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

Directory of Open Access Journals (Sweden)

Scherer Samuel

2009-08-01

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

28 CFR 550.52 - Non-residential drug abuse treatment services.

Science.gov (United States)

2010-07-01

... 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...

Religious Coping, Meaning-Making and Stress: Perspective of Support Staff of Children with Disabilities in Residential Disability Centres in Oman

Science.gov (United States)

Emam, Mahmoud; Al-Bahrani, Muna

2016-01-01

Staff providing support to children with disabilities in residential disability centres in Oman are exposed to stressful work environments which may put them at an increased risk of burnout. Previous research has examined predictors of stress in disability support staff, but there is little consensus as the findings are inconclusive. Using a…

Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme.

Science.gov (United States)

Scerri, Anthony; Scerri, Charles

2017-11-08

Dementia training programmes for staff working in long-term care settings have been found to be effective in improving staff outcomes. This study investigated the impact of a dementia training programme for all Maltese nursing staff working in public nursing/residential homes on their knowledge, attitudes and confidence. Additionally, we identified the predictors of these domains before and after the programme. A 14-hour training programme focusing on dementia management, care and policy was developed for all nursing staff working in public nursing and residential homes in Malta. A pretest-posttest design was used to evaluate the participants' knowledge of dementia, attitudes and confidence in working with residents with dementia using validated tools. Demographic variables were measured and compared with each staff domain. The majority of nursing staff attended the training programme with 261 fully completed questionnaires being collected pre-training and 214 post-training. The programme significantly improved nursing staff knowledge, attitudes and confidence. Stepwise regression analysis of each staff domain showed that the strongest predictor in all models at pre-training was the intensity of previous training programmes. Furthermore, staff who attended previous training continued to improve in their attitudes and confidence following programme completion. The study continues to shed further evidence on the impact of dementia training programs on staff outcomes. It also indicated that the intensity of previous participation in dementia training programmes was related to the participants' knowledge, attitudes and confidence and that continual exposure to training had a cumulative effect.

Utility of Staff Training on Correcting Sleep Problems in People With Intellectual Disabilities Living in Residential Settings

NARCIS (Netherlands)

Hylkema, T.; Petitiaux, W.; Vlaskamp, C.

While sleep problems in people with intellectual disabilities (ID) living in residential settings are very common, scant attention is paid to them. This study examined how to improve the knowledge and understanding of sleep quality and sleep problems in people with ID among care staff at a

How much do residential aged care staff members know about the nutritional needs of residents?

Science.gov (United States)

Beattie, Elizabeth; O'Reilly, Maria; Strange, Elise; Franklin, Sara; Isenring, Elisabeth

2014-03-01

Undernutrition, weight loss and dehydration are major clinical issues for people with dementia in residential care, with excessive weight loss contributing to increased risk of frailty, immobility, illness and premature morbidity. This paper discusses a nutritional knowledge and attitudes survey conducted as part of a larger project focused on improving nutritional intake of people with dementia within a residential care facility in Brisbane, Australia. The specific aims of the survey were to identify (i) knowledge of the nutritional needs of aged care facility residents; (ii) mealtime practices; and (iii) attitudes towards mealtime practices and organisation. A survey based on those used in other healthcare settings was completed by 76 staff members. The survey included questions about nutritional knowledge, opinions of the food service, frequency of feeding assistance provided and feeding assessment practices. Nutritional knowledge scores ranged from 1 to 9 of a possible 10, with a mean score of 4.67. While 76% of respondents correctly identified risk factors associated with malnutrition in nursing home residents, only 38% of participants correctly identified the need for increased protein and energy in residents with pressure ulcers, and just 15% exhibited correct knowledge of fluid requirements. Further, while nutritional assessment was considered an important part of practice by 83% of respondents, just 53% indicated that they actually carried out such assessments. Identified barriers to promoting optimal nutrition included insufficient time to observe residents (56%); being unaware of residents' feeding issues (46%); poor knowledge of nutritional assessments (44%); and unappetising appearance of food served (57%). An important step towards improving health and quality of life for residents of aged care facilities would be to enhance staff nutritional awareness and assessment skills. This should be carried out through increased attention to both preservice

Residential Treatment Centers for Child Abuse

Directory of Open Access Journals (Sweden)

Serhat Nasiroglu

2014-02-01

Full Text Available Every year millions of reports are being held and cases regarding those reports in courts are carrying on about abusement and omission against children . Abusement against children has been seen throughout of the history. Significant and permanent impacts can occur upon child abusement and neglect on victim children. It is important to know the psychological dynamics which have been lived by the children by the mental health professionalsto protect the children after the abusement report has been written. Cognitive Behaviour Therapy and medications are being used commonly in the treatment of abusement cases. However in some cases it is necessary to send away the victims from environment, enable them to continue their education life, make sure that they are treated by the professional individuals in safe area. For this end there are many Residential Treatment Centers around the world. and ldquo;Oguz Kagan Koksal Social Care and Rehabilitation Center and rdquo; was established in Adana as the first Residential Treatment Center in Turkey. In this report the historical dimensions of the child abusement, the definition of it, its psychological dynamics, the psychological disorders caused by it, treatment approaches and residential treatment centers have been reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(1.000: 67-78

Effects of dialectical behavior therapy skills training on outcomes for mental health staff in a child and adolescent residential setting.

Science.gov (United States)

Haynos, Ann F; Fruzzetti, Alan E; Anderson, Calli; Briggs, David; Walenta, Jason

2016-04-01

Training in Dialectical Behavior Therapy (DBT) skills coaching is desirable for staff in psychiatric settings, due to the efficacy of DBT in treating difficult patient populations. In such settings, training resources are typically limited, and staff turnover is high, necessitating brief training. This study evaluated the effects of a brief training in DBT skills coaching for nursing staff working in a child and adolescent psychiatric residential program. Nursing staff ( n = 22) completed assessments of DBT skill knowledge, burnout, and stigma towards patients with borderline personality disorder (BPD) before and after a six-week DBT skills coaching training. Repeated measure ANOVAs were conducted to examine changes on all measures from pre- to post- treatment and hierarchical linear regressions to examine relationships between pre- training DBT knowledge, burnout, and BPD stigma and these same measures post-training. The brief DBT skill coaching training significantly increased DBT knowledge ( p = .007) and decreased staff personal ( p = .02) and work ( p = .03) burnout and stigma towards BPD patients ( p = .02). Burnout indices and BPD stigma were highly correlated at both time points ( p training BPD stigma significantly predicted post-training client burnout ( p = .04), pre-training burnout did not predict post-training BPD stigma. These findings suggest that brief training of psychiatric nursing staff in DBT skills and coaching techniques can result in significant benefits, including reduced staff burnout and stigma toward patients with BPD-related problems, and that reducing BPD stigma may particularly promote lower burnout.

Costs of day hospital and community residential chemical dependency treatment.

Science.gov (United States)

Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

2008-03-01

Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

Pinworm Eradication in Community Residential Settings for People with Developmental Disabilities.

Science.gov (United States)

Kastner, Theodore; And Others

1992-01-01

A public health approach was used to eliminate pinworm from a system of community residential settings for individuals with developmental disabilities. The approach involved screening and treatment of staff members and clients living and working in close proximity to index cases, and prophylactically treating many clients and staff based on…

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

Science.gov (United States)

Leipoldt, Jonathan D.; Kayed, Nanna S.; Harder, Annemiek T.; Grietens, Hans; Rimehaug, Tormod

2018-01-01

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

A Cluster-Randomised Trial of Staff Education to Improve the Quality of Life of People with Dementia Living in Residential Care: The DIRECT Study

OpenAIRE

Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T.; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P.

2011-01-01

BACKGROUND: The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. METHODOLOGY/PRINCIPAL FINDINGS: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 ...

Job-Demands, Job Control, Social Support, Self-Efficacy, and Burnout of Staff of Residential Children's Homes

Science.gov (United States)

Brouwers, André; Tomic, Welko

2016-01-01

The aim of the current study was to examine among educational staff members of residential children's homes to what extent task demands, job control, emotional and social support from colleagues and management as well as self-efficacy beliefs concerning coping with aggressive behaviour in youngsters are associated with emotional exhaustion,…

28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

Development and Pilot Testing of a Food Safety Curriculum for Managers and Staff of Residential Childcare Institutions (RCCIs)

Science.gov (United States)

Pivarnik, Lori F.; Patnoad, Martha S.; Nyachuba, David; McLandsborough, Lynne; Couto, Stephen; Hagan, Elsina E.; Breau, Marti

2013-01-01

Food safety training materials, targeted for residential childcare institution (RCCI) staff of facilities of 20 residents or less, were developed, piloted, and evaluated. The goal was to assist in the implementation of a Hazard Analysis Critical Control Points (HACCP)-based food safety plan as required by Food and Nutrition Service/United States…

Qualitative exploration of relationships between peers in residential addiction treatment.

Science.gov (United States)

Neale, Joanne; Tompkins, Charlotte N E; Strang, John

2018-01-01

Relationships between peers are often considered central to the therapeutic process, yet there is relatively little empirical research either on the nature of peer-to-peer relationships within residential treatment or on how those relationships generate positive behaviour change or facilitate recovery. In this paper, we explore relationships between peers in residential addiction treatment, drawing upon the concept of social capital to frame our analyses. Our study was undertaken during 2015 and 2016 in two English residential treatment services using the same therapeutic community-informed model of treatment. We conducted 22 in-depth interviews with 13 current and 9 former service residents. All interviews were audio-recorded, transcribed verbatim, coded in MAXQDA, and analysed using Iterative Categorisation. Residents reported difficult relationship histories and limited social networks on entry into treatment. Once in treatment, few residents described bonding with their peers on the basis of shared experiences and lifestyles. Instead, interpersonal differences polarised residents in ways that undermined their social capital further. Some senior peers who had been in residential treatment longer acted as positive role models, but many modelled negative behaviours that undermined others' commitment to treatment. Relationships between peers could generate feelings of comfort and connectedness, and friendships developed when residents found things in common with each other. However, residents more often reported isolation, loneliness, wariness, bullying, manipulation, intimidation, social distancing, tensions and conflict. Overall, relationships between peers within residential treatment seemed to generate some positive but more negative social capital; undermining the notion of the community as a method of positive behaviour change. With the caveat that our data have limitations and further research is needed, we suggest that residential treatment providers should

Smoking Behaviors and Attitudes Among Clients and Staff at New York Addiction Treatment Programs Following a Smoking Ban: Findings After 5 Years.

Science.gov (United States)

Pagano, Anna; Guydish, Joseph; Le, Thao; Tajima, Barbara; Passalacqua, Emma; Soto-Nevarez, Arturo; Brown, Lawrence S; Delucchi, Kevin L

2016-05-01

Addiction treatment clients are more likely to die of tobacco-related diseases than of alcohol or illicit drug-related causes. We aimed to assess smoking behavior, and smoking-related attitudes and services, in New York addiction treatment programs before a statewide smoking ban in treatment facilities was implemented (2008), 1 year (2009) and 5 years after implementation (2013). We conducted surveys at each time point with clients (N = 329, 341, and 353, respectively) and staff (N = 202, 203, and 166, respectively) from five residential and two methadone maintenance programs in New York State. At each data collection wave, questionnaires measured smoking behavior as well as smoking-related knowledge, attitudes, and experiences with tobacco cessation services as part of addiction treatment. Staff smoking prevalence decreased from 35.2% in 2008 to 21.8% in 2013 (P = .005) while client smoking prevalence over the same period was unchanged (68.1% vs. 66.0%, P = .564). Among clients who smoked, mean cigarettes per day decreased from 13.7 (SD = 8.38) to 10.2 (SD = 4.44; P attitudes and cessation services received; and for staff self-efficacy and cessation services provided. In residential programs, scores for most items decreased (became less positive) in 2009 followed by a partial rebound in 2013. Methadone program scores tended to rise (become more positive) throughout the study period. Staff and clients may respond differentially to tobacco-free policies depending on type of treatment program, and this finding may help to inform the implementation of tobacco-free policies in other statewide addiction treatment systems. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

Directory of Open Access Journals (Sweden)

Christopher Beer

Full Text Available BACKGROUND: The Dementia In Residential care: EduCation intervention Trial (DIRECT was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. METHODOLOGY/PRINCIPAL FINDINGS: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15 higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. CONCLUSION: The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12607000417482.

A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

Science.gov (United States)

Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P

2011-01-01

The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. ANZCTR.org.au ACTRN12607000417482.

Belongingness--The Critical Variable in the Residential Treatment of Alcoholism.

Science.gov (United States)

Machell, David F.

Many alcohol treatment programs have stressed a sense of belongingness as a means for successful treatment of alcoholics in a residential setting. An examination of the effectiveness of this strategy in highly structured and less structured programs involved 200 chronic, recidivistic male adult alcoholics in a residential program. Subjects were…

Exploring the Relationship between Conduct Disorder and Residential Treatment Outcomes

Science.gov (United States)

Shabat, Julia Cathcart; Lyons, John S.; Martinovich, Zoran

2008-01-01

We examined the differential outcomes in residential treatment for youths with conduct disorder (CD)--with special attention paid to interactions with age and gender--in a sample of children and adolescents in 50 residential treatment centers and group homes across Illinois. Multi-disciplinary teams rated youths ages 6-20 (N = 457) on measures of…

Training of Residential Social Care Staff to Meet the Needs of Older People with Intellectual Disabilities who Develop Age-Related Health Problems: An Exploratory Study.

Science.gov (United States)

Northway, Ruth; Jenkins, Robert; Holland-Hart, Daniella

2017-09-01

Despite awareness of the age related health needs of people with intellectual disabilities little is known regarding how residential social care staff are prepared to meet such needs. Data were gathered via semi-structured interviews from 14 managers of supported living settings. Transcripts were thematically analysed. Staff may work in supported living settings with no prior experience of care work, and previous knowledge/experience of supporting people in relation to their health is not required. Whilst health related training is provided there is a lack of specific training regarding healthy ageing, and training seems to be reactive to changing needs of tenants meaning that proactive monitoring for changes in health status may not occur. Whilst some training is provided for residential social care staff in relation to health and ageing a more proactive approach is required which should include a focus on healthy ageing. © 2016 John Wiley & Sons Ltd.

Advocacy for Kids: A View from the Residential Trenches.

Science.gov (United States)

Parsons, Jon R.

1995-01-01

Presents the concept of advocacy in the trenches, wherein residential care staff intercede with and for dysfunctional families, dysfunctional children, and the bureaucracy. This advocacy emphasizes individualized treatment and case-by-case networking, focusing not on broad causes but on what is in the best interest of each child. (ET)

Study protocol: a randomized controlled trial of a computer-based depression and substance abuse intervention for people attending residential substance abuse treatment

Directory of Open Access Journals (Sweden)

Kelly Peter J

2012-02-01

Full Text Available Abstract Background A large proportion of people attending residential alcohol and other substance abuse treatment have a co-occurring mental illness. Empirical evidence suggests that it is important to treat both the substance abuse problem and co-occurring mental illness concurrently and in an integrated fashion. However, the majority of residential alcohol and other substance abuse services do not address mental illness in a systematic way. It is likely that computer delivered interventions could improve the ability of substance abuse services to address co-occurring mental illness. This protocol describes a study in which we will assess the effectiveness of adding a computer delivered depression and substance abuse intervention for people who are attending residential alcohol and other substance abuse treatment. Methods/Design Participants will be recruited from residential rehabilitation programs operated by the Australian Salvation Army. All participants who satisfy the diagnostic criteria for an alcohol or other substance dependence disorder will be asked to participate in the study. After completion of a baseline assessment, participants will be randomly assigned to either a computer delivered substance abuse and depression intervention (treatment condition or to a computer-delivered typing tutorial (active control condition. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based treatment facility. Randomisation will be stratified by gender (Male, Female, length of time the participant has been in the program at the commencement of the study (4 weeks or less, 4 weeks or more, and use of anti-depressant medication (currently prescribed medication, not prescribed medication. Participants in both conditions will complete computer sessions twice per week, over a five-week period. Research staff blind to treatment allocation will complete the assessments at baseline, and then 3, 6, 9

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

Science.gov (United States)

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

2017-12-01

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

Attitudes towards preventive tuberculosis treatment among hospital staff

Directory of Open Access Journals (Sweden)

Vidya Pathak

2016-02-01

Full Text Available Background. Healthcare workers have an increased risk of latent tuberculosis infection (LTBI, but previous studies suggested that they might be reluctant to accept preventive tuberculosis (TB treatment. We aimed to examine doctors’ and nurses’ experience of TB screening and to explore their attitudes towards preventive TB treatment. Methods. We conducted a survey among randomly selected healthcare workers at a tertiary hospital in Sydney, Australia, using a paper-based questionnaire. Results. A total of 1,304 questionnaires were distributed and 311 (24% responses were received. The majority of hospital staff supported preventive TB treatment in health care workers with evidence of latent TB infection (LTBI in general (74%, 164/223 and for them personally (81%, 198/244 while 80 and 53 healthcare workers respectively had no opinion on the topic. Staff working in respiratory medicine were significantly less likely to support preventive TB treatment in health care workers in general or for them personally if they would have evidence of LTBI compared to other specialties (p = 0.001. Only 13% (14/106 of respondents with evidence of LTBI indicated that they had been offered preventive TB treatment. Twenty-one percent (64/306 of respondents indicated that they did not know the difference between active and latent TB. Among staff who had undergone testing for LTBI, only 33% (75/230 felt adequately informed about the meaning of their test results. Discussion. Hospital staff in general had positive attitudes towards preventive TB treatment, but actual treatment rates were low and perceived knowledge about LTBI was insufficient among a significant proportion of staff. The gap between high support for preventive TB treatment among staff and low treatment rates needs to be addressed. Better education on the concept of LTBI and the meaning of screening test results is required.

Regionalised tertiary psychiatric residential facilities.

Science.gov (United States)

Lesage, Alain; Groden, David; Goldner, Elliot M; Gelinas, Daniel; Arnold, Leslie M

2008-01-01

Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely--with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call. This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing. In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments with hostel wards since the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia, Community Care Units (CCUs) have been applying this concept. In the Canadian province of British Columbia (BC), Tertiary Psychiatric Residential Facilities (TPRFs) have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital. This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary

Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

Science.gov (United States)

Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

2010-01-01

Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial.

Science.gov (United States)

Cardoso, Graça; Papoila, Ana; Tomé, Gina; Killaspy, Helen; King, Michael; Caldas-de-Almeida, José Miguel

2017-11-01

This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial. All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit's manager. Half the units (n = 12) were randomly assigned to continue providing treatment as usual, and half (n = 11) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users' level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users' quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117). Knowledge acquired by the staff during the initial workshops increased significantly (p ≤ 0.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up. The intervention increased the level of knowledge of staff without leading to an improvement in service users' engagement in activities, quality of life, or quality of care in the units.

Difficult relationships--interactions between family members and staff in long-term care.

Science.gov (United States)

Norris, S

2000-01-01

Staff of long-term care facilities and family members have a common responsibility to ensure the best course of treatment and everyday care for residents who often cannot speak for themselves. Understanding the difference between instrumental and preservative care, and who the proper agent is to provide care in each category will not only improve staff/family interactions, but residential care in general. The Resident Enrichment and Activity Program improves the family/staff relationship obliquely by involving family in social activities; the Family Involvement in Care program, and the Patterns in Caregiving program directly target the relationship and involve the facility's administration to effect policy change.

Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

Science.gov (United States)

Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

2010-01-01

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…

Do physiotherapy staff record treatment time accurately? An observational study.

Science.gov (United States)

Bagley, Pam; Hudson, Mary; Green, John; Forster, Anne; Young, John

2009-09-01

To assess the reliability of duration of treatment time measured by physiotherapy staff in early-stage stroke patients. Comparison of physiotherapy staff's recording of treatment sessions and video recording. Rehabilitation stroke unit in a general hospital. Thirty-nine stroke patients without trunk control or who were unable to stand with an erect trunk without the support of two therapists recruited to a randomized trial evaluating the Oswestry Standing Frame. Twenty-six physiotherapy staff who were involved in patient treatment. Contemporaneous recording by physiotherapy staff of treatment time (in minutes) compared with video recording. Intraclass correlation with 95% confidence interval and the Bland and Altman method for assessing agreement by calculating the mean difference (standard deviation; 95% confidence interval), reliability coefficient and 95% limits of agreement for the differences between the measurements. The mean duration (standard deviation, SD) of treatment time recorded by physiotherapy staff was 32 (11) minutes compared with 25 (9) minutes as evidenced in the video recording. The mean difference (SD) was -6 (9) minutes (95% confidence interval (CI) -9 to -3). The reliability coefficient was 18 minutes and the 95% limits of agreement were -24 to 12 minutes. Intraclass correlation coefficient for agreement between the two methods was 0.50 (95% CI 0.12 to 0.73). Physiotherapy staff's recording of duration of treatment time was not reliable and was systematically greater than the video recording.

Staff and consumer perspectives on defining treatment success and failure in assertive community treatment.

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Stull, Laura G; McGrew, John H; Salyers, Michelle P

2010-09-01

Although assertive community treatment (ACT) has been consistently recognized as effective, there has been little research as to what constitutes success in ACT. The purpose of this study was to understand how ACT consumers and staff define treatment success and failure and to examine whether definitions varied between staff and consumers. Investigators conducted semistructured interviews with 25 staff and 23 consumers from four ACT teams. Across perspectives, success and failure were most clearly related to consumer factors. Other themes included having basic needs met, being socially involved, and taking medications. Reduced hospitalizations were mentioned infrequently. Consumers were more likely than staff to identify the level or type of treatment as defining success and failure, whereas staff were more likely than consumers to discuss substance abuse when defining failure and improved symptoms when defining success. Success in ACT should be viewed more broadly than reduced hospitalizations and include domains such as social involvement.

38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

Science.gov (United States)

2010-07-01

... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study.

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Sjögren, Karin; Lindkvist, Marie; Sandman, Per-Olof; Zingmark, Karin; Edvardsson, David

2017-01-01

Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics. A cross-sectional design was used. Residents ( n  = 1460) and staff ( n  = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents . Descriptive and comparative statistics, independent samples t-test, Chi 2 test, Eta Squared and Phi coefficient were used to analyse data. Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care. It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

Emotion regulation promotes persistence in a residential substance abuse treatment.

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Hopwood, Christopher J; Schade, Nick; Matusiewicz, Alexis; Daughters, Stacey B; Lejuez, Carl W

2015-01-01

Emotion regulation at treatment entry was evaluated among 115 patients in an inner-city substance use residential facility who either persisted (N = 94) or discontinued treatment (N = 21). Emotion regulation capacity including emotional clarity and the ability to engage in goal-directed behavior despite emotional distress, as well as lower scores on a measure of trait-negative emotionality, were associated with treatment persistence, whereas motivational variables were not. Findings indicate the importance of regulating negative emotions for treatment engagement among substance abusers.

Smartphone and Mobile Application Utilization Prior to and Following Treatment Among Individuals Enrolled in Residential Substance Use Treatment

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Dahne, Jennifer; Lejuez, C. W.

2015-01-01

Background Following completion of substance use treatment, it is crucial for patients to continue to utilize skills learned in treatment for optimal treatment outcomes. Mobile applications (apps) on smartphones offer a unique platform to promote utilization of evidence-based skills following completion of substance use treatment. Despite the promise of mobile apps and smartphones for treatment delivery, it remains unknown whether patients in substance use treatment in the United States have access to smartphones and utilize mobile apps on smartphones. The present study sought to determine smartphone utilization among individuals enrolled in one residential substance use treatment center in the U.S catering specifically to low-income adults. Methods Participants included 251 individuals at a residential substance use treatment center in Washington DC admitted to the center between March, 2014 and January, 2015. During the intake process, participants completed interviewer-administered demographics and psychiatric questionnaires as well as a self-report of technology utilization. Results Results indicated that the majority of patients in this residential substance use treatment center owned mobile phones prior to treatment entry (86.9%) and expected to own mobile phones after leaving treatment (92.6%). Moreover, the majority of these phones were (68.5%) or will be smartphones (72.4%) on which patients reported utilizing mobile applications (Prior to treatment: 61.3%; Post treatment: 64.3%) and accessing the internet (Prior to treatment: 61.3%; Post treatment: 65.9%). Conclusions Mobile phone and smartphone ownership among this sample were comparable to ownership among U.S. adults broadly. Findings suggest that smartphones and mobile apps may hold clinical utility for fostering continued use of treatment skills following substance use treatment completion. PMID:26231698

Predictors of residential treatment retention among individuals with co-occurring substance abuse and mental health disorders.

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Choi, Sam; Adams, Susie M; MacMaster, Samuel A; Seiters, John

2013-01-01

A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders. The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA. Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days. The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change. These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.

Childhood maltreatment and motivation for treatment in girls in compulsory residential care

NARCIS (Netherlands)

Leenarts, L.E.W.; Hoeve, M.; van de Ven, P.M.; Lodewijks, H.P.B.; Dorelijers, T.A.H.

2013-01-01

The first objective of the current study was to examine the relationship between childhood maltreatment, trauma-related symptoms and motivation for treatment in girls in compulsory residential treatment facilities. The second objective was to examine the extent to which various forms of childhood

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

NARCIS (Netherlands)

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

2016-01-01

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

Parenting training for women in residential substance abuse treatment. Results of a demonstration project.

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Camp, J M; Finkelstein, N

1997-01-01

This paper presents findings on the impact of implementing a parenting component in two urban residential treatment programs in Massachusetts for pregnant and parenting chemically-dependent women. The parenting component consisted of multiple services for both women and their infants while they were in residential treatment as well as aftercare services after discharge from treatment. Findings presented focus on: (a) the characteristics of the 170 pregnant and parenting women who participated in the parenting component during its 48 months of implementation; (b) changes in the parenting skills and self-esteem of women who completed parenting training; (c) the quality of mother-child interaction; and (d) the participants' perceptions about the impact of the parenting training. Women in both programs made dramatic improvements in self-esteem and experienced significant gains in parenting knowledge and attitudes. The participants were also overwhelmingly positive about the impact of the parenting training on their lives. Study findings underline the importance of parenting services for pregnant and parenting women in residential substance abuse treatment.

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

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

2013-01-01

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

Personal networks of women in residential and outpatient substance abuse treatment.

Science.gov (United States)

Kim, HyunSoo; Tracy, Elizabeth; Brown, Suzanne; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung; McCarty, Chris

This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t -tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.

The Untreated Addiction: Going Tobacco-Free in a VA Substance Abuse Residential Rehabilitation Treatment Program (SARRTP).

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Conrad, Megan; Bolte, Teri; Gaines, Leigh; Avery, Zackery; Bodie, Linda

2018-05-02

Despite negative effects of tobacco on the human body and the high prevalence of smoking among those who enter treatment for substance use, few residential programs endorse a tobacco-free policy. Conventional wisdom suggests that it is overwhelming to quit more than one substance at a time, and as a result, many clinicians believe that a shift to a tobacco-free treatment environment is unfeasible. However, the most recent scientific literature suggests the opposite: targeting tobacco use during substance use treatment can increase abstinence rates from both smoking and substances of choice. Therefore, the purpose of the current project is to outline the process by which a residential substance use treatment program within a Veterans Affairs (VA) medical center implemented a tobacco-free policy. In addition, preliminary program evaluation data dispels the myth that eliminating tobacco use in a residential treatment program leads to a decline in patient interest and program utilization.

Attitudes and beliefs towards methadone maintenance treatment among Australian prison health staff.

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Gjersing, Linn R; Butler, Tony; Caplehorn, John R M; Belcher, Josephine M; Matthews, Richard

2007-09-01

Justice Health NSW has one of the most extensive prison-based methadone programmes in the world. We examine prison health staff attitudes towards methadone treatment and compare these with community methadone staff. A cross-sectional survey of 202 staff employed by Justice Health New South Wales was undertaken in 2003. Results. The mean scores on the various sub-scales were: abstinence-orientation (AO) 2.9 (95% CI 2.8 - 3.0); disapproval of drug use (DDU) 3.3 (95% CI 3.2 - 3.4); knowledge (Know) 2.7 (95% CI 2.4 - 2.9); and toxicity 4.6 (95% CI 4.2 - 5.0). Both the AO and DDU score were correlated negatively with the Know score (r = -0.37 and r = -0.13, respectively). Prison health staff had higher AO (2.9 vs. 2.6, p US community methadone staff about the toxicity of methadone (4.6 vs. 0.0, p prison health staff attitudes to methadone treatment. Correctional health staff tend to be more abstinence-orientated, more likely to disapprove of drug use, and less knowledgeable about the risks and benefits of methadone than Australian community methadone staff. The findings have important implications for training health staff working in the prison environment with regard to client retention on methadone treatment.

Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: do cognitive and social dysfunction moderate treatment outcome?

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Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold

2010-09-01

The predictors of residential cognitive (RCT) and residential interpersonal Treatment (RIPT) for social phobia were explored. (1) Sotsky et al. (1991) found differential effects of CT and IPT for depression, suggesting that the level of cognitive or social dysfunction predicted differential outcome. We examined whether an analogous effect could be demonstrated in 10 weeks of residential treatment of 80 social phobia subjects. (2) We also included expectations, age of onset, severity of illness, concurrent anxiety, mood, avoidant personality disorder, and body dysmorphic disorder as predictors in this exploratory study. Main outcome was the social phobia subscale of Social Phobia and Anxiety Inventory (SPAI SP). DSM-IV axis I and II interviews were completed. (1) Sotsky et al. (1991) findings were not reproduced. However, RIPT subjects with poor general functioning were less improved following treatment. Subjects with concurrent agoraphobia responded better with RCT than subjects without agoraphobia. (2) Age of onset and expectations were the most powerful predictors of post treatment outcome. Some patient characteristics appear to impact outcome with RIPT and RCT differentially. The findings are discussed. (c) 2010 Elsevier Ltd. All rights reserved.

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

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

2016-06-01

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

Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

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McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

2004-09-01

Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

Early Maladaptive Schemas in a Sample of Airline Pilots seeking Residential Substance Use Treatment: An Initial Investigation.

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Shorey, Ryan C; Brasfield, Hope; Anderson, Scott; Stuart, Gregory L

2014-01-01

Recent research has begun to examine the early maladaptive schemas of substance abusers, as it is believed that targeting these core beliefs in treatment may result in improved substance use outcomes. One special population that has received scant attention in the research literature, despite high levels of substance use, is airline pilots. The current study examined the early maladaptive schemas of a sample of airline pilots ( n = 64) who were seeking residential treatment for alcohol dependence and whether they differed in early maladaptive schemas from non-pilot substance abusers who were also seeking residential treatment for alcohol dependence ( n = 45). Pre-existing medical records from patients of a residential substance abuse treatment facility were reviewed for the current study. Of the 18 early maladaptive schemas, results demonstrated that pilots scored higher than non-pilots on the early maladaptive schema of unrelenting standards (high internalized standards of behavior), whereas non-pilots scored higher on insufficient self-control (low frustration tolerance and self-control). Early maladaptive schemas may be a relevant treatment target for substance abuse treatment seeking pilots and non-pilots.

Organisational culture in residential aged care facilities: a cross-sectional observational study.

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Etherton-Beer, Christopher; Venturato, Lorraine; Horner, Barbara

2013-01-01

Organisational culture is increasingly recognised as important for provision of high-quality long-term care. We undertook this study to measure organisational culture in residential aged care facilities in two Australian states. Cross-sectional observational study in 21 residential aged care facilities in Western Australia (n = 14) and Queensland (n = 7), Australia. Staff and next-of-kin of residents participated. Measurement comprised surveys of facility staff and residents' next-of-kin, and structured observation of indicators of care quality. Staff tended to rate organisational culture positively. Some qualitative feedback from staff emphasised negative perceptions of communication, leadership and teamwork. Staffing levels were perceived as a dominant challenge, threatening care quality. Direct observation revealed variability within and between facilities but suggested that most facilities (n = 12) were in the typical range, or were quality facilities (n = 8). There was scope to strengthen organisational culture in participating aged care facilities.

Attitudes and preferences towards exercise training in individuals with alcohol use disorders in a residential treatment setting.

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Stoutenberg, Mark; Warne, James; Vidot, Denise; Jimenez, Erika; Read, Jennifer P

2015-02-01

Alcohol use disorders (AUD) are a major public health concern due to their association with several acute and chronic health conditions. Exercise training offers a myriad of physical and mental health benefits, and may be a promising adjunct intervention for those in AUD treatment. The purpose of this study was to explore the possible role of exercise training as a treatment strategy by examining the attitudes, beliefs, and preferences of individuals entering residential AUD treatment. Surveys were administered to eligible individuals with AUD within 2days of intake to one of two residential treatment centers. The survey asked respondents about their attitudes, beliefs, and preferences towards exercise training as a part of their residential treatment. Respondents were in favor of receiving exercise counseling as part of their treatment (70.6%), in a face-to-face format (90.0%), and from an exercise counselor at the treatment center (55.5%). The top reported benefits included: improved health, feeling good about oneself, and feeling more confident. The most commonly reported barriers to exercise training included transportation issues, lack of motivation, knowledge, and proper equipment, and cost. Our study supports previous work in individuals with substance abuse disorders and suggests that exercise training would be widely accepted as a part of residential treatment for AUD. This study also identified several strategies that can be used to individualize exercise training programs to better meet the needs of AUD patients and maximize their participation in future interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

Perception of Helpfulness among Participants in a Prison-Based Residential Substance Abuse Treatment Program

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Raney, Valerie K.; Magaletta, Philip; Hubbert, Timothy A.

2005-01-01

The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates' perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were…

HPA axis response to psychological stress and treatment retention in residential substance abuse treatment: a prospective study.

Science.gov (United States)

Daughters, Stacey B; Richards, Jessica M; Gorka, Stephanie M; Sinha, Rajita

2009-12-01

Substance abuse treatment programs are often characterized by high rates of premature treatment dropout, which increases the likelihood of relapse to drug use. Negative reinforcement models of addiction emphasize an individual's inability to tolerate stress as a key factor for understanding poor substance use treatment outcomes, and evidence indicates that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis contributes to an individual's inability to respond adaptively to stress. The aim of the current study was to examine whether HPA axis response to stress is predictive of treatment retention among a sample of drug users in residential substance abuse treatment. Prospective study assessing treatment retention among 102 individuals enrolled in residential substance abuse treatment. Participants completed two computerized stress tasks, and HPA axis response to stress was measured via salivary cortisol at five time points from baseline (pre-stress) to 30 min post-stress exposure. The main outcome measures were treatment dropout (categorical) and total number of days in treatment (continuous). A significantly higher salivary cortisol response to stress was observed in treatment dropouts compared to treatment completers. Further, Cox proportional hazards survival analyses indicated that a higher peak cortisol response to stress was associated with a shorter number of days to treatment dropout. Results indicate that a higher salivary cortisol level in response to stress is associated with an inability to remain in substance abuse treatment. These findings are the first to document a biological marker of stress as a predictor of substance abuse treatment dropout, and support the development and implementation of treatments targeting this vulnerability.

Expectations of hospital treatment. Conflicting views of patients and staff.

Science.gov (United States)

Skodol, A E; Plutchik, R; Karasu, T B

1980-02-01

A 40-item therapeutic community questionnaire, developed from a survey of experts, was used to assess the treatment needs and expectations of a group of 30 hospitalized psychiatric patients. The patients' attitudes regarding an ideal ward atmosphere were compared to those, as measured previously by the identical instrument, of the treating staff. The results indicated that psychiatric inpatients found the therapeutic community modality consistent with their needs and expectations. However, staff and patients were divided in attitude toward the therapeutic community concept. The staff's definition of therapeutic community was broad and exceeded the principles of the therapeutic community experts. The patients desired a more conservative approach which combined respect and responsibility with a ward structure that was unambiguous and less democratic. Studies of ward atmosphere as well as premature termination in psychotherapy indicate that such conflicts in viewpoint between patients and staff might have detrimental effects on hospital outcome. A negotiated approach to inpatient treatment is suggested as a means to establish greater autonomy, growth in self-esteem, sense of responsibility, and increased trust on the part of hospitalized patients.

Association between Psychopathology and Physical Health Problems among Youth in Residential Treatment

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Nelson, Timothy D.; Smith, Tori R.; Duppong Hurley, Kristin; Epstein, Michael H.; Thompson, Ronald W.; Tonniges, Thomas F.

2013-01-01

Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to…

Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder.

Science.gov (United States)

Suter, Marius; Strik, Werner; Moggi, Franz

2011-10-01

Alcohol use disorder (AUD) and depressive disorders often co-occur. Findings on the effects of major depressive disorder (MDD) or depressive symptoms on posttreatment alcohol relapse are controversial. The study's aim is to examine the association of MDD and depressive symptoms with treatment outcomes after residential AUD programs. In a naturalistic-prospective, multisite study with 12 residential AUD treatment programs in the German-speaking part of Switzerland, 64 patients with AUD with MDD, 283 patients with AUD with clinically significant depressive symptoms at admission, and 81 patients with AUD with such problems at discharge were compared with patients with AUD only on alcohol use, depressive symptoms, and treatment service utilization. MDD was provisionally identified at admission and definitively defined at discharge. Whereas patients with MDD did not differ from patients with AUD only at 1-year follow-up, patients with AUD with clinically significant depressive symptoms had significantly shorter time-to-first-drink and a lower abstinence rate. These patients also had elevated AUD indices and treatment service utilization for psychiatric disorders. Our results suggest that clinically significant depressive symptoms are a substantial risk factor for relapse so that it may be important to treat them during and after residential AUD treatment programs. Copyright © 2011 Elsevier Inc. All rights reserved.

Association between addiction treatment staff professional and educational levels and perceptions of organizational climate and resources.

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Krull, Ivy; Lundgren, Lena; Beltrame, Clelia

2014-01-01

Research studies have identified addiction treatment staff who have higher levels of education as having more positive attitudes about evidence-based treatment practices, science-based training, and the usefulness of evidence-based practices. This study examined associations between addiction treatment staff level of education and their perceptions of 3 measures of organizational change: organizational stress, training resources and staffing resources in their treatment unit. The sample included 588 clinical staff from community-based substance abuse treatment organizations who received Substance Abuse and Mental Health Services Administration (SAMHSA) funding (2003-2008) to implement evidence-based practices (EBPs). Bivariate analysis and regression modeling methods examined the relationship between staff education level (no high school education, high school education, some college, associate's degree, bachelor's degree, master's degree, doctoral degree, and other type of degree such as medical assistant, registered nurse [RN], or postdoctoral) and attitudes about organizational climate (stress), training resources, and staffing resources while controlling for staff and treatment unit characteristics. Multivariable models identified staff with lower levels of education as having significantly more positive attitudes about their unit's organizational capacity. These results contradict findings that addiction treatment staff with higher levels of education work in units with greater levels of organizational readiness for change. It cannot be inferred that higher levels of education among treatment staff is necessarily associated with high levels of organizational readiness for change.

"I just feel comfortable out here, there's something about the place": staff and client perceptions of a remote Australian Aboriginal drug and alcohol rehabilitation service.

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Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Breen, Courtney

2017-12-06

The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and largely ignored the impact of treatment and service factors, such as the nature and quality of therapeutic components and relationships with staff. This qualitative study was undertaken as part of a three-year mixed methods community-based participatory research (CBPR) project that aimed to empirically describe a remote Aboriginal drug and alcohol rehabilitation service. Researchers utilised purposive sampling to conduct 21 in-depth, semi-structured interviews. The interviews used a 'research yarning' approach, a form of culturally appropriate conversation that is relaxed and narrative-based. The interview transcripts were thematically coded using iterative categorization. The emerging themes were then analysed from an Interpretative Phenomenological Analysis, focusing on how participants' lived experiences before and during their admission to the service shaped their perceptions of the program. A total of 12 clients (mean age 35 years, SD 9.07, 91% Aboriginal) and 9 staff (2 female, 7 male, mean age 48 years, SD 8.54, 67% Aboriginal) were interviewed. Five themes about specific program components were identified in the interview data: healing through culture and country; emotional safety and relationships; strengthening life skills; improved wellbeing; and perceived areas for improvement. This research found that Aboriginal drug and alcohol residential rehabilitation is not just about length of time in treatment, but also about the culture, activities and relationships that are part of the treatment process. This study highlights that cultural elements were highly valued by both clients and staff of a remote Aboriginal residential

Implementation of transdiagnostic treatment for emotional disorders in residential eating disorder programs: A preliminary pre-post evaluation.

