj. Methods: The present quasi-experimental study was conducted using a pre-test, post-test and control ...
The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.
Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D Heather
People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and
Dodevska, G. A.; Vassos, M. V.
Background: To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a "good" direct care worker…
Abbott, Douglas A.
This report summarizes interviews with five social workers who helped families that experienced political violence, and with 16 families that lost a family member due to terrorist activity in Israel and Palestine from 2000 to 2005. Results revealed a great disparity between the Israelis and the Palestinians on the types of and extent of benefits…
Laver, Kate; Gnanamanickam, Emmanuel; Whitehead, Craig; Kurrle, Susan; Corlis, Megan; Ratcliffe, Julie; Shulver, Wendy; Crotty, Maria
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
Olley, Hannah; Psaila, Kim; Fowler, Cathrine; Kruske, Sue; Homer, Caroline; Schmied, Virginia
This article explores the characteristics and functions of the liaison role in child and family health services in Australia. Liaison roles are increasingly being used to improve communication between health services and professionals and to facilitate access to support for individuals and families in need. Nurses are commonly, although not always, the professionals who undertake these roles. Research on the role and outcomes of liaison positions in child and family health services is limited in Australia and internationally. A qualitative interpretive design informed this study. Interviews and focus groups were conducted with 40 liaison and other health professionals, primarily nurses, working with families with newborn and young children in two Australian States. Data were analysed thematically. Three major themes were identified reflecting the importance of defining the role and tasks which included building bridges between services and professionals, supporting families during transition between services and supporting clinicians. Several facilitators and barriers were identified, including concerns about sustainability of the roles. Professionals working in a liaison role in child and family health services emphasise that these positions have the potential to link services and professionals, thereby providing more effective care pathways for children and families especially for those with complex and multiple vulnerabilities. While a few children and family health services in Australia provide liaison services, the extent of liaison support and the outcomes for families in Australia is unknown. Nurses working with children and families are the most likely health professionals to undertake a liaison role. In many nursing contexts, liaison roles are relatively new and those in the role have the responsibility to define the key purpose of their role. Liaison roles are multifaceted requiring the nurse to have excellent communication and negotiation skills to
Funakoshi, Akiko; Miyamoto, Yuki
Hikikomori is a new psychosociological phenomenon among youth, of almost complete withdrawal from social interaction, and it has received considerable attention in community mental health in Japan. The aims of the present study were to identify the influential factors of family difficulties of parents who use support services for children with hikikomori, and compare them between fathers and mothers. Data were collected from 110 parents (55 couples) of children with hikikomori with regard to family difficulties, quality of life, and depression variables via self-report questionnaires. To assess the influential factors of Family Difficulties for parents with children with hikikomori, hierarchical multiple linear regression analysis was carried out for gender. While 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. For both genders, the number of services that the fathers received was significantly correlated with marital cooperation, and the number of services that the mothers received was significantly correlated with support resource utilization. It is necessary for fathers to receive more support, and it is important for professionals to encourage parents to address their difficulties together. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
German, a. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)
This research conducted by the Alliance for Residential Building Innovation team evaluated mechanical air conditioner pre-cooling strategies in homes throughout the United States. EnergyPlus modeling evaluated two homes with different performance characteristics in seven climates. Results are applicable to new construction homes and most existing homes built in the last 10 years, as well as fairly efficient retrofitted homes.
This publication contains student and teacher instructional materials for a course in residential solar systems. The text is designed either as a basic solar course or as a supplement to extend student skills in areas such as architectural drafting, air conditioning and refrigeration, and plumbing. The materials are presented in four units…
Stark, Lindsay; Rubenstein, Beth L; Pak, Kimchoeun; Kosal, Sok
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
Diego Armando Casas-Beltrán
Full Text Available Migration of foreign retirees in Mexico has increased, especially in Los Cabos, where settlements trailer type are increasing and are moving into rural coastal areas of high ecological value, without the knowledge of impacts that may result. Thus the aim of this paper is to contribute to the understanding of this type of settlement, by documenting a case study, the characteristics of their community, their environmental impacts and implications for the provision of public services. We conclude that the town will become a short-term retreat site, because while it does not have high densities, its environmental implications are significant and broad coverage. Its current demand for services is minimal, but may cause conflicts in the future, especially with the water
Yoder, Jamie R
Clinical and research professionals working with youth who have sexually offended have increasingly advocated for community-based care. However, other scholars have noted the appropriateness of residential placements for many youth. Research is inconclusive concerning the degree to which youth with sexually harmful behaviors receive family services, particularly family therapy in either community-based care settings or residential settings, and has yet to thoroughly identify how placement influences family therapy involvement. This study reviews the files of youth who have been adjudicated of a sexual crime (N = 85) to quantitatively identify how living situations influence family therapy involvement. Using bivariate estimations, findings reveal that youth living out of the home and those who change placements were more involved in family therapy than those treated in their own communities or homes. Implications and future research directions are considered. © The Author(s) 2014.