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Thompson-Brenner, Heather; Boswell, James F; Espel-Huynh, Hallie; Brooks, Gayle; Lowe, Michael R

2018-03-19

Data are lacking from empirically supported therapies implemented in residential programs for eating disorders (EDs). Common elements treatments may be well-suited to address the complex implementation and treatment challenges that characterize these settings. This study assessed the preliminary effect of implementing a common elements therapy on clinician treatment delivery and patient (N = 616) symptom outcomes in two residential ED programs. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders was adapted to address ED and co-occurring psychopathology and implemented across sites. Therapists' treatment fidelity was rated independently to assess implementation success. Additionally, longitudinal (pre-post) design compared treatment outcomes among patients treated before and after implementation. Patient outcomes included ED and depressive symptoms, experiential avoidance, anxiety sensitivity, and mindfulness. Following training and implementation, clinicians demonstrated adequate to good fidelity. Relative to pre-implementation, post-implementation patients showed significantly greater improvements in experiential avoidance, anxiety sensitivity, and mindfulness at discharge (ps ≤ .04) and more favorable outcomes on ED symptom severity, depression, and experiential avoidance at 6-month follow up (ps ≤ .0001). Preliminary pilot data support the feasibility of implementing transdiagnostic common elements therapy in residential ED treatment, and suggest that implementation may benefit transdiagnostic outcomes for patients.

Explaining Perceptions of Administrative Support among Prison Treatment Staff: A Spotlight on Deputy Wardens in Charge of Treatment

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Garland, Brett E.; McCarty, William P.

2006-01-01

This paper explores how perceptions of administrative support among 83 treatment staff working in a midwest prison system vary according to personal and work-related variables. It extends on previous literature by: (1) analyzing how perceptions of administrative support vary exclusively among prison treatment staff; (2) focusing on a single type…

Perceptions of Personal Well-Being among Youth Accessing Residential or Intensive Home-Based Treatment

Science.gov (United States)

Preyde, Michele; Watkins, Hanna; Ashbourne, Graham; Lazure, Kelly; Carter, Jeff; Penney, Randy; White, Sara; Frensch, Karen; Cameron, Gary

2013-01-01

The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental…

Risky decision-making predicts short-term outcome of community but not residential treatment for opiate addiction. Implications for case management.

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Passetti, F; Clark, L; Davis, P; Mehta, M A; White, S; Checinski, K; King, M; Abou-Saleh, M

2011-10-01

Opiate addiction is associated with decision-making deficits and we previously showed that the extent of these impairments predicts aspects of treatment outcome. Here we aimed to establish whether measures of decision-making performance might be used to inform placement matching. Two groups of opiate dependent individuals, one receiving treatment in a community setting (n=48) and one in a residential setting (n=32) were administered computerised tests of decision-making, impulsivity and planning shortly after the beginning of treatment, to be followed up three months into each programme. In the community sample, performance on the decision-making tasks at initial assessment predicted abstinence from illicit drugs at follow-up. In contrast, in the residential sample there was no relationship between decision-making and clinical outcome. Intact decision-making processes appear to be necessary for upholding a resolve to avoid taking drugs in a community setting, but the importance of these mechanisms may be attenuated in a residential treatment setting. The results support the placement matching hypothesis, suggesting that individuals with more prominent decision-making deficits may particularly benefit from treatment in a residential setting and from the inclusion of aspects of cognitive rehabilitation in their treatment programme. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

On Becoming Batman: An Ethnographic Examination of Hero Imagery in Early-Career Residential Life Emergency Management

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Molina, Danielle K.

2016-01-01

Emergency response is an essential function of all residential life staff, but particularly for resident assistants serving on the front line. This organizational ethnography examined the role that professional identity played for early-career residential life practitioners engaged in emergency management. The data elucidated heroism as a…

Evaluating effects of residential treatment for juvenile offenders by statistical metaanalysis : A review

NARCIS (Netherlands)

Grietens, H; Hellinckx, W

Statistical metaanalyses on the effects of residential treatment for juvenile offenders were reviewed to examine the mean effect sizes and reductions of recidivism reported for this group. Five metaanalyses (three on North American and two on European studies) were selected and synthesized in a

Investigating the factors that affect the communication of death-related bad news to people with intellectual disabilities by staff in residential and supported living services: An interview study.

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Tuffrey-Wijne, I; Rose, T

2017-08-01

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.

Organizational Consequences of Staff Turnover in Outpatient Substance Abuse Treatment Programs

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Knight, Danica K.; Edwards, Jennifer R.; Flynn, Patrick M.

2014-01-01

The purpose of this study was to examine the impact of staff turnover on perceptions of organizational demands and support among staff who remained employed in substance abuse treatment programs. The sample consisted of 353 clinical staff from 63 outpatient agencies. Two scales from the Survey of Organizational Functioning (SOF) measured work-environment demands (Stress, Inadequate Staffing), and three measured supportive work relationships (Communication, Cohesion, Peer Collaboration). Results from a series of multilevel models documented that counselors working in programs that had previously experienced high staff turnover perceived higher demands and lower support within their organization, even after controlling for other potentially burdensome factors such as budget, census, and individual measures of workload. Two individual-level variables, caseload and tenure, were important determinants of work-environment demands, but were not related to supportive work relationships. Findings suggest that staff turnover increases workplace demands and decreases perceptions of support, and underscore the need to reduce stress and minimize subsequent turnover among clinical staff. PMID:22154028

Encopresis and Sexual Abuse in a Sample of Boys in Residential Treatment.

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Morrow, Jan; And Others

1997-01-01

This study of 23 boys (ages 6 to 14) in a residential psychiatric treatment program found nine of the boys were encopretic (27 times the incidence of encopresis in the general population of boys 10-12). Seven of the nine boys had histories of sexual abuse by males, suggesting that encopresis may be a marker of sexual abuse. (DB)

Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

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Garner, Bryan R.; Hunter, Brooke D.; Modisette, Kathryn C.; Ihnes, Pamela C.; Godley, Susan H.

2011-01-01

High staff turnover has been described as a problem for the substance use disorder treatment field. This assertion is based primarily on the assumption that staff turnover adversely impacts treatment delivery and effectiveness. This assumption, however, has not been empirically tested. In this study, we computed annualized rates of turnover for treatment staff (n=249) participating in an evidence-based practice implementation initiative and examined the association between organizational-level rates of staff turnover and client-level outcomes. Annualized rates of staff turnover were 31% for clinicians and 19% for clinical supervisors. Additionally, multilevel analyses did not reveal the expected relationship between staff turnover and poorer client-level outcomes. Rather, organizational-level rates of staff turnover were found to have a significant positive association with two measures of treatment effectiveness: less involvement in illegal activity and lower social risk. Possible explanations for these findings are discussed. PMID:22154040

Organizational consequences of staff turnover in outpatient substance abuse treatment programs.

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Knight, Danica K; Becan, Jennifer E; Flynn, Patrick M

2012-03-01

The purpose of this study was to examine the impact of staff turnover on perceptions of organizational demands and support among staff who remained employed in substance abuse treatment programs. The sample consisted of 353 clinical staff from 63 outpatient agencies. Two scales from the Survey of Organizational Functioning measured work environment demands (stress and inadequate staffing), and 3 measured supportive work relationships (communication, cohesion, and peer collaboration). Results from a series of multilevel models documented that counselors working in programs that had previously experienced high staff turnover perceived higher demands and lower support within their organization, even after controlling for other potentially burdensome factors such as budget, census, and individual measures of workload. Two individual-level variables, caseload and tenure, were important determinants of work environment demands but were not related to supportive work relationships. Findings suggest that staff turnover increases workplace demands, decreases perceptions of support, and underscores the need to reduce stress and minimize subsequent turnover among clinical staff. Copyright © 2012 Elsevier Inc. All rights reserved.

Managing Austerity: Emotional Containment in a Residential Children’s Home Under Threat

OpenAIRE

Melaugh, Brian

2016-01-01

The aim of the study was to explore the process and practice of leading change in residential child care and assess the efficacy of ‘emotional containment’ in this context. Residential child care in Ireland is experiencing significant change. Change is an emotional experience for staff and leadership is named as pivotal in organisational change. However, there is gap in the literature because leadership and organisational change theory does not fully fit with the relational nature of resident...

Long-term residential substance abuse treatment for women: lessons learned from Israel

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Schori M

2012-02-01

. Analysis of the questionnaires revealed that compared to non-completers, completers had fewer psychiatric symptoms, higher levels of introverted behavior in stressful situations, a better sense of coherence, and less ability to share emotions. No significant differences were found with regard to demographic and substance use factors. All 19 women who completed treatment and the follow-up questionnaire remained abstinent from illicit drugs for 18 months following the end of treatment.Conclusion: Results indicate that women see the women-only treatment setting as extremely significant. Also, there is a profile of psychiatric co-morbidity, extrapunitiveness, and fewer personal resources that predict a risk for attrition. Thus, women at risk for attrition may be identified early and treatment staff can utilize the results to assist clients in achieving their treatment goals. Results can inform policymakers in making decisions regarding the allocation of resources, by pointing to the importance of long-term women-only residential treatment in increasing positive treatment outcomes.Keywords: gender, drug abuse, therapeutic community, mixed methods, program evaluation

Multidimensional Treatment Foster Care: An Alternative to Residential Treatment for High Risk Children and Adolescents

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Philip A. Fisher

2012-07-01

Full Text Available This paper describes the Multidimensional Treatment Foster Care program (MTFC, an evidence based approach for providing psychotherapeutic treatment for very troubled children and adolescents that is an alternative to residential care. Versions of the MTFC program have been developed and validated for young children with a history of maltreatment as well as for older children and adolescents who are involved with the youth justice system. In the paper we describe the development of the MTFC program and its foundations in the social learning model that originated at the Oregon Social Learning Center in the 1960's and 70's. We present information about program elements. We then review the research that has been conducted on MTFC.

Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis.

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Mac Giolla Phadraig, Caoimhin; Nunn, June; Guerin, Suzanne; Normand, Charles

2016-04-01

Oral health training is often introduced into community-based residential settings to improve the oral health of people with intellectual disabilities (ID). There is a lack of appropriate evaluation of such programs, leading to difficulty in deciding how best to allocate scarce resources to achieve maximum effect. This article reports an economic analysis of one such oral health program, undertaken as part of a cluster randomized controlled trial. Firstly, we report a cost-effectiveness analysis of training care-staff compared to no training, using incremental cost-effectiveness ratios (ICERs). Effectiveness was measured as change in knowledge, reported behaviors, attitude and self-efficacy, using validated scales (K&BAS). Secondly, we costed training as it was scaled up to include all staff within the service provider in question. Data were collected in Dublin, Ireland in 2009. It cost between €7000 and €10,000 more to achieve modest improvement in K&BAS scores among a subsample of 162 care-staff, in comparison to doing nothing. Considering scaled up first round training, it cost between €58,000 and €64,000 to train the whole population of staff, from a combined dental and disability service perspective. Less than €15,000-€20,000 of this was additional to the cost of doing nothing (incremental cost). From a dental perspective, a further, second training cycle including all staff would cost between €561 and €3484 (capital costs) and €5815 (operating costs) on a two yearly basis. This study indicates that the program was a cost-effective means of improving self-reported measures and possibly oral health, relative to doing nothing. This was mainly due to low cost, rather than the large effect. In this instance, the use of cost effectiveness analysis has produced evidence, which may be more useful to decision makers than that arising from traditional methods of evaluation. There is a need for CEAs of effective interventions to allow comparison

Patient-centered feedback on the results of personality testing increases early engagement in residential substance use disorder treatment: a pilot randomized controlled trial.

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Blonigen, Daniel M; Timko, Christine; Jacob, Theodore; Moos, Rudolf H

2015-03-14

Patient-centered models of assessment have shown considerable promise for increasing patients' readiness for mental health treatment in general, but have not been used to facilitate patients' engagement in substance use disorder (SUD) treatment. We developed a brief patient-centered intervention using assessment and feedback of personality data and examined its acceptability and efficacy to increase early engagement in residential SUD treatment. Thirty patients entering a 90-day residential SUD treatment program were randomly assigned to a feedback (n = 17) or control (n = 13; assessment-only) condition. Normal-range personality was assessed with the NEO Personality Inventory-Revised (NEO PI-R). Patients were re-interviewed one month after treatment entry to obtain information on their satisfaction with the intervention, as well as their adjustment to the residential milieu. Electronic medical records were reviewed to obtain information on patients' length of stay in the program and discharge status. Univariate ANOVAs and chi-square tests were conducted to examine group differences on outcomes. Patients' ratings indicated strong satisfaction with the feedback intervention and expectations that it would have a positive impact on their treatment experiences. Among patients who had not previously been treated in the residential program, the feedback intervention was associated with more positive relationships with other residents in treatment and a stronger alliance with the treatment program one month after treatment entry. The feedback intervention was also associated with a longer length of stay in treatment, although this effect did not reach statistical significance. The findings highlight the clinical utility of providing SUD patients with patient-centered feedback based on the results of personality testing, and provide preliminary support for the acceptability and efficacy of this intervention to facilitate early engagement in residential SUD treatment.

Psychoanalysis and the early beginnings of residential treatment for troubled youth.

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Cohler, Bertram J; Friedman, Daniel H

2004-04-01

One of the intentions of Aichhom, Redl, Wineman, Bettelheim, and Anna Freud in their writings about group care was to advocate for the need to simplify the lives of youths who had known only chaos, to create an atmosphere in which everything has a purpose and predictable positive responses were given unconditionally. Recent efforts, such as those by Greenberg et at, have focused on building community-wide early interventions to forestall later emergence of emotional or behavioral disorders. The efforts also mark a shift away from punishment and exclusion for troubled children at school to more inclusive systems of positive behavioral interventions and support by providing a place to achieve academic and social behavioral success. Contemporary social policy regarding residential care for troubled children reflects the belief that a child's development is inevitably enhanced by residence ina family environment. This belief in the value of home and family, so central to contemporary child welfare policy, has been challenged by the recognition that some family situations are not conducive for growth. Redl and Wineman observed that the children who ended up in residential treatment had used up all community treatment resources and soon became the children that nobody wants. Eventually, the homes that produced them, the communities in which they lived, the schools they attended, and the neighborhoods in which they played were unwilling to tolerate their disruptive and disturbing behavior. The chaotic lives of the parents of these children hindered effective monitoring and management,which limited the family's ability to spend time with children, teach conflict-resolution skills, or communicate consistent behavioral expectations. Walker suggested that divorce, abuse, poverty, drugs, and other forces that interfere with normal parenting increasingly disrupt advantaged and disadvantaged families. Vogel and Bell and Spiegel observed that some troubled young people become the

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

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Lindley, Lisa C

2017-01-01

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

Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

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Peters, Claudia

2014-09-01

Full Text Available [english] Background: The increase of multidrug-resistant organisms (MDROs causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff.Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs.Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution.Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work.

Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

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Attia, Evelyn; Blackwood, Kristy L; Guarda, Angela S; Marcus, Marsha D; Rothman, David J

2016-06-01

Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.

The effectiveness of staff training focused on increasing emotional intelligence and improving interaction between support staff and clients.

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Zijlmans, L J M; Embregts, P J C M; Gerits, L; Bosman, A M T; Derksen, J J L

2015-07-01

Recent research addressed the relationship between staff behaviour and challenging behaviour of individuals with an intellectual disability (ID). Consequently, research on interventions aimed at staff is warranted. The present study focused on the effectiveness of a staff training aimed at emotional intelligence and interactions between staff and clients. The effects of the training on emotional intelligence, coping style and emotions of support staff were investigated. Participants were 214 support staff working within residential settings for individuals with ID and challenging behaviour. The experimental group consisted of 76 staff members, 138 staff members participated in two different control groups. A pre-test, post-test, follow-up control group design was used. Effectiveness was assessed using questionnaires addressing emotional intelligence, coping and emotions. Emotional intelligence of the experimental group changed significantly more than that of the two control groups. The experimental group showed an increase in task-oriented coping, whereas one control group did not. The results with regard to emotions were mixed. Follow-up data revealed that effects within the experimental group were still present four months after the training ended. A staff training aimed at emotional intelligence and staff-client interactions is effective in improving emotional intelligence and coping styles of support staff. However, the need for more research aiming at the relationship between staff characteristics, organisational factors and their mediating role in the effectiveness of staff training is emphasised. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Considering a Private Residential Treatment Program for a Troubled Teen? Questions for Parents and Guardians to Ask

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Federal Trade Commission, 2008

2008-01-01

Private residential treatment programs for young people offer a range of services, including drug and alcohol treatment, confidence building, military-style discipline, and psychological counseling for a variety of addiction, behavioral, and emotional problems. Many of these programs are intended to provide a less-restrictive alternative to…

[The model program of psycho-social treatment and staff training].

Science.gov (United States)

Ikebuchi, Emi

2012-01-01

The model program of psycho-social treatment and staff training were reported in this issue. The mission of model program is supporting recovery of persons with mental illness and their family as well as empowering their hope and sense of values. The personal support specialists belonging to multi-disciplinary team have responsibility to support life-long process of recovery across hospitalization, out-patients clinic, day treatment, and outreach service. The shared value of multi-disciplinary team (the community life supporting team) is recovery so that the team renders self directive life, various alternatives of their lives, and peer group with models of recovery to persons with mental illness. There should be several technologies which are used in the team such as engagement, psycho-education, cognitive-behavior therapy, care-management, cooperating with other resources. The responsibility, assessment and evaluation techniques, guarantee of opportunities for training, and auditing system of the team and process of treatment are important factors to educate team staff. Raising effective multi-disciplinary team requires existence of a mentor or good model near the team.

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

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

2017-01-01

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

Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence.

Science.gov (United States)

Bird, Mike; Anderson, Katrina; MacPherson, Sarah; Blair, Annaliese

2016-12-01

Common sense suggests and research indicates relationships between staff factors in residential dementia care and quality of life (QOL) for residents, with poor care increasing suffering. However, we do not have a coherent picture of which staff interventions have an impact on quality of care (QOC) or resident QOL. A comprehensive search of 20 years' peer-reviewed literature using Medline, PsycINFO, Embase, PubMed, CINAHL, and the Cochrane, Campbell Collaboration identified 4,760 studies meriting full text review. Forty-six met the inclusion criteria, namely interventions in long-term facilities helping staff develop their capacity to provide better care and/or QOL for residents with dementia. Thirty-five other papers comprised an associated predictor review. Conclusions from these limited data are further compromised because nine studies failed to measure effects on residents and only half assessed effects after the project team withdrew. Of these, excellent studies produced change over the medium (3-4 months) or longer term, including reduction in challenging behavior and restraint use but this applied only to a minority. A number of studies failed to measure effects on QOC, limiting conclusions about mechanisms underlying change. In general, level of intervention required depended on the target. For outcomes like restraint use, structured education sessions with some support appear adequate. Programs to reduce pain require more support. For complicated issues like challenging behavior and increasing co-operation in showering, detailed, supportive, on-site interventions are required. Improvements in restraint and staff/resident interactions were the most promising findings. (Review registration number: PROSPERO 2014:CRD42014015224).

Organizational Predictors of Staff Stress, Satisfaction, and Intended Turnover in a Service for People with Multiple Disabilities.

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Hatton, Chris; Emerson, Eric

1993-01-01

Questionnaire data were collected from 64 direct-care staff members in a residential facility for people with multiple disabilities. Path analyses identified factors predicting levels of perceived stress, overall job satisfaction, overall life satisfaction, and perceived likelihood of leaving the organization. Factors included staff support, job…

Staff Group Unanimity in the Care of Juveniles in Institutional Treatment: Routines, Rituals, and Relationships

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Ahonen, Lia; Degner, Jurgen

2013-01-01

One prerequisite for effective institutional care is that staff agree on how to deliver treatment and have a unified view of how to achieve change--in other words, to have staff group unanimity (SGU). This study used the Correctional Program Assessment Inventory (CPAI) 2000, interviews with key staff, and observations of daily activities to…

Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings.

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Miller-Thomas, Tonya; Leoutsakos, Jeannie-Marie S; Terplan, Mishka; Brigham, Emily P; Chisolm, Margaret S

2014-01-01

Despite the high prevalence and known morbidity and mortality caused by cigarette smoking, 60% to 70% of substance abuse treatment programs lack smoking cessation counseling or fail to offer pharmacotherapy for smoking cessation, including those programs designed to meet the needs of drug-dependent pregnant patients. Previous studies of staff knowledge, attitudes, and practices (S-KAP) at general substance abuse/HIV treatment programs have suggested that staff may contribute to the deficiency in smoking cessation treatment in these settings. It is not known whether similar deficiencies exist at perinatal substance abuse treatment programs. This study compared cigarette S-KAP in perinatal substance abuse (n = 41) and general substance abuse/HIV treatment (Veterans Affairs [VA] medical center, hospital-, and community-based) workforce samples (n = 335). Significant differences were seen between the 2 groups on all measures, but perinatal staff compared favorably to general staff only on measures of barriers to smoking cessation services. Perinatal staff compared unfavorably on all other measures: knowledge, beliefs/attitudes, self-efficacy, and smoking cessation practices. Pair-wise comparisons of knowledge and beliefs/attitudes revealed a significant difference between perinatal and VA staff; of self-efficacy, between perinatal and staff at all other settings; and of smoking cessation practices, between perinatal and VA and community-based staff. These results-showing deficiencies of perinatal staff on most S-KAP measures-are concerning and suggest that identifying gaps in and improving S-KAP in perinatal substance abuse programs is urgently needed, for which the VA may provide an efficacious model.

Snoezelen or Controlled Multisensory Stimulation. Treatment Aspects from Israel

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Joav Merrick

2004-01-01

Full Text Available In Israel today, with a total population of over 6 million persons, the Division for Mental Retardation (DMR provides services to 23,000 persons with intellectual disability (ID. Of the 23,000, residential services are provided to more than 6,000 in close to 60 residential centers, another 2,000 are provided residential care in hostels or group homes in the community in about 50 locations, while the rest are served with day-care kindergarten, day-treatment centers, sheltered workshops, or integrated care in the community. The first Snoezelen room (controlled multisensory stimulation in the DMR was established at the Bnei Zion residential care center in 1995. The Snoezelen method is now used in Israel in more than 30 residential care centers and 3 community settings. Since the year 2000, a physiotherapist has been employed in order to supervise the treatment and development of the method nationally. Professional staff meetings take place every 4 months. A certification course has been established on a national basis for individuals from different professions (occupational therapists, physiotherapists, teachers, music therapists, nurses, speech therapists, or caregivers. Snoezelen has proved to be an important instrument and a powerful therapeutic tool among the various treatment modules employed in Israel for persons with ID. This paper presents the concept illustrated with two case stories.

Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders.

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Thylstrup, Birgitte; Bloomfield, Kim; Hesse, Morten

2018-01-01

The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, psuicide (SHR=11.45, pdrug use disorders who could benefit from additional mental health treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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John A. A. Geddes

2013-01-01

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

The effects of residential dual diagnosis treatment on alcohol abuse

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Schoenthaler, Stephen J; Blum, Kenneth; Fried, Lyle; Oscar-Berman, Marlene; Giordano, John; Modestino, Edward J.; Badgaiyan, Rajendra

2017-01-01

This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p treatment of both disorders and explained their effectiveness. Co-occurring DSM IV mood disorders such as anxiety and depression as well as drug abuse involving opioids or cocaine fell between 66 and 95% at months one, six, and twelve. PMID:28868159

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

Science.gov (United States)

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

2018-02-01

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

Conflict and user involvement in drug misuse treatment decision-making: a qualitative study.

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Fischer, Jan; Neale, Joanne; Bloor, Michael; Jenkins, Nicholas

2008-10-06

This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making. Seventy-nine in-depth interviews were conducted with new treatment clients in two residential and two community drug treatment agencies. Fifty-nine of these clients were interviewed again after twelve weeks. Twenty-seven interviews were also conducted with staff, who were the keyworkers for the interviewed clients. Drug users did not expect, desire or prepare for conflict at treatment entry. They reported few actual conflicts within the treatment setting, but routinely discussed latent conflicts--that is, negative experiences and problematic aspects of current or previous treatment that could potentially escalate into overt disputes. Conflict resulted in a number of possible outcomes, including the premature termination of treatment; staff deciding on the appropriate outcome; the client appealing to the governance structure of the agency; brokered compromise; and staff skilfully eliciting client consent for staff decisions. Although the implementation of user involvement in drug treatment decision-making has the potential to trigger high levels of staff-client conflict, latent conflict is more common than overt conflict and not all conflict is negative. Drug users generally want to be co-operative at treatment entry and often adopt non-confrontational forms of covert resistance to decisions about which they disagree. Staff sometimes deploy user involvement as a strategy for managing conflict and soliciting client compliance to treatment protocols. Suggestions for minimising and avoiding harmful conflict in treatment settings are given.

Building Multicultural Residential Communities: A Model for Training Student Staff

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Petryk, Taryn; Thompson, Monita C.; Boynton, Trelawny

2013-01-01

The growing diversity and changing demographics within the United States increases the importance of students developing skills to engage across identity difference. The purpose of this chapter is to describe how a pre-employment course for student staff members is used as a multicultural intervention training to provide students with the…

The association between anxiety sensitivity and motivation to quit smoking among women and men in residential substance use treatment.

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Dahne, Jennifer; Hoffman, Elana M; MacPherson, Laura

2015-01-01

Smoking-attributed mortality is the leading cause of death among individuals in residential substance use treatment. As such, identifying factors that influence smoking cessation is highly relevant and important for this group. Motivation to quit (MTQ) smoking is one such factor that is related to smoking cessation. In the present study we examine the relationship between Anxiety Sensitivity (AS) and MTQ among individuals enrolled in a residential substance use treatment center in Washington, DC. In light of gender differences in smoking cessation as well as factors that contribute to cessation, we examined this relationship by gender in men and women using multiple group path analysis. Participants (n = 472) completed a measure of MTQ, the structured clinical interview for DSM-IV (SCID-IV-TR), a measure of AS, and self-reported their number of cigarettes smoked per day prior to entering a restricted environment. RESULTS indicated that AS was significantly related to MTQ in women (standardized path estimate = 0.21, p = .01), but was not significantly related to MTQ in men. Conclusions/Importance: Findings suggest the importance of considering AS as a factor in MTQ for women and subsequent smoking cessation among individuals in residential substance use treatment. RESULTS of this study contribute to the extant literature on predictors of MTQ and highlight the need for tailored cessation interventions with AS as one potential cessation treatment target.

Community pharmacists as educators in Danish residential facilities: a qualitative study.

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Mygind, Anna; El-Souri, Mira; Pultz, Kirsten; Rossing, Charlotte; Thomsen, Linda A

2017-08-01

To explore experiences with engaging community pharmacists in educational programmes on quality and safety in medication handling in residential facilities for the disabled. A secondary analysis of data from two Danish intervention studies where community pharmacists were engaged in educational programmes. Data included 10 semi-structured interviews with staff, five semi-structured interviews and three open-ended questionnaires with residential facility managers, and five open-ended questionnaires to community pharmacists. Data were thematically coded to identify key points pertaining to the themes 'pharmacists as educators' and 'perceived effects of engaging pharmacists in competence development'. As educators, pharmacists were successful as medicines experts. Some pharmacists experienced pedagogical challenges. Previous teaching experience and obtained knowledge of the local residential facility before teaching often provided sufficient pedagogical skills and tailored teaching to local needs. Effects of engaging community pharmacists included in most instances improved cooperation between residential facilities and community pharmacies through a trustful relationship and improved dialogue about the residents' medication. Other effects included a perception of improved patient safety, teaching skills and branding of the pharmacy. Community pharmacists provide a resource to engage in educational programmes on medication handling in residential facilities, which may facilitate improved cooperation between community pharmacies and residential facilities. However, development of pedagogical competences and understandings of local settings are prerequisites for facilities and pharmacists to experience the programmes as successful. © 2016 Royal Pharmaceutical Society.

Resource handbook for low-income residential retrofits

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Callaway, J.W.; Brenchley, D.L.; Davis, L.J.; Ivey, D.L.; Smith, S.A.; Westergard, E.J.

1987-04-01

The purpose of the handbook is to provide technical assistance to state grantees participating in the Partnerships in Low-Income Residential Retrofit (PILIRR) Program. PILIRR is a demonstration program aimed at identifying innovative, successful approaches to developing public and private support for weatherization of low-income households. The program reflects the basic concept that responsibility for financial support for conservation activities such as low-income residential retrofitting is likely to gradually shift from the DOE to the states and the private sector. In preparing the handbook, PNL staff surveyed over 50 programs that provide assistance to low-income residents. The survey provided information on factors that contribute to successful programs. PNL also studied the winning PILIRR proposals (from the states of Florida, Iowa, Kentucky, Oklahoma and Washington) and identified the approaches proposed and the type of information that would be most helpful in implementing these approaches.

Self-management-support in dementia care: A mixed methods study among nursing staff.

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Verkaik, Renate; van Antwerpen-Hoogenraad, Paulien; de Veer, Anke; Francke, Anneke; Huis In Het Veld, Judith

2017-11-01

Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: 'What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and 'Do nursing staff feel sufficiently trained and skilled for self-management support?'. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider 'helping people with dementia to maintain control over their lives by involving them in decisions in daily care' the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN's and CNA's did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations

Disadvantageous decision-making as a predictor of drop-out among cocaine-dependent individuals in long-term residential treatment.

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Laura eStevens

2013-11-01

Full Text Available Background: The treatment of cocaine-dependent individuals (CDI is substantially challenged by high drop-out rates, raising questions regarding contributing factors. Recently, a number of studies have highlighted the potential of greater focus on the clinical significance of neurocognitive impairments in treatment-seeking cocaine users. In the present study, we hypothesized that disadvantageous decision-making would be one such factor placing CDI at greater risk for treatment drop-out. Methods: In order to explore this hypothesis, the present study contrasted baseline performance (at treatment onset on two validated tasks of decision-making, the Iowa Gambling Task (IGT and the Cambridge Gamble Task (CGT in CDI who completed treatment in a residential Therapeutic Community (TC (N=66 and those who dropped out of TC prematurely (N=84. Results: Compared to treatment completers, CDI who dropped out of TC prematurely did not establish a consistent and advantageous response pattern as the IGT progressed and exhibited a poorer ability to choose the most likely outcome on the CGT. There were no group differences in betting behavior.Conclusions: Our findings suggest that neurocognitive rehabilitation of disadvantageous decision-making may have clinical benefits in CDI admitted to long-term residential treatment programs.

The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

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Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

2008-01-01

Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

A Pilot Investigation into the Efficacy of a Signing Training Strategy for Staff Working with Adults with Intellectual Disabilities

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Chadwick, Darren D.; Jolliffe, Jane

2009-01-01

To contribute to increasing the quality and quantity of communication between staff and adults with intellectual disabilities, training was undertaken to enhance the awareness and knowledge of signing as a method of communication. Multidisciplinary team members, residential and day centre staff were trained to use 20 core signs. Training methods…

Interdisciplinary Residential Treatment of Posttraumatic Stress Disorder and Traumatic Brain Injury: Effects on Symptom Severity and Occupational Performance and Satisfaction

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Speicher, Sarah M.; Walter, Kristen H.

2014-01-01

OBJECTIVE. This study examined outcomes of an 8-wk residential treatment program for veterans with posttraumatic stress disorder (PTSD) and a history of traumatic brain injury (TBI). METHOD. Twenty-six veterans completed the Canadian Occupational Performance Measure, Clinician-Administered PTSD Scale, Beck Depression Inventory–2nd Edition, and PTSD Checklist before and after treatment. RESULTS. Veterans demonstrated significant improvements in occupational performance and satisfaction with their performance, as well as in PTSD and depression symptom severity after residential PTSD/TBI treatment. Additionally, improvements in occupational performance and satisfaction were associated with decreases in depression symptom severity. CONCLUSION. Although preliminary, results suggest that veterans with PTSD and a history of TBI experienced significant decreases in PTSD and depression symptom severity and improvement in self-perception of performance and satisfaction in problematic occupational areas. Changes in occupational areas and depression symptom severity were related, highlighting the importance of interdisciplinary treatment. PMID:25005504

[Opinions and attitudes of clinical staff on systems for the assessment and treatment of children's pain].

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Ullan, A M; Fernández, E; Badia, M; Lorente, F; Malmierca, F; Zapatero, I

2013-08-01

Many factors affect the assessment and treatment of pain, among them being the knowledge and attitudes of clinical staff. The goal of this work was to determine the opinions and attitudes of clinical staff from two hospitals on the different aspects of the assessment and treatment of children's pain. A cross-sectional, descriptive study was conducted using a self-administered questionnaire issued to clinical staff. The questionnaire was given to the professionals, doctors, and nursing staff of the paediatric services of two hospitals, and to an incidental sample of paediatric doctors. Of the 146 questionnaires sent out, 105 were completed. Participants indicated that standardised scales and physiological recordings were the least frequently used methods to assess children's pain. Participants considered that pharmacological techniques for the treatment of pain were used more frequently than non-pharmacological techniques, at all ages. Participants acknowledged being significantly more knowledgeable about pharmacological methods to relieve paediatric pain than about non-pharmacological methods. There is margin for improvement in systems for the assessment and treatment of children's pain as regards the more frequent and standardised use of techniques and standardised tools for the assessment of pain, and the greater administration of non-pharmacological strategies for its treatment. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Internalizing and externalizing personality subtypes predict differences in functioning and outcomes among veterans in residential substance use disorder treatment.

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Blonigen, Daniel M; Bui, Leena; Britt, Jessica Y; Thomas, Katherine M; Timko, Christine

2016-10-01

There is a long history of using personality to subtype patients in treatment for substance use disorders (SUD). However, no one has validated a typology of SUD patients using a structural model of normal-range personality, particularly indicating whether subtypes differ on treatment processes and outcomes. We developed a personality-based typology among 196 military veterans enrolled in residential SUD treatment at a Veterans Affairs medical center. Patients were assessed at treatment entry, 1 month into treatment, and at discharge from treatment. Personality was assessed using the Multidimensional Personality Questionnaire-Brief Form at treatment entry. Latent profile analyses identified a 3-group solution consisting of low pathology, internalizing, and externalizing groups. The internalizing group scored lowest on measures of functioning at treatment entry, whereas the externalizing group scored more poorly on treatment processes and outcomes over the course of their residential stay (e.g., more stressful relationships with other residents, lower program alliance). These findings support a clinically meaningful typology of SUD patients based on a 3-factor model of personality and can serve as a guide for future efforts aimed at developing targeted interventions that can address the individual differences of patients in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Mindfulness and its relationship with eating disorders symptomatology in women receiving residential treatment.

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Butryn, Meghan L; Juarascio, Adrienne; Shaw, Jena; Kerrigan, Stephanie G; Clark, Vicki; O'Planick, Antonia; Forman, Evan M

2013-01-01

Mindfulness and its related constructs (e.g., awareness and acceptance) are increasingly being recognized as relevant to understanding eating disorders and improving treatment. The purpose of this study was to (1) examine the relationship between mindfulness and ED symptomatology at baseline and (2) examine how changes in mindfulness relate to change in ED symptomatology. Measures of mindfulness and ED symptomatology were administered to 88 patients upon admission to residential ED treatment and at discharge. Baseline ED symptomatology was associated with lower awareness, acceptance, and cognitive defusion, and higher emotional avoidance. Improvements in these variables were related to improvement in ED symptomatology. Interventions targeting mindfulness could be beneficial for patients with EDs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Implementation of an Initial Training Program for New Employees in a Profoundly Mentally and Physically Handicapped Children and Adult Residential Facility.

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Hoeft, Linda A.

A project was designed to reduce the turnover of direct care staff in a community-based residential facility that provides a home and educational or adult day training services for 54 severely or profoundly mentally and physically handicapped children and adults. The project sought to reduce total staff turnover by 40%, reduce employee…

Perceptions of conscience, stress of conscience and burnout among nursing staff in residential elder care.

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Juthberg, Christina; Eriksson, Sture; Norberg, Astrid; Sundin, Karin

2010-08-01

This paper is a report of a study of patterns of perceptions of conscience, stress of conscience and burnout in relation to occupational belonging among Registered Nurses and nursing assistants in municipal residential care of older people. Stress and burnout among healthcare personnel and experiences of ethical difficulties are associated with troubled conscience. In elder care the experience of a troubled conscience seems to be connected to occupational role, but little is known about how Registered Nurses and nursing assistants perceive their conscience, stress of conscience and burnout. Results of previous analyses of data collected in 2003, where 50 Registered Nurses and 96 nursing assistants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire and Maslach Burnout Inventory, led to a request for further analysis. In this study Partial Least Square Regression was used to detect statistical predictive patterns. Perceptions of conscience and stress of conscience explained 41.9% of the variance in occupational belonging. A statistical predictive pattern for Registered Nurses was stress of conscience in relation to falling short of expectations and demands and to perception of conscience as demanding sensitivity. A statistical predictive pattern for nursing assistants was perceptions that conscience is an authority and an asset in their work. Burnout did not contribute to the explained variance in occupational belonging. Both occupational groups viewed conscience as an asset and not a burden. Registered Nurses seemed to exhibit sensitivity to expectations and demands and nursing assistants used their conscience as a source of guidance in their work. Structured group supervision with personnel from different occupations is needed so that staff can gain better understanding about their own occupational situation as well as the situation of other occupational groups.

Effects of residential wastewater treatment systems on ground-water quality in west-central Jefferson County, Colorado

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Hall, Dennis C.; Hillier, D.E.; Nickum, Edward; Dorrance, W.G.

1981-01-01

The use of residential wastewater-treatment systems in Evergreen Meadows, Marshdale, and Herzman Mesa, Colo., has degraded ground-water quality to some extent in each community. Age of community; average lot size; slope of land surface; composition, permeability, and thickness of surficial material; density, size , and orientation of fractures; maintenance of wastewater-treatment systems; and presence of animals are factors possibly contributing to the degradation of ground-water quality. When compared with effluent from aeration-treatment tanks, effluent fom septic-treatment tanks is characterized by greater biochemical oxygen demand and greater concentrations of detergents. When compared with effluent from septic-treatment tanks, effluent from aeration-treatment tanks is characterized by greater concentrations of dissolved oxygen, nitrite, nitrate, sulfate, and dissolved solids. (USGS)

Training the Staff of a Drug Addiction Treatment Facility: A Case Study of Hogar De Encuentro

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Sorensen, Andrew A.; Leske, M. Cristina

1977-01-01

This paper, presented at the American Public Health Association meeting; Chicago, November 1975, discusses a staff training program at a drug addiction treatment facility established for Spanish-speaking (and other) drug addicts. Staff improved counseling skills and knowledge of drug addiction, but changed little in attitudes toward drug use and…

The Relationship between Eating Disorder Symptoms and Treatment Rejection among Young Adult Men in Residential Substance Use Treatment

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JoAnna Elmquist

2016-01-01

Full Text Available Research has demonstrated that individuals with substance use disorders (SUDs and comorbid mental health problems evidence heightened negative consequences, including poorer treatment outcomes, a higher risk for relapse, and mortality compared to individuals with a single disorder. In this study, we focus on the comorbidity between SUDs and eating disorder (ED symptomatology, as EDs are similarly associated with high rates of relapse, morbidity, and mortality. Of particular importance is research examining treatment rejection among individuals in treatment for SUDs with cooccurring ED symptomatology. This study seeks to add to the literature by examining treatment rejection among young adult men in residential treatment for SUDs ( N = 68 with cooccurring ED symptomatology. Results from hierarchical regression analyses indicated that ED symptoms were significantly associated with treatment rejection after controlling for alcohol and drug use and problems and depression symptoms. Although this is a preliminary study, the results add to a growing body of research examining the comorbidity between SUDs and ED symptomatology. Future research examining this relationship is needed to further elucidate the treatment patterns among individuals with comorbid ED symptoms and substance use diagnoses.

Cooptation of Peer Support Staff: Quantitative Evidence

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Anthony J. Alberta

2014-03-01

Full Text Available Objective In 2007, the Centers for Medicare and Medicaid Services (CMS sent a letter to state Medicaid directors outlining requirements for implementing peer-based recovery support services (P-BRSS as a Medicaid-funded service. Since then, 30 states have implemented these services. Although the literature describing implementation of P-BRSS has identified the cooptation of peer support staff (PSS as a barrier to the effective provision of P-BRSS, the evidence for it remains anecdotal. This study attempts to determine if the context of employment in either a treatment organization or peer organization affected cooptation. Methods We conducted a survey of PSS in the fall of 2013. In all, 92 of the 181 respondents were working as PSS at the time, 53 in treatment organizations. Chi-square analysis was used to determine if the context of employment had an effect on the cooptation of peer staff. Results Peer staff working in treatment organizations reported that they were supervised by treatment staff and participated in employment-related training to improve their skills at providing treatment services more frequently than their counterparts in peer organizations. Peer staff working in treatment organizations also participated in training and education to prepare for employment as treatment professionals more frequently than peer staff working in peer organizations. Conclusions and Implications for Practice Peer staff members working in treatment organizations are subject to processes of acculturation into professional cultures that peer staff working in peer organizations are not. Effective implementation of P-BRSS should include specific efforts to minimize the cooptation of peer staff.

Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices.

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Beresford, B; Gibson, F; Bayliss, J; Mukherjee, S

2018-03-01

Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

What Adolescents Need to Prevent Relapse after Treatment for Substance Abuse: A Comparison of Youth, Parent, and Staff Perspectives

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Acri, Mary C.; Gogel, Leah P.; Pollock, Michele; Wisdom, Jennifer P.

2012-01-01

Objective: Little is known about what factors and supports youths identify as important for their sustained recovery after substance abuse treatment, and if their caregivers and treatment staff identify similar needs. The purpose of this study was to explore what youths, caregivers, and staff perceive as important to remain substance free after…

The impact of staff and service user gender on staff responses towards adults with intellectual disabilities who display aggressive behaviour.

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Kleinberg, I; Scior, K

2014-02-01

The impact of staff and service user gender on responses of staff in intellectual disability (ID) services is poorly understood. The present study set out to assess the role of gender in influencing staff emotions, attributions and behavioural intentions in response to aggression displayed by adults with ID. A new scale measuring staff behavioural intentions was developed. A two × two (staff gender × service user gender) between subjects design was used to compare the responses of day and residential support staff to physical aggression by a hypothetical service user. In response to a vignette depicting a service user with ID assaulting a member of staff, 160 respondents completed measures of affective responses, causal attributions and behavioural intentions while imagining themselves as the target of the service user's assault. Female participants reported feeling more fear/anxiety, more depression/anger and less confident/relaxed than male participants. The longer staff had worked with people with ID, the more likely they were to favour safety-focused behaviours. More confident female participants were less likely to favour safety-focused behaviours, but confidence had no effect on male participants' endorsement of these behaviours. Increased confidence in both was associated with lower agreement of safety-focused behaviours in relation to the female vignette, regardless of participant gender. The more control women believed the service user had over their behaviour, the more likely they were to choose safety-focused behaviours. Punitive behaviours were favoured more in response to the male rather than the female service user. Punitive behaviours were also favoured more by more junior staff and by participants who expected feeling more depressed/angry in response to the vignettes. Both staff and service user gender influenced staff responses to aggression, yet the latter played a smaller role than expected. The role of gender in staff-service user

Evaluation of a Residential Mental Health Recovery Service in North Queensland.

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Heyeres, Marion; Kinchin, Irina; Whatley, Elise; Brophy, Lisa; Jago, Jon; Wintzloff, Thomas; Morton, Steve; Mosby, Vinitta; Gopalkrishnan, Narayan; Tsey, Komla

2018-01-01

Evidence shows that subacute mental health recovery occurs best when a person remains active within the community and fulfils meaningful and satisfying roles of their choosing. Several residential care services that incorporate these values have been established in Australia and overseas. This study describes (a) the development of an evaluation framework for a new subacute residential mental health recovery service in regional Australia and (b) reports on the formative evaluation outcomes. Continuous quality improvement and participatory research approaches informed all stages of the development of the evaluation framework. A program logic was established and subsequently tested for practicability. The resultant logic utilizes the Scottish Recovery Indicator 2 (SRI 2) service development tool, Individual Recovery Plans (IRPs), and the impact assessment of the service on psychiatric inpatient admissions (reported separately). Service strengths included a recovery-focused practice that identifies and addresses the basic needs of residents (consumers). The consumers of the service were encouraged to develop their own goals and self-manage their recovery plans. The staff of the service were identified as working effectively in the context of the recovery process; the staff were seen as supported and valued. Areas for improvement included more opportunities for self-management for residents and more feedback from residents and carers.

Evaluation of a Residential Mental Health Recovery Service in North Queensland

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Marion Heyeres

2018-05-01

Full Text Available BackgroundEvidence shows that subacute mental health recovery occurs best when a person remains active within the community and fulfils meaningful and satisfying roles of their choosing. Several residential care services that incorporate these values have been established in Australia and overseas.AimsThis study describes (a the development of an evaluation framework for a new subacute residential mental health recovery service in regional Australia and (b reports on the formative evaluation outcomes.MethodsContinuous quality improvement and participatory research approaches informed all stages of the development of the evaluation framework. A program logic was established and subsequently tested for practicability. The resultant logic utilizes the Scottish Recovery Indicator 2 (SRI 2 service development tool, Individual Recovery Plans (IRPs, and the impact assessment of the service on psychiatric inpatient admissions (reported separately.ResultsService strengths included a recovery-focused practice that identifies and addresses the basic needs of residents (consumers. The consumers of the service were encouraged to develop their own goals and self-manage their recovery plans. The staff of the service were identified as working effectively in the context of the recovery process; the staff were seen as supported and valued. Areas for improvement included more opportunities for self-management for residents and more feedback from residents and carers.

A narrative exploration of older people's transitions into residential care.

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Lee, Victoria S P; Simpson, Jane; Froggatt, Katherine

2013-01-01

Moving into residential care has been argued to be a significant life transition for older people, often resulting in stress and anxiety. This research aimed to explore qualitatively older people's experiences of this transition, including how relocation is reflected upon and incorporated into their personal narratives. Eight older adults (65-97 years) living in a residential facility for between three and 12 months participated in interviews focussed on their experiences of relocating to a residential care home. Narrative analysis revealed that rather than depicting time bound stages of transition, participants' experiences reflected key plots of 'control', 'power', 'identity' and 'uncertainty' interwoven throughout their narratives. Participants experienced some difficulties in incorporating this transition into their life stories. Furthermore, participants discussed not feeling confident in their decision to move, living in constant fear of losing their memory, and limited expectations for their future. Professionals should move away from considering transition as a stage-based process ending in acceptance, instead focussing on how residents perceive relocation in relation to previous life experiences, unspoken fears evoked by moving and how the environment and relationships with staff may be altered to assist residents in maintaining their identity and sense of control.

Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

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Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

2011-01-01

This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…

Parental and Staff Perceptions of Individual Programming Teams: Collaboration in and beyond the Conference.

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Hermary, Martin E.; Rempel, Judith

1990-01-01

Questionnaires were completed by 103 staff and 76 parents of clients of a day training and residential agency for persons with mental handicaps. Although, in general, respondents felt part of their respective teams, differences of opinion arose with respect to team cohesiveness, and comprehensibility and participatory equality at conferences.…

Studying feasibility and effects of a two-stage nursing staff training in residential geriatric care using a 30 month mixed-methods design [ISRCTN24344776

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Hantikainen Virpi

2011-05-01

Full Text Available Abstract Background Transfer techniques and lifting weights often cause back pain and disorders for nurses in geriatric care. The Kinaesthetics care conception claims to be an alternative, yielding benefits for nurses as well as for clients. Starting a multi-step research program on the effects of Kinaesthetics, we assess the feasibility of a two-stage nursing staff training and a pre-post research design. Using quantitative and qualitative success criteria, we address mobilisation from the bed to a chair and backwards, walking with aid and positioning in bed on the staff level as well as on the resident level. In addition, effect estimates should help to decide on and to prepare a controlled trial. Methods/Design Standard basic and advanced Kinaesthetics courses (each comprising four subsequent days and an additional counselling day during the following four months are offered to n = 36 out of 60 nurses in a residential geriatric care home, who are in charge of 76 residents. N = 22 residents needing movement support are participating to this study. On the staff level, measurements include focus group discussions, questionnaires, physical strain self-assessment (Borg scale, video recordings and external observation of patient assistance skills using a specialised instrument (SOPMAS. Questionnaires used on the resident level include safety, comfort, pain, and level of own participation during mobilisation. A functional mobility profile is assessed using a specialised test procedure (MOTPA. Measurements will take place at baseline (T0, after basic training (T1, and after the advanced course (T2. Follow-up focus groups will be offered at T1 and 10 months later (T3. Discussion Ten criteria for feasibility success are established before the trial, assigned to resources (missing data, processes (drop-out of nurses and residents and science (minimum effects criteria. This will help to make rational decision on entering the next stage of the research

Is the amount of exposure to aggressive challenging behaviour related to staff work-related well-being in intellectual disability services? Evidence from a clustered research design.

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Flynn, Samantha; Hastings, Richard P; Gillespie, David; McNamara, Rachel; Randell, Elizabeth

2018-04-17

Previous research has demonstrated an association between aggressive challenging behaviour (CB) and reductions in work-related well-being for intellectual disability (ID) support staff. Much of this research has used subjective measures of CB. To examine whether exposure to aggressive CB is associated with reduced work-related well-being in staff working in ID residential settings across the UK. A cross-sectional analysis was undertaken as part of a randomised trial; 186 staff from 100 settings completed questionnaires on their CB self-efficacy, empathy, positive work motivation, and burnout. Objective measures of aggressive CB in the preceding 16 weeks were collected from each setting. There was little association between staff exposure to aggressive CB and work-related well-being. Clustering effects were found for emotional exhaustion and positive work motivation, suggesting these variables are more likely to be influenced by the environment in which staff work. The level of clustering may be key to understanding how to support staff working in ID residential settings, and should be explored further. Longitudinal data, and studies including a comparison of staff working in ID services without aggressive CB exposure are needed to fully understand any association between aggressive CB and staff well-being. Copyright © 2018 Elsevier Ltd. All rights reserved.

Predicting intention to use nicotine replacement therapy in people attending residential treatment for substance dependency.

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Kelly, Peter J; Townsend, Camilla J; Osborne, Briony A; Baker, Amanda L; Deane, Frank P; Keane, Carol; Ingram, Isabella; Lunn, Joanne

2018-02-28

Nicotine Replacement Therapy (NRT) is recommended as a frontline smoking cessation tool for people attending mental health and substance dependence treatment services. Previous research suggests that NRT is underutilized in these settings. To improve the use of NRT amongst people attending residential treatment for substance use disorders (SUDs) it is important that the factors influencing smokers' decisions to use NRT are understood. The study aimed to examine: (1) smoking cessation strategies used by participants in previous quit attempts, (2) participants' attitudes towards NRT (i.e. safety concerns and perceived efficacy), and (3) the predictors of participants' intention to use NRT to support future quit attempts. Participants completed a cross-sectional survey that examined their smoking behaviours, previous experiences using smoking cessation strategies, attitudes and beliefs regarding NRT, and intention to use NRT as part of future quit attempts (N = 218). All participants were attending residential treatment for substance use disorders provided by We Help Ourselves (WHOS), a large provider of specialist alcohol and other drug treatment in Australia. The majority of respondents (98%) reported that they had smoked regularly in their lifetime, and 89% were current smokers. Forty-five percent of the current smokers reported that they had previously used NRT to support a quit attempt, with 54% reporting that they intended to use NRT to support a future quit attempt. Intentions to use NRT were not related to the participants' mental health status or the participants' perceptions regarding the safety or potential drawbacks associated with using NRT. However, participants were more likely to report that they would use NRT to support future quit attempts if they were female, had previously used NRT and perceived NRT to be effective. Improving the use of evidence based smoking cessation strategies within substance use treatment continues to be a priority. To enhance

Consumer Preferences for Psychological Report Contents in a Residential School and Center for the Mentally Retarded.

Science.gov (United States)

Isett, Robert; Roszkowski, Michael

1979-01-01

Results of a survey of staff of a short-term residential facility serving mentally retarded clients indicate that recommendations and social competency information are perceived to be the most important sections of psychological reports while projective test personality interpretation and IQ test results are considered to have the least value.…

A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

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Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

2017-09-19

Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

77 FR 28519 - Test Procedure Guidance for Room Air Conditioners, Residential Dishwashers, and Residential...

Science.gov (United States)

2012-05-15

... Guidance for Room Air Conditioners, Residential Dishwashers, and Residential Clothes Washers: Public... procedures for room air conditioners, residential dishwashers, and residential clothes washers. DATES: DOE...'s existing test procedures for residential room air conditioners, residential dishwashers, and...

Evaluation of changes in prescription medication use after a residential treatment programme for borderline personality disorder.

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Broadbear, Jillian H; Nesci, Julian; Thomas, Rosemary; Thompson, Katherine; Beatson, Josephine; Rao, Sathya

2016-12-01

Residential patients diagnosed with borderline personality disorder were evaluated to determine whether borderline personality disorder-focused psychotherapy reduced prescribing, personality disorder and co-morbid symptom severity. Psychotropic prescriptions were measured at admission, discharge and 1 year later in 74 female participants with one or more personality disorder diagnosis and co-morbid mood disorders. Changes in pharmacotherapy were examined in the context of improvements in borderline personality disorder and/or co-morbid disorder symptom severity. Residential treatment included individual and group psychotherapy for borderline personality disorder. The Structured Clinical Interview for DSM-IV was used to confirm the borderline personality disorder diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point. A significant reduction in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including borderline personality disorder, was accompanied by a reduction in prescription of psychoactive medications. Three to six months of intensive borderline personality disorder-specific psychotherapy showed lasting benefit with regard to symptom severity of personality disorders (borderline personality disorder in particular) as well as depressive symptoms. This improvement corresponded with a reduction in prescriptions for psychoactive medications, which is consistent with current thinking regarding treatment for borderline personality disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.

A preliminary investigation of the relationship between dispositional mindfulness and eating disorder symptoms among men in residential substance use treatment.

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Elmquist, JoAnna; Shorey, Ryan C; Anderson, Scott E; Stuart, Gregory L

2017-01-01

The comorbidity between eating disorders (EDs) and substance use disorders (SUDs) is of particular concern given the high rates of mortality, relapse and poor treatment outcomes associated with both disorders. As a result, there has been a growing impetus within the field to elucidate factors that might influence and aid treatment for this comorbidity. One such factor is dispositional mindfulness, as past literature has demonstrated a significant relationship between mindfulness and both EDs and SUDs. However, we are unaware of any research that has examined the relationship between dispositional mindfulness and ED symptoms in a sample of men in residential treatment for SUDs. Medical records from 152 men were included in the current study. Alcohol and drug use and problems, ED symptoms, and dispositional mindfulness were assessed with self-report measures. Hierarchical regression analysis indicated that dispositional mindfulness was inversely related to ED symptoms after controlling for alcohol use, drug use, and age. Although results are preliminary and continued research in this area is needed, our findings suggest that there may be potential usefulness in targeting and enhancing mindfulness among patients in residential treatment for SUDs with co-occurring psychiatric symptoms (e.g., EDs).

The relation between trait mindfulness and aggression in men seeking residential substance use treatment.

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Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L

2015-06-01

There has been an abundance of research in recent years on mindfulness, including mindfulness within individuals seeking substance use treatment. However, to date, there has been no research on whether trait mindfulness is associated with increased aggression among individuals seeking substance use treatment. Past research has demonstrated that individuals in substance use treatment evidence higher levels of aggression than non-substance abusers, and preliminary research has shown that trait mindfulness is inversely associated with aggression in non-substance-use treatment-seeking populations. The current study examined whether trait mindfulness was associated with aggression among men seeking residential substance use treatment (N = 116). Results demonstrated that lower trait mindfulness was associated with increased aggression (physical, verbal, and aggressive attitude). Moreover, this relation held for both verbal aggression and aggressive attitude after controlling for alcohol use, drug use, and age, all known predictors of aggression. Findings provide the first evidence that mindfulness is negatively associated with aggression among men in substance use treatment, which could have important implications for intervention. That is, mindfulness-based interventions may prove helpful for the treatment of both substance use and aggression. © The Author(s) 2014.

Training Emotional Intelligence Related to Treatment Skills of Staff Working with Clients with Intellectual Disabilities and Challenging Behaviour

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Zijlmans, L. J. M.; Embregts, P. J. C. M.; Gerits, L.; Bosman, A. M. T.; Derksen, J. J. L.

2011-01-01

Background: Staff working with clients with intellectual disabilities (ID) who display challenging behaviour may contribute to the continuation of this behaviour, because it causes emotional reactions such as anxiety, anger and annoyance, which may prohibit adequate response behaviour. To enhance staff behaviour and treatment skills a training…

Social and occupational engagement of staff in two Irish nursing homes for people with dementia

LENUS (Irish Health Repository)

Morgan-Brown, M

2011-01-01

This observational study evaluated the amounts of social and occupational engagement of staff (nurses, care workers, activity coordinators) in two traditional style Irish residential nursing homes for people with dementia. A snapshot observational technique was used to obtain daily quantitative data. Approximately 65% of the time that staff were in communal sitting rooms during the observational periods was spent in work and care tasks, with approximately 25% of the time spent in social engagement and 10% spent in interactive occupational activities with the residents. Staff were absent from the room for over one-third of the observed time. Environmental and operational observations are discussed using narrative descriptions to give a context to the quantitative outcome measures.

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

NARCIS (Netherlands)

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

2015-01-01

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

Examination of Negative Peer Contagion in a Residential Care Setting

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Huefner, Jonathan C.; Ringle, Jay L.

2012-01-01

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

Exposure to Violence, Posttraumatic Stress Symptoms, and Borderline Personality Pathology Among Adolescents in Residential Psychiatric Treatment: The Influence of Emotion Dysregulation.

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Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L

2015-12-01

Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment.

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

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Buckley, Catherine; McCormack, Brendan; Ryan, Assumpta

2014-09-01

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

RESIDENTIAL TREATMENT FOR SEVERELY DISRUPTIVE MINORS: TECHNICAL CONTRIBUTIONS TO A SOCIAL AND INSTITUTIONAL DEBATE

Directory of Open Access Journals (Sweden)

Antonio Galán Rodríguez

2013-01-01

Full Text Available Residential treatment for minors with severe conduct problems has been questioned from a social and institutional point of view, but little attention has been paid from academic contexts. Difficulties in definition, implementation and management are analyzed, including problems caused by clinical-based definitions. Management by the Healthcare System is considered the best choice in most cases; nevertheless, Child Protection Services could run these centers for children in foster care. If so, a number of concepts and models different from clinical ones should be used: deficits in self-regulation as the core problem, and psycho-educational intervention as the axis of the treatment. Other controversial topics are analyzed, such as restraint methods, intervention models, or the relationship with the Juvenile Justice System. Finally, some recommendations related to the definition and functioning of these facilities are provided.

Increasing Opportunities for Question-Asking in School-Aged Children with Autism Spectrum Disorder: Effectiveness of Staff Training in Pivotal Response Treatment.

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Verschuur, Rianne; Huskens, Bibi; Verhoeven, Ludo; Didden, Robert

2017-02-01

Deficits in question-asking are common in children with autism spectrum disorder (ASD). Furthermore, their opportunities to self-initiate questions are often hindered by directive behavior of their conversation partners. This study assessed the effectiveness of staff training in pivotal response treatment (PRT) on staff member-created opportunities and self-initiated questions of school-aged children with ASD. Generalization and maintenance were also assessed. Participants were 14 staff members and children with ASD attending an inpatient treatment facility. Data showed that PRT resulted in significant increases in both staff member-created opportunities and child-initiated questions. Generalization to group situations and collateral changes in children's language, pragmatic, and adaptive skills, and maladaptive behaviors did not occur. Implications for clinical practice and directions for future research are discussed.

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

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

2017-07-01

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

Substance Abuse, Relapse, and Treatment Program Evaluation in Malaysia: Perspective of Rehab Patients and Staff Using the Mixed Method Approach

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Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Dang, Hoang Minh; Khairuddin, Rozainee

2016-01-01

This study examined reasons for substance abuse and evaluated the effectiveness of substance treatment programs in Malaysia through interviews with rehab patients and staff. Substance rehab patients (aged 18–69 years; n = 30) and staff (ages 30–72 years; n = 10) participated in semi-structured interviews covering a range of topics, including family and peer relationships, substance use and treatment history, factors for substance use and relapse, motivation for entering treatment, work experience, job satisfaction, treatment evaluation, and patient satisfaction. Most patients did not demonstrate the substance progression trend and had normal family relationships. Most patients reported having peers from normal family backgrounds as well. Various environmental and personal factors was cited as contributing to substance abuse and relapse. There was no significant difference between patient and staff program evaluation scores although the mean score for patients was lower. A holistic treatment approach with a combination of cognitive–behavioral, medical, social, and spiritual components was favored by patients. Suggestions for improving existing programs include better tailoring treatment to individual needs, and providing more post-treatment group support. PMID:27303313

A One Year Study of Mode Deactivation Therapy: Adolescent Residential Patients with Conduct and Personality Disorders

Science.gov (United States)

Murphy, Christopher J.; Siv, Alexander M.

2011-01-01

This case study is to evaluate the effectiveness of Mode Deactivation Therapy (MDT) implementation in a child and adolescent residential treatment unit and provide preliminary effectiveness data on MDT versus treatment as usual (TAU). This case study compared the efficacy of two treatment methodologies for adolescent males in residential treatment…

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

DEFF Research Database (Denmark)

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

2014-01-01

INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

Decentralization matters – Differently organized mental health services relationship to staff competence and treatment practice: the VELO study

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Molvik Stian

2009-05-01

Full Text Available Abstract Background The VELO study is a comparative study of two Community Mental Health Centres (CMHC in Northern Norway. The CMHCs are organized differently: one has no local inpatient unit, the other has three. Both CMHCs use the Central Mental Hospital situated rather far away for compulsory and other admissions, but one uses mainly local beds while the other uses only central hospital beds. In this part of the study the ward staffs level of competence and treatment philosophy in the CMHCs bed units are compared to Central Mental Hospital units. Differences may influence health service given, resulting in different treatment for similar patients from the two CMHCs. Methods 167 ward staff at Vesterålen CMHCs bed units and the Nordland Central Mental Hospital bed units answered two questionnaires on clinical practice: one with questions about education, work experience and clinical orientation; the other with questions about the philosophy and practice at the unit. An extended version of Community Program Philosophy Scale (CPPS was used. Data were analyzed with descriptive statistics, non-parametric test and logistic regression. Results We found significant differences in several aspects of competence and treatment philosophy between local bed units and central bed units. CMHC staff are younger, have shorter work experience and a more generalised postgraduate education. CMHC emphasises family therapy and cooperation with GP, while Hospital staff emphasise diagnostic assessment, medication, long term treatment and handling aggression. Conclusion The implications of the differences found, and the possibility that these differences influence the treatment mode for patients with similar psychiatric problems from the two catchment areas, are discussed.

Disseminating contingency management: impacts of staff training and implementation at an opiate treatment program.

Science.gov (United States)

Hartzler, Bryan; Jackson, T Ron; Jones, Brinn E; Beadnell, Blair; Calsyn, Donald A

2014-04-01

Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (intervention cost, feasibility, and sustainability) were assessed at study conclusion in a qualitative interview with OTP management. Intervention effectiveness was also assessed via independent chart review of trial CM implementation vs. a historical control period. Results included: 1) robust, durable increases in delivery skill, knowledge, and adoption readiness among trained staff; 2) positive managerial perspectives of intervention cost, feasibility, and sustainability; and 3) significant clinical impacts on targeted patient indices. Collective results offer support for the study's collaborative intervention design and the applied, skills-based focus of staff training processes. Implications for CM dissemination are discussed. Published by Elsevier Inc.

Families of Children with Serious Emotional Disorder: Maternal Reports on the Decision and Impact of Their Child's Placement in Residential Treatment

Science.gov (United States)

Tahhan, Julia; St. Pierre, Jeff; Stewart, Shannon L.; Leschied, Alan W.; Cook, Steve

2010-01-01

Findings are reported regarding maternal experiences of their seriously emotionally disordered child both prior to and following a stay in a residential children's mental health treatment facility. Prior to placement, these parents had exhausted all nonresidential forms of intervention and, increasingly, became concerned not only for their…

Examination of the utility of the promoting action on research implementation in health services framework for implementation of evidence based practice in residential aged care settings.

Science.gov (United States)

Perry, Lin; Bellchambers, Helen; Howie, Andrew; Moxey, Annette; Parkinson, Lynne; Capra, Sandra; Byles, Julie

2011-10-01

This study examined the relevance and fit of the PARiHS framework (Promoting Action on Research Implementation in Health Services) as an explanatory model for practice change in residential aged care. Translation of research knowledge into routine practice is a complex matter in health and social care environments. Examination of the environment may identify factors likely to support and hinder practice change, inform strategy development, predict and explain successful uptake of new ways of working. Frameworks to enable this have been described but none has been tested in residential aged care. This paper reports preliminary qualitative analyses from the Encouraging Best Practice in Residential Aged Care Nutrition and Hydration project conducted in New South Wales in 2007-2009. We examined congruence with the PARiHS framework of factors staff described as influential for practice change during 29 digitally recorded and transcribed staff interviews and meetings at three facilities. Unique features of the setting were flagged, with facilities simultaneously filling the roles of residents' home, staff's workplace and businesses. Participants discussed many of the same characteristics identified by the PARiHS framework, but in addition temporal dimensions of practice change were flagged. Overall factors described by staff as important for practice change in aged care settings showed good fit with those of the PARiHS framework. This framework can be recommended for use in this setting. Widespread adoption will enable cross-project and international synthesis of findings, a major step towards building a cumulative science of knowledge translation and practice change. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Participation in a novel treatment component during residential substance use treatment is associated with improved outcome: a pilot study.

Science.gov (United States)

Decker, Kathleen P; Peglow, Stephanie L; Samples, Carl R

2014-05-16

A person-centered substance use treatment component, the Natural Recovery Program, was developed. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies. This was a pilot study of the program and was not randomized. A retrospective record review of 643 veterans in an inpatient mental health recovery and rehabilitation program was analyzed to determine if participants of Natural Recovery had a different rate of treatment completion than those who elected to participate in the core program alone. Univariate and multivariate analyses were conducted on: participation in the Natural Recovery Program; co-morbid psychiatric disorders; and legal, medical, and psychiatric issues. Participation in Natural Recovery was significantly associated with successful treatment completion when analyzed by univariate analysis (p = 0.01). Other significant variables associated with successful completion included: no co-morbid psychiatric diagnosis, fewer prior suicide attempts, and no homelessness prior to admission. Binary logistic regression demonstrated that participation in Natural Recovery was associated with improved treatment completion, even when other variables were considered (p = 0.01). Treatment retention was longer for patients who participated in Natural Recovery, even if they did not complete treatment. The Natural Recovery Program was associated with improved outcomes, as measured by treatment retention in the first 60 days and by treatment completion. Participants of Natural Recovery with co-morbid psychiatric disorders completed treatment at a higher rate than those with co-morbid psychiatric disorders who participated in the core program. Patients reported high satisfaction with the program. This program may be a valuable adjunct to residential treatment.

Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change Over Time Matters.

Science.gov (United States)

Garner, Bryan R; Hunter, Brooke D

2014-01-01

This study examined the extent to which changes over time in clinicians' responses to measures of work attitude (eg, job satisfaction) and psychological climate (eg, supervisor support) could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians (N = 96) being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity) explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction.

Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change over Time Matters

Directory of Open Access Journals (Sweden)

Bryan R. Garner

2014-01-01

Full Text Available This study examined the extent to which changes over time in clinicians’ responses to measures of work attitude (eg, job satisfaction and psychological climate (eg, supervisor support could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians ( N = 96 being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction.

High Performance Residential Housing Units at U.S. Coast Guard Base Kodiak: Preprint

Energy Technology Data Exchange (ETDEWEB)

Romero, R.; Hickey, J.

2013-10-01

The United States Coast Guard (USCG) constructs residential housing throughout the country using a basic template that must meet the minimum Leadership in Energy and Environmental Design (LEED) Silver criteria or better for the units. In Kodiak, Alaska, USCG is procuring between 24 and 100 residential multi-family housing units. Priorities for the Kodiak project were to reduce overall energyconsumption by at least 20% over existing units, improve envelope construction, and evaluate space heating options. USCG is challenged with maintaining similar existing units that have complicated residential diesel boilers. Additionally, fuel and material costs are high in Kodiak. While USCG has worked to optimize the performance of the housing units with principles of improved buildingenvelope, the engineers realize there are still opportunities for improvement, especially within the heating, ventilation, and air conditioning (HVAC) system and different envelope measures. USCG staff also desires to balance higher upfront project costs for significantly reduced life-cycle costs of the residential units that have an expected lifetime of 50 or more years. To answer thesequestions, this analysis used the residential modeling tool BEoptE+ to examine potential energy- saving opportunities for the climate. The results suggest criteria for achieving optimized housing performance at the lowest cost. USCG will integrate the criteria into their procurement process. To achieve greater than 50% energy savings, USCG will need to specify full 2x 6 wood stud R-21 insulationwith two 2 inches of exterior foam, R-38 ceiling insulation or even wall insulation in the crawl space, and R-49 fiberglass batts in a the vented attic. The air barrier should be improved to ensure a tight envelope with minimal infiltration to the goal of 2.0 ACH50. With the implementation of an air source heat pump for space heating requirements, the combination of HVAC and envelope savings inthe residential unit can save

Parent-Child Relationships and Family Functioning of Children and Youth Discharged from Residential Mental Health Treatment or a Home-Based Alternative

Science.gov (United States)

Preyde, Michele; Cameron, Gary; Frensch, Karen; Adams, Gerald

2011-01-01

This report stems from a larger study on the outcomes of children and youth who accessed residential treatment or a home-based alternative. In this report an analysis of family descriptive information, the nature of family relationships, and indicators of family functioning for children and youth who have participated in children's mental health…

Occurrence and fate of benzotriazoles UV filters in a typical residential wastewater treatment plant in Harbin, China

International Nuclear Information System (INIS)

Zhao, Xue; Zhang, Zi-Feng; Xu, Lei; Liu, Li-Yan; Song, Wei-Wei; Zhu, Fu-Jie; Li, Yi-Fan; Ma, Wan-Li

2017-01-01

Benzotriazoles (BTs) UV filters are widely used as ultraviolet absorbents for our daily products, which received increasing attention in the past decades. Residential wastewater treatment plant (WWTP) is both an important sink for wastewater and a key pollution source for receiving water for these chemicals. In this study, pretreatment and gas chromatography-tandem mass spectrometry analysis method were developed to determine the occurrence and fate of 9 BTs UV filters in wastewater and sludge from the WWTP with anaerobic-oxic treatment process (A/O) and biological aerated filter treatment process (BAF). Totally, 81 wastewater samples and 11 sludge samples were collected in four seasons. In wastewater, UV-326 and UV-329 were frequently detected, while the highest mean concentrations were detected for UV-234 and UV-329. The concentrations were in the range of 85% in A/O process and 60–77% in BAF process except for UV-350, which was more difficult to remove with lower removal efficiencies of 33.3% for both A/O and BAF. All the target chemicals except for UV-320 were detected in sludge samples with the mean concentration ranging from 0.90 ng/g to 303.39 ng/g. There was no significant difference with concentrations and removal efficiency among different seasons. Higher detection frequency and concentration of BTs UV filters in downstream of the receiving water system indicated the contribution of effluent of the WWTP. Compared with other rivers, the lower concentrations in surface water in the Songhua River indicated light pollution status with of BTs UV filters. - Highlights: • UV-234 and UV-329 were the predominated compounds in residential wastewater. • The A/O treatment process had higher removal effect than the BAF treatment process. • Removal efficiency of UV filters was not significantly influenced by season changes. • Effluent from the WWTP was not the

Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative literature.

Science.gov (United States)

Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

2014-06-01

Ensuring older adults' involvement in their care is accepted as good practice and is vital, particularly for people with dementia, whose care and treatment needs change considerably over the course of the illness. However, involving family members in decision making on people's behalf is still practically difficult for staff and family. The aim of this review was to identify and appraise the existing quantitative evidence about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute (JBI) metasynthesis assessed studies that investigated involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this paper presents the quantitative findings. A comprehensive search of 15 electronic databases was performed. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as being relevant; 10 were quantitative, with 1 mixed method study. Two independent reviewers assessed the studies for methodological validity and extracted the data using the JBI Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The findings were synthesized and presented in narrative form. The findings related to decisions encountered and made by family surrogates, variables associated with decisions, surrogates' perceptions of, and preferences for, their roles, as well as outcomes for people with dementia and their families. The results identified patterns within, and variables associated with, surrogate decision making, all of which highlight the complexity and variation regarding family involvement. Attention needs to be paid to supporting family members in decision making in collaboration with staff.

Evaluation of the 'Ladder to the Moon, Culture Change Studio Engagement Programme' staff training: Two quasi-experimental case studies.

Science.gov (United States)

Guzmán, Azucena; Wenborn, Jennifer; Swinson, Tom; Orrell, Martin

2017-09-01

To evaluate the impact of the CCSEP on care home staff in two care settings for older people in one nursing home and one residential home. Care homes provide personal care and accommodation for older people. The English Dementia Strategy aims to improve the quality of service provision for people with dementia. This includes specific mention of improving the quality of life in care homes and as such includes objectives related to developing the workforce knowledge and skills. The Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP) is a staff training approach based on the Positive Psychology framework that uses theatre- and film-based activities. This study used a wait-list controlled design. However, the data analysis plan was amended to reflect difficulties in data collection, and a quasi-experimental case study approach was consequently utilised. Outcome measures for staff attitudes and beliefs were as follows: Sense of Competence in Dementia Care Staff; Approaches to Dementia Questionnaire; Job Satisfaction Index; Brief Learning Transfer System Inventory; and Scale of Positive and Negative Experience. The Quality of Interaction Schedule (QUIS) was used to observe changes in staff-resident interaction. Fifty staff in two care homes completed the questionnaires and forty-one undertook formal CCSEP training. In Home A (nursing home), there was no significant change in any of the measures. In Home B (residential home), the QUIS showed an increase in positive interactions post intervention; a significant increase in the Building Relationship subscale of Sense of Competence; and a significant increase in staff sense of hopefulness towards people with dementia. The Brief Learning Transfer System Inventory showed a significant decrease post-intervention. The intervention did not significantly affect the happiness or job satisfaction of care home staff. The results of this study provide tentative evidence about the efficacy of this staff training

Barriers to Accessing Detox Facilities, Substance Use Treatment, and Residential Services among Women Impacted by Commercial Sexual Exploitation & Trafficking.

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Gerassi, Lara B

2017-10-06

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.

[Effects of an intensive therapy program for behaviorally disordered mentally handicapped patients on staff personnel in residential care].

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Elbing, U; Rohmann, U H

1994-03-01

This study evaluates the effects of an intensive therapy program designed for mentally handicapped persons with severely disturbed or autistic behavior on their staff personal which had an active role in the program. The staff members rated their professional competence, quality of interaction with the client, team culture and work satisfaction before and after being engaged in the program, with additional ratings of their personal aims at the beginning of the program. Three sets of data were obtained with the program being conducted three times in a row. The testings of the related as well as the independent samples show differentiated program effects. The main effect is an increase of the professional competence and quality of interaction, especially by the qualified staff members. Trainees put emphasis on the development of their personal relationship with the client. The results are discussed in terms of the impact of learning processes specific to the roles of the staff members and motivational factors on learning and therapy outcome, along with institutional conditions influencing successful learning. Thus the program facilitates the professional and interpersonal learning process of staff members in a specific way with success as well as with limitations.

Use of in-patient hospital beds by people living in residential care.

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Finucane, P; Wundke, R; Whitehead, C; Williamson, L; Baggoley, C

2000-01-01

There is concern that people living in residential care in Australia make significant and often inappropriate use of acute in-patient hospital services. To date, no factual information has been collected in Australia and its absence may allow myths and negative stereotypes to proliferate. To determine how and why people living in residential care in Australia use in-patient hospital beds. To determine the outcome of hospitalisation and functional status at 3 months following discharge. Prospective study of 184 consecutive admissions to hospital following Emergency Department (ED) attendance involving people aged over 65 years and living in residential care in southern Adelaide, South Australia. Information was obtained from the facilities' transfer letters, and where these were inadequate or absent, telephone interviews were held with residential care staff. 153 people accounted for the 184 admissions. They had a mean age of 84 years and 69% were female. 61% came from hostels and 35% from nursing homes. They had a wide range of clinical problems and twice as many were admitted to medical than to surgical units. Their mean length of hospital stay was 7.9 days, 2.3 days higher than for non-same-day patients and was higher for hostel than for nursing home residents. All but two admissions were considered unavoidable though the provision of specialised care within residential care could have prevented a further 19 (10%) admissions. 96% of admissions resulted in survival to leave hospital and in 74%, people returned directly to their place of origin. At 3 months follow-up, a further 20% of the group had died while 5% were in hospital. In all, 14% of the original group were in a different long-term care facility while 56% were living at their former residence. People living in residential care are often hospitalised because of acute illness. In the vast majority of cases hospitalisation is both appropriate and unavoidable. Most did not require prolonged hospitalisation

Hypertension in a female nursing staff-pattern of occurrence, diagnosis, and treatment

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Estela Maria Motta Lima Leão de Aquino

2001-03-01

Full Text Available OBJECTIVE: To report the pattern of occurrence, diagnosis, and treatment of hypertension in a female nursing staff of an emergency hospital. METHODS: We carried out a cross-sectional study that included interviews and blood pressure measurements of 494 nursing professionals at an emergency hospital in the city of Salvador, in the state of Bahia, Brazil. We considered hypertensive all individual with blood pressure > or = 140/90 mmHg or normal pressure if on regular treatment. RESULTS: We found a prevalence of hypertension of 36.4%. Only 18.3% of the individuals ignored their hypertensive condition, and 64.2% admitted not being having regular treatment. Of those individuals who were having treatment, 69.4% had elevated blood pressure on examination. The major reasons for not being on treatment was the occasional elevation of blood pressure (22.2% and medical counseling (20.0%. CONCLUSION: The results point to the need to introduce hypertension control measures in this occupational group, because of the magnitude of the disease and the potential impact on diffusion of knowledge and measures to control hypertension.

Assessment of prostatic fiducial marker introduction: patient morbidity, staff satisfaction and improved treatment field placement

International Nuclear Information System (INIS)

Brown, Simon; Lehman, Margot; Ferrari-Anderson, Janet; Glyde, Alan; Burmeister, Elizabeth; Nicol, David

2011-01-01

Increased accuracy when using fiducial markers for prostate localisation is well documented. This project aimed to establish the improvement in accuracy when using gold markers for daily prostate localisation, to assess patient satisfaction and morbidity from the transrectal implantation of gold seed markers and establish staff attitudes towards the newly introduced processes. Twenty patients with prostate cancer had three gold seeds implanted into the base, apex and central zone of the prostate transrectally using ultrasound guidance. Surveys were conducted to assess staff and patient satisfaction with the process of gold seed localisation. The gold markers were used to localise the prostate on a daily basis using megavoltage electronic portal imaging. Measurements were taken to establish the increase in accuracy when using gold fiducial markers compared with using the surrounding bony anatomy. Inter-fraction motion (1 standard deviation (SD)) of the fiducial markers was 2.20, 4.28 and 4.27 mm in the LR, SI and AP directions, respectively. Intra-fraction prostate motion (1 SD) was measured as 0.8 mm LR, 1.1 mm SI and 2.0 mm AP. The patient survey showed that the insertion and associated side effects were acceptable, with 5% of patients stating that the seed insertion was worse than the prostate biopsy, and 23.1% of patients experienced short duration (1–2 days) haematuria. The staff survey showed that daily online image guidance was achievable without affecting patient throughput. Thirty percent of treatment staff believed that performing online daily localisation did not add any extra time to a standard treatment, and the remaining 70% thought that the added time was minimal (2–4 min). Gold fiducial markers are an accurate, reliable and tolerable method of daily prostate localisation.

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

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Simone Vidal Santos

2014-12-01

Full Text Available Objective To understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method Qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results The following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion There is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.

Increasing Opportunities for Question-Asking in School-Aged Children with Autism Spectrum Disorder: Effectiveness of Staff Training in Pivotal Response Treatment

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Verschuur, Rianne; Huskens, Bibi; Verhoeven, Ludo; Didden, Robert

2017-01-01

Deficits in question-asking are common in children with autism spectrum disorder (ASD). Furthermore, their opportunities to self-initiate questions are often hindered by directive behavior of their conversation partners. This study assessed the effectiveness of staff training in pivotal response treatment (PRT) on staff member-created…

Organizational climate and self-efficacy as predictors of staff strain in caring for dementia residents: A mediation model.