Full Text Available Background: Literature has documented the role of family in the outcome of chronic schizophrenia. In the light of this, family interventions (FIs are becoming an integral component of treatment for psychosis. The First Episode of Psychosis (FEP is the period when most of the changes in family atmosphere are observed; unfortunately, few studies on the relatives are available.Objective: To explore burden of care and emotional distress at baseline and at 9-month follow-up and the levels of service satisfaction at follow-up in the two groups of relatives (experimental treatment EXP vs. treatment as usual TAU recruited in the cluster-randomized controlled GET UP PIANO trial.Methods: The experimental treatment was provided by routine public Community Mental Health Centers (Italian National Health Service and consisted of Treatment as Usual plus evidence-based additional treatment (Cognitive Behavioral Therapy for psychosis for patients, Family Intervention for psychosis, and Case Management. TAU consisted of personalized outpatient psychopharmacological treatment, combined with non-specific supportive clinical management and informal support/educational sessions for families. The outcomes on relatives were assessed by the Involvement Evaluation Questionnaire (IEQ-EU, the General Health Questionnaire (GHQ-12, and the Verona Service Satisfaction Scale (VSSS-EU. Differences within and between groups were evaluated.Results: At baseline, 75 TAU and 185 EXP caregivers were assessed. In the experimental group 92% of relatives participated in at least 1 family session. At follow-up both groups experienced improvement in all IEQ and GHQ items, but caregivers belonging to the EXP arm experienced a significantly greater change in 10 IEQ items (mainly pertaining to the “Tension” dimension and in GHQ items. Due to the low sample size, a significant effectiveness was only observed for 2 IEQ items and 1 GHQ-12 item. With respect to VSSS data at follow
Daff, Bocar Mamadou; Seck, Cheikh; Belkhayat, Hassan; Sutton, Perri
Contraceptive use in Senegal is among the lowest in the world and has barely increased over the past 5 years, from 10% of married women in 2005 to 12% in 2011. Contraceptive stockouts in public facilities, where 85% of women access family planning services, are common. In 2011, we conducted a supply chain study of 33 public-sector facilities in Pikine and Guediawaye districts of the Dakar region to understand the magnitude and root causes of stockouts. The study included stock audits, surveys with 156 consumers, and interviews with facility staff, managers, and other stakeholders. At the facility level, stockouts of injectables and implants occurred, on average, 43% and 83% of the year, respectively. At least 60% of stockouts occurred despite stock availability at the national level. Data from interviews revealed that the current "pull-based" distribution system was complex and inefficient. In order to reduce stockout rates to the commercial-sector standard of 2% or less, the Government of Senegal and the Senegal Urban Reproductive Health Initiative developed the informed push distribution model (IPM) and pilot-tested it in Pikine district between February 2012 and July 2012. IPM brings the source of supply (a delivery truck loaded with supplies) closer to the source of demand (clients in health facilities) and streamlines the steps in between. With a professional logistician managing stock and deliveries, the health facilities no longer need to place and pick up orders. Stockouts of contraceptive pills, injectables, implants, and intrauterine devices (IUDs) were completely eliminated at the 14 public health facilities in Pikine over the 6-month pilot phase. The government expanded IPM to all 140 public facilities in the Dakar region, and 6 months later stockout rates throughout the region dropped to less than 2%. National coverage of the IPM is expected by July 2015.
Lara, Diana; Decker, Martha J; Brindis, Claire D
Teenage birth rates among young people aged 15-19 years in California, USA, have declined from 47 births per 1000 in 2000 to 24 per 1000 in 2013. Nevertheless, the US counties with the highest teenage birth rates are predominantly rural and have a high proportion of Latinos/as. We conducted 42 interviews with key stakeholders and 12 focus groups with 107 young people in five rural communities to better understand local migration patterns and their influence on intermediate and proximate variables of pregnancy, such as interaction with role models and barriers to access contraception. The migration patterns identified were: residential mobility due to seasonal jobs, residential mobility due to economic and housing changes and migration from other countries to California. These patterns affect young people and families' interactions with school and health systems and other community members, creating both opportunities and barriers to prevent risky sexual behaviours. In rural areas, residential mobility and migration to the USA interconnect. As a result, young people dually navigate the challenges of residential mobility, while also adapting to the dominant US culture. It is important to promote programmes that support the integration of immigrant youth to reduce their sense of isolation, as well as to assure access to sexual health education and reproductive health services.
Gaugler, Joseph E.; Kane, Robert L.
Purpose: Despite growing research on assisted living (AL) as a residential care option for older adults, the social ramifications of residents' transitions to AL are relatively unexplored. This article examines family involvement in AL, including family structures of residents, types of involvement from family members living outside the AL…
Gulzar, Jamshaid; Ali, Moazzam; Kuroiwa, Chushi
In the 1990s, social marketing approach was introduced in Pakistan to improve the quality and accessibility of family planning methods involving private practitioners. This study measured six quality elements using a Bruce-Jain framework. Cross-sectional survey data were collected from 29 randomly selected Green Star clinics. The study's four components were 1) an inventory of each outlet (infrastructure, equipment, and supplies); 2) an observation guide for interaction between family planning clients and service providers; 3) exit interviews with clients attending the outlet; and 4) interviews with providers at the outlet. Of the 29 clients participating in the exit interviews, 72% were new users of family planning. The clients' mean age was 32 years; all clients were married; 93% had received formal education. Housework was the principal activity of 93% of clients. The mean number of children reported was three. Both hormonal and intrauterine contraceptives (IUCDs) were available in all facilities; 86% of the clients reported being able to obtain their contraceptive of choice. Most facilities had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service outlets emphasized mechanisms to ensure continuity of use. Notable shortcomings included a shortage of information on alternative methods, contraindications, and side-effect management, as well as a dearth of registration records. In conclusion, this is a good example of public-private partnership involving private practitioners using a social marketing approach. The quality components of a Bruce-Jain framework were achieved, resulting in a satisfied clientele. Involvement of private service outlets increased the accessibility and enhanced the use of services. Social marketing may be expanded to improve quality and access by involving further components of health care.
Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall
Lund, Darren; Lianne, Lee
This article documents a community-initiated service-learning project within a teacher education program. A social justice model guided the initiative to raise critical awareness on power and privilege while countering deficit-model thinking. Partnering with community agencies serving immigrant children and youth, the faculty researcher worked…
Appleby, Sandy; And Others
Respite and in-home services have been identified by caregivers as vital for maintaining a frail older person in the community. A program called The Alzheimer Support/Tender Loving Caregivers Project was undertaken in northwest Indiana to strengthen the informal support network of disabled elderly in the community. An interfaith coalition of…
Spector, Anya Y; Pinto, Rogério M; Rahman, Rahbel; da Fonseca, Aline
Brazil's "family health strategy" (ESF), provides primary care, mostly to individuals in impoverished communities through teams of physicians, nurses, and community health workers (CHWs). ESF workers are called upon to offer drug use services (e.g., referrals, counseling) as drug use represents an urgent public health crisis. New federal initiatives are being implemented to build capacity in this workforce to deliver drug use services, yet little is known about whether ESF workers are providing drug use services already. Guided by social cognitive theory, this study examines factors associated with ESF workers' provision of drug use services. Cross-sectional surveys were collected from 262 ESF workers (168 CHWs, 62 nurses, and 32 physicians) in Mesquita, Rio de Janeiro State and Santa Luzia, Minas Gerais State. provision of drug-use services. capacity to engage in evidence-based practice (EBP), resource constraints, peer support, knowledge of EBP, and job title. Logistic regression was used to determine relative influence of each predictor upon the outcome. Thirty-nine percent reported providing drug use services. Younger workers, CHWs, workers with knowledge about EBP and workers that report peer support were more likely to offer drug use services. Workers that reported resource constraints and more capacity to implement EBP were less likely to offer drug use services. ESF workers require education in locating, assessing and evaluating the latest research. Mentorship from physicians and peer support through team meetings may enhance workers' delivery of drug use services, across professional disciplines. Educational initiatives aimed at ESF teams should consider these factors as potentially enhancing implementation of drug use services. Building ESF workers' capacity to collaborate across disciplines and to gain access to tools for providing assessment and treatment of drug use issues may improve uptake of new initiatives. Copyright © 2014 Elsevier B.V. All
Full Text Available Background: Uttar Pradesh (UP is the most populous state in India. The maternal mortality ratio, infant mortality rate, and fertility rates are all higher than the national average. Sixty percent of UP inhabitants live in rural communities. The reasons behind the poor state of health and services in many areas of UP are inadequate knowledge and availability in communities of healthy behaviors, and information on available government health services. Methods: World Vision, Inc. implemented a three-and-half year mobilizing plan for maternal and neonatal health through a birth spacing and advocacy project (MOMENT, partnering with local organizations in rural Hardoi and urban slums of Lucknow districts in UP. World Vision used print, audio, visual media, and house-to-house contacts to educate communities on timing and spacing of pregnancies; and the benefits of seeking and using maternal and child health services (MCH including immunization and family planning (FP.This paper focuses on World Vision’s social accountability strategy – Citizen Voice and Action (CVA and interface meetings – used in Hardoi that helped educate and empower Village Health Sanitation and Nutrition Committees (VHSNCs and village leaders to access government untied funds to improve community social and health services. Results: Forty VHSNCs were revived in 24 months. Nine local leaders accessed government untied funds. In addition, increased knowledge of the benefits of timing and spacing of pregnancies, maternal child health, family planning services, and access to community entitlements led the community to embrace and contribute their time to rebuild and re-open 17 non-functional Auxiliary Nurse Midwife (ANM sub-centers. Seventeen ANMs received refresher training to provide quality care. Sub-center data showed that 1,121 and 3,156 women opted for intra-uterine contraceptive device and oral pills, respectively, and 29,316 condoms were distributed. Conclusion: In Hardoi
Bromer, Juliet; Bibbs, Tonya
Family child care (FCC) providers often experience isolation from other early childhood and child care professionals. Yet, research suggests that providers who network with other providers, engage with community resources, and belong to support groups tend to offer higher quality child care. For example, the Family Child Care Network Impact Study…
Thompson, Sanna J.; Safyer, Andrew W.; Pollio, David E.
Article discusses two questions: (1) What are the differences among runaway-homeless, throwaway, and independent youth? (2) What youth demographics, personal characteristics, and family factors predict youth's reunification? Among runaway-homeless youths, family characteristics were most important for reunification; among throwaway youths, problem…
Steens, R.; Hermans, K.; van Regenmortel, M.R.F.
In the margin of the ongoing experimental and quasi-experimental research projects on family preservation, some research projects focus on the process through which families accomplish change and acknowledge the importance of the working alliance. There is, however, little information about barriers
Malik, Neena M.; Ward, Kristin; Janczewski, Colleen
There is increasing awareness that domestic violence (DV) and child maltreatment often overlap and that there are significant negative consequences to women and children who are victims in the same families. The present study contains data from a participatory evaluation of a multisite national demonstration project on family violence (the…
Hudson, Lucy; Almeida, Connie; Bentley, Dawn; Brown, Josie; Harlin, Daria; Norris, Judy
Family reunification is not always possible for children who have been removed from the care of their biological parents because of abuse or neglect. Concurrent planning puts into place a secondary plan for a permanent home should family reunification prove to be impossible. Working in four diverse communities around the country in an innovative…
Hebert, Luciana E; Fabiyi, Camille; Hasselbacher, Lee A; Starr, Katherine; Gilliam, Melissa L
As frontline providers, publicly funded family planning clinics represent a critical link in the health system for women seeking information about pregnancy options, yet scant information exists on their provision of relevant services. Understanding their practices is important for gauging how well these facilities serve patients' needs. A 2012 survey of 567 publicly funded family planning facilities in 16 states gathered information on referral-making for adoption and abortion services, and perceived proximity to abortion services. Chi-square, multivariable logistic regression and multinomial logistic regression analyses were performed to assess differences among facilities in referral-making and reported proximity to abortion services. Abortion referrals were provided by a significantly smaller proportion of providers than were adoption referrals (84% vs. 97%). Health departments and community health centers were significantly less likely than comprehensive reproductive health centers to refer for abortion services and to have a list of abortion providers available (odds ratios, 0.1-0.2). Rural facilities were more likely than urban ones to report a distance of more than 100 miles to the closest first-trimester abortion provider (relative risk ratio, 11.4), second-trimester abortion provider (8.7) and medication abortion provider (8.0). Health departments were more likely than comprehensive reproductive health centers not to know the location of the closest first-trimester, second-trimester or medication abortion provider (2.5-3.5). A better understanding of disparities in provision of pregnancy options counseling and referrals at publicly funded family planning clinics is needed to ensure that women get timely care. Copyright © 2016 by the Guttmacher Institute.