Science.gov (United States)

Karantzas, Gery C; McCabe, Marita P; Mellor, David; Von Treuer, Kathryn; Davison, Tanya E; O'Connor, Daniel; Haselden, Rachel; Konis, Anastasia

2016-01-01

To date, no research has investigated how the organizational climate of aged care influences the self-efficacy of staff in caring for residents with dementia, or, how self-efficacy is associated with the strain experienced by staff. This study sought to investigate the extent to which the self-efficacy of aged care staff mediates the association between organizational climate variables (such as autonomy, trusting and supportive workplace relations, and the recognition of competence and ability, and perceptions of workplace pressure) and staff strain. A cross-sectional survey design was implemented in which 255 residential aged care staff recruited across aged care facilities in Melbourne, Australia. Staff completed self-report measures of organizational climate, self-efficacy, and strains in caring for residents with dementia. Indirect effects analyses using bootstrapping indicated that self-efficacy of staff mediated the association between the organizational climate variables of autonomy, trust, support, pressure, and staff strain. The findings of this study emphasize that the aged care sector needs to target organizational climate variables that enhance the self-efficacy of staff, and that this in turn, can help ameliorate the strain experienced by staff caring for residents experiencing dementia. Copyright © 2016. Published by Elsevier Ireland Ltd.

Behavioral Emergency Response Team: Implementation Improves Patient Safety, Staff Safety, and Staff Collaboration.

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Zicko, Cdr Jennifer M; Schroeder, Lcdr Rebecca A; Byers, Cdr William S; Taylor, Lt Adam M; Spence, Cdr Dennis L

2017-10-01

Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies. A BERT was piloted on one MS unit for 5 months and expanded to two additional units for 3 months. Pre- and postimplementation staff surveys were conducted, and the number of staff assaults and injuries, restraint usage, and security intervention were compared. The BERT responded to 17 behavioral emergencies. The number of assaults decreased from 10 (pre) to 1 (post); security intervention decreased from 14 to 1; and restraint use decreased from 8 to 1. MS staffs' level of BERT knowledge and rating of support between MH staff and their staff significantly increased. Both MS and MH nurses rated the BERT as supportive and effective. A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety. © 2017 Sigma Theta Tau International.

Addiction treatment staff perceptions of training as a facilitator or barrier to implementing evidence-based practices: a national qualitative research study.

Science.gov (United States)

D'Ippolito, Melinda; Lundgren, Lena; Amodeo, Maryann; Beltrame, Clelia; Lim, Lynn; Chassler, Deborah

2015-01-01

This qualitative effort examines training-related facilitators and barriers to implementing evidence-based practices (EBPs) in 285 community-based addiction treatment organizations (CBOs) nationwide that were funded by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) to implement EBPs. Using qualitative interviews, the authors explored staff (N = 514) descriptions of training as a facilitator or barrier to implementation. Training-related factors were described 663 times as facilitators (by 440 staff) and 233 times as barriers (by 170 staff). Responses were coded using content analysis. Specific characteristics of the training received, such as access to expert knowledge and quality, as well as ongoing training were described as central facilitating factors to EBP implementation. Key reasons training was perceived as a barrier included the amount of training; the training did not fit current staff and/or organizational needs; the training for some EBPs was perceived to be too demanding; and the difficulty accessing training. Since government funders of addiction treatments require that CBOs implement EBPs and they provide training resources, the quality, flexibility, and accessibility of the available training needs to be promoted throughout the addiction treatment network. Only 17% of CBOs reported that they used the SAMHSA-funded ATTC (Addiction Technology Transfer Center) training centers and 42% used SAMHSA technical assistance. Hence, federally funded resources for training were not always used.

Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

Directory of Open Access Journals (Sweden)

Peisah C

2014-10-01

Full Text Available Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NSW, Australia Background: Pain is common in older people, particularly those in residential aged care facilities (RACF and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods: A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results: While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation. Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and nonpharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief.Conclusion: A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings

Staff dose of hospitalization in the treatment of patients in ophthalmic brachytherapy with 125 I

International Nuclear Information System (INIS)

Terron Leon, J. A.; Gomez Palacios, M.; Moreno Reyes, J. C.; Perales Molina, A.

2013-01-01

The objective of this work, therefore, has been the evaluation of the dose levels which nursing staff can receive in care for ophthalmic brachytherapy patients treated with 125 I from measurements made on the same, evaluating, in an experimental way, job security following the PR rules laid down for these treatments. (Author)

Effectiveness of the 'Who's Challenging Who' support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial.

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Randell, Elizabeth; Hastings, Richard P; McNamara, Rachel; Knight, Roseanna; Gillespie, David; Taylor, Zachary

2017-10-05

Findings suggest approximately one in six people with intellectual disability engage in 'challenging behaviours', which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. 'Who's Challenging Who?' (WCW) training is designed to emphasise the role of staff in residential settings as a challenge also to people with intellectual disability. The course is delivered jointly by a trainer with intellectual disability who has been labelled as having challenging behaviour, along with a trainer without intellectual disability. This is a cluster randomised two-arm trial of WCW training versus a waiting list control. Overall, 118 residential settings will be recruited and randomised on a 1:1 ratio. Within each setting, two members of staff will be invited to take part in the trial. Participants will complete assessments at baseline and at 6 and 20 weeks. WCW is a half day initial training course with some follow-on coaching to ensure implementation. The primary outcome is changes in staff empathy towards people with challenging behaviour. Secondary outcomes at the staff level include confidence, attitudes and work-related well-being. Secondary outcomes at the residential setting level include recorded incidents of aggressive challenging behaviour, and use of any restrictive practices. If the results of the cluster randomised trial are positive, we will disseminate the findings widely and make all training manuals and materials freely available for anyone in intellectual disability services (and beyond) to use. Our training approach may have wider implications in other areas of social care. It may also provide a generally applicable model for how to train people with

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

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Rapegno, Noémie; Ravaud, Jean-François

2017-09-29

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

Re-thinking residential mobility

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van Ham, Maarten; Findlay, Allan M.

2015-01-01

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

Information Processing and Creative Thinking Abilities of Residential and Non-Residential School Children

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Atasi Mohanty

2015-10-01

Full Text Available This study attempts to assess and compare the residential and non-residential schoolchildren in information-processing skills and creative thinking abilities. A sample of 80 children from Classes 5 and 7 were selected from two types of schools, residential/ashram (02 and non-residential/formal schools (02 in Bolpur subdivision of West Bengal in India where the medium of instruction is Bengali language/mother-tongue. All the children were individually administered the PASS (Planning, Attention, Simultaneous, Successive, Stroop, Matching Familiar Figure Test (MFFT-20, and creative thinking tasks. The residential school children were found to perform better both in information processing and creative thinking tasks. The developmental trend could not be clearly observed due to small sample size, but with increasing age, children were using better processing strategies. Due to ashram environment, creative pedagogy, and various co-curricular activities, the residential school children were found to be more creative than their formal school counterparts. Moreover, some significant positive correlations were found among information processing skills and creative thinking dimensions.

Disseminating contingency management: Impacts of staff training and implementation at an opiate treatment program

OpenAIRE

Hartzler, Bryan; Jackson, T. Ron; Jones, Brinn E.; Beadnell, Blair; Calsyn, Donald A.

2013-01-01

Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (interventio...

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

NARCIS (Netherlands)

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

2008-01-01

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

Developing the mental health awareness of prison staff in England and Wales.

Science.gov (United States)

Walsh, Elizabeth; Freshwater, Dawn

2009-10-01

In 2010, the prison population in England and Wales could reach a high of 91,500, according to a recent population projection. HM Prison Service (U.K.) reports that in 2004 to 2005, there were 33,144 prison officers employed to care for the prisoners in the prison system. This article focuses on the mental health of this prisoner population and the training needs of staff caring for them. It reports the experience of a national project, funded by the Department of Health, in which the project team developed and piloted mental health awareness training for prison officers on the residential units and for staff who work with prisoners and lack a mental health background. Key findings from the posttraining evaluation are highlighted. Participant feedback demonstrates the value placed on this type of training by those working in the prison setting.

Understanding Residential Polarization in a Globalizing City

Directory of Open Access Journals (Sweden)

Ibrahim Rotimi Aliu

2013-12-01

Full Text Available This study examines the spatial polarization that characterizes the dwellings in the African leading megacity of Lagos. Data were collected through an extensive housing survey carried out on 1,485 household residences in 56 wards within 12 administrative units in Lagos megacity. The spatial dimension of residential density in the city generates three unique residential patterns which are low residential density (LRD, medium residential density (MRD, and high residential density (HRD areas. Descriptive and multivariate inferential statistics were used to render explanations for the spatial variations in the residential quality variables in the study area. Findings indicated that a clear difference exists in the residential quality within the three residential density areas of Lagos. High correlations exist among the residential quality indicators and housing type. The principal component analysis shows that residential polarizations that occur in the LRD, MRD, and HRD are based on the location, dwelling facility, interior and exterior quality, neighborhood integrity, social bond, barrier to entry, and security. The practical implications of residential polarizations along the residential density areas are explicitly expressed.

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

Science.gov (United States)

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

2016-12-03

Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between these changes, sociodemographics, and clinical characteristics. From January 2006 to January 2012, all data relating to changes in residential and/or care setting by SMI patients (N = 262) were collected from electronic case files. Data covering psychopathology, substance use, and medication adherence were assessed in 2006. There were more changes in the residential than in the care setting. In 6 years, only 22% of our sample did not move, 23% changed residence once, 19% twice, 10% three times, and 26% four or more times. Substance use predicted changes of care and/or residential setting and rehospitalisation. The severity of negative symptoms predicted rehospitalisation and duration of hospitalisation. Disorganisation symptoms predicted the duration of hospitalisation. A majority of patients with SMI changed residential and/or care settings several times in 6 years. Patients with substance use or severe negative and disorganisation symptoms may need more intensive and customised treatment. Further research is needed to investigate prevention programmes for highly-frequent movers.

Residential Waste

DEFF Research Database (Denmark)

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

2011-01-01

are discussed in this chapter. Characterizing residential waste is faced with the problem that many residences already divert some waste away from the official collection systems, for example performing home composting of vegetable waste and garden waste, having their bundled newspaper picked up by the scouts...... twice a year or bringing their used furniture to the flea markets organized by charity clubs. Thus, much of the data available on residential waste represents collected waste and not necessarily all generated waste. The latter can only be characterized by careful studies directly at the source......, but such studies are very expensive if fair representation of both spatial and temporal variations should be obtained. In addition, onsite studies may affect the waste generation in the residence because of the increased focus on the issue. Residential waste is defined in different ways in different countries...

"They Treat Us Like Human Beings"--Experiencing a Therapeutic Sex Offenders Prison: Impact on Prisoners and Staff and Implications for Treatment.

Science.gov (United States)

Blagden, Nicholas; Winder, Belinda; Hames, Charlie

2016-03-01

Research evidence demonstrates that sex offender treatment programmes (SOTPs) can reduce the number of sex offenders who are reconvicted. However, there has been much less empirical research exploring the experiences and perspectives of the prison environment within which treatment takes place. This is important, particularly for sexual offenders, as they often face multiple stigmas in prison. This study used a mixed-methods approach to explore the experiences of prisoners and staff at a therapeutically orientated sexual offenders' prison to understand whether the prison environment was conducive to rehabilitation. The quantitative strand of the research sampled prisoners (n = 112) and staff (n = 48) from a therapeutically orientated sex offenders prison. This strand highlighted that both prisoners and staff had positive attitudes toward offenders and high beliefs that offenders could change. Importantly, the climate was rated positively and, in particular, participants had very high ratings of "experienced safety." The qualitative strand of the research consisted of semistructured interviews with prisoners (n = 15) and a range of prison staff (n = 16). The qualitative analysis revealed positive prisoner views toward staff relationships, with most participants articulating that the prison and its staff had contributed to positive change in prisoners. Crucially, the environment was perceived as safe and allowed prisoners "headspace" to work through problems and contemplate change. This research offers some support to the notion that context is important for sex offender rehabilitation. © The Author(s) 2014.

Shift report: a ritual play on a residential adolescent psychiatric unit.

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Yonge, O

2008-01-01

The author conducted an ethnographic study of an adolescent residential psychiatric unit which revealed a category of behaviour--the shift report. A questionnaire was administered to staff to reveal further meanings. Reporting was found to schematize knowledge according to common referents, promote and validate insider roles through language, offer a means of personal reintegration and catharsis, and provide a forum for the symbolic enactment of democratic values which permeated every aspect of culture on the unit. Staff members were categorically in favour of their verbal and private shift report. There was little partitioning of informal and formal aspects of report in the interest of saving time. Instead, socializing and 'catching up' were important aspects of shift report and constituted a large part of team building. The informal nature of report, particularly in the use of language allowed staff to come to terms with frustrations rather than constituting patient stereotyping. As a ritual, the shift report fostered behavioural synchrony, individual empowerment and a democratic 'all-channel network' of communication. It is hoped that this account will encourage more practising nurses and managers to view their shift report as something more than a simple 'handover'; that is, a ritual play of core values, roles and relationships.

Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

Science.gov (United States)

Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

2011-11-01

This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

Family ties and residential locations

NARCIS (Netherlands)

Mulder, C.H.; Cooke, T.J.

2009-01-01

In this paper, and in the Special Issue it introduces, the focus is on the role of family ties in residential location choice and, conversely, the role of residential locations in maintaining family ties. Not only do events in the nuclear family trigger residential relocations, but nearby family

The role of support staff in promoting the social inclusion of persons with an intellectual disability.

Science.gov (United States)

McConkey, R; Collins, S

2010-08-01

Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention. In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job. Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks. Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities.

Measuring Group Care Worker Interventions in Residential Youth Care

NARCIS (Netherlands)

Bastiaanssen, I.L.W.; Kroes, G.; Nijhof, K.S.; Delsing, M.J.M.H.; Engels, R.C.M.E.; Veerman, J.W.

2012-01-01

Background By interacting with children, group care workers shape daily living environments to influence treatment. Current literature provides little knowledge about the content of youth residential care. Objective In this study, a questionnaire called the Group care worker Intervention

Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

Science.gov (United States)

Meißner, Anne; Schnepp, Wilfried

2014-06-20

Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when

Dispositional Mindfulness, Shame, and Compulsive Sexual Behaviors among Men in Residential Treatment for Substance Use Disorders.

Science.gov (United States)

Brem, Meagan J; Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L

2017-12-01

Approximately 31% of men in treatment for a substance use disorders (SUD) engage in compulsive sexual behavior (CSB). Shame, a well-documented consequence of CSB, increases the likelihood of relapse following treatment for SUDs. Despite the risk of relapse, prior research has not investigated factors that may attenuate the relation between CSB and shame. Dispositional mindfulness is one such factor known to mitigate shame. However, researchers have yet to examine dispositional mindfulness as a moderator of the relationship between CSB and shame among a sample of men in treatment for SUDs. In an effort to inform intervention efforts, the present study aimed to investigate the hypothesis that CSB would not relate to shame among men with high, as opposed to low, levels of dispositional mindfulness. The present study reviewed medical records of 184 men in residential treatment for SUDs who completed cross-sectional measures of shame, CSB, dispositional mindfulness, and substance use problems. Results demonstrated a significant interaction between CSB and dispositional mindfulness such that CSB positively related to shame at low, but not mean or high, levels of dispositional mindfulness. These results support and extend previous mindfulness and CSB treatment research. Findings suggested that intervention efforts for CSB may benefit from increasing dispositional mindfulness in an effort to reduce shame-related cognitions.

Community treatment adoption of contingency management: a conceptual profile of U.S. clinics based on innovativeness of executive staff.

Science.gov (United States)

Hartzler, Bryan; Rabun, Carl

2013-07-01

Community adoption of contingency management (CM) varies considerably, and executive innovativeness may help explain variance due to its presumed influence on clinic decision-making. Sixteen U.S. opioid treatment programs (OTPs) were visited, with ethnographic interviewing used in casual contacts with executives to inform their eventual classification by study investigators into one of Rogers' (2003) five adopter categories. Audio-recorded interviews were also conducted individually with the executive and three staff members (N = 64) wherein they reported reactions to clinic CM implementation during the prior year, from which study investigators later identified salient excerpts during interview transcript reviews. The executive sample was progressive, with 56% classified as innovators or early adopters. Implementation reports and corresponding staff reactions were generally consistent with what might be expected according to diffusion theory. Clinics led by innovators had durably implemented multiple CM applications, for which staff voiced support. Clinics led by early adopters reported CM exposure via research trial participation, with mixed reporting of sustained and discontinued applications and similarly mixed staff views. Clinics led by early majority adopters employed CM selectively for administrative purposes, with staff reticence about its expansion to therapeutic uses. Clinics led by late majority adopters had either deferred or discontinued CM adoption, with typically disenchanted staff views. Clinics led by a laggard executive evidenced no CM exposure and strongly dogmatic staff views against its use. Study findings are consistent with diffusion theory precepts, and illustrate pervasive influences of executive innovativeness on clinic practices and staff impressions of implementation experiences. Published by Elsevier B.V.

Development and Psychometric Testing of a Novel Food Service Satisfaction Questionnaire for Food Service Staff of Aged Care Homes.

Science.gov (United States)

Miller, M; Hamilton, J; Scupham, R; Matwiejczyk, L; Prichard, I; Farrer, O; Yaxley, A

2018-01-01

Food service staff are integral to delivery of quality food in aged care homes yet measurement of their satisfaction is unable to be performed due to an absence of a valid and reliable questionnaire. The aim of this study was to develop and perform psychometric testing for a new Food Service Satisfaction Questionnaire developed in Australia specifically for use by food service staff working in residential aged care homes (Flinders FSSQFSAC). A mixed methods design utilizing both a qualitative (in-depth interviews, focus groups) and a quantitative approach (cross sectional survey) was used. Content validity was determined from focus groups and interviews with food service staff currently working in aged care homes, related questionnaires from the literature and consultation with an expert panel. The questionnaire was tested for construct validity and internal consistency using data from food service staff currently working in aged care homes that responded to an electronic invitation circulated to Australian aged care homes using a national database of email addresses. Construct validity was tested via principle components analysis and internal consistency through Cronbach's alpha. Temporal stability of the questionnaire was determined from food service staff undertaking the Flinders FSSQFSAC on two occasions, two weeks apart, and analysed using Pearson's correlations. Content validity for the Flinders FSSQFSAC was established from a panel of experts and stakeholders. Principle components analysis revealed food service staff satisfaction was represented by 61-items divided into eight domains: job satisfaction (α=0.832), food quality (α=0.871), staff training (α=0.922), consultation (α=0.840), eating environment (α=0.777), reliability (α=0.695), family expectations (α=0.781) and resident relationships (α=0.429), establishing construct validity in all domains, and internal consistency in all (α>0.5) except for "resident relationships" (α=0.429). Test

Experiences of Power and Violence in Mexican Men Attending Mutual-Aid Residential Centers for Addiction Treatment.

Science.gov (United States)

Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio

2016-05-01

Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs). CRAMAAs are a culturally specific form of substance abuse treatment in Mexico that are characterized by control and violence. Fifteen interviews were carried out with men of varied sociodemographic characteristics, and who resided in at least two of these centers. Results identify that power is expressed through drug abuse and leads them to subsequent biopsychosocial degradation. Residency in CRAMAAs is motivated by women, but men do not seek the residency and are usually admitted unwillingly. Power through violence is carried out inside CRAMAAs where men are victims of abuse. From a 12-step philosophy, this violence is believed to lead them to a path of recovery but instead produces feelings of anger and frustration. The implications of these centers on Mexican public health are discussed. © The Author(s) 2015.

Residential environmental evaluation of local cities considering regional characteristic and personal residential preference-a case study of Saga City,Japan

Institute of Scientific and Technical Information of China (English)

GE Jian; HOKAO Kazunori

2004-01-01

Questionnaire surveys and subjective evaluations on residential environment were performed in order to grasp the main factors of residential environment of small local cities. The suitable evaluation index system was established, and the regional residential environment characteristics and personal residential preference types were analyzed, so that their influence on residential environment evaluation could be grasped. The results can be applied to the residential environment planning, construction and monitoring of local cities.

[Psychotherapeutic treatment of traumatized refugees in Germany].

Science.gov (United States)

Böttche, M; Stammel, N; Knaevelsrud, C

2016-11-01

Traumatic experiences resulting from war and violence can lead to a broad spectrum of psychological and somatic stress responses. The psychological strain of traumatized refugees is frequently aggravated by specific post-migration stressors. The current healthcare provision in Germany is characterized by many restrictions. The different residence permits are associated with a limited access to medical and psychotherapeutic services. In addition, there are several barriers limiting access of this group of patients to the healthcare system (e. g. low level of training of mental healthcare staff, language barriers and lack of financing for interpreters). Empirical studies have shown that traumatized refugees profit from existing trauma-focused and evidence-based interventions. Treatment is associated with particular challenges and issues (e. g. use of interpreters, migration and culture-specific as well as legal aspects). Specialized treatment centers for traumatized refugees use a multidisciplinary treatment approach, which includes psychotherapeutic, medical and social work interventions as well as assistance with the residential status and integration programs.

Residential family treatment for parents with substance use disorders who are involved with child welfare: two perspectives on program design, collaboration, and sustainability.

Science.gov (United States)

Hammond, Gretchen Clark; McGlone, Amanda

2013-01-01

This article discusses the service design, implementation, and evaluation findings of two residential family treatment programs: Wayside House (MN) and OnTrack (OR). Both programs specialize in family-centered services for adults with substance use disorders (SUD) who are involved with child welfare. Information on program design, services offered, and key collaborations are detailed. Implications for program sustainability are provided.

Affective predictors of the severity and change in eating psychopathology in residential eating disorder treatment: The role of social anxiety.

Science.gov (United States)

Smith, Kathryn E; Mason, Tyler B; Leonard, Rachel C; Wetterneck, Chad T; Smith, Brad E R; Farrell, Nicholas R; Riemann, Brad C

2018-01-01

Despite evidence documenting relationships between eating disorder (ED) psychopathology, depression, and anxiety, little is known regarding how social anxiety is related to ED symptoms in treatment. Therefore this study examined associations between depression, general anxiety, social anxiety, and ED psychopathology at the beginning and end of treatment (EOT) among patients (N = 380) treated in a residential ED program. Participants completed measures of ED psychopathology and affective variables. Higher depression and general anxiety, but not social anxiety, were related to higher ED psychopathology at baseline. However, social anxiety emerged as a unique predictor of ED psychopathology at EOT such that participants with higher social anxiety evidenced less improvement in ED psychopathology. Findings suggest that social anxiety has specific relevance to treatment in EDs, which may reflect shared mechanisms and underlying deficits in emotion regulation.

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.

Science.gov (United States)

Llewellyn-Jones, R H; Baikie, K A; Smithers, H; Cohen, J; Snowdon, J; Tennant, C C

1999-09-11

To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Population of residential facility in Sydney living in self care units and hostels. 220 depressed residents aged >/=65 without severe cognitive impairment. The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Geriatric depression scale. Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents.

12 CFR 541.23 - Residential real estate.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Residential real estate. 541.23 Section 541.23... AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.23 Residential real estate. The terms residential real estate... home used in part for business); (c) Other real estate used for primarily residential purposes other...

Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

Science.gov (United States)

Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

2017-03-01

Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

Science.gov (United States)

Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

2016-01-01

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

The Association between Perceptions of Distributive Justice and Procedural Justice with Support of Treatment and Support of Punishment among Correctional Staff

Science.gov (United States)

Lambert, Eric G.; Hogan, Nancy L.; Barton-Bellessa, Shannon M.

2011-01-01

Previous literature exploring the relationship between correctional officer orientations toward treatment and punishment is inconsistent at best. One rarely studied aspect is the influence of distributive and procedural justice on correctional staff support for treatment and punishment. For this study, ordinary least squares regression analysis of…

A descriptive survey of types, spread and characteristics of substance abuse treatment centers in Nigeria.

Science.gov (United States)

Onifade, Peter O; Somoye, Edward B; Ogunwobi, Olorunfemi O; Ogunwale, Adegboyega; Akinhanmi, Akinwande O; Adamson, Taiwo A

2011-09-18

Nigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3%) in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7%) and Opioids (0.7%) use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria. The study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European Treatment Unit/Program Form (June 1997 version). All the units completed the online questionnaire. A large proportion (48%) was located in the South-West geopolitical zone of the country. Most (58%) were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%). No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147) and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services. The study revealed a dearth of substance abuse treatment units (and of funds for the available ones) in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring, funding and continuous quality improvement, the units need to

A descriptive survey of types, spread and characteristics of substance abuse treatment centers in Nigeria

Directory of Open Access Journals (Sweden)

Akinhanmi Akinwande O

2011-09-01

Full Text Available Abstract Background Nigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3% in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7% and Opioids (0.7% use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria. Methods The study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European Treatment Unit/Program Form (June 1997 version. Results All the units completed the online questionnaire. A large proportion (48% was located in the South-West geopolitical zone of the country. Most (58% were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%. No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147 and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services. Conclusions The study revealed a dearth of substance abuse treatment units (and of funds for the available ones in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring

Longitudinal comparative evaluation of the equivalence of an integrated peer-support and clinical staffing model for residential mental health rehabilitation: a mixed methods protocol incorporating multiple stakeholder perspectives.

Science.gov (United States)

Parker, Stephen; Dark, Frances; Newman, Ellie; Korman, Nicole; Meurk, Carla; Siskind, Dan; Harris, Meredith

2016-06-02

A novel staffing model integrating peer support workers and clinical staff within a unified team is being trialled at community based residential rehabilitation units in Australia. A mixed-methods protocol for the longitudinal evaluation of the outcomes, expectations and experiences of care by consumers and staff under this staffing model in two units will be compared to one unit operating a traditional clinical staffing. The study is unique with regards to the context, the longitudinal approach and consideration of multiple stakeholder perspectives. The longitudinal mixed methods design integrates a quantitative evaluation of the outcomes of care for consumers at three residential rehabilitation units with an applied qualitative research methodology. The quantitative component utilizes a prospective cohort design to explore whether equivalent outcomes are achieved through engagement at residential rehabilitation units operating integrated and clinical staffing models. Comparative data will be available from the time of admission, discharge and 12-month period post-discharge from the units. Additionally, retrospective data for the 12-month period prior to admission will be utilized to consider changes in functioning pre and post engagement with residential rehabilitation care. The primary outcome will be change in psychosocial functioning, assessed using the total score on the Health of the Nation Outcome Scales (HoNOS). Planned secondary outcomes will include changes in symptomatology, disability, recovery orientation, carer quality of life, emergency department presentations, psychiatric inpatient bed days, and psychological distress and wellbeing. Planned analyses will include: cohort description; hierarchical linear regression modelling of the predictors of change in HoNOS following CCU care; and descriptive comparisons of the costs associated with the two staffing models. The qualitative component utilizes a pragmatic approach to grounded theory, with

The Consequences of Emotional Burnout Among Correctional Staff

Directory of Open Access Journals (Sweden)

Eric G. Lambert

2015-06-01

Full Text Available The vast majority of past correctional staff burnout studies have focused on the possible antecedents of job burnout. Far fewer studies have been published on the possible outcomes of burnout among correctional staff. This study examined the effects of the emotional exhaustion dimension of burnout on life satisfaction, support for treatment, support for punishment, absenteeism, views on use of sick leave, and turnover intent among 272 staff at a state-run Midwestern maximum security prison. Ordinary least squares (OLS regression analysis of survey data indicated that emotional burnout had significant negative associations with life satisfaction and support for treatment and significant positive relationships with support for punishment, absenteeism, views on use of sick leave (i.e., a right to be used however the employee wishes, and turnover intent. The results indicate that job burnout has negative outcomes for both staff and correctional institutions.

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

Science.gov (United States)

Yu, Ping; Qian, Siyu

2018-01-01

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

24 CFR 40.2 - Definition of “residential structure”.

Science.gov (United States)

2010-04-01

... OWNED RESIDENTIAL STRUCTURES § 40.2 Definition of “residential structure”. (a) As used in this part, the term residential structure means a residential structure (other than a privately owned residential structure and a residential structure on a military reservation): (1) Constructed or altered by or on behalf...

The nature, characteristics and associations of care home staff stress and wellbeing: a national survey.

Science.gov (United States)

Islam, Muhammad Saiful; Baker, Christine; Huxley, Peter; Russell, Ian T; Dennis, Michael S

2017-01-01

The majority of residents in care homes in the United Kingdom are living with dementia or significant memory problems. Caring in this setting can be difficult and stressful for care staff who work long hours, have little opportunity for training, are poorly paid and yet subject to high expectation. This may affect their mental and physical wellbeing, cause high rates of staff turnover and absenteeism, and affect the quality of care they provide. The main objective of this survey was to explore the nature, characteristics and associations of stress in care home staff. Staff working in a stratified random sample of care homes within Wales completed measures covering: general health and wellbeing (SF-12); stress (Work Stress Inventory); job content (Karasek Job Content); approach to, and experience of, working with people living with dementia (Approaches to Dementia Questionnaire; and Experience of Working with Dementia Patients); and Productivity and Health Status (SPS-6). Multiple linear regressions explored the effects of home and staff characteristics on carers. 212 staff from 72 care homes completed questionnaires. Staff from nursing homes experienced more work stress than those from residential homes (difference 0.30; 95% confidence interval (CI) from 0.10 to 0.51; P  work (difference -4.77; CI -7.80 to -1.73; P  working in local authority homes than in the private sector (difference 7.75; CI 2.56 to 12.94; P  < 0.01). Our study highlights the importance of dementia training in care homes, with a particular need in the private sector. An effective intervention to reduce stress in health and social care staff is required, especially in nursing and larger care homes, and for nursing staff. ISRCTN registry: ISRCTN80487202. Registered 24 July 2013.

Effectiveness of the ‘Who’s Challenging Who’ support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial

OpenAIRE

Randell, Elizabeth; Hastings, Richard P.; McNamara, Rachel; Knight, Roseanna; Gillespie, David; Taylor, Zachary

2017-01-01

Background Findings suggest approximately one in six people with intellectual disability engage in ‘challenging behaviours’, which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. ‘Who’s ...

The Effectiveness of Group Cognitive Hypnotherapy on Major Depression Referred to Residential and Semi-residential Addiction Recovery Centers

Directory of Open Access Journals (Sweden)

S Haghighi

2016-12-01

Full Text Available 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 group. The population included all patients drug dependent as residential and semi-residential referred to Yasuj addiction recovery centers. 40 patients were selected by convenience sampling and randomly assigned to experimental and control groups. The instrument used in this study included Beck Depression Inventory which depressed patients diagnosed and according to clinical interview they entered the study. Group cognitive Hypnotherapy intervention model was carried out on the experimental group for 8 sessions for one hour once a week, but there was no intervention on control group. After the intervention both experimental and control groups were assessed. Collected   data was analyzed using covariance analysis. Results: The results revealed that the cognitive hypnotherapy treatment of group, leading to depression reduced significantly in the experimental group compared control group significantly (p <0.001. The mean pre-test score of major depression in the experimental group and in control group was 39/5 ± 10/54 and 61/4 ± 20/52 respectively.  Whereas the mean and standard deviation of major depression and post-test scores in the experimental group 55/2 ± 05/25 and in the control group was 50/3 ± 55/51. Conclusion: Cognitive hypnotherapy can be used as adjunctive therapy in reducing major depression or used in addiction recovery centers.

Primary care and addiction treatment: lessons learned from building bridges across traditions.

Science.gov (United States)

Stanley, A H

1999-01-01

A primary care unit combined with residential addiction treatment allows patients with addictive disease and chronic medical or psychiatric problems to successfully complete the treatment. These are patients who would otherwise fail treatment or fail to be considered candidates for treatment. Health care providers should have a background in primary care and have the potential to respond professionally to clinical problems in behavioral medicine. Ongoing professional training and statistical quality management principles can maintain morale and productivity. Health education is an integral part of primary care. The costs of such concurrent care when viewed in the context of the high societal and economic costs of untreated addictive disease and untreated chronic medical problems are low. The principles used to develop this primary care unit can be used to develop health care units for other underserved populations. These principles include identification of specific health care priorities and continuity of rapport with the target population and with addiction treatment staff.

Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

Science.gov (United States)

Hutchison, Andrew; Kroese, Biza Stenfert

2016-01-01

Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

12 CFR 541.16 - Improved residential real estate.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Improved residential real estate. 541.16... REGULATIONS AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.16 Improved residential real estate. The term improved residential real estate means residential real estate containing offsite or other improvements...

The relation between residential property and its surroundings and day- and night-time residential burglary

NARCIS (Netherlands)

Montoya, Lorena; Junger, Marianne; Ongena, Yfke

This article examines how residential property and its surroundings influence day- and night-time residential burglary. Crime Prevention Through Environmental Design (CPTED) principles of territoriality, surveillance, access control, target hardening, image maintenance, and activity support underpin

The Relation Between Residential Property and its Surroundings and Day- and Night-Time Residential Burglary

NARCIS (Netherlands)

Montoya, L.; Junger, Marianne; Ongena, Yfke

This article examines how residential property and its surroundings influence day- and night-time residential burglary. Crime Prevention Through Environmental Design (CPTED) principles of territoriality, surveillance, access control, target hardening, image maintenance, and activity support underpin

Mother-infant consultation during drug treatment: Research and innovative clinical practice

Directory of Open Access Journals (Sweden)

Lester Barry M

2008-02-01

Full Text Available Abstract Background This paper details a model for consulting with mothers and infants, and drug treatment staff used in a residential drug treatment program and relevant to other treatment settings. The role of parent-infant consultation based on the Neonatal Network Neurobehavioral Scale (NNNS was evaluated. Methods A sequential cohort model was used to assign participants to 1. NNNS consultation versus 2. standard care. The effects of NNNS consultation were evaluated using the Parenting Stress Index and NNNS summary scores. Results Participants in the NNNS consultation condition had significantly less stress overall, and less stress related to infant behavior than participants in standard care. There were no differences in infant behavior on the NNNS Summary scores. Conclusion The implications for NNNS consultation in drug treatment programs is outlined. The importance of prevention/intervention to establish satisfactory mother-infant interaction in recovery programs which include a central parenting component is indicated.

A pilot study on the feasibility of training nurses to formulate multicomponent oral health interventions in a residential aged care facility.

Science.gov (United States)

Deutsch, Alan; Siegel, Emma; Cations, Monica; Wright, Clive; Naganathan, Vasi; Brodaty, Henry

2017-12-01

This 10 weeks feasibility study investigated whether residential care nurses with 12 hours advanced oral health training in assessments and saliva testing could formulate, implement and monitor individualised oral care plans of early dementia residents. Four trained lead advocate nurses using SXI-D, OHIP14, oral health assessment tool (OHAT) assessments and a modified saliva test formulated nurse scheduled comprehensive oral care plans (NSCOCPs) by selecting and scheduling preventive products and procedures multiple times throughout the day to alkalise the mouth of 8 residents as an adjunct to assisted brushing and high-fluoride toothpaste. Nurse assessments, saliva tests and care plans were validated against oral health therapist (OHT) findings. Care plan agreement between Nurse and OHT intervention selection and scheduling was high (75%-88%). Untrained nurse compliance was very high, 86%-99% for the 4930 scheduled interventions. Untrained nurses delivered multiple scheduled interventions by following NSCOCPs despite initially not understanding the reason for each of 9 interventions categories. NSCOCPs could track and monitor whether a recommended intervention had been completed by general nursing staff over 3 nursing shifts. The role of nurses may have to be expanded beyond traditional roles to meet the growth and changes in oral health needs in residential facilities. Intensive training of a few lead advocate nurses to assess risk and formulate individualised NSCOCPs provides a method to transfer knowledge to untrained staff and deliver multicomponent preventive interventions soon after entry into residential care where timely visits by dental professionals to examine residents and prescribe preventive interventions are infrequent or unlikely. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Examining the temporal relationship between psychological climate, work attitude, and staff turnover

Science.gov (United States)

Garner, Bryan R.; Hunter, Brooke D.

2012-01-01

Relative to the broader industrial-organizational (I-O) psychology field, research on the turnover of substance use disorder (SUD) treatment staff is in its infancy. Despite its long and rich history, recent reviews of the turnover literature within I-O psychology have noted there remains considerable room for improvement. In particular, recommendations have been made for research that considers time in the turnover process and explores more distal causes of staff turnover. Addressing these gaps, this paper examined the temporal relationship between latent measures of psychological climate, work attitude, and staff turnover. Using data from 95 SUD treatment staff clustered within 29 treatment organizations, multilevel discrete-time survival analyses revealed that a latent measure of work attitude (e.g., job satisfaction, pay satisfaction, turnover intentions) fully mediated the temporal relationship between latent measures of psychological climate (e.g., supervisor support, coworker support, role conflict) and subsequent staff turnover. PMID:22658290

PowerChoice Residential Customer Response to TOU Rates

Energy Technology Data Exchange (ETDEWEB)

Peters, Jane S.; Moezzi, Mithra; Lutzenhiser, Susan; Woods, James; Dethman, Linda; Kunkle, Rick

2009-10-01

Research Into Action, Inc. and the Sacramento Municipal Utility District (SMUD) worked together to conduct research on the behaviors and energy use patterns of SMUD residential customers who voluntarily signed on to a Time-of-Use rate pilot launched under the PowerChoice label. The project was designed to consider the how and why of residential customers ability and willingness to engage in demand reduction behaviors, and to link social and behavioral factors to observed changes in demand. The research drew on a combination of load interval data and three successive surveys of participating households. Two experimental treatments were applied to test the effects of increased information on households ability to respond to the Time-of-Use rates. Survey results indicated that participants understood the purpose of the Time-of-Use rate and undertook substantial appropriate actions to shift load and conserve. Statistical tests revealed minor initial price effects and more marked, but still modest, adjustments to seasonal rate changes. Tests of the two information interventions indicated that neither made much difference to consumption patterns. Despite the lackluster statistical evidence for load shifting, the analysis points to key issues for critical analysis and development of residential Time-of-Use rates, especially pertinent as California sets the stage for demand response in more California residences.

Internet addiction disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program.

Science.gov (United States)

Yung, Kathryn; Eickhoff, Erin; Davis, Diane L; Klam, Warren P; Doan, Andrew P

2015-02-01

Internet addiction disorder (IAD) is characterized by the problematic use of online video games, computer use, and mobile handheld devices. While not officially a clinical diagnosis according to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), individuals with IAD manifest severe emotional, social, and mental dysfunction in multiple areas of daily activities due to their problematic use of technology and the internet. We report a 31year-old man who exhibited problematic use of Google Glass™. The patient has a history of a mood disorder most consistent with a substance induced hypomania overlaying a depressive disorder, anxiety disorder with characteristics of social phobia and obsessive compulsive disorder, and severe alcohol and tobacco use disorders. During his residential treatment program at the Navy's Substance Abuse and Recovery Program (SARP) for alcohol use disorder, it was noted that the patient exhibited significant frustration and irritability related to not being able to use his Google Glass™. The patient exhibited a notable, nearly involuntary movement of the right hand up to his temple area and tapping it with his forefinger. He reported that if he had been prevented from wearing the device while at work, he would become extremely irritable and argumentative. Over the course of his 35-day residential treatment, the patient noted a reduction in irritability, reduction in motor movements to his temple to turn on the device, and improvements in his short-term memory and clarity of thought processes. He continued to intermittently experience dreams as if looking through the device. To our knowledge, this is the first reported case of IAD involving problematic use of Google Glass™. Published by Elsevier Ltd.

Differences between Residential and Non-Residential Fathers on Sexual Socialisation of African American Youth

Science.gov (United States)

Sneed, Carl D.; Willis, Leigh A.

2016-01-01

This study investigated differences between residential and non-residential fathers on topics discussed during father-child sex communication and factors associated with child sexual socialisation. Young people (N = 159, 53% female) provided self-reports using computer surveys on the role of their fathers on father-child sex communication, general…

The use of surveillance technology in residential facilities for people with dementia or intellectual disabilities: a study among nurses and support staff.

NARCIS (Netherlands)

Niemeijer, A.R.; Depla, M.; Hertogh, C.; Frederiks, B.; Francke, A.