Wray, Craig P.; Walker, Iain S.; Sherman, Max H.
Currently, houses do not perform optimally or even as many codes and forecasts predict, largely because they are field assembled and there is no consistent process to identify problems or to correct them. Residential commissioning is a solution to this problem. This guide is the culmination of a 30-month project that began in September 1999. The ultimate objective of the project is to increase the number of houses that undergo commissioning, which will improve the quality, comfort, and safety of homes for California citizens. The project goal is to lay the groundwork for a residential commissioning industry in California focused on end-use energy and non-energy issues. As such, we intend this guide to be a beginning and not an end. Our intent is that the guide will lead to the programmatic integration of commissioning with other building industry processes, which in turn will provide more value to a single site visit for people such as home energy auditors and raters, home inspectors, and building performance contractors. Project work to support the development of this guide includes: a literature review and annotated bibliography, which facilitates access to 469 documents related to residential commissioning published over the past 20 years (Wray et al. 2000), an analysis of the potential benefits one can realistically expect from commissioning new and existing California houses (Matson et al. 2002), and an assessment of 107 diagnostic tools for evaluating residential commissioning metrics (Wray et al. 2002). In this guide, we describe the issues that non-experts should consider in developing a commissioning program to achieve the benefits we have identified. We do this by providing specific recommendations about: how to structure the commissioning process, which diagnostics to use, and how to use them to commission new and existing houses. Using examples, we also demonstrate the potential benefits of applying the recommended whole-house commissioning approach to
Data on residential loads has been collected from four residences in real time. The data, measured at 5-second intervals for 53 days of continuous operation, were statistically characterized. An algorithm was developed and incorporated into the modeling code SOLCEL. Performance simulations with SOLCEL using these data as well as previous data collected over longer time intervals indicate that no significant errors in system value are introduced through the use of long-term average data.
Rodriguez, Maria Isabel; Darney, Blair G; Elman, Emily; Linz, Rachel; Caughey, Aaron B; McConnell, K John
To assess the quality of care provided to adolescents (10-19 years old) compared to women (aged 20-25 years) who accessed services in Oregon's Contraceptive Care (CCare) program. We analyzed data routinely collected using the Clinic Visit Record form from women aged 25 years and younger who visited CCare clinics between January 1, 2004, and October 31, 2010. Modern methods were characterized into three tiers: Tier 1 is the intrauterine device, implant and sterilization; Tier 2, hormonal methods; and Tier 3, all barrier methods. Nonmodern methods included no method, withdrawal and natural family planning. We used multivariable logistic regression models to examine the effect of age on three indicators of quality of contraceptive care: transitioning from a nonmodern to a modern method, transitioning from Tier 3 methods to Tier 1 or Tier 2 methods, and initiation of long-acting reversible contraception (LARC). We then produced predicted probabilities to facilitate data interpretation. Adolescents accounted for 344,856 (41%) of the 848,221 clinic visits occurring in CCare among women under age 25. Compared with women (ages 20-25 years), young and older adolescents had decreased odds of LARC initiation [odds ratio (OR) 0.24 (95% confidence interval [CI] 0.16-0.35) and OR 0.44 (95% CI 0.38-0.52), respectively]. However, compared with women, both young and older adolescents had increased odds of leaving with any contraceptive method [OR 1.8 95% (CI 1.26-2.59) and OR 1.42 (95% CI 1.21-1.66)]. Among clients presenting with no method of contraception at the beginning of the visit, 78.7% of young adolescents (95% CI 73.84-83.03) compared with 81.44% (95% CI 77.02-85.52) of older adolescents, and 76.63% (95% CI 69.90-80.75) of young women left with a modern method, controlling for other covariates. Although adolescents served by CCare are more likely to initiate contraception, they are less likely to receive LARC than women aged 20-25 years. Efforts are needed to ensure that
Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul
Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p family planning services when integrated with community-based services in Jharkhand.
Edmond, Karen M; McAuley, Kimberley; McAullay, Daniel; Matthews, Veronica; Strobel, Natalie; Marriott, Rhonda; Bailie, Ross
The quality of social and emotional wellbeing services for Indigenous families of young children is not known, in many settings especially services provided by primary care centers. Our primary objective was to assess delivery of social and emotional wellbeing services to the families of young (3-11 months) and older (12-59 months) Indigenous children attending primary care centers. Our secondary objective was to assess if delivery differed by geographic location. Two thousand four hundred sixty-six client files from 109 primary care centers across Australia from 2012 to 2014 were analysed using logistic regression and generalised estimating equations. The proportion of families receiving social and emotional wellbeing services ranged from 10.6% (102) (food security) to 74.7% (1216) (assessment of parent child interaction). Seventy one percent (71%, 126) of families received follow up care. Families of children aged 3-11 months (39.5%, 225) were more likely to receive social and emotional wellbeing services (advice about domestic environment, social support, housing condition, child stimulation) than families of children aged 12-59 months (30.0%, 487) (adjusted odds ratio [aOR] 1.68 95% CI 1.33 to 2.13). Remote area families (32.6%, 622) received similar services to rural (29.4%, 68) and urban families (44.0%, 22) (aOR 0.64 95% CI 0.29, 1.44). The families of young Indigenous children appear to receive priority for social and emotional wellbeing care in Australian primary care centers, however many Indigenous families are not receiving services. Improvement in resourcing and support of social and emotional wellbeing services in primary care centers is needed.
Ashcroft, Nicki; Shelus, Victoria; Garg, Himanshu; McLarnon-Silk, Courtney; Jennings, Victoria H
CycleTel Family Advice (CFA), an SMS-based service designed to improve knowledge of fertility and family planning (FP), was delivered to over 100,000 people in India from April to August 2015. The goal of CFA was to increase knowledge on a range of reproductive health topics, e.g., the menstrual cycle, fertility, and FP, and to increase positive perceptions and use of FP. This paper focuses on the best practices and operational challenges for providing an SMS service based on the implementation experience of CFA. The implementation process for CFA was well documented, specifically program design, commercial partnerships, formative research, design of messages, and recruitment of users. The impact of CFA on knowledge, attitudes, and behaviors was assessed through phone surveys before and after message delivery. Programmatic data and phone surveys resulted in several operational findings, particularly in the areas of user behavior, partnership management, and mHealth research. While there were improvements in knowledge, there were not significant changes in FP use and couple communication. The intervention yielded insights into designing an mHealth intervention as well as the opportunities and challenges of implementing a stand-alone SMS-based service with a broad audience. Lessons learned were that (I) SMS-based interventions, without other supporting systems, may not lead to high user engagement or behavior change; (II) partnerships with private sector technical platforms can help overcome the difficult problem of marketing and outreach, but they bring limitations to user interface and dependencies on a commercial structure; (III) collecting demographic data required to provide tailored content may be a barrier to user acquisition; and (IV) while phone surveys are useful for evaluation of mHealth interventions, reaching users is challenging and response rates are low.
Farmanova, Elina; Grenier, Jean; Chomienne, Marie-Hélène
Family health teams (FHTs), regarded today as a premier model of provision of primary care services in North America, were introduced in 2004 to improve traditionally fragmented primary healthcare in Ontario. Physicians and healthcare providers from various disciplines team up under the same roof in FHTs to provide and coordinate care and to ensure adequate access to and continuity of care. Because many Canadians with mental health problems consult family physicians in primary care, routine evaluation of the delivery of primary mental health care services in FHTs is becoming important. The authors' goal was to develop and test an evaluation tool (containing a questionnaire for patients and a questionnaire for providers) for mental health services provided in FHTs with a focus on accessibility, availability, quality, continuity of care and coordination of services. They developed and pilot tested an English-French tailored evaluation instrument in several FHTs in South East, Champlain and North East Local Health Integration Networks across Ontario. A convenience sample of English- and French-speaking healthcare providers and patients using mental health services was recruited. Provider and patient questionnaires were developed and pilot-tested with 12 providers and 10 clients. Patient reviewers rated the patient questionnaire consistently as "good" or "very good." Provider reviewers found the provider questionnaire to be important and timely and the questions to be adequate and interesting. This instrument evaluates, from both the patient and provider perspectives, whether mental health services are structured to meet expectations set for FHTs, and enables healthcare providers, administrators and policy makers to learn about the benefits and the deficiencies of mental health care delivered through these clinics. This instrument can also be used to enhance future research and evaluation of FHTs. Further validation effort will be required to establish its validity and
Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B
This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess
Grossman, Daniel; Onono, Maricianah; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Shade, Starley B; Steinfeld, Rachel L; Cohen, Craig R
To determine whether integrating family planning services into HIV care is associated with increased use of more effective contraceptive methods (sterilization, intrauterine device, implant, injectable or oral contraceptives). Cluster-randomized trial. Eighteen public HIV clinics in Nyanza Province, Kenya. Women aged 18-45 years receiving care at participating HIV clinics; 5682 clinical encounters from baseline period (December 2009-February 2010) and 12,531 encounters from end-line period (July 2011-September 2011, 1 year after site training). Twelve sites were randomized to integrate family planning services into the HIV clinic, whereas six clinics were controls where clients desiring contraception were referred to family planning clinics at the same facility. Increase in use of more effective contraceptive methods between baseline and end-line periods. Pregnancy rates during the follow-up year (October 2010-September 2011) were also compared. Women seen at integrated sites were significantly more likely to use more effective contraceptive methods at the end of the study [increased from 16.7 to 36.6% at integrated sites, compared to increase from 21.1 to 29.8% at controls; odds ratio (OR) 1.81, 95% confidence interval (CI) 1.24-2.63]. Condom use decreased non-significantly at intervention sites compared to controls (OR 0.64, 95% CI 0.35-1.19). No difference was observed in incident pregnancy in the first year after integration comparing intervention to control sites (incidence rate ratio 0.90; 95% CI 0.68-1.20). Integration of family planning services into HIV care clinics increased use of more effective contraceptive methods with a non-significant reduction in condom use. Although no significant reduction in pregnancy incidence was observed during the study, 1 year may be too short a period of observation for this outcome.