2014-01-01

Background: The use of surveillance technology in residential care facilities for people with dementia or intellectual disabilities is often promoted both as a solution to understaffing and as a means to increasing clients' autonomy. But there are fears that such use might attenuate the care

Life-cycle energy of residential buildings in China

International Nuclear Information System (INIS)

Chang, Yuan; Ries, Robert J.; Wang, Yaowu

2013-01-01

In the context of rapid urbanization and new construction in rural China, residential building energy consumption has the potential to increase with the expected increase in demand. A process-based hybrid life-cycle assessment model is used to quantify the life-cycle energy use for both urban and rural residential buildings in China and determine the energy use characteristics of each life cycle phase. An input–output model for the pre-use phases is based on 2007 Chinese economic benchmark data. A process-based life-cycle assessment model for estimating the operation and demolition phases uses historical energy-intensity data. Results show that operation energy in both urban and rural residential buildings is dominant and varies from 75% to 86% of life cycle energy respectively. Gaps in living standards as well as differences in building structure and materials result in a life-cycle energy intensity of urban residential buildings that is 20% higher than that of rural residential buildings. The life-cycle energy of urban residential buildings is most sensitive to the reduction of operational energy intensity excluding heating energy which depends on both the occupants' energy-saving behavior as well as the performance of the building itself. -- Highlights: •We developed a hybrid LCA model to quantify the life-cycle energy for urban and rural residential buildings in China. •Operation energy in urban and rural residential buildings is dominant, varying from 75% to 86% of life cycle energy respectively. •Compared with rural residential buildings, the life-cycle energy intensity of urban residential buildings is 20% higher. •The life-cycle energy of urban residential buildings is most sensitive to the reduction of daily activity energy

Antibiotic-resistant genes and antibiotic-resistant bacteria in the effluent of urban residential areas, hospitals, and a municipal wastewater treatment plant system.

Science.gov (United States)

Li, Jianan; Cheng, Weixiao; Xu, Like; Strong, P J; Chen, Hong

2015-03-01

In this study, we determined the abundance of 8 antibiotics (3 tetracyclines, 4 sulfonamides, and 1 trimethoprim), 12 antibiotic-resistant genes (10 tet, 2 sul), 4 antibiotic-resistant bacteria (tetracycline, sulfamethoxazole, and combined resistance), and class 1 integron integrase gene (intI1) in the effluent of residential areas, hospitals, and municipal wastewater treatment plant (WWTP) systems. The concentrations of total/individual targets (antibiotics, genes, and bacteria) varied remarkably among different samples, but the hospital samples generally had a lower abundance than the residential area samples. The WWTP demonstrated removal efficiencies of 50.8% tetracyclines, 66.8% sulfonamides, 0.5 logs to 2.5 logs tet genes, and less than 1 log of sul and intI1 genes, as well as 0.5 log to 1 log removal for target bacteria. Except for the total tetracycline concentration and the proportion of tetracycline-resistant bacteria (R (2) = 0.330, P antibiotics and the corresponding resistant bacteria (P > 0.05). In contrast, various relationships were identified between antibiotics and antibiotic resistance genes (P antibiotic-resistant bacteria (P < 0.01).

Factors associated with constructive staff-family relationships in the care of older adults in the institutional setting.

Science.gov (United States)

Haesler, Emily; Bauer, Michael; Nay, Rhonda

2006-12-01

Background  Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives  The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. Search strategy  A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage

Constructive staff-family relationships in the care of older adults in the institutional setting: A systematic review.

Science.gov (United States)

Haesler, Emily; Bauer, Michael; Nay, Rhonda

2004-01-01

Modern health care philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's wellbeing. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family imvolvement in the health care of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the health care environment to benefit from the involvement of their family members, health care professionals need an understanding of the issues surrounding family presence in the health care environement and the strategies to best support it. The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the health care setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family & Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO, and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference

The Staff of Life.

Science.gov (United States)

Jones, Rebecca

1994-01-01

Some children have chronic illnesses that require diet modifications as part of their medical treatment. Advises school districts to hire a registered dietitian or look for resources at a local hospital or public health office. In addition, schools should work with parents, improve staff training, and conduct spot checks of school cafeterias. (MLF)

Steering Angle Function Algorithm of Morphing of Residential Area

Directory of Open Access Journals (Sweden)

XIE Tian

2015-07-01

Full Text Available A residential area feature morphing method based on steering angle function is presented. To residential area with the same representation under two different scales,transforming the representation of the residential area polygon from vector coordinates to steering angle function,then using the steering angle function to match,and finding out the similarity and the differences between the residential areas under different scale to get the steering angle function of the the residential areas under any middle scale,the final,transforming the middle scale steering angle function to vector coordinates form,and get the middle shape interpolation of the the residential area polygon.Experimental results show:the residential area morphing method by using steering angle function presented can realize the continuous multi-scale representation under the premise of keeping in shape for the residential area with the rectangular boundary features.

THE PSYCHOLOGICAL TREATMENT OF CHILDREN AND ADOLESCENTS IN RESIDENTIAL CARE. CONTRIBUTIONS TO A SPECIFIC FIELD OF INTERVENTION

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Antonio Galán Rodríguez

2014-09-01

Full Text Available Psychological treatment is provided to a great number of minors fostered in residential centres of the child protection system; however, a deep and systematic analysis regarding the specific topics of this field has not yet been carried out. We analyse the ways of organizing units to attend children, taking into account three different options (general practice, specific practice in common settings, and specialized programs, and their advantages and disadvantages. We consider the role of the theoretical models, underlining the need for complexity and critical analysis, illustrated by reviewing three common models (the psychopathological, trauma-informed, and attachment models. Finally, we pay attention to the specificity of the technical interventions, calling for modified adaptations based on the characteristics of the minors, specific topics in this field, and some particular aspects of the context.

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

Science.gov (United States)

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

2012-11-01

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

Residential energy demand in Brazil

International Nuclear Information System (INIS)

Arouca, M.; Gomes, F.M.; Rosa, L.P.

1981-01-01

The energy demand in Brazilian residential sector is studied, discussing the methodology for analyzing this demand from some ideas suggested, for developing an adequate method to brazilian characteristics. The residential energy consumption of several fuels in Brazil is also presented, including a comparative evaluation with the United States and France. (author)

Brief screening for co-occurring disorders among women entering substance abuse treatment

Directory of Open Access Journals (Sweden)

Chernoff Miriam

2006-09-01

Full Text Available Abstract Background Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient at five treatment sites were screened at intake (N = 374. Results Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Conclusion Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment

Residential Care

Science.gov (United States)

... Kids For Teens For Parents & Teachers Resolving Family Conflicts The Holidays and Alzheimer's Glossary Virtual Library Online ... longer an option Costs Choosing a care setting Types of residential care A good long-term care ...

Personal Staff - Joint Staff - The National Guard

Science.gov (United States)

the ARNG Deputy Director of the ARNG Chief of Staff of the ARNG Command Chief Warrant Officer of the Site Maintenance Battle Focused Training Strategy Battle Staff Training Resources News Publications March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J

Development of Residential SOFC Cogeneration System

International Nuclear Information System (INIS)

Ono, Takashi; Miyachi, Itaru; Suzuki, Minoru; Higaki, Katsuki

2011-01-01

Since 2001 Kyocera has been developing 1kW class Solid Oxide Fuel Cell (SOFC) for power generation system. We have developed a cell, stack, module and system. Since 2004, Kyocera and Osaka Gas Co., Ltd. have been developed SOFC residential co-generation system. From 2007, we took part in the 'Demonstrative Research on Solid Oxide Fuel Cells' Project conducted by New Energy Foundation (NEF). Total 57 units of 0.7kW class SOFC cogeneration systems had been installed at residential houses. In spite of residential small power demand, the actual electric efficiency was about 40%(netAC,LHV), and high CO2 reduction performance was achieved by these systems. Hereafter, new joint development, Osaka Gas, Toyota Motors, Kyocera and Aisin Seiki, aims early commercialization of residential SOFC CHP system.

Development of Residential SOFC Cogeneration System

Science.gov (United States)

Ono, Takashi; Miyachi, Itaru; Suzuki, Minoru; Higaki, Katsuki

2011-06-01

Since 2001 Kyocera has been developing 1kW class Solid Oxide Fuel Cell (SOFC) for power generation system. We have developed a cell, stack, module and system. Since 2004, Kyocera and Osaka Gas Co., Ltd. have been developed SOFC residential co-generation system. From 2007, we took part in the "Demonstrative Research on Solid Oxide Fuel Cells" Project conducted by New Energy Foundation (NEF). Total 57 units of 0.7kW class SOFC cogeneration systems had been installed at residential houses. In spite of residential small power demand, the actual electric efficiency was about 40%(netAC,LHV), and high CO2 reduction performance was achieved by these systems. Hereafter, new joint development, Osaka Gas, Toyota Motors, Kyocera and Aisin Seiki, aims early commercialization of residential SOFC CHP system.

Therapeutic Residential Care for Children and Youth:

DEFF Research Database (Denmark)

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

2016-01-01

so in closer collaboration with their families and in closer proximity to their home communities; and, (3) with the hope of reducing the high costs often associated with group residential provision. In some jurisdictions, efforts to reduce residential care resources in the absence of sufficient...... 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...... 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...

Retailing residential electricity : A concept that makes sense?

International Nuclear Information System (INIS)

MacDonald, C.

2003-07-01

A heated debate centres around the deregulation of the electricity industry and the retailing of residential electricity. An assessment of the current situation in the industry was provided in this paper to provide a basis for discussion. The experience gained both in Alberta and Texas in residential retail was examined. The main issue of concern is whether residential customers will benefit from deregulation of the electricity sector. The Retail Energy Deregulation (RED) Index provides a benchmark for those jurisdictions considering the residential options. Deregulation has not led to significant benefits to residential customers in most jurisdictions. The electricity industry will always require a central dispatch/market process that will have to designed, governed, regulated, modified regularly. The benefits to residential consumers are not expected for a very long time. Standard market design is an issue that will require attention. refs., 7 figs

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

Science.gov (United States)

Khoury-Kassabri, Mona; Attar-Schwartz, Shalhevet

2014-03-01

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

Main challenges of residential areas

Directory of Open Access Journals (Sweden)

Oana Luca

2017-06-01

Full Text Available The present article is a position paper aiming to initiate a professional debate related to the aspects related to the urban dysfunctions leading to the wear of the residential areas. The paper proposes a definition of the wear process, identify the main causes leading to its occurrence and propose a number of solutions to neutralise the dysfunctions. The three wearing phases of residential areas components are emphasized, exploring their lifecycle. In order to perform the study of urban wear, the status of the residential areas components can be established and monitored, and also the variables of the function that can mathematically model the specific wear process may be considered. The paper is considered a first step for the model adjustment, to be tested and validated in the following steps. Based on the mathematical method and model, there can be created, in a potential future research, the possibility of determining the precarity degree for residential areas/neighbourhoods and cities, by minimising the subjective component of the analyses preceding the decision for renovation or regeneration.

Field validation of a system for autodissemination of an entomopathogenic fungus, Isaria fumosorosea, to control the Asian citrus psyllid on residential citrus

Science.gov (United States)

The citrus industries of California and Texas share a pressing problem with the Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae) and huanglongbing (HLB) spreading in residential citrus near commercial groves. Insecticidal treatment of residential trees for the psyllid is problem...

When goals diverge: Staff consensus and the organizational climate.

Science.gov (United States)

Melnick, Gerald; Ulaszek, Wendy R; Lin, Hsiu-Ju; Wexler, Harry K

2009-08-01

A sample of correctional officers and prison substance abuse treatment staff collected by the National Criminal Justice Treatment Practices Survey is used to provide an exploratory study of an aspect of organizational culture consisting of consensus (agreement) among prison personnel regarding their beliefs about rehabilitation in the presence of conflicting organizational goals and aspects of the organizational climate important to change. Findings show that among those staff members responding to the survey, the belief in rehabilitation scale mean score was associated with higher levels of organizational commitment, and interdepartmental coordination. However, an hierarchical linear modeling (HLM) analysis that used an index score derived from the standard deviation for staff consensus regarding these same beliefs about rehabilitation produced a different pattern of results, showing that high levels of consensus were associated with job frustration, cynicism towards the ability of the institution to change, and lower levels of organizational commitment. The authors conclude that, although the sample may not express the beliefs of corrections officers or prison-based treatment staff at large, within the sample, consensus appeared to play a unique role in evaluating the effect of divergent goals on organizational climate as it relates to change, and warrants consideration when considering the effects of organizational climate.

Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

Directory of Open Access Journals (Sweden)

Mubyazi Godfrey M

2012-02-01

Full Text Available Abstract Background Since its introduction in the national antenatal care (ANC system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment

Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

Science.gov (United States)

2012-01-01

Background Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water

Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts.

Science.gov (United States)

Mubyazi, Godfrey M; Bloch, Paul; Byskov, Jens; Magnussen, Pascal; Bygbjerg, Ib C; Hansen, Kristian S

2012-02-18

Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water, electricity and cups for

Family events and the residential mobility of couples

NARCIS (Netherlands)

Michielin, F.; Mulder, C.H.

2008-01-01

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

Sex differences in the relation of weight loss self-efficacy, binge eating, and depressive symptoms to weight loss success in a residential obesity treatment program.

Science.gov (United States)

Presnell, Katherine; Pells, Jennifer; Stout, Anna; Musante, Gerard

2008-04-01

The aim of the current study was to examine whether weight loss self-efficacy, binge eating, and depressive symptoms predicted weight loss during treatment, and whether gender moderates these associations with prospective data from 297 participants (223 women and 74 men) enrolled in a residential obesity treatment program. Men reported higher initial levels of self-efficacy than women, whereas women reported greater pre-treatment levels of binge eating and depressive symptoms. Higher pre-treatment levels of weight control self-efficacy, binge eating, and depressive symptoms predicted greater weight loss in men, but not in women. Results suggest that certain psychological and behavioral factors should be considered when implementing weight loss interventions, and indicate a need to consider gender differences in predictors of weight loss treatment. Future research should seek to identify predictors of weight loss among women.

The impact of revised DSM-5 criteria on the relative distribution and inter-rater reliability of eating disorder diagnoses in a residential treatment setting.

Science.gov (United States)

Thomas, Jennifer J; Eddy, Kamryn T; Murray, Helen B; Tromp, Marilou D P; Hartmann, Andrea S; Stone, Melissa T; Levendusky, Philip G; Becker, Anne E

2015-09-30

This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (κ=.48) and DSM-5 (κ=.57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (κ=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Treatment of Osteoporosis in Australian Residential Aged Care Facilities: Update on Consensus Recommendations for Fracture Prevention

Science.gov (United States)

Duque, Gustavo; Lord, Stephen R.; Mak, Jenson; Ganda, Kirtan; Close, Jacqueline J.T.; Ebeling, Peter; Papaioannou, Alexandra; Inderjeeth, Charles A.

2016-01-01

Background Older people living in residential aged care facilities (RACFs) are at a higher risk of suffering fractures than the community-dwelling older population. The first Consensus Conference on Treatment of Osteoporosis in RACFs in Australia, held in Sydney in July 2009, aimed to address some of the issues relating to the treatment of older residents with osteoporosis in RACFs. Considering that the field of osteoporosis diagnosis and management has significantly advanced in the last 5 years and that new evidence has been generated from studies performed within RACFs, a Second Consensus Conference was held in Sydney in November 2014. Methods An expert panel met in November 2014 in Penrith, NSW, Australia in an attempt to reach a consensus on diverse issues related to the treatment of osteoporosis at RACFs. Participants were selected by the scientific committee on the basis of their practice in an RACF and/or major published articles. The co-chairs distributed topics randomly to all participants, who then had to propose a statement on each topic for approval by the conference after a short, evidence-based presentation, when possible. Results This article provides an update on the most relevant evidence on osteoporosis in older people living in RACFs graded according to its level, quality, and relevance. Conclusion As with the first consensus, it is hoped that this statement will constitute an important guide to aid physicians in their decision making while practicing at RACFs. PMID:27349626

Following patient pathways to psycho-oncological treatment: Identification of treatment needs by clinical staff and electronic screening.

Science.gov (United States)

Loth, Fanny L; Meraner, Verena; Holzner, Bernhard; Singer, Susanne; Virgolini, Irene; Gamper, Eva M

2018-04-01

In this retrospective investigation of patient pathways to psycho-oncological treatment (POT), we compared the number of POT referrals before and after implementation of electronic screening for POT needs and investigated psychosocial predictors for POT wish at a nuclear medicine department. We extracted medical chart information about number of referrals and extent of follow-up contacts. During standard referral (November 2014 to October 2015), POT needs were identified by clinical staff only. In the screening-assisted referral period (November 2015 to October 2016), identification was supported by electronic screening for POT needs. Psychosocial predictors for POT wish were examined using logistic regression. We analysed data from 487 patients during standard referral (mean age 56.4 years; 60.2% female, 88.7% thyroid carcinoma or neuroendocrine tumours) of which 28 patients (5.7%) were referred for POT. Of 502 patients in the screening-assisted referral period (mean age 57.0 years; 55.8% female, 86.6% thyroid carcinoma or neuroendocrine tumours), 69 (13.7%) were referred for POT. Of these, 36 were identified by psycho-oncological (PO) screening and 33 by clinical staff. After PO-screening implementation, referrals increased by a factor of 2.4. The strongest predictor of POT wish was depressive mood (P patients visited the PO outpatient unit additionally to inpatient PO consultations. Our results provide evidence from a real-life setting that PO screening can foster POT referrals, reduce barriers to express the POT wish, and hence help to meet psychosocial needs of this specific patient group. Differences between patients' needs, wish, and POT uptake should be further investigated. © 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Greenhouse gas emissions accounting of urban residential consumption: a household survey based approach.

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Tao Lin

Full Text Available Devising policies for a low carbon city requires a careful understanding of the characteristics of urban residential lifestyle and consumption. The production-based accounting approach based on top-down statistical data has a limited ability to reflect the total greenhouse gas (GHG emissions from residential consumption. In this paper, we present a survey-based GHG emissions accounting methodology for urban residential consumption, and apply it in Xiamen City, a rapidly urbanizing coastal city in southeast China. Based on this, the main influencing factors determining residential GHG emissions at the household and community scale are identified, and the typical profiles of low, medium and high GHG emission households and communities are identified. Up to 70% of household GHG emissions are from regional and national activities that support household consumption including the supply of energy and building materials, while 17% are from urban level basic services and supplies such as sewage treatment and solid waste management, and only 13% are direct emissions from household consumption. Housing area and household size are the two main factors determining GHG emissions from residential consumption at the household scale, while average housing area and building height were the main factors at the community scale. Our results show a large disparity in GHG emissions profiles among different households, with high GHG emissions households emitting about five times more than low GHG emissions households. Emissions from high GHG emissions communities are about twice as high as from low GHG emissions communities. Our findings can contribute to better tailored and targeted policies aimed at reducing household GHG emissions, and developing low GHG emissions residential communities in China.

Greenhouse Gas Emissions Accounting of Urban Residential Consumption: A Household Survey Based Approach

Science.gov (United States)

Lin, Tao; Yu, Yunjun; Bai, Xuemei; Feng, Ling; Wang, Jin

2013-01-01

Devising policies for a low carbon city requires a careful understanding of the characteristics of urban residential lifestyle and consumption. The production-based accounting approach based on top-down statistical data has a limited ability to reflect the total greenhouse gas (GHG) emissions from residential consumption. In this paper, we present a survey-based GHG emissions accounting methodology for urban residential consumption, and apply it in Xiamen City, a rapidly urbanizing coastal city in southeast China. Based on this, the main influencing factors determining residential GHG emissions at the household and community scale are identified, and the typical profiles of low, medium and high GHG emission households and communities are identified. Up to 70% of household GHG emissions are from regional and national activities that support household consumption including the supply of energy and building materials, while 17% are from urban level basic services and supplies such as sewage treatment and solid waste management, and only 13% are direct emissions from household consumption. Housing area and household size are the two main factors determining GHG emissions from residential consumption at the household scale, while average housing area and building height were the main factors at the community scale. Our results show a large disparity in GHG emissions profiles among different households, with high GHG emissions households emitting about five times more than low GHG emissions households. Emissions from high GHG emissions communities are about twice as high as from low GHG emissions communities. Our findings can contribute to better tailored and targeted policies aimed at reducing household GHG emissions, and developing low GHG emissions residential communities in China. PMID:23405187

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

Directory of Open Access Journals (Sweden)

Bamford Claire

2012-10-01

Full Text Available Abstract Background Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality of life. However, there is evidence that the nutritional intake of older people living in care homes is suboptimal, with high levels of saturated fat, salt, and added sugars. The UK Food Standards Agency therefore developed nutrient- and food-based guidance for residential care homes. The acceptability of these guidelines and their feasibility in practice is unknown. This study used the Normalization Process Theory (NPT to understand the barriers and facilitators to implementing the guidelines and inform future implementation. Methods We conducted a process evaluation in five care homes in the north of England using qualitative methods (observation and interviews to explore the views of managers, care staff, catering staff, and domestic staff. Data were analyzed thematically and discussed in data workshops; emerging themes were then mapped to the constructs of NPT. Results Many staff perceived the guidelines as unnecessarily restrictive and irrelevant to older people. In terms of NPT, the guidelines simply did not make sense (coherence, and as a result, relatively few staff invested in the guidelines (cognitive participation. Even where staff supported the guidelines, implementation was hampered by a lack of nutritional knowledge and institutional support (collective action. Finally, the absence of observable benefits to clients confirmed the negative preconceptions of many staff, with limited evidence of reappraisal following implementation (reflexive monitoring. Conclusions The successful implementation of the nutrition guidelines requires that the fundamental issues relating to their perceived value and fit with other priorities and goals be addressed. Specialist support is needed to equip staff with the technical knowledge and skills required for menu analysis and development and to

Special Staff - Joint Staff - Leadership - The National Guard

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the ARNG Deputy Director of the ARNG Chief of Staff of the ARNG Command Chief Warrant Officer of the Site Maintenance Battle Focused Training Strategy Battle Staff Training Resources News Publications March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J

Communication, advice exchange and job satisfaction of nursing staff: a social network analyses of 35 long-term care units.

Science.gov (United States)

van Beek, Adriana P A; Wagner, Cordula; Spreeuwenberg, Peter P M; Frijters, Dinnus H M; Ribbe, Miel W; Groenewegen, Peter P

2011-06-01

The behaviour of individuals is affected by the social networks in which they are embedded. Networks are also important for the diffusion of information and the influence of employees in organisations. Yet, at the moment little is known about the social networks of nursing staff in healthcare settings. This is the first study that investigates informal communication and advice networks of nursing staff in long-term care. We examine the structure of the networks, how they are related to the size of units and characteristics of nursing staff, and their relationship with job satisfaction. We collected social network data of 380 nursing staff of 35 units in group projects and psychogeriatric units in nursing homes and residential homes in the Netherlands. Communication and advice networks were analyzed in a social network application (UCINET), focusing on the number of contacts (density) between nursing staff on the units. We then studied the correlation between the density of networks, size of the units and characteristics of nursing staff. We used multilevel analyses to investigate the relationship between social networks and job satisfaction of nursing staff, taking characteristics of units and nursing staff into account. Both communication and advice networks were negatively related to the number of residents and the number of nursing staff of the units. Communication and advice networks were more dense when more staff worked part-time. Furthermore, density of communication networks was positively related to the age of nursing staff of the units. Multilevel analyses showed that job satisfaction differed significantly between individual staff members and units and was influenced by the number of nursing staff of the units. However, this relationship disappeared when density of communication networks was added to the model. Overall, communication and advice networks of nursing staff in long-term care are relatively dense. This fits with the high level of cooperation

Suggestions on Strengthening Greening Construction of Ecological Residential Areas

OpenAIRE

Li, Peng

2013-01-01

Greening construction is an important part of the construction of ecological residential areas, but there exist some misunderstandings in greening construction of ecological residential districts at present. Based on the description of functions of green space in ecological residential areas, the summarization of principles of greening design, and the discussion of questions in greening construction of ecological residential districts, some suggestions as well as specific measures for strengt...

A hybrid society model for simulating residential electricity consumption

International Nuclear Information System (INIS)

Xu, Minjie; Hu, Zhaoguang; Wu, Junyong; Zhou, Yuhui

2008-01-01

In this paper, a hybrid social model of econometric model and social influence model is proposed for evaluating the influence of pricing policy and public education policy on residential habit of electricity using in power resources management. And, a hybrid society simulation platform based on the proposed model, called residential electricity consumption multi-agent systems (RECMAS), is designed for simulating residential electricity consumption by multi-agent system. RECMAS is composed of consumer agent, power supplier agent, and policy maker agent. It provides the policy makers with a useful tool to evaluate power price policies and public education campaigns in different scenarios. According to an influenced diffusion mechanism, RECMAS can simulate the residential electricity demand-supply chain and analyze impacts of the factors on residential electricity consumption. Finally, the proposed method is used to simulate urban residential electricity consumption in China. (author)

A hybrid society model for simulating residential electricity consumption

Energy Technology Data Exchange (ETDEWEB)

Xu, Minjie [School of Electrical Engineering, Beijing Jiaotong University, Beijing (China); State Power Economic Research Institute, Beijing (China); Hu, Zhaoguang [State Power Economic Research Institute, Beijing (China); Wu, Junyong; Zhou, Yuhui [School of Electrical Engineering, Beijing Jiaotong University, Beijing (China)

2008-12-15

In this paper, a hybrid social model of econometric model and social influence model is proposed for evaluating the influence of pricing policy and public education policy on residential habit of electricity using in power resources management. And, a hybrid society simulation platform based on the proposed model, called residential electricity consumption multi-agent systems (RECMAS), is designed for simulating residential electricity consumption by multi-agent system. RECMAS is composed of consumer agent, power supplier agent, and policy maker agent. It provides the policy makers with a useful tool to evaluate power price policies and public education campaigns in different scenarios. According to an influenced diffusion mechanism, RECMAS can simulate the residential electricity demand-supply chain and analyze impacts of the factors on residential electricity consumption. Finally, the proposed method is used to simulate urban residential electricity consumption in China. (author)

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

Science.gov (United States)

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

2017-02-01

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

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

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Barnard Debbie

2011-07-01

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

PRN 2011-1: Residential Exposure Joint Venture

Science.gov (United States)

This PR Notice is to advise registrants of an industry-wide joint venture, titled the Residential Exposure Joint Venture (REJV), which has developed a national survey regarding residential consumer use/usage data for pesticides.

Integrated Management of Residential Energy Resources

Directory of Open Access Journals (Sweden)

Antunes C. H.

2012-10-01

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.

Technical Problems of Residential Construction

Science.gov (United States)

Nowogońska, Beata; Cibis, Jerzy

2017-10-01

Beauty, utility, durability - these are the features of good architecture and should also be the distinguishing qualities of every residential building. But do beauty and utility remain along with the passing of time? Performance characteristics are an indicator of both, the technical as well as aesthetic state of buildings. Aesthetic needs are in disagreement with the merciless aging process. The beauty of a city is formed not only by the original forms of new residential buildings, but also by existing tenement housing; thus preserving their aesthetics becomes a necessity. Time is continuously passing and along with it, aging intensifies. The aging process is a natural phenomenon for every material. The life expectancy of building materials is also limited. Along with the passing of time, the technical state of residential buildings continuously deteriorates. With the passing of time, the aesthetic values and preferences of users of flats change and the usability of the building decreases. The permanence of buildings, including residential buildings, is shaped not only by the forces of nature but also by activities of humans. A long lifespan is ensured by carrying out ongoing, systematic renovation-repair works. It is thanks to them that buildings derived from past centuries are still being used, and their market attractiveness is not decreasing.

Evaluation of advanced technologies for residential appliances and residential and commercial lighting

Energy Technology Data Exchange (ETDEWEB)

Turiel, I.; Atkinson, B.; Boghosian, S.; Chan, P.; Jennings, J.; Lutz, J.; McMahon, J.; Rosenquist, G.

1995-01-01

Section 127 of the Energy Policy Act requires that the Department of Energy (DOE) prepare a report to Congress on the potential for the development and commercialization of appliances that substantially exceed the present federal or state efficiency standards. Candidate high-efficiency appliances must meet several criteria including: the potential exists for substantial improvement (beyond the minimum established in law) of the appliance`s energy efficiency; electric, water, or gas utilities are prepared to support and promote the commercialization of such appliances; manufacturers are unlikely to undertake development and commercialization of such appliances on their own, or development and production would be substantially accelerated by support to manufacturers. This report describes options to improve the efficiency of residential appliances, including water heaters, clothes washers and dryers, refrigerator/freezers, dishwashers, space heating and cooling devices, as well as residential and commercial lighting products. Data from this report (particularly Appendix 1)were used to prepare the report to Congress mentioned previously. For the residential sector, national energy savings are calculated using the LBL Residential Energy Model. This model projects the number of households and appliance saturations over time. First, end-use consumption is calculated for a base case where models that only meet the standard replace existing models as these reach the end of their lifetime. Second, models with efficiencies equal to the technology under consideration replace existing models that reach the end of their lifetime. For the commercial sector, the COMMEND model was utilized to project national energy savings from new technologies. In this report, energy savings are shown for the period 1988 to 2015.

Improving and ensuring best practice continence management in residential aged care.

Science.gov (United States)

Heckenberg, Gayle

2008-06-01

Background  Continence Management within residential aged care is an every day component of care that requires assessment, implementation of strategies, resource allocation and evaluation. At times the management of incontinence of aged residents can be challenging and unsuccessful. The project chosen through the Clinical Fellowship program was Continence Management with the aim of raising awareness of best practice to assist in improving and providing person-centred resident care. Aims/objectives •  Review the literature on best practice management of incontinence •  Evaluate current practice in continence management for elderly residents within residential aged care services •  Improve adherence to best practice strategies of care for incontinence •  Raise awareness within the nursing home of the best practice management of incontinence •  Promote appropriate and effective use of resources for continence management •  Deliver individualised person-centred care to residents. •  Ensure best practice in continence management Methods  The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System clinical audit tool was utilised to measure current practice against best practice. The results identify gaps that require improvement. The Getting Research into Practice process then allowed analysis of the level of compliance with each of the audit criteria, which would identify any barriers in implementing a selected course of action and aim to improve compliance. The project team was consulted with additional stakeholder consultation to form an action plan and implement strategies to improve practice. Results  Although 100% compliance with all audit criteria in audit 1 and 2 was not achieved, there was improvement in the criteria concerning the documented fluid intake for residents. Further strategies have been identified and implemented and this continues to be a 'work in progress'. Staff now have an acute awareness

Daily activities and living at a Therapeutic Residential Care Center

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Luciane Prado Kantorki

2014-12-01

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

Study protocol: A Montessori approach to dementia-related, non-residential respite services in Australia.

Science.gov (United States)

Hanna, Andrew; Donnelly, James; Aggar, Christina

2018-03-27

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.

Using research evidence to inform staff learning needs in cross-cultural communication in aged care homes.

Science.gov (United States)

Gillham, David; De Bellis, Anita; Xiao, Lily; Willis, Eileen; Harrington, Ann; Morey, Wendy; Jeffers, Lesley

2018-04-01

Developed countries worldwide are facing an unprecedented demand for aged care services, with recent migrants of diverse linguistic and cultural backgrounds increasingly recruited as care workers while at the same time there is growing cultural diversity among aged care residents. This situation is compounded by rapidly changing technology and varied educational levels of care workers from diverse backgrounds. The objectives were threefold: to identify staff learning needs to enable them to provide high-quality cross-cultural care; to improve team cohesion; and identify preferred learning approaches. An interpretive qualitative study utilising focus group and interview data informed the development of an education resource. Fifty six care workers from four residential aged care facilities participated in either focus groups or interviews conducted in private meeting rooms within the care facilities. Participants included personal care attendants, registered and clinical nurses, managers, hospitality staff and allied health professionals. Focus group and interview data were categorised and thematically analysed. Data relevant to cross-cultural care, team cohesion and preferred learning approaches informed education resource development, including case studies. Major themes identified the need to promote cultural awareness and understanding, and strategies for cross-cultural care and communication. Themes related to team cohesion demonstrated that staff were already sympathetic and sensitive to cross-cultural issues, and that culturally and linguistically diverse staff add value to the workforce and are supported by the organisation. Staff required clear, uncomplicated education resources to equip them with skills to address problematic cultural situations. Preferred learning approaches varied and highlighted the need for varied educational materials and approaches, as well as time efficient, opportunistic education strategies for the busy workplace. An education

Implementing an Assessment Clinic in a Residential PTSD Program

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Joan McDowell

2014-08-01

Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

Solar Photovoltaic Financing: Residential Sector Deployment

Energy Technology Data Exchange (ETDEWEB)

Coughlin, J.; Cory, K.

2009-03-01

This report presents the information that homeowners and policy makers need to facilitate PV financing at the residential level. The full range of cash payments, bill savings, and tax incentives is covered, as well as potentially available solar attribute payments. Traditional financing is also compared to innovative solutions, many of which are borrowed from the commercial sector. Together, these mechanisms are critical for making the economic case for a residential PV installation, given its high upfront costs. Unfortunately, these programs are presently limited to select locations around the country. By calling attention to these innovative initiatives, this report aims to help policy makers consider greater adoption of these models to benefit homeowners interested installing a residential PV system.

A Neo-Rawlsian Approach to Residential Integration

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Kevin J. Brown

2013-08-01

Full Text Available Over the past 40 years, the United States has engaged in various policies to integrate otherwise segregated black and white households within a shared space. However, little work has been done to fully articulate a moral argument for residential integration among black and white households. This paper offers what I refer to as the normative argument, which possesses two morally-impelled arguments for residential integration. Since the ethical appeal to integrate is often couched in the language of justice, I begin with a framework—based upon the work of the late philosopher John Rawls—for considering the moral aspects of residential integration. However, I go on to point out intractable problems related to the Rawlsian framework that would fail to flesh out all ethical considerations of the normative argument. From here, I provide a revised, or neo-Rawlsian, framework for understanding residential integration which addresses the aforementioned problems. This exercise is both important and necessary for the future of residential mixing, as better understanding the moral and ethical attributes of this discussion is, perhaps, the best means to lubricate the fundamental shift from 'spatial' to 'social' integration.

An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients.

Science.gov (United States)

Colson, D B; Allen, J G; Coyne, L; Dexter, N; Jehl, N; Mayer, C A; Spohn, H

1986-09-01

Countertransference among hospital staff was investigated as part of ongoing research on difficult-to-treat psychiatric hospital patients. Staff's ratings of their emotional reactions to 127 patients on long-term units were analyzed by factor analysis, and the resulting factors were correlated by discipline with patient problem behaviors. Among the conclusions were that different forms of psychopathology elicit characteristic patterns of emotional reaction from staff; that some dimensions of psychopathology, particularly suicidal-depressed behavior and violence-agitation, elicit different emotional reactions among different disciplines, thus laying the groundwork for division among staff; and that the more difficult the process of hospital treatment, the more likely staff will experience a variety of emotions.

38 CFR 36.4357 - Combination residential and business property.

Science.gov (United States)

2010-07-01

... Reporting § 36.4357 Combination residential and business property. If otherwise eligible, a loan for the purchase or construction of a combination of residential property and business property which the veteran... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Combination residential...

Directorate of Management - Special Staff - Joint Staff - Leadership - The

Science.gov (United States)

NGB Official March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J-7 J-8 Personal Staff Inspector General Judge Advocate General Officer Management Public Affairs Executive Support Services Legislative Liaison Special Staff Directorate of Management

Training and Practices of Cannabis Dispensary Staff.

Science.gov (United States)

Haug, Nancy A; Kieschnick, Dustin; Sottile, James E; Babson, Kimberly A; Vandrey, Ryan; Bonn-Miller, Marcel O

2016-01-01

Introduction: The proliferation of cannabis dispensaries within the United States has emerged from patient demand for the legalization of cannabis as an alternative treatment for a number of conditions and symptoms. Unfortunately, nothing is known about the practices of dispensary staff with respect to recommendation of cannabis strains/concentrations for specific patient ailments. To address this limitation, the present study assessed the training and practices of cannabis dispensary staff. Materials and Methods: Medical and nonmedical dispensary staff ( n =55) were recruited via e-mail and social media to complete an online survey assessing their demographic characteristics, dispensary features, patient characteristics, formal training, and cannabis recommendation practices. Results: Fifty-five percent of dispensary staff reported some formal training for their position, with 20% reporting medical/scientific training. A majority (94%) indicated that they provide specific cannabis advice to patients. In terms of strains, dispensary staff trended toward recommendations of Indica for anxiety, chronic pain, insomnia, nightmares, and Tourette's syndrome. They were more likely to recommend Indica and hybrid plants for post-traumatic stress disorder (PTSD)/trauma and muscle spasms. In contrast, staff were less likely to recommend Indica for depression; hybrid strains were most often recommended for amyotrophic lateral sclerosis (ALS). In terms of cannabinoid concentrations, dispensary staff were most likely to recommend a 1:1 ratio of delta-9-tetrahydrocannabinol (THC):cannabidiol (CBD) for patients suffering from anxiety, Crohn's disease, hepatitis C, and PTSD/trauma, while patients seeking appetite stimulation were most likely to be recommended THC. Staff recommended high CBD for arthritis and Alzheimer's disease and a high CBD or 1:1 ratio for ALS, epilepsy, and muscle spasms. Conclusions: Although many dispensary staff are making recommendations consistent with

Joint Chiefs of Staff > About > The Joint Staff > Senior Enlisted Advisor

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Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

The Design of an Effective Family Reintegration and Aftercare Program for Youth Successfully Leaving Residential Care.

Science.gov (United States)

Roley, Jeffrey H.

The lack of support services following the release of adolescent youths from a residential treatment center back to their families is examined in this practicum. Consequently, the development of a family reintegration program for the treatment center is focused on the concept that effective aftercare begins at intake. Understandably, families…

Negotiated risk and resident autonomy: Frontline care staff perspectives on culture change in long term care in Nova Scotia, Canada.

Science.gov (United States)

Roberts, Emily

2016-08-12

Regulating risk, freedom of action, and autonomy in decision making are problems shared by both caregivers and residents in long term care settings, and may become the subject of tension and constant negotiation. This study focuses on long term care staff and management perceptions of day to day life in a care community which has gone through a culture change transition, where small residentially scaled households replace large instutional models of care. In each household, the setting is considered to be home for the 8-12 residents, creating a major shift of roles for the caregivers; they are, in essence, coming into a home rather than institutional environment as a place of work. This potentially changes the dynamics of both patterns of work for caregivers and patterns of daily living for residents. Participant observations and care staff interviews. Several key themes emrged which include: teamwork; the culture of care; regulating risk; the physical environment and care staff empowerment. An unexpected outcome was the consensus among care staff that it is they who feel at home while working in the care households, leading to empowerment in their work roles and a deeper understanding of the importance of their role in the lives of the residents.

Coping modeling problem solving versus mastery modeling: effects on adherence, in-session process, and skill acquisition in a residential parent-training program.

Science.gov (United States)

Cunningham, C E; Davis, J R; Bremner, R; Dunn, K W; Rzasa, T

1993-10-01

This trial compared two approaches used to introduce parenting skills in a residential staff training program. Fifty staff were randomly assigned to: mastery modelling in which videotaped models demonstrated new skills, coping modelling problem solving (CMPS) in which participants formulated their own solutions to the errors depicted by videotaped models, or a waiting-list control group. In both, leaders used modelling, role playing, and homework projects to promote mastery and transfer of new skills. The skills of all groups improved, but CMPS participants attended more sessions, were late to fewer sessions, completed more homework, engaged in more cooperative in-session interaction, rated the program more positively, and reported higher job accomplishment scores. These data suggest that CMPS allowing participants to formulate their own solutions may enhance adherence and reduce the resistance observed in more didactic programs.

Residential normalcy and environmental experiences of very old people: changes in residential reasoning over time.