Heslop, P; Abbott, D
Previous research, and official guidance, has suggested that planning for the transition between children's and adults' services is failing young people with intellectual disabilities and their families in the UK. Youngsters placed away from home in residential schools or colleges are likely to be at even greater risk of poor transition planning and outcomes, yet there is little understanding of what factors parents consider contribute to a smoother transition and what a satisfactory outcome would be. The parents of 15 young people from five areas of the UK were interviewed about what they thought contributed to a satisfactory pathway for their son or daughter from an out-of-area residential school or college on to the next phase of their life. Parents identified four main process issues: being well-connected with other parents or with key professionals; being proactive; having sufficient information; and good forward planning. Most considered a good outcome to be if the young person was happy, fulfilled and stimulated. Parents were clear about what they thought helped, and there was little disagreement between their views. While some of these factors have been previously identified regarding the transition of disabled youngsters, they raise some unique issues for families with a youngster educated in an out-of-area residential school or college.
Handwerk, Michael L.; Huefner, Jonathan C.; Ringle, Jay L.; Howard, Brigid K.; Soper, Stephen H.; Almquist, Julie K.; Chmelka, M. Beth
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…
Macleod, Ashley; Tatangelo, Gemma; McCabe, Marita; You, Emily
Family caregivers of people with dementia have significant unmet needs in regard to their caregiving role. Despite this, they are reluctant to utilize services to reduce their burden. The aim of this study was to examine the barriers and facilitators of service use among family caregivers of people with dementia. Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analyzed using thematic analysis. Six main barriers and three facilitators were identified. These barriers and facilitators were relevant across many types of services and supports. The barriers were: the inability to find information about relevant services or support, the poor quality or mistrust of the services, the inflexibility of services, caregivers' beliefs about their obligations to the caregiving role and resistance by the care recipient. Key facilitators were: having good communication with the care recipient, having an "expert" point of contact, and having beliefs about the caregiving role that enabled the use of services. Given the significant changes in the aged care service-system, it is important to discuss the barriers faced by family caregivers of people with dementia. This will inform the development of targeted strategies to address the lack of service use among these family caregivers.
Woo, C.K.; Ho, T.; Shiu, A.; Cheng, Y.S.; Horowitz, I.; Wang, J.
Hong Kong has almost perfect electricity reliability, the result of substantial investments ultimately financed by electricity consumers who may be willing to accept lower reliability in exchange for lower bills. But consumers with high outage costs are likely to reject the reliability reduction. Our ordered-logit regression analysis of the responses by 1876 households to a telephone survey conducted in June 2013 indicates that Hong Kong residents exhibit a statistically-significant preference for their existing service reliability and rate. Moreover, the average residential cost estimate for a 1-h outage is US$45 (HK$350), topping the estimates reported in 10 of the 11 studies published in the last 10 years. The policy implication is that absent additional compelling evidence, Hong Kong should not reduce its service reliability. - Highlights: • Use a contingent valuation survey to obtain residential preferences for reliability. • Use an ordered logit analysis to estimate Hong Kong's residential outage costs. • Find high outage cost estimates that imply high reliability requirements. • Conclude that sans new evidence, Hong Kong should not reduce its reliability
Souverein, F.A.; van der Helm, G.H.P.; Stams, G.J.J.M.
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
...) and characteristics (e.g., self-esteem, relationship skills) can moderate the impacts of past and... Prevention and Services/Grants for Domestic Violence Shelters and Supportive Services/Grants to States AGENCY... Act (FVPSA) to States (including Territories and Insular Areas). The purpose of these grants is to: (1...
... avoid any risk of loss of eligibility brought about by unanticipated delays, computer service outages... partnership, the sole general partner of which is an organization meeting the requirements of paragraphs (1)(i... conditions of such Notice of Fund Availability. G. Requirements for the Use of Supportive Services Grant...
Wansink, H.J.; Hosman, C.M.H.; Janssens, J.M.A.M.; Hoencamp, E.; Willems, W.J.H.
TOPIC: The Preventive Basic Care Management (PBCM) program is a Dutch service coordination program for parents with mental illnesses, which focuses on organizing tailored support from various services for parents and their children from a preventive perspective. PURPOSE: The article discusses our
Hainstock, Taylor; Cloutier, Denise; Penning, Margaret
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.
van Ham, Maarten; Findlay, Allan M.
While researchers are increasingly re-conceptualizing international migration, far less attention has been devoted to re-thinking short-distance residential mobility and immobility. In this paper we harness the life course approach to propose a new conceptual framework for residential mobility research. We contend that residential mobility and immobility should be re-conceptualized as relational practices that link lives through time and space while connecting people to structural conditions. Re-thinking and re-assessing residential mobility by exploiting new developments in longitudinal analysis will allow geographers to understand, critique and address pressing societal challenges. PMID:27330243
The EPA provides resources for handling residential demolitions or renovations. This includes planning, handling harmful materials, recycling, funding, compliance assistance, good practices and regulations.
Joshi, Beena; Velhal, Gajanan; Chauhan, Sanjay; Kulkarni, Ragini; Begum, Shahina
Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women. An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year. At the end of one year, 60 per cent women in the intervention group reached Family Planning centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods along with increase in consistent use of condoms and less number of unplanned pregnancies in the intervention group than the control group. The study findings demonstrate that linking HIV and family planning services may facilitate the uptake of dual methods of contraception without reducing consistent condom use among HIV infected women. The PPTCT programmes need to focus on the component of Prong 2 of PPTCT which aims to prevent unintended pregnancies among HIV positive women.