Science.gov (United States)

Granbom, Marianne; Himmelsbach, Ines; Haak, Maria; Löfqvist, Charlotte; Oswald, Frank; Iwarsson, Susanne

2014-04-01

The decision to relocate in old age is intricately linked to thoughts and desires to stay put. However, most research focuses either on strategies that allow people to age in place or on their reasons for relocation. There is a need for more knowledge on very old peoples' residential reasoning, including thoughts about aging in place and thoughts about relocation as one intertwined process evolving in everyday life. The aim of this study was to explore what we refer to as the process of residential reasoning and how it changes over time among very old people, and to contribute to the theoretical development regarding aging in place and relocation. Taking a longitudinal perspective, data stem from the ENABLE-AGE In-depth Study, with interviews conducted in 2003 followed up in interviews in 2011. The 16 participants of the present study were 80-89years at the time of the first interview. During analysis the Theoretical Model of Residential Normalcy by Golant and the Life Course Model of Environmental Experience by Rowles & Watkins were used as sensitizing concepts. The findings revealed changes in the process of residential reasoning that related to a wide variety of issues. Such issues included the way very old people use their environmental experience, their striving to build upon or dismiss attachment to place, and their attempts to maintain or regain residential normalcy during years of declining health and loss of independence. In addition, the changes in reasoning were related to end-of-life issues. The findings contribute to the theoretical discussion on aging in place, relocation as a coping strategy, and reattachment after moving in very old age. Copyright © 2014 Elsevier Inc. All rights reserved.

Radiation exposure of owners and veterinary staff members after treatment of hyperthyroid cats with 131I

International Nuclear Information System (INIS)

Vandermeulen, E.; Dobbeleir, A.; Peremans, K.; Bacher, K.; Monsieurs, M.

2015-01-01

Full text of publication follows. Aim: the present study aims to evaluate radiation exposure of owners and veterinary staff members after 131 I treatment of hyperthyroid cats. Additionally, radiation dose rates from the treated cats were measured at different time points to analyze the effective half-life of 131 I within the cat. Materials and methods: 28 cats received a mean activity of (173 ± 84) MBq of 131 I. During the 5 day hospitalization period, the veterinary staff (3 persons) involved in the care for these cats wore waterproof bracelets and rings (at left and right hand) containing calibrated (LiF:Mg,Cu,P) thermoluminescent dosimeters (TLDs). TLDs were read out after 5 days and readings were converted in a dose value using an in-house measured calibration factor. Further, equivalent dose rates (μSv/h) were registered at 1 m distance from the cat at 4 h, 24 h, 48 h and 72 h after injection. The dose rates were plotted against time and fitted to an exponential function. From the fitting results, the effective half-life (T 1/2eff ) could be calculated. Owners were also given waterproof bracelets containing TLDs at the moment their cat was released from the Veterinary Nuclear Medicine Division. They were given strict instructions concerning the management of the cat at home (emphasizing limited time, keeping distance and waste management). The bracelets were returned by mail after 1 week together with the owners' estimation of the time spent with the cat. TLDs doses were analyzed using the aforementioned procedure. Results: 4 hours after injection, mean equivalent dose rate at 1 m was (9 ± 4) μSv/h. This value further decreased to (4 ± 3) μSv/h. Based on the dose rate measurements a mean T 1/2eff of (3.0 ± 1.6) days was found. Over 7 days, the average accumulated wrist dose of the owners was 504 μSv (range 26-2682 μSv). Concerning staff members, mean accumulated wrist doses over 5 days were 101 μGy and 120 μGy for left and right wrists

Modeling Residential Electricity Consumption Function in Malaysia: Time Series Approach

OpenAIRE

L. L. Ivy-Yap; H. A. Bekhet

2014-01-01

As the Malaysian residential electricity consumption continued to increase rapidly, effective energy policies, which address factors affecting residential electricity consumption, is urgently needed. This study attempts to investigate the relationship between residential electricity consumption (EC), real disposable income (Y), price of electricity (Pe) and population (Po) in Malaysia for 1978-2011 period. Unlike previous studies on Malaysia, the current study focuses on the residential secto...

Dynamic management of integrated residential energy systems

Science.gov (United States)

Muratori, Matteo

This study combines principles of energy systems engineering and statistics to develop integrated models of residential energy use in the United States, to include residential recharging of electric vehicles. These models can be used by government, policymakers, and the utility industry to provide answers and guidance regarding the future of the U.S. energy system. Currently, electric power generation must match the total demand at each instant, following seasonal patterns and instantaneous fluctuations. Thus, one of the biggest drivers of costs and capacity requirement is the electricity demand that occurs during peak periods. These peak periods require utility companies to maintain operational capacity that often is underutilized, outdated, expensive, and inefficient. In light of this, flattening the demand curve has long been recognized as an effective way of cutting the cost of producing electricity and increasing overall efficiency. The problem is exacerbated by expected widespread adoption of non-dispatchable renewable power generation. The intermittent nature of renewable resources and their non-dispatchability substantially limit the ability of electric power generation of adapting to the fluctuating demand. Smart grid technologies and demand response programs are proposed as a technical solution to make the electric power demand more flexible and able to adapt to power generation. Residential demand response programs offer different incentives and benefits to consumers in response to their flexibility in the timing of their electricity consumption. Understanding interactions between new and existing energy technologies, and policy impacts therein, is key to driving sustainable energy use and economic growth. Comprehensive and accurate models of the next-generation power system allow for understanding the effects of new energy technologies on the power system infrastructure, and can be used to guide policy, technology, and economic decisions. This

Innovative public library services - staff-less or staff-intensive?

DEFF Research Database (Denmark)

Johannsen, Carl Gustav Viggo

2014-01-01

Purpose – Several recent library innovations seem to make professional and clerical staff superfluous such as automated loan and delivery equipment, staff-less libraries open in 80 hours a week, and virtual services, enabling users to search the library catalogue and make reservations of library...... materials from their home address. The purpose of this paper is to examine whether such developments will necessarily lead to a situation where public libraries become self-service institutions or to what extent self-service and innovative staff-intensive library services can develop and co......-exist. Furthermore, the paper will examine what challenges library leaders face and what they can do, and actually have done, to handle staff resistance and other related problems to the benefit of both the users, the local communities, and also, the staff, in particular, when introducing new and innovative services...

Financing Non-Residential Photovoltaic Projects: Options and Implications

Energy Technology Data Exchange (ETDEWEB)

Bolinger, Mark

2009-01-09

Installations of grid-connected photovoltaic (PV) systems in the United States have increased dramatically in recent years, growing from less than 20 MW in 2000 to nearly 500 MW at the end of 2007, a compound average annual growth rate of 59%. Of particular note is the increasing contribution of 'non-residential' grid-connected PV systems--defined here as those systems installed on the customer (rather than utility) side of the meter at commercial, institutional, non-profit, or governmental properties--to the overall growth trend. Although there is some uncertainty in the numbers, non-residential PV capacity grew from less than half of aggregate annual capacity installations in 2000-2002 to nearly two-thirds in 2007. This relative growth trend is expected to have continued through 2008. The non-residential sector's commanding lead in terms of installed capacity in recent years primarily reflects two important differences between the non-residential and residential markets: (1) the greater federal 'Tax Benefits'--including the 30% investment tax credit (ITC) and accelerated tax depreciation--provided to commercial (relative to residential) PV systems, at least historically (this relative tax advantage has largely disappeared starting in 2009) and (2) larger non-residential project size. These two attributes have attracted to the market a number of institutional investors (referred to in this report as 'Tax Investors') seeking to invest in PV projects primarily to capture their Tax Benefits. The presence of these Tax Investors, in turn, has fostered a variety of innovative approaches to financing non-residential PV systems. This financial innovation--which is the topic of this report--has helped to overcome some of the largest barriers to the adoption of non-residential PV, and is therefore partly responsible (along with the policy changes that have driven this innovation) for the rapid growth in the market seen in recent years

Service Differentiation in Residential Broadband Networks

DEFF Research Database (Denmark)

Sigurdsson, Halldór Matthias

2004-01-01

As broadband gains widespread adoption with residential users, revenue generating voice- and video-services have not yet taken off. This slow uptake is often attributed to lack of Quality of Service management in residential broadband networks. To resolve this and induce service variety, network...... 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...... in digital subscriber line (DSL) based residential broadband networks. Four possible implementation scenarios and their technical characteristics and effects are described. To conclude, the paper discusses how network access providers can be induced to open their networks for third party service providers....

Readiness for change and short-term outcomes of female adolescents in residential treatment for anorexia nervosa.

Science.gov (United States)

McHugh, Matthew D

2007-11-01

To determine if readiness for change (RFC) at admission predicted length of stay (LOS) and short-term outcomes among female adolescents in residential treatment for anorexia nervosa (AN). Using a prospective cohort design to collect data from participants (N = 65) at admission and discharge, Kaplan-Meier survival analysis and Cox regression tested whether RFC on admission predicted time in LOS to a favorable short-term outcome--a composite endpoint based on minimum criteria for weight gain, drive for thinness, depression, anxiety, and health-related quality of life (HRQOL). Participants with low RFC had a mean survival time to a favorable short-term outcome of 59.4 days compared to 34.1 days for those with high RFC (log rank = 8.44, df = 1, p = .003). The probability of a favorable short-term outcome was 5.30 times greater for participants with high RFC. Readiness for change is a useful predictor of a favorable short-term outcome and should be considered in the assessment profile of patients with AN. (c) 2007 by Wiley Periodicals, Inc.

Modelling and forecasting Turkish residential electricity demand

International Nuclear Information System (INIS)

Dilaver, Zafer; Hunt, Lester C

2011-01-01

This research investigates the relationship between Turkish residential electricity consumption, household total final consumption expenditure and residential electricity prices by applying the structural time series model to annual data over the period from 1960 to 2008. Household total final consumption expenditure, real energy prices and an underlying energy demand trend are found to be important drivers of Turkish residential electricity demand with the estimated short run and the long run total final consumption expenditure elasticities being 0.38 and 1.57, respectively, and the estimated short run and long run price elasticities being -0.09 and -0.38, respectively. Moreover, the estimated underlying energy demand trend, (which, as far as is known, has not been investigated before for the Turkish residential sector) should be of some benefit to Turkish decision makers in terms of energy planning. It provides information about the impact of past policies, the influence of technical progress, the impacts of changes in consumer behaviour and the effects of changes in economic structure. Furthermore, based on the estimated equation, and different forecast assumptions, it is predicted that Turkish residential electricity demand will be somewhere between 48 and 80 TWh by 2020 compared to 40 TWh in 2008. - Research highlights: → Estimated short run and long run expenditure elasticities of 0.38 and 1.57, respectively. → Estimated short run and long run price elasticities of -0.09 and -0.38, respectively. → Estimated UEDT has increasing (i.e. energy using) and decreasing (i.e. energy saving) periods. → Predicted Turkish residential electricity demand between 48 and 80 TWh in 2020.

Family-centred residential care : the new reality?

NARCIS (Netherlands)

Geurts, Esther M. W.; Boddy, Janet; Noom, Marc J.; Knorth, Erik J.

This paper considers therapeutic approaches to residential care with specific attention to the question of family involvement. It builds on a body of literature indicating the potential of residential care as a positive intervention for young people, and examines the contention that even when family

Integration of fuel cells into residential buildings

International Nuclear Information System (INIS)

Bell, J.M.; Entchev, E.; Gusdorf, J.; Szadkowski, F.; Swinton, M.; Kalbfleisch, W.; Marchand, R.

2004-01-01

Integration of small combined heat and power systems (CHP) into residential buildings is challenging as the loads are small, the load diversity is limited and there are a number of unresolved issues concerning sizing, control, peak loads, emergency operation, grid connection and export, etc. Natural Resources Canada has undertaken an initiative to investigate and develop techniques for the integration of small CHP systems into residential buildings using a highly instrumented house modified to allow quick installation and thorough monitoring of CHP integration techniques as well determining the performance of the CHP systems themselves when operating in a house. The first CHP system installed was a Stirling engine residential CHP system. It was used to examine the completeness of the CHP modifications to the house, to evaluate various building integration techniques and to measure the performance of the CHP system itself. The testing demonstrated the modified house to be an excellent facility for the development of CHP building integration techniques and the testing of residential CHP systems. The Stirling engine CHP system was found to operate well and produce meaningful input to the house. A second system (residential fuel cell) is presently being installed and building integration techniques and the performance of the fuel cell will be tested over the coming year. (author)

"We do as well as we can". The experiences of staff assisting disabled people in community residential homes "Við gerum bara eins og við getum" - Þjónusta við fólk með fjölþættar skerðingar

Directory of Open Access Journals (Sweden)

Guðný Jónsdóttir

2013-06-01

Full Text Available Staff supporting young people and adults with complex and severe neurological impairments are the key to their communication, quality of life and participation. This study reports the knowledge and experiences of staff members supporting disabled people living in community residential homes, as well as their perceived needs for information and support. Furthermore, the study aimed to reveal staff´s views on their possibilities to support service users´ wellbeing, participation and quality of life. Participants were twelve experienced staff members. Qualitative methods were used and data were collected through semi-structured interviews. The results of the study reveal that services provided in community residential homes for people with complex and severe impairments are not in line with human rights treaties, including the right to health. Further, it does not mirror the social approach to disability which today is the focus of policy frameworks. The staff were positive toward service users, tried to do their best but lacked resources. Their knowledge of service user´s health-related needs was scarce and little was done to prevent further impairments or increasing health problems. Staff reported lack of human resources, high staff turnover and lack of information, training and support. Recent governmental changes, provide possibilities for revised emphasis in the service provided, on cooperation between different sectors as well as for the development of transdisciplinary services.Aðstoðarfólk á heimilum fólks með fjölþættar skerðingar er mikilvægur hlekkur í lífi þess og lykill að samskiptum, lífsgæðum og þátttöku. Rannsóknin varpar ljósi á sýn þessa starfsfólks á megináherslur í þjónustu við fólk með flóknar stuðningsþarfir og þörf fyrir fræðslu og stuðning í starfi. Ennfremur var leitað eftir skilningi á heilsutengdum þörfum þjónustunotenda og möguleikum til að styðja við velferð �

Building a sense of belonging among tertiary commuter students: The Monash Non-Residential Colleges program

Directory of Open Access Journals (Sweden)

Adam Fernandes

2017-07-01

Full Text Available Student engagement at university is significantly influenced by sense of belonging. In 2013, our university developed a novel extra-curricular program designed to foster a sense of belonging in students who commute to university – the Monash Non-Residential Colleges (NRC program. This study examines whether participation in the Monash NRC program changed students’ perceptions about their university experience and their sense of belonging to the university community. We show that our NRC program appears to be effective in fostering a more positive university experience for students when compared with non-NRC students. Additionally, we demonstrate that our NRC program influenced students’ sense of belonging through increased interaction with peers and staff as well as greater reported attendance on campus.

Large-Scale Residential Demolition

Science.gov (United States)

The EPA provides resources for handling residential demolitions or renovations. This includes planning, handling harmful materials, recycling, funding, compliance assistance, good practices and regulations.

Residentialization of Public Spaces: Bratislava Example

Science.gov (United States)

Bacová, Andrea; Puškár, Branislav; Vráblová, Edita

2017-10-01

The housing estates in Bratislava saturated the housing needs of a large number of inhabitants who come after World War II to the city. Design of public spaces often did not have priority in the process of designing. The solutions for mentioned exterior spaces had been planned after blocks of flat realization, but many of them are not realized to this day. The article analyzes the example of the unrealized public spaces in existing housing estates Devinska Nova Ves and Petržalka (city districts of Bratislava) and offer practical solutions in relation to residencialization method. Residencialization of missing public places is an effective method of adding identities to settlements. It improves the quality of residential environment and public spaces. The main aim is to create better conditions for social activities in public areas, which are missing on the present. The research will be focused on the examination of the urban, cultural and construction potential of the existing residential enviroment in Bratislava. The main aim of residentialization is not only to enhance the quality of spatial and building structures in the selected residential area and maintain long-term sustainability in the pertinent programme area, but mainly to improve the quality of living for the residents. The outputs of the project are proposals and practical procedures developed with regard to planning documents for local municipal authorities and regional organizations. The solutions will have a positive impact on the enhancement of the quality of public spaces, attractive social activities and of a conceptual link - residentialization.

Forecasting residential electricity demand in provincial China.

Science.gov (United States)

Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan

2017-03-01

In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.

Structured outpatient treatment of alcohol vs. drug dependencies.

Science.gov (United States)

Washton, A M

1990-01-01

This chapter describes the rationale, indications, design, and use of a structured outpatient treatment approach as an effective alternative to residential treatment for alcohol and drug dependencies. An increasing demand for outpatient treatment services is being created by a combination of clinical and economic factors, including the influx of employed drug abusers who do not need or desire residential care and mounting financial pressures to contain health care costs. To be effective as a primary treatment modality, outpatient programs must be highly structured and intensive and able to deal with the full spectrum of alcohol and drug addictions. Perpetuating the historical separation between alcoholism and drug abuse treatment programs is unnecessary and counterproductive, although certain modifications in treatment approaches are needed to accommodate the distinctive characteristics of particular classes of drugs and the people who use them. The "outpatient rehab," a treatment model that approximates the intensity of inpatient treatment on an outpatient basis, may help to maximize the clinical efficacy and cost-effectiveness of outpatient treatment as a viable alternative to residential care. Initial treatment results with this model are encouraging.

Adjustment problems and residential care environment

Directory of Open Access Journals (Sweden)

Jan Sebastian Novotný

2015-01-01

Full Text Available Problem: Residential care environment represents a specific social space that is associated with a number of negative consequences, covering most aspects of children and youth functioning. The paper analyzes of the presence of adjustment problems among adolescents from institutional care environment and compares this results with a population of adolescents who grew up in a family. Methods: The sample consisted of two groups of adolescents. The first group included 285 adolescents currently growing up in an residential care environment, aged 13 to 21 (M = 16.23, SD = 1.643. The second group consisted of 214 adolescents growing up in a family, aged 15 to 20 (M = 17.07, SD = 1.070. We used a questionnaire Youth Self Report. Data were analyzed using descriptive statistics and MANOVA. Results: Results showed that adolescents in residential care exhibit higher average values in all adjustment problems. Also, in the context of diagnostic categories are the residential care adolescents more frequently in non-normal range (borderline and clinical, primarily in the border range. The greatest differences were reflected in the Thought problems and Rule-breaking behavior. MANOVA showed a significant multivariate effect between groups of adolescents, Hotelling's T = .803, F(8, 490 = 49.202, p <.001, d = .445 (large effect. Univariate analysis further showed a significant effect for Withdrawn/depressed (p = .044, d = .089, small effect, Somatic complaints (p = .002, d = .139, medium effect, Social problems (p = 004, d = .127, a small effect, Thought problems (p <.001, d = .633, strong effect, Attention problems (p <.001, d = .320,strong effect, Rule-breaking behavior (p <.001 , d = .383, strong effect, and Aggressive behavior (p = 015, d = .110, small effect. Results for the dimension of Anxious/depressed were not significant (p = .159. Discussion: The results didn’t confirmed the assumption that more than 30% of residential care adolescents have adjustment

Risks from Radon: Reconciling Miner and Residential Epidemiology

International Nuclear Information System (INIS)

Chambers, Douglas B.; Harley, Naomi H.

2008-01-01

Everyone is exposed to radon, an inert radioactive gas that occurs naturally and is present everywhere in the atmosphere. The annual dose from radon and its (short-lived) decay products is typically about one-half of the dose received by members of the public from all natural sources of ionizing radiation. Data on exposures and consequent effects have recently been reviewed by the National Council on Radiation Protection and Measurements (NCRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Studies of underground miners provides a well-established basis for estimating risks from occupational exposures to radon and for studying factors that may affect the dose response relationship such as the reduction of risk (coefficients) with increasing time since exposure. Miners' studies previously formed the basis for estimating risks to people exposed to radon at home, with downward extrapolation from exposures in mines to residential levels of radon. Presently, the risk estimates from residential studies are adequate to estimate radon risks in homes. Although there are major uncertainties in extrapolating the risks of exposure to radon from the miner studies to assessing risks in the home, there is remarkably good agreement between the average of risk factors derived from miner studies and those from pooled residential case-control studies. There are now over 20 analytical studies of residential radon and lung cancer. These studies typically assess the relative risk from exposure to radon based on estimates of residential exposure over a period of 25 to 30 years prior to diagnosis of lung cancer. Recent pooled analyses of residential case-control studies support a small but detectable lung cancer risk from residential exposure, and this risk increases with increasing concentrations. The excess relative risk of lung cancer from long-term residential exposure is about the same for both smokers and non-smokers; however, because the

Development and piloting of a treatment foster care program for older youth with psychiatric problems.

Science.gov (United States)

McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David

2015-01-01

Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important

Chelant-aided enhancement of lead mobilization in residential soils

International Nuclear Information System (INIS)

Sarkar, Dibyendu; Andra, Syam S.; Saminathan, Sumathi K.M.; Datta, Rupali

2008-01-01

Chelation of metals is an important factor in enhancing solubility and hence, availability to plants to promote phytoremediation. We compared the effects of two chelants, namely, ethylenediaminetetraacetic acid (EDTA) and ethylenediaminedisuccinic acid (EDDS) in enhancing mobilized lead (Pb) in Pb-based paint contaminated residential soils collected from San Antonio, Texas and Baltimore, Maryland. Batch incubation studies were performed to investigate the effectiveness of the two chelants in enhancing mobilized Pb, at various concentrations and treatment durations. Over a period of 1 month, the mobilized Pb pool in the San Antonio study soils increased from 52 mg kg -1 to 287 and 114 mg kg -1 in the presence of 15 mM kg -1 EDTA and EDDS, respectively. Stepwise linear regression analysis demonstrated that pH and organic matter content significantly affected the mobilized Pb fraction. The regression models explained a large percentage, from 83 to 99%, of the total variation in mobilized Pb concentrations. - Complexation by a biodegradable chelating agent, EDDS enhances mobilized Pb concentrations in Pb-paint contaminated residential soils

Residential heat pumps in the future Danish energy system

DEFF Research Database (Denmark)

Petrovic, Stefan; Karlsson, Kenneth Bernard

2016-01-01

for politically agreed targets which include: at least 50% of electricity consumption from wind power starting from 2020, fossil fuel free heat and power sector from 2035 and 100% renewable energy system starting from 2050. Residential heat pumps supply around 25% of total residential heating demand after 2035......Denmark is striving towards 100% renewable energy system in 2050. Residential heat pumps are expected to be a part of that system.We propose two novel approaches to improve the representation of residential heat pumps: Coefficients of performance (COPs) are modelled as dependent on air and ground...... temperature while installation of ground-source heat pumps is constrained by available ground area. In this study, TIMES-DK model is utilised to test the effects of improved modelling of residential heat pumps on the Danish energy system until 2050.The analysis of the Danish energy system was done...

Practice leadership and active support in residential services for people with intellectual disabilities: an exploratory study.

Science.gov (United States)

Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B

2014-09-01

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.

The drivers to adopt renewable energy among residential users.

Science.gov (United States)

Rahman, Zahari Abdul; Elinda, Esa

2016-03-01

This study aims to examine the drivers to adopt renewable energy (RE) among residential users in Malaysia. Based on the theoretical framework of a consumer’s decision making process, an empirical study of the adoption of RE was conducted. A total of 501 residential users were used in this study. This study proved that perceived utility of new technology, perceived utility of new service, and perceived benefit of new technology are the drivers to adopt RE among residential users. These factors are knowing crucial to RE suppliers and producers because it will generates more demand from the residential users and the percentage of energy mix from RE sources can be increase.

Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

Science.gov (United States)

Broad, Joanna B; Boyd, Michal; Kerse, Ngaire; Whitehead, Noeline; Chelimo, Carol; Lay-Yee, Roy; von Randow, Martin; Foster, Susan; Connolly, Martin J

2011-07-01

in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.

Unidirectionality Between Borderline Personality Disorder Traits and Psychopathology in a Residential Addictions Sample: A Short-Term Longitudinal Study.

Science.gov (United States)

Webber, Troy A; Kiselica, Andrew M; Arango, Alejandra; Rojas, Elizabeth; Neale, Michael C; Bornovalova, Marina A

2015-12-01

Borderline personality disorder (BPD) is a barrier to treatment, yet the relationship between BPD features and other psychopathology symptoms in residential addictions treatment samples is understudied. Using a sample of adults enrolled in a residential drug treatment facility measured at baseline and 2-3 month follow-up, the authors examined the prospective relationship between BPD features and five indices of psychopathology: depression, anxiety, interpersonal sensitivity, hostility, and psychoticism, as well as psychopathology global severity. There was no effect of time on any of the forms of psychopathology, but females reported higher levels of BPD features, anxiety symptoms, and interpersonal sensitivity than males. A series of latent change score models indicated that BPD features predicted increases in all psychopathology scales at follow-up, while the reverse was not true. These results suggest that targeting BPD features in residents of drug treatment facilities may reduce the emergence of new psychopathology in the short term.

Integration of motor traffic in residential areas.

NARCIS (Netherlands)

Schreuder, D.A.

1977-01-01

In stead of banning the cars from residential areas, the plan is to integrate them in such a way that they can still be used, but that they will loose their predominant position. The areas where this integration is to take place are called residential yards. This paper concentrates on the lighting

Doses to patients and staff from endovascular treatment of abdominal aortic aneurysms - Preliminary results

International Nuclear Information System (INIS)

Bjoerklund, E.G.; Widmark, A.; Gjoelberg, T.; Bay, D.; Joergensen, J.J.; Staxrud, L.E.

2001-01-01

Patient radiation doses received during endovascular treatment of abdominal aortic aneurysms (AAA) can be significant and give rise to both deterministic and stochastic effects. Recording of dose-area product (DAP), fluoroscopy time and number of exposures together with calculations of effective dose, were performed for 8 patients. In addition, the entrance surface dose was measured for 3 of the patients. Typically, DAPs of 340 Gycm 2 , fluoroscopy times of 30 minutes and 310 exposures were obtained together with maximum entrance surface doses of 1,8 Gy and effective doses of 50 mSv. Finger doses to the staff performing the procedure were in the order of a few hundred μSv. Conversion factors (effective dose/DAP) and (maximum entrance surface does/DAP) of 0,61·10 -2 Gy/Gycm 2 and 0,15 mSv/Gycm 2 were obtained, respectively. (author)

A collaborative community-based treatment program for offenders with mental illness.

Science.gov (United States)

Roskes, E; Feldman, R

1999-12-01

The paper describes initial results of collaboration between a mental health treatment program at a community mental health center in Baltimore and a probation officer of the U.S. federal prison system to serve the mental health needs of offenders on federal probation, parole, supervised release, or conditional release in the community. A forensic psychiatrist in the treatment program and a licensed social worker in the probation office facilitate the close working relationship between the agencies. Treatment services provided or brokered by the community mental health center staff include psychiatric and medical treatment, intensive case management, addictions treatment, urine toxicology screening, psychosocial or residential rehabilitation services, intensive outpatient care, partial hospitalization, and inpatient treatment. Among the 16 offenders referred for treatment during the first 24 months of the collaborative program, 14 were male and 14 were African American. Three of the 16 violated the terms of their release due to noncompliance with stipulated mental health treatment; only one of the three had been successfully engaged in treatment. One patient died, two completed their terms of supervision, and ten remained in treatment at the time of the report. The major strength of this collaboration is the cooperation of the treatment and monitoring agencies with the overall goal of maintaining the offender in the community. Further research is needed to confirm the effectiveness of the clinical model in reducing recidivism and retaining clients.

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

Science.gov (United States)

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

2013-09-01

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

[Perspective of intensive care nursing staff on the limitation of life support treatment].

Science.gov (United States)

Vallès-Fructuoso, O; Ruiz-de Pablo, B; Fernández-Plaza, M; Fuentes-Milà, V; Vallès-Fructuoso, O; Martínez-Estalella, G

To determine the perspective of intensive care nursing staff on the limitation of life support treatment (LLST) in the Intensive Care Units. An exploratory qualitative study was carried out by applying the theory of Strauss and Corbin as the analysis tool. Constructivist paradigm. Nursing staff from three Intensive Care Units of Hospital Universitari de Bellvitge. Convenience sampling to reach theoretical saturation of data. Data collection through semi-structured interview recorded prior to informed consent. Rigor and quality criteria (reliability, credibility, transferability), and authenticity criteria: reflexivity. Demographic data was analysed using Excel. A total of 28 interviews were conducted. The mean age of the nurses was 35.6 years, with a mean seniority of 11.46 years of working in ICU. A minority of nurses (21.46%) had received basic training in bioethics. The large majority (85.7%) believe that LLST is not a common practice due to therapeutic cruelty and poor management with it. There is a correlation with the technical concepts; but among the main ethical problems is the decision to apply LLST. Nurses recognise that the decision on applying LLST depends on medical consensus with relatives, and they believe that their opinion is not considered. Their objective is trying to avoid suffering, and assist in providing a dignified death and support to relatives. There is still a paternalistic pattern between the doctor and patient relationship, where the doctor makes the decision and then agrees with the relatives to apply LLST. Organ failure and poor prognosis are the most important criteria for applying LLST. It is necessary to develop a guide for applying LLST, emphasising the involvement of nurses, patients, and their relatives. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Residential damage in an area of underground coal mining

International Nuclear Information System (INIS)

Padgett, M.F.

1988-01-01

In order to estimate the potential for future subsidence-related residential damage, a statistical analysis of past residential damage in the Boulder-Weld, Colorado, coal field was performed. The objectives of this study were to assess the difference in damage severity and frequency between undermined and non-undermined areas, and to determine, where applicable, which mining factors significantly influence the severity and frequency of residential damage. The results of this study suggest that undermined homes have almost three times the risk of having some type of structural damage than do non-undermined homes. The study also indicated that both geologic factors, such as the ratio of sandstone/claystone in the overburden, and mining factors, such as the mining feature (room, pillar, entry, etc.), can significantly affect the severity of overlying residential damage. However, the results of this study are dependent on local conditions and should not be applied elsewhere unless the geologic, mining, and residential conditions are similar

Analysis of a Residential Building Energy Consumption Demand Model

Directory of Open Access Journals (Sweden)

Meng Liu

2011-03-01

Full Text Available In order to estimate the energy consumption demand of residential buildings, this paper first discusses the status and shortcomings of current domestic energy consumption models. Then it proposes and develops a residential building energy consumption demand model based on a back propagation (BP neural network model. After that, taking residential buildings in Chongqing (P.R. China as an example, 16 energy consumption indicators are introduced as characteristics of the residential buildings in Chongqing. The index system of the BP neutral network prediction model is established and the multi-factorial BP neural network prediction model of Chongqing residential building energy consumption is developed using the Cshap language, based on the SQL server 2005 platform. The results obtained by applying the model in Chongqing are in good agreement with actual ones. In addition, the model provides corresponding approximate data by taking into account the potential energy structure adjustments and relevant energy policy regulations.

Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care.

Science.gov (United States)

Helmes, Edward; Ward, Bradley G

2017-03-01

Anxiety in older people is under-diagnosed and poorly treated despite significant impairments that arise from anxiety. Mindfulness-based cognitive therapy (MBCT) has been shown to be a promising treatment for anxiety. The aim of this study was to determine the effect of an MBCT program on anxiety symptoms in older people living in residential care. Fifty-two participants (34 females) were randomly allocated into therapy and control groups using a 2 × 3 mixed design. The average age of participants was 83 years. The group effect showed significant improvements on all measures at the end of the seven-week program in the therapy group, while the control group did not show significant changes. This study represents one of the first studies of the effectiveness of an MBCT program on anxiety symptoms for older people using a randomized controlled trial. The study has implications for future research that include the effectiveness of MBCT for the treatment of anxiety symptoms in older people, the utility of group therapy programs in residential care and the benefits of using specialized instruments for older populations.

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

Science.gov (United States)

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

2016-09-01

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

Tracking the Sun VIII. The Installed Price of Residential and Non-Residential Photovoltaic Systems in the United States

Energy Technology Data Exchange (ETDEWEB)

Barbose, Galen L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, Naïm R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Spears, Mike [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Buckley, Michael [Exeter Associates, Columbia, MD (United States); Widiss, Rebecca [Exeter Associates, Columbia, MD (United States); Grue, Nick [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-08-01

Now in its eighth edition, Lawrence Berkeley National Laboratory (LBNL)’s Tracking the Sun report series is dedicated to summarizing trends in the installed price of grid-connected solar photovoltaic (PV) systems in the United States. The present report focuses on residential and nonresidential systems installed through year-end 2014, with preliminary trends for the first half of 2015. As noted in the text box below, this year’s report incorporates a number of important changes and enhancements. Among those changes, this year's report focuses solely on residential and nonresidential PV systems; data on utility-scale PV are reported in LBNL’s companion Utility-Scale Solar report series. Installed pricing trends presented within this report derive primarily from project-level data reported to state agencies and utilities that administer PV incentive programs, solar renewable energy credit (SREC) registration systems, or interconnection processes. In total, data were collected for roughly 400,000 individual PV systems, representing 81% of all U.S. residential and non-residential PV capacity installed through 2014 and 62% of capacity installed in 2014, though a smaller subset of this data were used in analysis.

Assessment of Residential History Generation Using a Public-Record Database

Directory of Open Access Journals (Sweden)

David C. Wheeler

2015-09-01

Full Text Available In studies of disease with potential environmental risk factors, residential location is often used as a surrogate for unknown environmental exposures or as a basis for assigning environmental exposures. These studies most typically use the residential location at the time of diagnosis due to ease of collection. However, previous residential locations may be more useful for risk analysis because of population mobility and disease latency. When residential histories have not been collected in a study, it may be possible to generate them through public-record databases. In this study, we evaluated the ability of a public-records database from LexisNexis to provide residential histories for subjects in a geographically diverse cohort study. We calculated 11 performance metrics comparing study-collected addresses and two address retrieval services from LexisNexis. We found 77% and 90% match rates for city and state and 72% and 87% detailed address match rates with the basic and enhanced services, respectively. The enhanced LexisNexis service covered 86% of the time at residential addresses recorded in the study. The mean match rate for detailed address matches varied spatially over states. The results suggest that public record databases can be useful for reconstructing residential histories for subjects in epidemiologic studies.

Residential Mobility Across Early Childhood and Children's Kindergarten Readiness.

Science.gov (United States)

Mollborn, Stefanie; Lawrence, Elizabeth; Root, Elisabeth Dowling

2018-04-01

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.

Staff Association

CERN Multimedia

Staff Association

2014-01-01

Remove of the staff association office   The Staff Association offices are going to be renovated during the coming four months, February to May 2014. The physical move from our current premises 64/R-002 to our temporary office in  510/R-010 will take place on Friday January 31st, so the Secretariat will be closed on that day. Hence, from Monday February 3rd until the end of May 2014 the Staff Association Secretariat will be located in 510/R-010 (entrance just across the CERN Printshop).    

Residential Preferences and Moving Behavior: A Family Life Cycle Analysis.

Science.gov (United States)

McAuley, William J.; Nutty, Cheri L.

The relationship of family life cycle changes to housing preferences and residential mobility is examined. Two residential decision-making issues are explored in detail--how family life cycle stages influence what people view as important to their choice of residential setting and what individuals at different family life cycle stages view as the…

The importance of engaging residential energy customers' hearts and minds

International Nuclear Information System (INIS)

Olaniyan, Monisola J.; Evans, Joanne

2014-01-01

In an attempt to reduce the contribution of residential greenhouse gas emissions the EU has implemented a variety of policy measures. The focus has been to promote domestic energy efficiency and ultimately a reduction in residential energy demand. In this study we estimate residential energy demand using Underlying Energy Demand Trend (UEDT) and Asymmetric Price Responses for 14 European OECD countries between 1978 and 2008. Our results support the conclusion that policies to reduce residential energy consumption and the consequent emissions need to account for behavioural, lifestyle and cultural factors in order to be effective. - Highlights: • Residential energy demand is estimated for 14 European OECD countries between 1978 and 2008. • Investigate the relative contributions of Underlying Energy Demand Trend (UEDT) which captures exogenous technical progress. • The most effective policies target behavioural, lifestyle and cultural factors to reduce residential energy consumption

32 CFR 199.6 - TRICARE-authorized providers.

Science.gov (United States)

2010-07-01

... shall implement an effective program to assure a safe environment for patients, staff, and visitors... structured therapeutic environment. Residential treatment is differentiated from: (i) Acute psychiatric care... requirements for a qualified mental health provider but are actively working toward licensure or certification...

Key Residential Building Equipment Technologies for Control and Grid Support PART I (Residential)

Energy Technology Data Exchange (ETDEWEB)

Starke, Michael R [ORNL; Onar, Omer C [ORNL; DeVault, Robert C [ORNL

2011-09-01

Electrical energy consumption of the residential sector is a crucial area of research that has in the past primarily focused on increasing the efficiency of household devices such as water heaters, dishwashers, air conditioners, and clothes washer and dryer units. However, the focus of this research is shifting as objectives such as developing the smart grid and ensuring that the power system remains reliable come to the fore, along with the increasing need to reduce energy use and costs. Load research has started to focus on mechanisms to support the power system through demand reduction and/or reliability services. The power system relies on matching generation and load, and day-ahead and real-time energy markets capture most of this need. However, a separate set of grid services exist to address the discrepancies in load and generation arising from contingencies and operational mismatches, and to ensure that the transmission system is available for delivery of power from generation to load. Currently, these grid services are mostly provided by generation resources. The addition of renewable resources with their inherent variability can complicate the issue of power system reliability and lead to the increased need for grid services. Using load as a resource, through demand response programs, can fill the additional need for flexible resources and even reduce costly energy peaks. Loads have been shown to have response that is equal to or better than generation in some cases. Furthermore, price-incentivized demand response programs have been shown to reduce the peak energy requirements, thereby affecting the wholesale market efficiency and overall energy prices. The residential sector is not only the largest consumer of electrical energy in the United States, but also has the highest potential to provide demand reduction and power system support, as technological advancements in load control, sensor technologies, and communication are made. The prevailing loads

Addressing Smoking in Supported Residential Facilities for People with Severe Mental Illness: Has Any Progress Been Achieved?

Directory of Open Access Journals (Sweden)

Sharon Lawn

2016-10-01

Full Text Available Background: Smoking rates for people with severe mental illness have remained high despite significant declines in smoking rates in the general population, particularly for residents of community supported residential facilities (SRFs where smoking has been largely neglected and institutionalized. Methods: Two studies undertaken 10 years apart (2000 and 2010 with SRFs in Adelaide, Australia looked at historical trends to determine whether any progress has been made to address smoking for this population. The first study was ethnographic and involved narrative description and analysis of the social milieu of smoking following multiple observations of smoking behaviours in two SRFs. The second study involved an eight-week smoking cessation group program providing tailored support and free nicotine replacement therapy to residents across six SRFs. Changes in smoking behaviours were measured using pre and post surveys with residents, with outcomes verified by also seeking SRF staff and smoking cessation group facilitator qualitative feedback and reflection on their observations of residents and the setting. Results: The culture of smoking in mental health SRFs is a complex part of the social milieu of these settings. There appears to have been little change in smoking behaviours of residents and attitudes and support responses by staff of SRFs since 2000 despite smoking rates declining in the general community. Tailored smoking cessation group programs for this population were well received and did help SRF residents to quit or cut down their smoking. They did challenge staff negative attitudes to residents’ capacity to smoke less or quit. Conclusions: A more systematic approach that addresses SRF regulations, smoke-free policies, staff attitudes and training, and consistent smoking cessation support to residents is needed.

Addressing Smoking in Supported Residential Facilities for People with Severe Mental Illness: Has Any Progress Been Achieved?

Science.gov (United States)

Lawn, Sharon; Lucas, Teri

2016-01-01

Background: Smoking rates for people with severe mental illness have remained high despite significant declines in smoking rates in the general population, particularly for residents of community supported residential facilities (SRFs) where smoking has been largely neglected and institutionalized. Methods: Two studies undertaken 10 years apart (2000 and 2010) with SRFs in Adelaide, Australia looked at historical trends to determine whether any progress has been made to address smoking for this population. The first study was ethnographic and involved narrative description and analysis of the social milieu of smoking following multiple observations of smoking behaviours in two SRFs. The second study involved an eight-week smoking cessation group program providing tailored support and free nicotine replacement therapy to residents across six SRFs. Changes in smoking behaviours were measured using pre and post surveys with residents, with outcomes verified by also seeking SRF staff and smoking cessation group facilitator qualitative feedback and reflection on their observations of residents and the setting. Results: The culture of smoking in mental health SRFs is a complex part of the social milieu of these settings. There appears to have been little change in smoking behaviours of residents and attitudes and support responses by staff of SRFs since 2000 despite smoking rates declining in the general community. Tailored smoking cessation group programs for this population were well received and did help SRF residents to quit or cut down their smoking. They did challenge staff negative attitudes to residents’ capacity to smoke less or quit. Conclusions: A more systematic approach that addresses SRF regulations, smoke-free policies, staff attitudes and training, and consistent smoking cessation support to residents is needed. PMID:27735881

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

Science.gov (United States)

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

2018-02-01

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

A systematic review of communication strategies for people with dementia in residential and nursing homes.