Sousa, Valmi D; Williams, Janet K; Barnette, Jack J; Reed, David A
RATIONALE, AIMS, AND OBJECTIVES: Huntington disease (HD) is a progressive genetic brain disease leading to disruptive cognitive, behavioural and physical impairments. Persons with the condition and their caregivers need appropriate and accessible health care services to help them manage the disease adequately. The purpose of this study was to evaluate the psychometric properties of a new scale that measures family members' perception of community health care services (CHCS) for persons with HD. A methodological design was used to examine the initial reliability and dimensionality of the CHCS scale among 245 family members of persons with a diagnosis of HD. Data analysis consisted of computing Cronbach's alpha coefficients, calculating the 95% confidence interval for alpha and performing item-analysis and exploratory factor analysis. Reliability of the scale based on Cronbach's alpha was 0.83. Factor analysis using principal component analysis and varimax rotation suggested that three interpretable factors underlie the scale. Factor 1, HD knowledge, had alpha = 0.82, eigenvalue of 4.67 and explained 33.42% of the variance; factor 2, HD community resources, had alpha = 0.62, eigenvalue of 1.68 and explained 12.02% of the variance; factor 3, individualized HD management, had alpha = 0.77, eigenvalue of 1.45 and explained 10.39% of the variance. Findings from this study provide evidence of both construct validity and internal consistency reliability of the CHCS scale. Further psychometric testing of the scale in other samples of family caregivers of persons with HD is warranted.
Shah, Nirali M; Wang, Wenjuan; Bishai, David M
Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.
Jen, Wen-Yuan; Hung, Ming-Chien
In an aging society, the issue of increased medical costs troubles both government agencies and families with aging parents. Many elderly people require long-term care, and the medical and financial problems associated with long-term care worry their entire family. Mobile healthcare service (MHS) has been widely applied by medical practitioners and researchers for years. Unfortunately, the elderly often fear both the technology and the cost its use incurs; hence, they seldom actively adopt MHS without the prompting and support of other family members. This study highlights this issue of long-term healthcare for the elderly and extracts the factors affecting their family's intentions in adopting MHS. Based on the integration of the Theory of Planned Behavior and the Technology Acceptance Model, the factors associated with the family's intention of the aging people toward MHS are explored. Data were collected from 200 students in the "Job Master" track in a local "Executive Master of Business Administration" program. Half of them had at least one immediate family member who was older than 65 years of age. A partial least squares (PLS) analysis shows that "attitude" significantly affected the behavioral intention of adopting MHS, and "perceived usefulness" and "perceived ease-of-use" had an indirect effect via "attitude." The PLS model explains the variance in intention (64.1%), attitude (58.1%), and perceived usefulness (33.8%). Overall, this study shows that attitude was an important determinant of MHS adoption. Gender also significantly affected the relationship between attitude and behavioral intention to adopt MHS.
Tang, Longmei; Wu, Shangchun; Li, Jiong; Wang, Kun; Xu, Jialin; Temmerman, Marleen; Zhang, Wei-Hong
To assess the practice of post-abortion family planning (PAFP) counselling among Chinese abortion service providers, and identify the influencing factors. A cross-sectional questionnaire survey was conducted between July and September 2013 among abortion services providers in 30 provinces in China. Univariate and multivariable logistic regression analyses were used to identify the factors that influenced PAFP counselling. 94% of the 579 service providers responded to the questionnaire in the survey. The median age was 39 years (range 20-72), and 95% were females. 92% providers showed a positive attitude and had promoted the PAFP counselling services; however, only 57% spent more than 10 min for it. The overall knowledge on PAFP was limited to the participants. After adjusting for potential confounding factors: providers from the middle region (compared with 'east region', OR adj = 3.33, 95% CI: 2.12-5.21) conducted more PAFP counseling; providers with more knowledge (OR adj = 2.08, 95% CI: 1.38-3.15) provided more counseling; and compared with 'middle school and below', providers with higher education gave more counseling [OR adj (95% CI)] for 'college', 'university' and 'master/doctor' [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively]. The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health and residence region were the main factors influencing the practice. Training of health providers and integrating family planning as a part of abortion services are essential to provide adequate PAFP to abortion seekers, thereby reducing the risk of unintended pregnancy.
El Tantawi, Maha; El-Din Hamza, Maha A; Sabry, Marwa M
This study compared dentists' perceptions of provided services in Family Health (FH) and Mother and Child Health (MCH) clinics. A questionnaire was distributed to 120 dentists in 7 FH and 4 MCH clinics in Alexandria, Egypt in 2012. The questionnaire assessed personal and professional background, perceptions of primary health care (PHC) role, types of services provided, patient recall and referral systems and perception of service quality. The response rate was 100%. More FH dentists perceived their role to include providing care for children and pregnant women. Restorations and scaling were provided by 90% of all dentists. More FH dentists reported providing simple extractions, paediatric extractions and multi-rooted endodontic treatment (P = 0.03, 0.001 and 0.001). In FH clinics, where the performance-based incentive system was implemented, a greater number of patients was served and there was a shift in the type of services provided although dentists had a less positive perception of quality aspects. Thus, there is a need for the establishment of a mission and clear guidelines for the FH clinics to guide service provision.
Sherman, Max H.
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
Rommel P. Sergio
Full Text Available This research paper discusses the profile of emotional intelligence, work/family conflict, and work values among 437 purposively selected customer service representatives (CSRs from the Middle East, Iran, Pakistan, Russia, India, and the Philippines. Moreover, the study leads to a set of organizational change development programs to assist organizations to cope with their diversity concerns. The descriptive, comparative-correlational methods were employed as this paper also aims to find the correlates of emotional intelligence such as work/family conflict, and work values. The researchers utilized several instruments, namely the Demographic Profile Sheet, Emotional Competence Inventory, Work/Family Conflict Scale, and Work Values Inventory. The general findings reveal that there is a significant relationship between emotional intelligence and work/family conflict, particularly on the areas of self- management, social awareness and relationship management; whereas, there is a significant relationship between emotional intelligence (particularly on the clusters of self- management, social awareness and relationship management and work values (specifically in the areas of management, achievement, supervisory relations, way of life, and independence. The organizational development support programs with emphasis on diversity management have been recommended to set future directions for call center organizations involved in the study.
Adeniyi, Oladele Vincent; Ajayi, Anthony Idowu; Moyaki, Mayowa Gabriel; Goon, Daniel Ter; Avramovic, Gordana; Lambert, John
Integration of family planning services into HIV care was implemented in South Africa as a core strategy aimed at reducing unintended pregnancies among childbearing women living with HIV. However, it is unclear whether this strategy has made any significant impact at the population level. This paper describes the prevalence and correlates of self-reported unplanned pregnancy among HIV-infected parturient women attending three large maternity centres in the Eastern Cape, South Africa. We also compare unplanned pregnancy rates between HIV-infected parturient women already in care (who have benefitted from services' integration) and newly diagnosed parturient women (who have not benefitted from services' integration). Drawing from the baseline data of the East London Prospective Cohort Study (ELPCS), data of 594 parturient women living with HIV in the Eastern Cape were included. Chi-square statistics and binary logistics regression were employed to determine the correlates of unplanned pregnancy among the cohort. The prevalence of unplanned pregnancy was 71% (n = 422) with a higher rate among parturient women newly diagnosed during the index pregnancy (87%). Unplanned pregnancy was significantly associated with younger age, single status, HIV diagnosis at booking, high parity and previous abortion. Women who reported unplanned pregnancy were more likely to book late and have lower CD4 counts. After adjusting for confounding variables, having one child and five to seven children (AOR = 2.2; CI = 1.3-3.1), age less than 21 years (AOR = 3.3; CI = 1.1-9.8), late booking after 27 weeks (AOR = 2.7; CI = 1.5-5.0), not married (AOR = 4.3; CI = 2.7-6.8) and HIV diagnosis at booking (AOR = 3.0; CI = 1.6-5.8) were the significant correlates of unplanned pregnancy in the cohort. Unplanned pregnancy remains high overall among parturient women living with HIV in the region, however, with significant reduction among those who were
The 1999 Active Duty Surveys (ADS) gather information on military assignments, retention issues, personal and military background, preparedness, mobilizations and deployments, family composition, use of military programs and services...
Bell, Melissa M; Newhill, Christina E
Social service professionals can face challenges in the course of providing family planning information to their clients. This article reports findings from a study that developed an original 27-item measure, the Reproductive Counseling Obstacle Scale (RCOS) designed to measure such obstacles based conceptually on Bandura's social cognitive theory (1986). We examine the reliability and factor structure of the RCOS using a sample of licensed social workers (N = 197). A 20-item revised version of the RCOS was derived using principal component factor analysis. Results indicate that barriers to discussing family planning, as measured by the RCOS, appear to be best represented by a two-factor solution, reflecting self-efficacy/interest and perceived professional obligation/moral concerns. Implications for practice and future research are discussed.
Becker, Davida; Díaz Olavarrieta, Claudia; Garcia, Sandra G; Harper, Cynthia C
To investigate patients' views of family-planning services provided in Mexico City during abortion care at public facilities and their acceptance of postabortion contraception. In total, 402 women seeking first-trimester abortion care in Mexico City were surveyed. Logistic regression was used to test whether postabortion contraception varied according to abortion visit characteristics or patient sociodemographics. Most participants (328 [81.6%]) reported being offered contraception at their visit and 359/401 (89.5%) selected a contraceptive method for postabortion use, with 236/401 (58.9%) selecting an intrauterine device. Women who underwent surgical abortion were more likely than those who underwent medical abortion to report being offered contraception (PMexico City provide a high level of postabortion family-planning care, and uptake of postabortion contraception is high. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Ganatra, Bela; Faundes, Anibal
Access to contraception reduces maternal deaths by preventing or delaying pregnancy in women who do not intend to be pregnant or those at higher risk of complications. However, not all unintended pregnancies can be prevented through increase in contraceptive use, and access to safe abortion is needed to prevent unsafe abortions. Despite not preventing the problem, provision of emergency care for complications can help prevent deaths from such unsafe abortions. Safe abortion in early pregnancy can be provided at primary care level and by non-physician providers, and the risks of mortality associated with such safe, legal abortions are minimal. Although entirely preventable, unsafe abortions continue to occur because of numerous barriers such as legal and policy restrictions, service delivery issues and provider attitudes to abortion stigma. Overall, the provision of contraception and safe abortion is important not just to prevent maternal deaths but as a measure of our ability to respect women's decisions and ensure that they have access to timely, evidence-based care that protects their health and human rights. Copyright © 2016. Published by Elsevier Ltd.
Mollborn, Stefanie; Lawrence, Elizabeth; Root, Elisabeth Dowling
Understanding residential mobility in early childhood is important for contextualizing family, school, and neighborhood influences on child well-being. We examined the consequences of residential mobility for socioemotional and cognitive kindergarten readiness using the Early Childhood Longitudinal Study-Birth Cohort, a nationally representative longitudinal survey that followed U.S. children born in 2001 from infancy to kindergarten. We described individual, household, and neighborhood characteristics associated with residential mobility for children aged 0-5. Our residential mobility indicators examined frequency of moves, nonlinearities in move frequency, quality of moves, comparisons between moving houses and moving neighborhoods, and heterogeneity in the consequences of residential mobility. Nearly three-quarters of children moved by kindergarten start. Mobility did not predict cognitive scores. More moves, particularly at relatively high frequencies, predicted lower kindergarten behavior scores. Moves from socioeconomically advantaged to disadvantaged neighborhoods were especially problematic, whereas moves within a ZIP code were not. The implications of moves were similar across socioeconomic status. The behavior findings largely support an instability perspective that highlights potential disruptions from frequent or problematic moves. Our study contributes to literature emphasizing the importance of contextualizing residential mobility. The high prevalence and distinct implications of early childhood moves support the need for further research.