Science.gov (United States)

Vasse, Emmelyne; Vernooij-Dassen, Myrra; Spijker, Anouk; Rikkert, Marcel Olde; Koopmans, Raymond

2010-03-01

The impairment of verbal skills of people with dementia challenges communication. The aim of this review was to study the effects of nonpharmacological interventions in residential and nursing homes on (1) communication between residents with dementia and care staff, and (2) the neuropsychiatric symptoms of residents with dementia. Pubmed, PsychInfo, Web of Science, the Cochrane Library, and reference lists from relevant publications were systematically searched to find articles about controlled interventions with communication strategies. The data collected were pooled and subjected to a meta-analysis. Nineteen intervention studies were selected for this review. They included structured and communicative "sessions at set times" for residents (e.g. life review) and communication techniques in activities of "daily care" applied by care staff (e.g. sensitivity to nonverbal communication). A meta-analysis of five set-time interventions (communication) and another meta-analysis of four set-time interventions (neuropsychiatric outcomes) found no significant overall effects. Individual set-time intervention studies report positive effects on communication when interventions are single-task sessions, like life review or one-on-one conversation. Interventions around daily care activities had positive effects on communication outcomes. Effects of both types of interventions on neuropsychiatric symptoms were divergent. This review indicates that care staff can improve their communication with residents with dementia when strategies are embedded in daily care activities or interventions are single-task sessions at set times. These results offer the possibility of improving the quality of care, but not of directly reducing neuropsychiatric symptoms. More research is needed to study the effect of communication interventions on neuropsychiatric symptoms.

Guidelines for residential commissioning

Energy Technology Data Exchange (ETDEWEB)

Wray, Craig P.; Walker, Iain S.; Sherman, Max H.

2003-01-31

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

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

Science.gov (United States)

Verderber, Stephen

2014-01-01

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

Enact legislation supporting residential property assessed clean energy financing (PACE)

Energy Technology Data Exchange (ETDEWEB)

Saha, Devashree

2012-11-15

Congress should enact legislation that supports residential property assessed clean energy (PACE) programs in the nation’s states and metropolitan areas. Such legislation should require the Federal Housing Finance Agency (FHFA) to allow Fannie Mae and Freddie Mac to purchase residential mortgages with PACE assessments while at the same time providing responsible underwriting standards and a set of benchmarks for residential PACE assessments in order to minimize financial risks to mortgage holders. Congressional support of residential PACE financing will improve energy efficiency, encourage job creation, and foster economic growth in the nation’s state and metropolitan areas.

Staff Performance Analysis: A Method for Identifying Brigade Staff Tasks

National Research Council Canada - National Science Library

Ford, Laura

1997-01-01

... members of conventional mounted brigade staff. Initial analysis of performance requirements in existing documentation revealed that the performance specifications were not sufficiently detailed for brigade battle staffs...

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

Science.gov (United States)

Francis-Coad, Jacqueline; Etherton-Beer, Christopher; Bulsara, Caroline; Nobre, Debbie; Hill, Anne-Marie

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training. Copyright © 2016 Elsevier Inc. All rights reserved.

How does pre-dialysis education need to change? Findings from a qualitative study with staff and patients.

Science.gov (United States)

Combes, Gill; Sein, Kim; Allen, Kerry

2017-11-23

Pre-dialysis education (PDE) is provided to thousands of patients every year, helping them decide which renal replacement therapy (RRT) to choose. However, its effectiveness is largely unknown, with relatively little previous research into patients' views about PDE, and no research into staff views. This study reports findings relevant to PDE from a larger mixed methods study, providing insights into what staff and patients think needs to improve. Semi-structured interviews in four hospitals with 96 clinical and managerial staff and 93 dialysis patients, exploring experiences of and views about PDE, and analysed using thematic framework analysis. Most patients found PDE helpful and staff valued its role in supporting patient decision-making. However, patients wanted to see teaching methods and materials improve and biases eliminated. Staff were less aware than patients of how informal staff-patient conversations can influence patients' treatment decision-making. Many staff felt ill equipped to talk about all treatment options in a balanced and unbiased way. Patient decision-making was found to be complex and patients' abilities to make treatment decisions were adversely affected in the pre-dialysis period by emotional distress. Suggested improvements to teaching methods and educational materials are in line with previous studies and current clinical guidelines. All staff, irrespective of their role, need to be trained about all treatment options so that informal conversations with patients are not biased. The study argues for a more individualised approach to PDE which is more like counselling than education and would demand a higher level of skill and training for specialist PDE staff. The study concludes that even if these improvements are made to PDE, not all patients will benefit, because some find decision-making in the pre-dialysis period too complex or are unable to engage with education due to illness or emotional distress. It is therefore recommended that

Elections to Staff Council

CERN Multimedia

Staff Association

2011-01-01

Elections to fill all seats in the Staff Council are being organized this month. The voting takes place from the 31st of October to the 14th of November, at noon. As you may have noted when reading Echo, many issues concerning our employment conditions are on the agenda of the coming months and will keep the next Staff Council very busy. So, make your voice heard and take part in the elections for a new Staff Council. By doing so, you will be encouraging the men and women who will be representing you over the next two years and they will doubtless appreciate your gratitude. Every member of the Staff Association will have received an email containing a link to the webpage which will allow voting. If you are a member of the Staff Association and you did not receive such an email, please contact the Staff Association secretariat (staff.association@cern.ch). Do not forget to vote * * * * * * * Vote Make your voice heard and be many to elect the new Staff Council. More details on the election...

Condition assessment and strengthening of residential units

Directory of Open Access Journals (Sweden)

Tatheer Zahra

2014-01-01

Full Text Available About 40, ground plus one (G+1 residential units were designed using a hybrid structural framing system (RC frame and load bearing walls. A few months after the completion of the ground floor of the residential units, cracks appeared at several locations in the structure. Field and Laboratory testing was conducted to ascertain the in situ strength of concrete and steel reinforcement. The results of the experimental work were used in the analytical ETABS model for the structural stability calculations. The results indicated that residential units were marginally safe in the existing condition (completed ground floor, but the anticipated construction of the floor above the ground floor (G+1 could not be carried out as the strength of the structural system was inadequate. To increase the safety of existing ground floor and to provide the option of the construction of one floor above, rehabilitation and strengthening design was performed. The proposed strengthening design made use of welded wire fabric (WWF and carbon fibre reinforced polymer (CFRP laminates/sheets for the strengthening of walls, columns and slabs. The residential units will be strengthened in the near future.

Employee influenza vaccination in residential care facilities.

Science.gov (United States)

Apenteng, Bettye A; Opoku, Samuel T

2014-03-01

The organizational literature on infection control in residential care facilities is limited. Using a nationally representative dataset, we examined the organizational factors associated with implementing at least 1 influenza-related employee vaccination policy/program, as well as the effect of vaccination policies on health care worker (HCW) influenza vaccine uptake in residential care facilities. The study was a cross-sectional study using data from the 2010 National Survey of Residential Care Facilities. Multivariate logistic regression analysis was used to address the study's objectives. Facility size, director's educational attainment, and having a written influenza pandemic preparedness plan were significantly associated with the implementation of at least 1 influenza-related employee vaccination policy/program, after controlling for other facility-level factors. Recommending vaccination to employees, providing vaccination on site, providing vaccinations to employees at no cost, and requiring vaccination as a condition of employment were associated with higher employee influenza vaccination rates. Residential care facilities can improve vaccination rates among employees by adopting effective employee vaccination policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

RESIDENTIAL MORTGAGE IN MODERN RUSSIA

Directory of Open Access Journals (Sweden)

Dementiev N. P.

2015-03-01

Full Text Available The article presents a comparative analysis of residential mortgages in Russia and the United States. The primary ways of mortgage refinancing are outlined. Predominance of the elements of two-level refinancing system of residential mortgage in Russia and the United States is shown. The activity of the Agency for Housing Mortgage Lending (AHML, the basic tool of the Russian government’s mortgage policy, is described in detail. In its objectives and functions the AHML is similar to the American mortgage agencies Ginnie Mae, Fannie Mae and Freddie Mac. Similarities were identified in the Russian and US residential mortgages in the pre-crisis period (high rates of mortgage growth, favourable economic conjuncture, low interest rates, large increase in house prices, speculative housing demand. During the mortgage crisis, the policies of the Russian and US governments and monetary authorities had also much in common (monetary policy easing, cheap central banks loans, extended facilities of mortgage refinancing on the part of state agencies, mortgage rescue scheme, social mortgage programs. But the scope of mortgage in Russia is enormously narrow as compared to the US mortgage. The most important reason for that - low incomes of the Russian population.

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

NARCIS (Netherlands)

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

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

Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

Science.gov (United States)

Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

2015-08-01

The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

Occupational safety issues in residential construction surveyed in Wisconsin, United States.

Science.gov (United States)

Choi, Sang D; Carlson, Kathryn

2014-01-01

Residential construction is a high-risk industry in the U.S. due to the exposure to work-related safety hazards and fall injuries. This study aimed to examine the safety training and safe work practices of construction workers within the small residential construction industry. In order to achieve the study objectives, a survey was designed and sent to approximately 200 Wisconsin based residential construction contractors. About one third of the respondents stated that they did not have any form of safety programs. The study indicated that the most common types of work-related injuries in residential construction were slips/trips/falls and cuts/lacerations. The survey findings also suggested that the residential construction contractors needed to increase the utilization of fall protection safety equipment. Further education and subject matter expert training could provide benefits to improve occupational safety and health of the small business workforce in the residential construction industry.

Processes underlying treatment success and failure in assertive community treatment.

Science.gov (United States)

Stull, Laura G; McGrew, John H; Salyers, Michelle P

2012-02-01

Processes underlying success and failure in assertive community treatment (ACT), a widely investigated treatment model for persons with severe mental illness, are poorly understood. The purpose of the current study was to examine processes in ACT by (1) understanding how consumers and staff describe the processes underlying treatment success and failure and (2) comparing processes identified by staff and consumers. Investigators conducted semi-structured interviews with 25 staff and 23 consumers from four ACT teams. Both staff and consumers identified aspects of the ACT team itself as the most critical in the process of consumer success. For failure, consumers identified consumer characteristics as most critical and staff identified lack of social relationships. Processes underlying failure were not viewed as merely the opposite of processes underlying success. In addition, there was notable disagreement between staff and consumers on important processes. Findings overlap with critical ingredients identified in previous studies, including aspects of the ACT team, social involvement and employment. In contrast to prior studies, there was little emphasis on hospitalizations and greater emphasis on not abusing substances, obtaining wants and desires, and consumer characteristics.

Procedural justice in prison: the importance of staff characteristics.

Science.gov (United States)

Beijersbergen, Karin A; Dirkzwager, Anja J E; Molleman, Toon; van der Laan, Peter H; Nieuwbeerta, Paul

2015-04-01

A humane and fair treatment of prisoners is of intrinsic value in itself, and is generally acclaimed to reduce prisoners' psychological distress and misconduct in prison, and their criminal behavior after release from prison. To create a more just prison climate, scholars have emphasized the importance of correctional staff. However, there is a lack of empirical research on the relationship between correctional officers' characteristics and prisoners' perceptions of a just treatment in prison. Our study fills this gap in knowledge. Data were used from (a) the Prison Project, a large-scale study in which prisoners held in all Dutch remand centers were surveyed (n = 1,610) and (b) the Dutch Correctional Staff Survey 2011 (n = 690). Multilevel analyses showed that prisoners perceived their treatment in prison as more procedurally just in units where there are more female officers, where officers held more positive attitudes toward rehabilitation, and where there is a higher officer-to-inmate ratio. © The Author(s) 2013.

Gentrification and Residential Mobility in Philadelphia.

Science.gov (United States)

Ding, Lei; Hwang, Jackelyn; Divringi, Eileen

2016-11-01

Gentrification has provoked considerable controversy surrounding its effects on residential displacement. Using a unique individual-level, longitudinal data set, this study examines mobility rates and residential destinations of residents in gentrifying neighborhoods during the recent housing boom and bust in Philadelphia for various strata of residents and different types of gentrification. We find that vulnerable residents, those with low credit scores and without mortgages, are generally no more likely to move from gentrifying neighborhoods compared with their counterparts in nongentrifying neighborhoods. When they do move, however, they are more likely to move to lower-income neighborhoods. Residents in gentrifying neighborhoods at the aggregate level have slightly higher mobility rates, but these rates are largely driven by more advantaged residents. These findings shed new light on the heterogeneity in mobility patterns across residents in gentrifying neighborhoods and suggest that researchers should focus more attention on the quality of residential moves and nonmoves for less advantaged residents, rather than mobility rates alone.

Measuring urban tree loss dynamics across residential landscapes.

Science.gov (United States)

Ossola, Alessandro; Hopton, Matthew E

2018-01-15

The spatial arrangement of urban vegetation depends on urban morphology and socio-economic settings. Urban vegetation changes over time because of human management. Urban trees are removed due to hazard prevention or aesthetic preferences. Previous research attributed tree loss to decreases in canopy cover. However, this provides little information about location and structural characteristics of trees lost, as well as environmental and social factors affecting tree loss dynamics. This is particularly relevant in residential landscapes where access to residential parcels for field surveys is limited. We tested whether multi-temporal airborne LiDAR and multi-spectral imagery collected at a 5-year interval can be used to investigate urban tree loss dynamics across residential landscapes in Denver, CO and Milwaukee, WI, covering 400,705 residential parcels in 444 census tracts. Position and stem height of trees lost were extracted from canopy height models calculated as the difference between final (year 5) and initial (year 0) vegetation height derived from LiDAR. Multivariate regression models were used to predict number and height of tree stems lost in residential parcels in each census tract based on urban morphological and socio-economic variables. A total of 28,427 stems were lost from residential parcels in Denver and Milwaukee over 5years. Overall, 7% of residential parcels lost one stem, averaging 90.87 stems per km 2 . Average stem height was 10.16m, though trees lost in Denver were taller compared to Milwaukee. The number of stems lost was higher in neighborhoods with higher canopy cover and developed before the 1970s. However, socio-economic characteristics had little effect on tree loss dynamics. The study provides a simple method for measuring urban tree loss dynamics within and across entire cities, and represents a further step toward high resolution assessments of the three-dimensional change of urban vegetation at large spatial scales. Published by

A Measure of the Parent-Team Alliance in Youth Residential Psychiatry: The Revised Short Working Alliance Inventory

NARCIS (Netherlands)

Lamers, A.; Delsing, M.J.M.H.; Van Widenfelt, B.M.; Vermeiren, R.R.J.M.

2015-01-01

Background: The therapeutic alliance between multidisciplinary teams and parents within youth (semi) residential psychiatry is essential for the treatment process and forms a promising process variable for Routine Outcome Monitoring (ROM). No short evaluative instrument, however, is currently

Occurrence and fate of benzotriazoles UV filters in a typical residential wastewater treatment plant in Harbin, China.

Science.gov (United States)

Zhao, Xue; Zhang, Zi-Feng; Xu, Lei; Liu, Li-Yan; Song, Wei-Wei; Zhu, Fu-Jie; Li, Yi-Fan; Ma, Wan-Li

2017-08-01

Benzotriazoles (BTs) UV filters are widely used as ultraviolet absorbents for our daily products, which received increasing attention in the past decades. Residential wastewater treatment plant (WWTP) is both an important sink for wastewater and a key pollution source for receiving water for these chemicals. In this study, pretreatment and gas chromatography-tandem mass spectrometry analysis method were developed to determine the occurrence and fate of 9 BTs UV filters in wastewater and sludge from the WWTP with anaerobic-oxic treatment process (A/O) and biological aerated filter treatment process (BAF). Totally, 81 wastewater samples and 11 sludge samples were collected in four seasons. In wastewater, UV-326 and UV-329 were frequently detected, while the highest mean concentrations were detected for UV-234 and UV-329. The concentrations were in the range of UV filters was >85% in A/O process and 60-77% in BAF process except for UV-350, which was more difficult to remove with lower removal efficiencies of 33.3% for both A/O and BAF. All the target chemicals except for UV-320 were detected in sludge samples with the mean concentration ranging from 0.90 ng/g to 303.39 ng/g. There was no significant difference with concentrations and removal efficiency among different seasons. Higher detection frequency and concentration of BTs UV filters in downstream of the receiving water system indicated the contribution of effluent of the WWTP. Compared with other rivers, the lower concentrations in surface water in the Songhua River indicated light pollution status with of BTs UV filters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Architectural design of passive solar residential building

Directory of Open Access Journals (Sweden)

Ma Jing

2015-01-01

Full Text Available This paper studies thermal environment of closed balconies that commonly exist in residential buildings, and designs a passive solar residential building. The design optimizes the architectural details of the house and passive utilization of solar energy to provide auxiliary heating for house in winter and cooling in summer. This design might provide a more sufficient and reasonable modification for microclimate in the house.

Modeling temporal variations in global residential energy consumption and pollutant emissions

International Nuclear Information System (INIS)

Chen, Han; Huang, Ye; Shen, Huizhong; Chen, Yilin; Ru, Muye; Chen, Yuanchen; Lin, Nan; Su, Shu; Zhuo, Shaojie; Zhong, Qirui; Wang, Xilong; Liu, Junfeng; Li, Bengang; Tao, Shu

2016-01-01

Highlights: • Space-for-time substitution was tested for seasonality of residential energy. • Regression models were developed to simulate global residential energy consumption. • Factors affecting the temporal trend in residential energy use were identified. • Climate warming will induce changes in residential energy use and emissions. - Abstract: Energy data are often reported on an annual basis. To address the climate and health impacts of greenhouse gases and air pollutants, seasonally resolved emissions inventories are needed. The seasonality of energy consumption is most affected by consumption in the residential sector. In this study, a set of regression models were developed based on temperature-related variables and a series of socioeconomic parameters to quantify global electricity and fuel consumption for the residential sector. The models were evaluated against observations and applied to simulate monthly changes in residential energy consumption and the resultant emissions of air pollutants. Changes in energy consumption are strongly affected by economic prosperity and population growth. Climate change, electricity prices, and urbanization also affect energy use. Climate warming will cause a net increase in electricity consumption and a decrease in fuel consumption by the residential sector. Consequently, emissions of CO_2, SO_2, and Hg are predicted to decrease, while emissions of incomplete combustion products are expected to increase. These changes vary regionally.

Residential greenhouse

Energy Technology Data Exchange (ETDEWEB)

1985-02-01

The following report examines the technical and economic viability of residential greenhouse additions in Whitehorse, Yukon. The greenhouse was constructed using the south facing wall of an existing residence as a common wall. Total construction costs were $18,000, including labour. Annual fuel demand for the residence has been reduced by about 10 per cent for an annual saving of $425. In addition, produce to the value of $1,000 is grown annually in the greenhouse for domestic consumption and commercial resale. Typically the greenhouse operates for nine months each year. There is a net thermal loss during the months of November, December and January as a result of the large area of glazing. As well as supplementing the heating supply solar greenhouses can provide additional cash crops which can be used to offset the cost of construction. Humidity problems are minimal and can be dealt with by exhausting high humidity air. One system which has been considered for the greenhouse is to use a standard residential heat pump to remove excess moisture and to pump heat into the house. This would have a secondary benefit of excluding the need to circulate greenhouse air through the house. Thus any allergenic reactions to the greenhouse air would be prevented. 8 refs., 3 figs, 2 tabs.

Preferences for Aftercare Among Persons Seeking Short-Term Opioid Detoxification.

Science.gov (United States)

Stein, Michael D; Anderson, Bradley J; Bailey, Genie L

2015-12-01

Without aftercare treatment, the period following discharge from short-term inpatient detoxification for opioid dependence presents a high risk of relapse. Yet the role of patient preference in treatment selection is rarely discussed in the substance-abuse literature. We surveyed 485 persons initiating inpatient opioid detoxification who were predominantly male (71.3%) and had detoxed in the past (73.2%). When asked to choose the one treatment that would work best for them after discharge, 43% of participants selected medication-assisted treatment (MAT), 29% preferred residential, 12% selected drug-free counseling, 12% NA/AA meetings only, and 4% preferred no additional treatment. Residential treatment preference was significantly associated with homelessness, having been in a detox program within the past year, and having pending legal problems, indicating that there is a distinct profile of detox patients who prefer residential treatment despite its limited availability. Detox program staff should work with patients to understand reasons for treatment preferences to optimize aftercare services. Copyright © 2015 Elsevier Inc. All rights reserved.

Prediction of greenhouse gas reduction potential in Japanese residential sector by residential energy end-use model

International Nuclear Information System (INIS)

Shimoda, Yoshiyuki; Yamaguchi, Yukio; Okamura, Tomo; Taniguchi, Ayako; Yamaguchi, Yohei

2010-01-01

A model is developed that simulates nationwide energy consumption of the residential sector by considering the diversity of household and building types. Since this model can simulate the energy consumption for each household and building category by dynamic energy use based on the schedule of the occupants' activities and a heating and cooling load calculation model, various kinds of energy-saving policies can be evaluated with considerable accuracy. In addition, the average energy efficiency of major electric appliances used in the residential sector and the percentages of housing insulation levels of existing houses is predicted by the 'stock transition model.' In this paper, energy consumption and CO 2 emissions in the Japanese residential sector until 2025 are predicted. For example, as a business - as-usual (BAU) case, CO 2 emissions will be reduced by 7% from the 1990 level. Also evaluated are mitigation measures such as the energy efficiency standard for home electric appliances, thermal insulation code, reduction of standby power, high-efficiency water heaters, energy-efficient behavior of occupants, and dissemination of photovoltaic panels.

Fire Situations and Prevention Measures of residential building

Directory of Open Access Journals (Sweden)

Zhou Baixia

2017-01-01

Full Text Available The proportion of residential building is the largest in all buildings. With the development of urbanization, residential building fires are at high momentum. The paper lists the residential building fires and the number of casualties’ proportion to total fires from 2011 to 2014, analyzing the high incidence causes of the fires and casualties and putting forward suggestions and countermeasures including carrying out fire safety education to improve the fire safety awareness of residents, fulfilling responsibility to enhancing fire safety management capabilities, perfecting fire apparatus to develop fire safety environment and enhancing public awareness of fire safety, equipping evacuation equipments to promote response ability to deal with disasters etc.

Procedures for Calculating Residential Dehumidification Loads

Energy Technology Data Exchange (ETDEWEB)

Winkler, Jon [National Renewable Energy Lab. (NREL), Golden, CO (United States); Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2016-06-01

Residential building codes and voluntary labeling programs are continually increasing the energy efficiency requirements of residential buildings. Improving a building's thermal enclosure and installing energy-efficient appliances and lighting can result in significant reductions in sensible cooling loads leading to smaller air conditioners and shorter cooling seasons. However due to fresh air ventilation requirements and internal gains, latent cooling loads are not reduced by the same proportion. Thus, it's becoming more challenging for conventional cooling equipment to control indoor humidity at part-load cooling conditions and using conventional cooling equipment in a non-conventional building poses the potential risk of high indoor humidity. The objective of this project was to investigate the impact the chosen design condition has on the calculated part-load cooling moisture load, and compare calculated moisture loads and the required dehumidification capacity to whole-building simulations. Procedures for sizing whole-house supplemental dehumidification equipment have yet to be formalized; however minor modifications to current Air-Conditioner Contractors of America (ACCA) Manual J load calculation procedures are appropriate for calculating residential part-load cooling moisture loads. Though ASHRAE 1% DP design conditions are commonly used to determine the dehumidification requirements for commercial buildings, an appropriate DP design condition for residential buildings has not been investigated. Two methods for sizing supplemental dehumidification equipment were developed and tested. The first method closely followed Manual J cooling load calculations; whereas the second method made more conservative assumptions impacting both sensible and latent loads.

Analyzing Residential End-Use Energy Consumption Data to Inform Residential Consumer Decisions and Enable Energy Efficiency Improvements

Science.gov (United States)

Carlson, Derrick R.

While renewable energy is in the process of maturing, energy efficiency improvements may provide an opportunity to reduce energy consumption and consequent greenhouse gas emissions to bridge the gap between current emissions and the reductions necessary to prevent serious effects of climate change and will continue to be an integral part of greenhouse gas emissions policy moving forward. Residential energy is a largely untapped source of energy reductions as consumers, who wish to reduce energy consumption for monetary, environmental, and other reasons, face barriers. One such barrier is a lack of knowledge or understanding of how energy is consumed in a home and how to reduce this consumption effectively through behavioral and technological changes. One way to improve understanding of residential energy consumption is through the creation of a model to predict which appliances and electronics will be present and significantly contribute to the electricity consumption of a home on the basis of various characteristics of that home. The basis of this model is publically available survey data from the Residential Energy Consumption Survey (RECS). By predicting how households are likely to consume energy, homeowners, policy makers, and other stakeholders have access to valuable data that enables reductions in energy consumption in the residential sector. This model can be used to select homes that may be ripe for energy reductions and to predict the appliances that are the basis of these potential reductions. This work suggests that most homes in the U.S. have about eight appliances that are responsible for about 80% of the electricity consumption in that home. Characteristics such as census region, floor space, income, and total electricity consumption affect which appliances are likely to be in a home, however the number of appliances is generally around 8. Generally it takes around 4 appliances to reach the 50% threshold and 12 appliances to reach 90% of electricity

[Considerations regarding the food of the hospital staff].

Science.gov (United States)

Nardin, Anne

2005-02-01

The question concerning the food of the hospital staff has drawn attention only tardily. However, food is a faithful mirror in which the knowledge, the capacities, the values and the imaginary ones of an institution are reflected. It is in 1905 that the reform made by the "Administration générale de l'Assistance Publique de Paris" is specifically concerned, for the first time, by the food of the hospital staff. It is a change in the practices, founded until then on the principle of equality in food treatment, resulting probably from the monastic form of the hospital in the earliest times. The introduction of the system into force today was done gradually in the years 1930. From now on, hospital staff pay their meal to the administration which establishes the account of it on the basis of a refectory card. At the end of this evolution, nothing is similar any more in the hospital on the ground of the hierarchical relations between the administration and its staff. The era of self-service restaurants has open, transforming the consumer into an autonomous active and participative individual, in an institution converted into the play of democraty company.

Elections to Staff Council

CERN Multimedia

Saff Association

2013-01-01

2013 Elections to Staff Council   Vote! Make your voice heard and be many to elect the new Staff Council. More details on the elections can be found on the Staff Association web site (https://ap-vote.web.cern.ch/elections-2013).   Timetable elections Monday 28 October to Monday 11 November, 12:00 am voting Monday 18 and Monday 25 November, publication of the results in Echo Tuesday 19 November, Staff Association Assizes Tuesday 3 December, first meeting of the new Staff Council and election of the new Executive Committee The voting procedure is monitored by the Election Committee.

MEANINGS OF SPACE OF COTTAGE-TYPE RESIDENTIAL CENTER IN MILIEU THERAPY FOR EMOTIONALLY DISTURBED CHILDREN

OpenAIRE

Ishigaki, Aya; Kanno, Minoru; Onoda, Yasuaki; Sakaguchi, Taiyo

2004-01-01

The number of emotionally disturbed children in Japan has been increasing recently; However, only few attempts with an aim at improving children's living space have been made at treatment centers. We conducted some field surveys on the cottage-type residential center to examine the relationship among space, communication, and the effectiveness of therapy. In addition, to clarify conditions of treatment for children with emotional disturbances, the children's daily life with milieu therapy was...

32 CFR 270.5 - Staff.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Staff. 270.5 Section 270.5 National Defense... Staff. (a) The Commission will have a support staff, which will include staff members sufficient to expeditiously and efficiently process the applications for payments under this part. All members of the staff...

Psychological changes in alcohol-dependent patients during a residential rehabilitation program

Directory of Open Access Journals (Sweden)

Giorgi I

2015-12-01

Full Text Available Ines Giorgi,1 Marcella Ottonello,2,3 Giovanni Vittadini,4 Giorgio Bertolotti5 1Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, 2Department of Physical & Rehabilitation Medicine, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Genoa, 3Department of Medicine, PhD Program in Advanced Sciences and Technologies in Rehabilitation Medicine and Sport, Università di Tor Vergata, Rome, 4Alcohol Rehabilitation Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Pavia, 5Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Tradate, Italy Background: Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive–affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse.Materials and methods: The sample included 560 subjects (mean age 46.91±10.2 years who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment – Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome

Staff/bed and staff/patient ratios in South African public sector mental ...

African Journals Online (AJOL)

Objectives. To document staff/bed and staff/patient ratios in public. sector mental health services in South Africa. Design. Cross-sectional survey. Method. Aquestionnaire was distributed to provincial mental health co-ordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all ...

Sustainable residential districts : the residents' role in project success

NARCIS (Netherlands)

Abdalla, G.

2012-01-01

Sustainable residential districts have been realized worldwide. These districts are promoted to be efficient in the use of natural materials and sustainable energy resources. Realization of sustainable residential districts can strongly contribute to achieve environmental objectives as imposed by

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

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

2014-10-01

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

Estimation of energy efficiency of residential buildings

Directory of Open Access Journals (Sweden)

Glushkov Sergey

2017-01-01

Full Text Available Increasing energy performance of the residential buildings by means of reducing heat consumption on the heating and ventilation is the last segment in the system of energy resources saving. The first segments in the energy saving process are heat producing and transportation over the main lines and outside distribution networks. In the period from 2006 to 2013. by means of the heat-supply schemes optimization and modernization of the heating systems. using expensive (200–300 $US per 1 m though hugely effective preliminary coated pipes. the economy reached 2.7 mln tons of fuel equivalent. Considering the multi-stage and multifactorial nature (electricity. heat and water supply of the residential sector energy saving. the reasonable estimate of the efficiency of the saving of residential buildings energy should be performed in tons of fuel equivalent per unit of time.

Energy savings in Danish residential building stock

DEFF Research Database (Denmark)

Tommerup, Henrik M.; Svendsen, Svend

2006-01-01

a short account of the technical energy-saving possibilities that are present in existing dwellings and presents a financial methodology used for assessing energy-saving measures. In order to estimate the total savings potential detailed calculations have been performed in a case with two typical...... buildings representing the residential building stock and based on these calculations an assessment of the energy-saving potential is performed. A profitable savings potential of energy used for space heating of about 80% is identified over 45 years (until 2050) within the residential building stock......A large potential for energy savings exists in the Danish residential building stock due to the fact that 75% of the buildings were constructed before 1979 when the first important demands for energy performance of building were introduced. It is also a fact that many buildings in Denmark face...

Elections to Staff Council

CERN Multimedia

Staff Association

2013-01-01

Elections to fill all seats in the Staff Council are being organized this month. The voting takes place from the 28 of October to the 11th of November, at noon. As you may have noted when reading Echo, many issues concerning our employment conditions are on the agenda of the coming months, and in particular the Five-yearly-Review 2015, subject of the questionnaire that you probably recently filled out. All this will keep the next Staff Council very busy indeed. So, make your voice heard and take part in the elections for a new Staff Council. By doing so, you will be encouraging the men and women who will be representing you over the next two years and they will doubtless appreciate your gratitude. Every member of the Staff Association will have received an email containing a link to the webpage which will allow voting. If you are a member of the Staff Association and you did not receive such an email, please contact the Staff Association secretariat (staff.association@cern.ch). Do not forget to v...

Tracking the Sun IX: The Installed Price of Residential and Non-Residential Photovoltaic Systems in the United States

Energy Technology Data Exchange (ETDEWEB)

Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area; Darghouth, Naïm [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area; Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cates, Sarah [Exeter Associates, Columbia, MD (United States); DiSanti, Nicholas [Exeter Associates, Columbia, MD (United States); Widiss, Rebecca [Exeter Associates, Columbia, MD (United States)

2016-08-16

Now in its ninth edition, Lawrence Berkeley National Laboratory (LBNL)’s Tracking the Sun report series is dedicated to summarizing trends in the installed price of grid-connected solar photovoltaic (PV) systems in the United States. The present report focuses on residential and non-residential systems installed through year-end 2015, with preliminary trends for the first half of 2016. An accompanying LBNL report, Utility-Scale Solar, addresses trends in the utility-scale sector. This year’s report incorporates a number of important changes and enhancements from prior editions. Among those changes, LBNL has made available a public data file containing all non-confidential project-level data underlying the analysis in this report. Installed pricing trends presented within this report derive primarily from project-level data reported to state agencies and utilities that administer PV incentive programs, solar renewable energy credit (SREC) registration systems, or interconnection processes. Refer to the text box to the right for several key notes about these data. In total, data were collected and cleaned for more than 820,000 individual PV systems, representing 85% of U.S. residential and non-residential PV systems installed cumulatively through 2015 and 82% of systems installed in 2015. The analysis in this report is based on a subset of this sample, consisting of roughly 450,000 systems with available installed price data.

Building and household X-factors and energy consumption at the residential sector

International Nuclear Information System (INIS)

Estiri, Hossein

2014-01-01

Energy use in residential buildings is one of the major sources of greenhouse gas emission production from cities. Using microdata from the 2009 Residential Energy Consumption Survey (RECS), this study applies structural equation modeling to analyze the direct, indirect, and total impacts of household and building characteristics on residential energy consumption. Results demonstrate that the direct impact of household characteristics on residential energy consumption is significantly smaller than the corresponding impact from the buildings. However, accounting for the indirect impact of household characteristics on energy consumption, through choice of the housing unit characteristics, the total impact of households on energy consumption is just slightly smaller than that of buildings. Outcomes of this paper call for smart policies to incorporate housing choice processes in managing residential energy consumption. - Highlights: • Households indirectly influence residential energy use through housing choice. • Households' total impact on energy use is comparable to that of buildings. • Understanding households' indirect impact will enhance residential energy policy. • Smart energy policies are needed to target both direct and indirect effects

Residential outage cost estimation: Hong Kong

International Nuclear Information System (INIS)

Woo, C.K.; Ho, T.; Shiu, A.; Cheng, Y.S.; Horowitz, I.; Wang, J.

2014-01-01

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

Increasing Direct Care Staff Compliance to Individualized Physical Therapy Body Positioning Prescriptions: Prescriptive Checklists.

Science.gov (United States)

Lattimore, Jennifer; And Others

1984-01-01

The study confirmed previous research indicating that workshop training by itself is an ineffective method of increasing direct care staff compliance to treatment prescriptions, and that providing direct staff supervisors with a training and management tool (prescriptive checklists) may be an effective alternative for serving multihandicapped…

Service dog training program for treatment of posttraumatic stress in service members.

Science.gov (United States)

Yount, Rick A; Olmert, Meg D; Lee, Mary R

2012-01-01

In July 2008, social worker and certified service dog trainer Rick Yount created the first Warrior dog-training program designed to be a safe, effective, nonpharmaceutical intervention to treat the symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury in Veterans and service members undergoing treatment at a large Veterans Administration residential treatment facility. In 2009, Yount was asked to establish the program at a prominent Department of Defense medical center. In October 2010, Yount was invited to create a service dog training program to support the research and treatment mission at the new National Intrepid Center of Excellence (NICoE), in Bethesda, Maryland. This program, now being offered through the nonprofit foundation Warrior Canine Connection, continues to produce anecdotal evidence that training service dogs reduces the PTSD symptoms of Warrior-trainers and that the presence of the dogs enhances the sense of wellness in the NICoE staff and the families of our Wounded Warriors. Under the research leadership of the NICoE, the Warrior Canine Connection research team plans to systematically investigate the physiological, psychological, and behavioral benefits of this program.

TB treatment in a chronic complex emergency: treatment outcomes and experiences in Somalia.

Science.gov (United States)

Liddle, Karin Fischer; Elema, Riekje; Thi, Sein Sein; Greig, Jane; Venis, Sarah

2013-11-01

Médecins Sans Frontières (MSF) provides TB treatment in Galkayo and Marere in Somalia. MSF international supervisory staff withdrew in 2008 owing to insecurity but maintained daily communication with Somali staff. In this paper, we aimed to assess the feasibility of treating TB in a complex emergency setting and describe the programme adaptations implemented to facilitate acceptable treatment outcomes. Routinely collected treatment data from 2005-2012 were retrospectively analysed. In multivariate analyses, factors associated with successful outcome (cure or completion versus failure, death and default) were assessed, including the presence of international supervisory staff. Informal interviews were conducted with Somali staff regarding programmatic factors affecting patient management and perceived reasons for default. In total, 6167 patients were admitted (34.8% female; median age 24.0 years [IQR 13.0-38.0 years]). Treatment success was 79% (programme range 69-87%). Presence of international staff did not improve outcomes (adjusted OR 0.85, 95% CI 0.66-1.09; p=0.27). Perceived reasons for default included being away from family, nomadic group, insecurity, travel cost, need to return to grazing land or feeling better. Despite the challenges, a high percentage of patients were successfully treated. Treatment outcomes were not adversely affected by withdrawal of international supervisory staff.

24 CFR 100.110 - Discriminatory practices in residential real estate-related transactions.

Science.gov (United States)

2010-04-01

... residential real estate-related transactions. 100.110 Section 100.110 Housing and Urban Development... Discrimination in Residential Real Estate-Related Transactions § 100.110 Discriminatory practices in residential real estate-related transactions. (a) This subpart provides the Department's interpretation of the...

A Longitudinal Study of Child Maltreatment and Mental Health Predictors of Admission to Psychiatric Residential Treatment Facilities

Directory of Open Access Journals (Sweden)

Roderick A. Rose

2017-09-01

Full Text Available The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children in out-of-home care, research is needed to examine the factors that predict entry in PRTFs among children investigated for maltreatment. This exploratory study used cross-sector administrative records linked across multiple systems, including child welfare records and Medicaid claims, from a single state over a five-year period (n = 105,982. Cox proportional hazards modeling was used to predict entry into a PRTF. After controlling for many factors, PRTF entry was predicted by diagnosis code indicating a trauma-related condition, antipsychotic medication prescriptions, and entry into lower levels of out-of-home care, supporting the view that youth are admitted to PRTFs largely due to clinical need. However, PRTF admission is also associated with characteristics of their experiences with the social service system, primarily foster care placement stability and permanency. Implications for practice and research are discussed.

Weight loss and improved gross motor coordination in children as a result of multidisciplinary residential obesity treatment.

Science.gov (United States)

D'Hondt, Eva; Gentier, Ilse; Deforche, Benedicte; Tanghe, Ann; De Bourdeaudhuij, Ilse; Lenoir, Matthieu

2011-10-01

This study evaluated the short-term effectiveness of a multidisciplinary residential obesity treatment program by describing changes in body weight, related measures, and gross motor co-ordination. Secondarily, it was examined to what extent the amount of relative weight loss achieved by overweight and obese (OW/OB) participants explained the projected improvement in gross motor co-ordination. Thirty-six OW/OB children (aged 10.5 ± 1.4 years, 12 girls and 24 boys) were recruited at the Zeepreventorium VZW (De Haan, Belgium), where they followed a specific program consisting of moderate dietary restriction, psychological support, and physical activity. For reference purposes, an additional group of 36 age- and gender-matched healthy-weight (HW) children was included in the study. Anthropometric measures were recorded and gross motor co-ordination was assessed using the Körperkoordinationstest für Kinder (KTK) on two occasions with an interval of 4 months. Regardless of the test moment, OW/OB participants displayed significantly poorer KTK performances (P motor co-ordination performance, with a greater increase in KTK score(s) from baseline to re-test as compared to HW peers (P motor co-ordination, which in turn may promote physical activity participation.

Residential cogeneration systems: review of the current technology

International Nuclear Information System (INIS)

Onovwiona, H.I.; Ugursal, V.I.

2006-01-01

There is a growing potential for the use of micro-cogeneration systems in the residential sector because they have the ability to produce both useful thermal energy and electricity from a single source of fuel such as oil or natural gas. In cogeneration systems, the efficiency of energy conversion increases to over 80% as compared to an average of 30-35% for conventional fossil fuel fired electricity generation systems. This increase in energy efficiency can result in lower costs and reduction in greenhouse gas emissions when compared to the conventional methods of generating heat and electricity separately. Cogeneration systems and equipment suitable for residential and small-scale commercial applications like hospitals, hotels or institutional buildings are available, and many new systems are under development. These products are used or aimed for meeting the electrical and thermal demands of a building for space and domestic hot water heating, and potentially, absorption cooling. The aim of this paper is to provide an up-to-date review of the various cogeneration technologies suitable for residential applications. The paper considers the various technologies available and under development for residential, i.e. single-family ( e ) and multi-family (10-30kW t ) applications, with focus on single-family applications. Technologies suitable for residential cogeneration systems include reciprocating internal combustion engine, micro-turbine, fuel cell, and reciprocating external combustion Stirling engine based cogeneration systems. The paper discusses the state of development and the performance, environmental benefits, and costs of these technologies. (author)

Examining the relationship between ethnicity and the use of drug-related services: an ethnographic study of Nepali drug users in Hong Kong

Directory of Open Access Journals (Sweden)

Tang WM

2014-06-01

Full Text Available Wai-Man Tang Anthropology Department, The Chinese University of Hong Kong, Hong Kong Abstract: A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed. Keywords: methadone, residential rehabilitation services, drug treatment, ethnicity, Nepalis

The impact of residential combustion emissions on atmospheric aerosol, human health, and climate

Directory of Open Access Journals (Sweden)

E. W. Butt

2016-01-01

Full Text Available Combustion of fuels in the residential sector for cooking and heating results in the emission of aerosol and aerosol precursors impacting air quality, human health, and climate. Residential emissions are dominated by the combustion of solid fuels. We use a global aerosol microphysics model to simulate the impact of residential fuel combustion on atmospheric aerosol for the year 2000. The model underestimates black carbon (BC and organic carbon (OC mass concentrations observed over Asia, Eastern Europe, and Africa, with better prediction when carbonaceous emissions from the residential sector are doubled. Observed seasonal variability of BC and OC concentrations are better simulated when residential emissions include a seasonal cycle. The largest contributions of residential emissions to annual surface mean particulate matter (PM2.5 concentrations are simulated for East Asia, South Asia, and Eastern Europe. We use a concentration response function to estimate the human health impact due to long-term exposure to ambient PM2.5 from residential emissions. We estimate global annual excess adult (>  30 years of age premature mortality (due to both cardiopulmonary disease and lung cancer to be 308 000 (113 300–497 000, 5th to 95th percentile uncertainty range for monthly varying residential emissions and 517 000 (192 000–827 000 when residential carbonaceous emissions are doubled. Mortality due to residential emissions is greatest in Asia, with China and India accounting for 50 % of simulated global excess mortality. Using an offline radiative transfer model we estimate that residential emissions exert a global annual mean direct radiative effect between −66 and +21 mW m−2, with sensitivity to the residential emission flux and the assumed ratio of BC, OC, and SO2 emissions. Residential emissions exert a global annual mean first aerosol indirect effect of between −52 and −16 mW m−2, which is sensitive to the

CBE Faculty and Staff

Science.gov (United States)

About Us Research Staff Edward Arens Fred Bauman Gail Brager Darryl Dickerhoff Ali Ghahramani Partners Facilities Graduate Programs Visiting Scholar Program Careers CBE Faculty and Staff CBE is an performance of buildings. The core research group for CBE includes faculty and research staff members

A Comparative Study of the Behavioral, Personality, and Fire History Characteristics of Residential and Outpatient Adolescents (Ages 12-17) With Firesetting Behaviors

Science.gov (United States)

Pollinger, Joyce; Samuels, Laura; Stadolnik, Robert

2005-01-01

Juvenile firesetting behavior has received relatively little research attention and previous attempts to systematically classify this heterogeneous population of children has been only partially successful. Currently there is no literature available that defines treatment and intervention needs of adolescents in residential treatment with…

Residential Mobility, Inhibitory Control, and Academic Achievement in Preschool

Science.gov (United States)

Schmitt, Sara A.; Finders, Jennifer K.; McClelland, Megan M.

2015-01-01

Research Findings: The present study investigated the direct effects of residential mobility on children's inhibitory control and academic achievement during the preschool year. It also explored fall inhibitory control and academic skills as mediators linking residential mobility and spring achievement. Participants included 359 preschool children…

Sharing your urban residential WiFi (UR-WiFi)

NARCIS (Netherlands)

Kawade, Santosh; van Bloem, J.W.H.; Abhayawardhana, V.S.; Wisely, D.

2006-01-01

Cheap and ubiquitous broadband wireless access is what most of the operators are aiming for. This paper analyses an innovative proposal to extend the traditional fixed coverage offered by residential broadband into an urban wireless coverage using urban residential wireless fidelity (UR-WiFi)

Engineering economic assessment of residential wood heating in NY

Science.gov (United States)

We provide insight into the recent resurgence in residential wood heating in New York by: (i) examining the lifetime costs of outdoor wood hydronic heaters (OWHHs) and other whole-house residential wood heat devices,(ii) comparing these lifetime costs with those of competing tech...

Residential neighbourhoods in Kathmandu: Key design guidelines

Directory of Open Access Journals (Sweden)

Bijaya K. Shrestha

2013-01-01

Full Text Available Residential neighbourhoods developed using various techniques in Kathmandu by both the public and private sectors have not only provided a poor urban setting and failed to address socio-cultural needs, but are also poor at building a community and creating links to the built environment, with the result that the planned areas lack a sense of place and the inhabitants lack a feeling of home. Although traditional neighbourhoods in the historic core area had many features of a good residential neighbourhood in the past, they are currently undergoing rapid destruction. The residents of these neighbourhoods have little awareness of these issues. The existing legal and institutional frameworks are inadequate and ineffective and cannot address these problems, and so the formulation of design guidelines, their strict implementation, and enhancement of socio-cultural events including social networking are recommended for future residential neighbourhood development.

Expressions of Prayer in Residential Care Homes.

Science.gov (United States)

Reimer-Kirkham, Sheryl; Sharma, Sonya; Smith, Brenda; Schutt, Kelly; Janzen, Kyla

2018-01-01

Although the value of spiritual care in the care of older adults is supported by research, few studies have focused specifically on prayer in residential care settings. This ethnographic study with fifteen chaplains and administrators in eleven residential care homes involved analyses of walking interviews and research diaries. Findings revealed the spaces in which prayer happens and the forms it takes. The identities of chaplains-their own spiritual practices, religious beliefs, and positioning within the facility-shaped their dis/comfort with prayer and how they located prayer within public and private spaces. Where organizational leadership endorsed the legitimacy of chaplaincy services, prayer was more likely to be offered. Even in these circumstances, however, religious diversity and questions about secularism left chaplains ambivalent about the appropriateness of prayer. The results demonstrate the relevance of religion and spirituality to residential care, and illustrate how prayer functions as an opportunity for connection and understanding.

Research Staff | Wind | NREL

Science.gov (United States)

Research Staff Research Staff Learn more about the expertise and technical skills of the wind power research team and staff at NREL. Name Position Email Phone Anstedt, Sheri Professional III-Writer/Editor /Web Content Sheri.Anstedt@nrel.gov 303-275-3255 Baker, Donald Research Technician V-Electrical

The value of residential photovoltaic systems: A comprehensive assessment

Science.gov (United States)

Borden, C. S.

1983-01-01

Utility-interactive photovoltaic (PV) arrays on residential rooftops appear to be a potentially attractive, large-scale application of PV technology. Results of a comprehensive assessment of the value (i.e., break-even cost) of utility-grid connected residential photovoltaic power systems under a variety of technological and economic assumptions are presented. A wide range of allowable PV system costs are calculated for small (4.34 kW (p) sub ac) residential PV systems in various locales across the United States. Primary factor in this variation are differences in local weather conditions, utility-specific electric generation capacity, fuel types, and customer-load profiles that effect purchase and sell-back rates, and non-uniform state tax considerations. Additional results from this analysis are: locations having the highest insolation values are not necessary the most economically attractive sites; residential PV systems connected in parallel to the utility demonstrate high percentages of energy sold back to the grid, and owner financial and tax assumptions cause large variations in break-even costs. Significant cost reduction and aggressive resolution of potential institutional impediments (e.g., liability, standards, metering, and technical integration) are required for a residential PV marker to become a major electric-grid-connected energy-generation source.

Measuring social climate in Norwegian residential youth care : A revision of the community oriented programs environment scale

NARCIS (Netherlands)

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

2016-01-01

Introduction and objectives: Social climate is an understudied factor in residential youth care (RYC) institutions. Already in the 1950’s, the World Health Organization stated that “atmosphere” is an important factor in psychiatric treatment, but a very difficult element to measure. Assessing the

Effects of person-centered care on residents and staff in aged-care facilities: a systematic review

Directory of Open Access Journals (Sweden)

Brownie S

2013-01-01

Full Text Available Sonya Brownie, Susan NancarrowSchool of Health and Human Sciences, Southern Cross University, Lismore, NSW, AustraliaBackground: Several residential aged-care facilities have replaced the institutional model of care to one that accepts person-centered care as the guiding standard of practice. This culture change is impacting the provision of aged-care services around the world. This systematic review evaluates the evidence for an impact of person-centered interventions on aged-care residents and nursing staff.Methods: We searched Medline, Cinahl, Academic Search Premier, Scopus, Proquest, and Expanded Academic ASAP databases for studies published between January 1995 and October 2012, using subject headings and free-text search terms (in UK and US English spelling including person-centered care, patient-centered care, resident-oriented care, Eden Alternative, Green House model, Wellspring model, long-term care, and nursing homes.Results: The search identified 323 potentially relevant articles. Once duplicates were removed, 146 were screened for inclusion in this review; 21 were assessed for methodological quality, resulting in nine articles (seven studies that met our inclusion criteria. There was only one randomized, controlled trial. The majority of studies were quasi-experimental pre-post test designs, with a control group (n = 4. The studies in this review incorporated a range of different outcome measures (ie, dependent variables to evaluate the impact of person-centered interventions on aged-care residents and staff. One person-centered intervention, ie, the Eden Alternative, was associated with significant improvements in residents' levels of boredom and helplessness. In contrast, facility-specific person-centered interventions were found to impact nurses' sense of job satisfaction and their capacity to meet the individual needs of residents in a positive way. Two studies found that person-centered care was actually associated with an

Residential Mechanical Precooling

Energy Technology Data Exchange (ETDEWEB)

German, a. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

2014-12-01

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.

The Impact of Residential and Nonresidential Drug Treatment on Recidivism among Drug-Involved Probationers: A Survival Analysis

Science.gov (United States)

Krebs, Christopher P.; Strom, Kevin J.; Koetse, Willem H.; Lattimore, Pamela K.

2009-01-01

A variety of approaches for addressing drug use and drug-related crime among the nearly 5 million offenders on community supervision in the United States has been tried and evaluated, but questions remain about which policies or programs are most effective. The authors use a large data set to assess the impact of residential and nonresidential…

Staff Association Cocktail

CERN Multimedia

Staff Association

2017-01-01

The Staff Association has been organising for many years a cocktail with delegates of the Member States participating in Finance Committees of March and September. This cocktail is held at the end of the day, after the Finance Committee meeting. This direct and regular communication helps establish an ongoing contact between the Staff Association and CERN Member States and, more recently, the Associate Member States. Ambassadors of the CERN Staff Association, who are Members of the Personnel, have the opportunity to meet their national delegation in an informal and friendly atmosphere. These exchanges, facilitated by the use of the national language, allow the personnel via the Staff Association to express its ideas and positions on current affairs and fundamental issues, and also to hear about those of the delegations in return.

ENERGY STAR Certified Residential Freezers

Data.gov (United States)

U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 5.0 ENERGY STAR Program Requirements for Residential Refrigerators and Freezers that are...

ENERGY STAR Certified Residential Refrigerators

Data.gov (United States)

U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 5.0 ENERGY STAR Program Requirements for Residential Refrigerators and Freezers that are...

Performance-based potential for residential energy efficiency

Energy Technology Data Exchange (ETDEWEB)

Performance-based potential for residential energy efficiency

2013-01-15

Energy performance contracts (EPCs) have proven an effective mechanism for increasing energy efficiency in nearly all sectors of the economy since their introduction nearly 30 years ago. In the modern form, activities undertaken as part of an EPC are scoped and implemented by experts with specialized technical knowledge, financed by commercial lenders, and enable a facility owner to limit risk and investment of time and resources while receiving the rewards of improved energy performance. This report provides a review of the experiences of the US with EPCs and discusses the possibilities for the residential sector to utilize EPCs. Notably absent from the EPC market is the residential segment. Historically, research has shown that the residential sector varies in several key ways from markets segments where EPCs have proven successful, including: high degree of heterogeneity of energy use characteristics among and within households, comparatively small quantity of energy consumed per residence, limited access to information about energy consumption and savings potential, and market inefficiencies that constrain the value of efficiency measures. However, the combination of recent technological advances in automated metering infrastructure, flexible financing options, and the expansion of competitive wholesale electricity markets to include energy efficiency as a biddable supply-side resource present an opportunity for EPC-like efforts to successfully engage the residential sector, albeit following a different model than has been used in EPCs traditionally.(Author)

Energy and exergy utilization efficiencies in the Japanese residential/commercial sectors

International Nuclear Information System (INIS)

Kondo, Kumiko

2009-01-01

Unlike the manufacturing sector, the residential/commercial sectors of Japan struggle to meet their environmental requirements. For instance, their CO 2 emission levels have increased tremendously since 1990. This research estimates energy and 'exergy (available energy)' efficiencies in Japan's residential/commercial sectors during the period 1990-2006. Since an exergy analysis reveals 'available energy losses', it is an effective tool to achieve sustainable societies. The primary objective of this paper is to examine the potential for advancing the 'true' energy efficiency in Japan's residential/commercial sectors-by observing energy and exergy efficiency disparities. The results show large differences between the overall energy and exergy efficiencies in the residential (60.12%, 6.33%)/commercial sectors (51.78%, 5.74%) in 2006. This implies great potential for energy savings in both sectors. Furthermore, this research suggests that the residential sector may face more difficulties than the commercial sector, although the latter appears to be less energy-efficient, according to recent statistics. This is because the disparity between energy and exergy efficiencies has expanded in the residential sector since 2000. This study illustrates the importance of exergy analyses in promoting sustainable energy policies and new adaptation strategies.

The Value of Green Infrastructure on Vacant and Residential Land in Roanoke, Virginia

Directory of Open Access Journals (Sweden)

Gunwoo Kim

2016-03-01

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.

ENERGY STAR Certified Residential Dishwashers

Data.gov (United States)

U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 6.0 ENERGY STAR Program Requirements for Residential Dishwashers that are effective as of...

GREEN RETROFITTING RESIDENTIAL BUILDINGS

Science.gov (United States)

When compared with the rest of the world, the United States consumes a disproportionately large amount of energy and is a major source of greenhouse gases from fossil fuel combustion. As much as two thirds of U.S. electricity production is consumed by residential and commerci...

Residential land values and their determinants in high density ...

African Journals Online (AJOL)

The study identified that residential segregation exists in Nigerian cities and the study area. Among urbanization and residential land use problems identified by the study are poor level of social and technical infrastructure, poor land and city management system capacity, paucity of planning laws, funding, poor institutional ...

Research Staff | Photovoltaic Research | NREL

Science.gov (United States)

Research Staff Research Staff desc Greg Wilson Center Director Dr. Greg Wilson is the Director of @nrel.gov 303-384-6649 Bosco, Nicholas Staff Scientist Nick.Bosco@nrel.gov 303-384-6337 Braunecker, Wade IV-Physics Michael.Deceglie@nrel.gov 303-384-6104 Deline, Chris Staff Engineer Chris.Deline@nrel.gov

Residential mobility and childhood leukemia.

Science.gov (United States)

Amoon, A T; Oksuzyan, S; Crespi, C M; Arah, O A; Cockburn, M; Vergara, X; Kheifets, L

2018-07-01

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.

Modelling residential electricity demand in the GCC countries

International Nuclear Information System (INIS)

Atalla, Tarek N.; Hunt, Lester C.

2016-01-01

This paper aims at understanding the drivers of residential electricity demand in the Gulf Cooperation Council countries by applying the structural time series model. In addition to the economic variables of GDP and real electricity prices, the model accounts for population, weather, and a stochastic underlying energy demand trend as a proxy for efficiency and human behaviour. The resulting income and price elasticities are informative for policy makers given the paucity of previous estimates for a region with particular political structures and economies subject to large shocks. In particular, the estimates allow for a sound assessment of the impact of energy-related policies suggesting that if policy makers in the region wish to curtail future residential electricity consumption they would need to improve the efficiency of appliances and increase energy using awareness of consumers, possibly by education and marketing campaigns. Moreover, even if prices were raised the impact on curbing residential electricity growth in the region is likely to be very small given the low estimated price elasticities—unless, that is, prices were raised so high that expenditure on electricity becomes such a large proportion of income that the price elasticities increase (in absolute terms). - Highlights: • Residential electricity demand for Bahrain, Kuwait, Oman, and Saudi Arabia • Estimated residential electricity demand relationships using STSM/UEDT approach • LR income and price elasticities from 0.43 to 0.71 and − 0.16 to zero respectively • Impact CDD elasticities from 0.2 to 0.7 • Estimated UEDTs suggest exogenous electricity using behaviour.

Criteria of Architectural Composition Design in Residential Courtyards

Science.gov (United States)

Ziemeļniece, Aija; Īle, Una

2017-10-01

The totalitarian times of the 50s-80s of the 20th century have brought the building of high-rise residential blocks in Latvian cities, characterized by an uninteresting solution of standard buildings and the alien scale which does not meet the regional features. During the above period, areas of the residential courtyards have not been addressed. The conclusion of the research is that today the courtyards of the high-rise residential houses have become a stagnant, functionally irrelevant area that forms a depressing nature of the outdoor living space. The uncharted area of courtyards is not being used fully which highlights a wide range of issues that applies to car parks, recreation areas, and the green areas. With the development of the urban infrastructure, the creation of high-rise parking facilities and separate car parks are insufficiently addressed. Consequently, the implementation of improvements in courtyards of high-rise residential houses is not possible if the above issue on the removal of the car load from courtyards is not solved. Many building districts are characterized by the same compositional, architectural-spatial structure which even more influences and causes discomfort in these areas to stay. In recent years, the solution to the above issue is sought by the municipal authorities of Latvia to create a new courtyard zoning. It applies to the project development and construction works. In the research, courtyards of the city of Jelgava are analysed and evaluated which from the qualitative point of view demonstrates and is a vivid example where the issues of the research are readable. The city of Jelgava, located 45 km away from Riga, is an expressed satellite city and serves for the agglomeration of Riga as a huge high-rise residential district. Consequently, the research includes separate courtyards of high-rise residential buildings of the city of Jelgava and their study is carried out from the point of view of the architectural composition

Radical programmes for developing the EU residential building sector

NARCIS (Netherlands)

Oostra, Mieke; Huovinen, Pekka

2016-01-01

The economic recession has hit especially hard the residential building sector in the EU region, e.g., the number of the housing completions has decreased -49% and the total residential output has been squeezed down by -24% between 2007 and 2014 (Euroconstruct, 2015). In turn, the aim of our paper

Energy efficient residential house wall system

International Nuclear Information System (INIS)

Aldawi, Fayez; Date, Abhijit; Alam, Firoz; Khan, Iftekhar; Alghamdi, Mohammed

2013-01-01

The energy consumption and greenhouse gas emission by the residential housing sector are considered to be one of the largest in economically developed countries. The larger energy consumption and greenhouse gas emission not only put additional pressure on finite fossil fuel resources but also cause global warming and climate change. Additionally, the residential housing sector will be consuming more energy as the house demand and average house floor area are progressively increasing. With currently used residential house wall systems, it is hard to reduce energy consumption for ongoing house space heating and cooling. A smart house wall envelope with optimal thermal masses and insulation materials is vital for reducing our increasing energy consumption. The major aim of this study is to investigate thermal performance and energy saving potential of a new house wall system for variable climate conditions. The thermal performance modelling was carried out using commercially developed software AccuRate ® . The findings indicate that a notable energy savings can be accomplished if a smart house wall system is used. -- Highlights: • Smart house wall system. • Thermal performance modelling and star energy rating. • Energy savings and greenhouse gas reduction

A systematic review of the relationship between staff perceptions of organizational readiness to change and the process of innovation adoption in substance misuse treatment programs.

Science.gov (United States)

Kelly, Peter; Hegarty, Josephine; Barry, Joe; Dyer, Kyle R; Horgan, Aine

2017-09-01

Translating innovation, such as contemporary research evidence, into policy and practice is a challenge, not just in substance misuse treatment programs, but across all spheres of healthcare. Organizational readiness to change (ORC) has been described as a fundamental concept, and an important determinant of the process of innovation adoption. The aim of this review was to describe the relationship between staff perceptions of ORC and the process of innovation adoption: exposure, adoption, implementation and integration into practice, in substance misuse treatment programs. This systematic review was conducted in accordance with PRISMA guidelines and fourteen papers were identified as being eligible for inclusion. This review was designed to include all constructs of ORC, but only one tool was used in all of the included papers. Despite this, the heterogeneity of studies in this review made a direct comparison of ORC related variables challenging. None of the included papers clearly related to one stage of the process of innovation adoption, and all of the included papers related to the early stages of the process. Only one paper attempted to measure the sustained integration of an innovation into practice. Overall, the papers were assessed as being low in terms of evidential hierarchy and the quality of the papers was assessed as being on average fair. ORC measurements provide us with a measure of organizational functioning which can be important in terms of predicting how successfully new innovations are adopted. Motivation for change was high in programs where staff identified more program deficits and these staff could also identify more specific needs, but were less likely to have exposure to new innovations. Better program resources and specific staff attributes, increase the likely hood of successful innovation adoption. A good organizational climate is potentially the strongest predictor for the adoption of new practices. It may be beneficial to measure ORC

Strategy Guideline: High Performance Residential Lighting

Energy Technology Data Exchange (ETDEWEB)

Holton, J.

2012-02-01

The Strategy Guideline: High Performance Residential Lighting has been developed to provide a tool for the understanding and application of high performance lighting in the home. The high performance lighting strategies featured in this guide are drawn from recent advances in commercial lighting for application to typical spaces found in residential buildings. This guide offers strategies to greatly reduce lighting energy use through the application of high quality fluorescent and light emitting diode (LED) technologies. It is important to note that these strategies not only save energy in the home but also serve to satisfy the homeowner's expectations for high quality lighting.

Staff personhood in dementia care settings: "Do they care about me?"

Science.gov (United States)

Cooke, Heather A

2018-06-01

This article aims to examine RCAs' own experiences of personhood in dementia care settings. Conceptually, person-centred care entails fostering the personhood of residents and the residential care aides (RCAs) who provide much of their hands-on care. To date, however, staff personhood has been overlooked in the empirical literature. The study was part of a larger focused ethnographic project exploring how the organisational care environment impedes or facilitates the provision of quality dementia care. Semi-structured interviews with 23 RCAs and more than 230 hours of participant observation were conducted in two nursing homes with specialised dementia units in British Columbia, Canada. Two overarching themes, "personhood undermined-management-staff relations" and "personhood undermined-workplace policies and practices" emerged, illustrating how, despite exposure to features believed beneficial to their working environment (e.g., favourable staffing ratios, relatively good remuneration), RCAs encountered repeated affronts to their personhood. The first theme encompasses the importance of being known (i.e., as persons and of their job demands) and valued (i.e., appreciated for their work in non-monetary terms). The second highlights the salience of work-life balance, full-staffing coverage and supportive human resource practices. RCAs' experiences reveal how the ongoing search for cost-efficiencies, cost-containment and cost-accountability overshadows their individuality, indicating a key disconnect between conceptual ideals and workplace realities. Organisations are encouraged to consider creating person-centred management and workplace practices that provide tangible evidence that RCAs, and their work, matter. © 2018 John Wiley & Sons Ltd.

Reconciliation or Racialization? Contemporary Discourses about Residential Schools in the Canadian Prairies

Science.gov (United States)

Gebhard, Amanda

2017-01-01

The residential school system is one of the darkest examples of Canada's colonial policy. Education about the residential schools is believed to be the path to reconciliation; that is, the restoration of equality between Aboriginal and non-Aboriginal peoples in Canada. While the acquisition of the long-ignored history of residential schools has…

Effect of music therapy on oncologic staff bystanders: a substantive grounded theory.

Science.gov (United States)

O'Callaghan, Clare; Magill, Lucanne

2009-06-01

Oncologic work can be satisfying but also stressful, as staff support patients and families through harsh treatment effects, uncertain illness trajectories, and occasional death. Although formal support programs are available, no research on the effects of staff witnessing patients' supportive therapies exists. This research examines staff responses to witnessing patient-focused music therapy (MT) programs in two comprehensive cancer centers. In Study 1, staff were invited to anonymously complete an open-ended questionnaire asking about the relevance of a music therapy program for patients and visitors (what it does; whether it helps). In Study 2, staff were theoretically sampled and interviewed regarding the personal effects of witnessing patient-centered music therapy. Data from each study were comparatively analyzed according to grounded theory procedures. Positive and negative cases were evident and data saturation arguably achieved. In Study 1, 38 staff unexpectedly described personally helpful emotional, cognitive, and team effects and consequent improved patient care. In Study 2, 62 staff described 197 multiple personal benefits and elicited patient care improvements. Respondents were mostly nursing (57) and medical (13) staff. Only three intrusive effects were reported: audibility, initial suspicion, and relaxation causing slowing of work pace. A substantive grounded theory emerged applicable to the two cancer centers: Staff witnessing MT can experience personally helpful emotions, moods, self-awarenesses, and teamwork and thus perceive improved patient care. Intrusive effects are uncommon. Music therapy's benefits for staff are attributed to the presence of live music, the human presence of the music therapist, and the observed positive effects in patients and families. Patient-centered oncologic music therapy in two cancer centers is an incidental supportive care modality for staff, which can reduce their stress and improve work environments and perceived

Factors contributing to the fluctuations in residential construction in Iran

Directory of Open Access Journals (Sweden)

Hassan Gholipour Fereidouni

2011-12-01

Full Text Available Residential construction is one of the most important pillars of Iran’s economy. Although this sector had an increasing trend over the past two decades, however, the growth rate of residential construction was very volatile. The purpose of this paper is to empirically investigate those factors contributing to this fluctuation over the 1991:Q2-2008:Q4. By applying cointegration approach, the empirical results show that housing prices, construction costs, GDP and gold prices are important factors to explain swings in residential construction in Iran.

Development of a Residential Integrated Ventilation Controller

Energy Technology Data Exchange (ETDEWEB)

Staff Scientist; Walker, Iain; Sherman, Max; Dickerhoff, Darryl

2011-12-01

The goal of this study was to develop a Residential Integrated Ventilation Controller (RIVEC) to reduce the energy impact of required mechanical ventilation by 20percent, maintain or improve indoor air quality and provide demand response benefits. This represents potential energy savings of about 140 GWh of electricity and 83 million therms of natural gas as well as proportional peak savings in California. The RIVEC controller is intended to meet the 2008 Title 24 requirements for residential ventilation as well as taking into account the issues of outdoor conditions, other ventilation devices (including economizers), peak demand concerns and occupant preferences. The controller is designed to manage all the residential ventilation systems that are currently available. A key innovation in this controller is the ability to implement the concept of efficacy and intermittent ventilation which allows time shifting of ventilation. Using this approach ventilation can be shifted away from times of high cost or high outdoor pollution towards times when it is cheaper and more effective. Simulations, based on the ones used to develop the new residential ventilation requirements for the California Buildings Energy code, were used to further define the specific criteria and strategies needed for the controller. These simulations provide estimates of the energy, peak power and contaminant improvement possible for different California climates for the various ventilation systems. Results from a field test of the prototype controller corroborate the predicted performance.

Residential solar-heating system

Science.gov (United States)

1978-01-01

Complete residential solar-heating and hot-water system, when installed in highly-insulated energy-saver home, can supply large percentage of total energy demand for space heating and domestic hot water. System which uses water-heating energy storage can be scaled to meet requirements of building in which it is installed.

FY 1997 report on the survey on the current residential waste treatment and integrated utilization of waste including heat supply in Shanghai city; 1997 nendo chosa hokokusho (Shanghai shi ni okeru seikatsu gomi shori no genjo narabini kyonetsunado wo fukumu sogo riyo ni kansuru chosa)

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

Survey was made on residential waste treatment in Shanghai city. Shanghai city with nearly 13 million registered residents produces on average 10,000-11,000 tons/day residential solid wastes. Such wastes are basically disposed by land filling. A landfill site has a current disposal capacity of 7,500 tons/day, and is scheduled to be expanded up to 9,000 tons/day. Problems of waste disposal in Shanghai city are as follows: transportation of wastes collected in the city by trucks, transportation through transit stations to the landfill site by ships, and high disposal cost. Shanghai Environmental Sanitation Bureau is pursuing researches on recycling of wastes, reduction of wastes and harmless treatment in place of conventional land filling. As the survey result, adoption of complete separate collection of wastes is basically important, and application of the latest technologies such as combustion treatment for every waste, heat use, gasification fusion furnace, and RDF (refuse derived fuel) for coal-firing boilers should be considered. 86 figs., 18 tabs.

Mediating the relation between workplace stressors and distress in ID support staff: comparison between the roles of psychological inflexibility and coping styles.

Science.gov (United States)

Kurz, A Solomon; Bethay, J Scott; Ladner-Graham, Jennifer M

2014-10-01

The present study examined how different patterns of coping influence psychological distress for staff members in programs serving individuals with intellectual disabilities. With a series of path models, we examined the relative usefulness of constructs (i.e., wishful thinking and psychological inflexibility) from two distinct models of coping (i.e., the transactional model and the psychological flexibility models, respectively) as mediators to explain how workplace stressors lead to psychological distress in staff serving individuals with intellectual disabilities. Analyses involved self-report questionnaires from 128 staff members (84% female; 71% African American) from a large, state-funded residential program for individuals with intellectual and physical disabilities in the southern United States of America. Cross-sectional path models using bootstrapped standard errors and confidence intervals revealed both wishful thinking and psychological inflexibility mediated the relation between workplace stressors and psychological distress when they were included in separate models. However, when both variables were included in a multiple mediator model, only psychological inflexibility remained a significant mediator. The results suggest psychological inflexibility and the psychological flexibility model may be particularly useful for further investigation on the causes and amelioration of workplace-related stress in ID settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Staff Association and you

CERN Multimedia

Association du personnel

2013-01-01

The Staff Association, your representative with the Management and the Member States The article VII 1.01 of the Staff Rules and Regulations (SR&R) provides that “the relations between the Director-General and the personnel shall be established either on an individual basis or on a collective basis with the Staff Association as intermediary”. This essential role of the Staff representatives, of being the spokesperson of the entire staff of the Organization vis-à-vis the Director-General and the Members States, is achieved through regular participation in the various joint advisory committees defined in the SR&R. The most important are the Standing Concertation Committee and the TREF, tripartite forum where your representatives meet with the Member States delegates, in the presence of the Management, to explain the position of the staff on the various issues concerning employment conditions. The Finance Committee also gives the opportunity to the Staff Association to ...

Working towards residential Radon survey in South America

International Nuclear Information System (INIS)

Zielinski, Jan M.; University of Ottawa, ON; Canoba, Analia C.; Shilnikova, Natalia S.; Veiga, Lene H. S.

2008-01-01

Information about residential radon levels in low and middle income countries is very sparse. In response to the World Health Organization initiative in the International Radon Project, we propose a research project that will address this knowledge gap in South America by conducting a residential radon survey. Following initial in vitro and in vivo studies of radon and studies of uranium miners exposed to radon, over twenty large case-control studies of lung cancer risk from exposure to residential radon have been completed worldwide by year 2004. Recently pooled data from these individual studies have been analyzed. These collaborative analyses of the indoor studies in Europe, North America, and China provide strong direct evidence that radon is causing a substantial number of lung cancers in the general population. To reduce radon lung cancer risk, national authorities must have methods and tools based on solid scientific evidence to develop sound public health policies. We propose to conduct a survey in ten South American countries using the distribution and analysis of passive alpha tracking detectors in houses selected at random in pre-selected cities in each participating country. We also present an approach to estimate the cost of carrying out such a survey and the radon laboratory infrastructure needed. The results of the proposed survey will allow to conduct assessment of the exposure to residential radon in the populations of South American countries and to assess the health impact of this exposure. The results of the project will also help national health authorities in developing national residential radon action levels and regulations, as well as provide public health guidance for radon awareness and mitigation. (author)

Types of spatial mobility and change in people's ethnic residential contexts

Directory of Open Access Journals (Sweden)

Kadi Mägi

2016-06-01

Full Text Available Background: Most studies of the ethnic composition of destination neighbourhoods after residential moves do not take into account the types of moves people have made. However, from an individual perspective, different types of moves may result in neighbourhood environments which differ in terms of their ethnic composition from those in which the individuals previously lived. Objective: We investigate how the ethnic residential context changes for individuals as a result of different types of mobility (immobility, intra-urban mobility, suburbanisation, and long-distance migration for residents of the segregated post-Soviet city of Tallinn. We compare the extent to which Estonian and Russian speakers integrate in residential terms. Methods: Using unique longitudinal Census data (2000-2011 we tracked changes in the individual ethnic residential context of both groups. Results: We found that the moving destinations of Estonian and Russian speakers diverge. When Estonians move, their new neighbourhood generally possesses a lower percentage of Russian speakers compared with when Russian speakers move, as well as compared with their previous neighbourhoods. For Russian speakers, the percentage of other Russian speakers in their residential surroundings decreases only for those who move to the rural suburbs or who move over longer distances to rural villages. Contribution: By applying a novel approach of tracking the changes in the ethnic residential context of individuals for all mobility types, we were able to demonstrate that the two largest ethnolinguistic groups in Estonia tend to behave as 'parallel populations' and that residential integration remains slow.

Potential energy savings by using direct current for residential applications

DEFF Research Database (Denmark)

Diaz, Enrique Rodriguez; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.

2017-01-01

improvement in the power converter units. However, for residential applications, the efficiency is not always improved. A grid connected residential microgrid, with renewable energy sources (RES), energy storage systems (ESS) and local loads, is presented in this work. The microgrid has been modelled...

Demand of elderly people for residential care: an exploratory study

NARCIS (Netherlands)

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

2006-01-01

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

2011 Residential Energy Efficiency Technical Update Meeting Summary Report

Energy Technology Data Exchange (ETDEWEB)

none,

2011-11-01

This report provides an overview of the U.S. Department of Energy Building America program's Summer 2011 Residential Energy Efficiency Technical Update Meeting. This meeting was held on August 9-11, 2011, in Denver, Colorado, and brought together more than 290 professionals representing organizations with a vested interest in energy efficiency improvements in residential buildings.

Residential Preferences: What's Terrorism Got to Do with It?

Science.gov (United States)

Kay, David; Geisler, Charles; Bills, Nelson

2010-01-01

Security has long been recognized as an element in residential preference and its relative importance has risen with fear of extremist attacks on U.S. cities. Using polling data from 2004, this research investigates whether the security breaches of 9/11 in New York City influenced residential preferences in New York State. Our results confirm that…

Views of general practice staff about the use of a patient-oriented treatment decision aid in shared decision making for patients with type 2 diabetes: A mixed-methods study.

Science.gov (United States)

Wildeboer, Anita; du Pon, Esther; Schuling, Jan; Haaijer-Ruskamp, Flora M; Denig, Petra

2018-02-01

Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited. To explore views of practice staff towards SDM and the DA. A mixed-methods study within the Dutch PORTDA-diab trial. Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients. Interviews were conducted focusing on applicability, usefulness and feasibility of the DA. Interviews were tape-recorded, transcribed verbatim and subjected to content analysis for identifying and classifying views. Patient-reported data about the use of the DA were collected. Associations between specific views and use of the DA were tested using Pearson point-biserial correlation. The majority of practice staff expressed positive views towards SDM, which was associated with making more use of the DA. Most of the staff expressed that the DA stimulated a two-way conversation. By using the DA, several became aware of their paternalistic approach. Some staff experienced a conflict with the content of the DA, which was associated with making less use of the DA. The DA was considered useful by practice staff to support SDM. A positive view towards SDM was a facilitator, whereas experiencing a conflict with the content of the DA was a barrier for making use of the DA. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Educating Emergency Department Staff on the Identification and Treatment of Human Trafficking Victims.

Science.gov (United States)

Donahue, Steven; Schwien, Michael; LaVallee, Danielle

2018-05-17

Hospitalization is one of the few circumstances in which the lives of trafficking victims intersect with the general population. Based on survivor testimonies, the majority of human trafficking victims may receive medical treatment in a hospital's emergency department while in captivity. With evidenced-based training, ED personnel have a better opportunity to screen persons who are being trafficked and intervene on their behalf. This project examined the efficacy of an innovative, evidence-based online training module (HTEmergency.com) created by the project team. Participants completed a pre-survey to determine learning needs and a post-survey to determine the effectiveness of the online education. The learning module contained a PowerPoint presentation, identification and treatment guidelines, and 2 realistic case studies. Data were collected among ED personnel in 2 suburban hospitals located near a northeast metropolitan city. Seventy-five employees participated in the survey and education. Staff completing the education included nurses, physicians, nurse practitioners/physician assistants, registration, and ED technicians. Results indicated that 89% of participants had not received previous human trafficking training. Less than half of the participants stated that they had a comprehensive understanding of human trafficking before the intervention, with an increase to 93% after education. The training module significantly increased confidence in identification (from an average confidence level of 4/10 to 7/10) and treatment (from an average confidence level of 4/10 to 8/10) of human trafficking victims within the emergency department; 96% found the educational module to be useful in their work setting. Participants reported that they are more confident in identifying a possible trafficking victim and are more likely to screen patients for human trafficking after participation in the online training module. The proposed general guideline for care provided ED

PERMEABILITY MAP OF RESIDENTIAL SETTLEMENTS IN THE TROPICS

OpenAIRE

I Gusti Ngurah Antaryama

2002-01-01

Source of information for ventilation design of residential settlement is generally derived from wind tunnel or, recently, CFD studies, which involves both modeling and simulation of wind flow pattern and speed. Yet this is not readily accessible to most architects. In order to gain similar objectives but without involving detailed studies, the present study introduces a graphical method of gathering information about permeability of residential. It describes how the way wind reaches and flow...

Older Men's Experiences of Moving Into Residential Care

OpenAIRE

Weighell, Simon

2015-01-01

Research examining the transition into residential aged care suggests that it can have a significant psychological and physiological impact upon older adults. There is a dearth of research examining the specific experiences of older men moving into and living in residential aged care. Older men may be at a significant disadvantage in managing the transition into care, particularly in context to; institutional living often characterised by increased dependency and a loss of control; physical d...

AGA predicts winter jump in residential gas price

International Nuclear Information System (INIS)

Anon.

1992-01-01

The American Gas Association predicts the average heating bill for residential gas consumers could increase by as much as 18% this winter. AGA Pres. Mike Baly said, Last year's winter was warmer than normal. If the 1992-93 winter is similar, AGA projects that residential natural gas heating bills will go up about 6%. If we see a return to normal winter weather, our projection show the average bill could rise by almost 18%

Barriers to postoperative pain management in hip fracture patients with dementia as evaluated by nursing staff.

Science.gov (United States)

Rantala, Maija; Kankkunen, Päivi; Kvist, Tarja; Hartikainen, Sirpa

2014-03-01

This paper reports a study of the perceptions of nursing staff regarding barriers to postoperative pain management in hip fracture patients with dementia, their expectations, and facilitators offered by their employers to overcome these barriers. Patients with dementia are at high risk for insufficient postoperative pain treatment, mainly owing to inability to articulate or convey their pain experience. Nursing staff have an essential role in the treatment and care of patients who are vulnerable, and therefore unable to advocate for their own pain treatment. Questionnaires with both structured and open-ended questions were used to collect data from nursing staff members in seven university hospitals and ten city-center hospitals from March to May 2011. The response rate was 52% (n = 331). According to nursing staff, the biggest barrier in pain management was the difficulty in assessing pain owing to a patient's cognitive impairment (86%). Resisting care and restlessness among patients with dementia can lead to use of restraints, although these kinds of behavioral changes can point to the occurrence of pain. There were statistically significant differences between the sufficiency of pain management and barriers. Those who expected pain management to be insufficient identified more barriers than those who expected pain management to be sufficient (p nursing staff in pain detection and management is needed so that nursing staff are also able to recognize behavioral symptoms as potential signs of pain and provide appropriate pain management. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Optimisation of staff protection

International Nuclear Information System (INIS)

Faulkner, K.; Marshall, N.W.; Rawlings, D.J.

1997-01-01

It is important to minimize the radiation dose received by staff, but it is particularly important in interventional radiology. Staff doses may be reduced by minimizing the fluoroscopic screening time and number of images, compatible with the clinical objective of the procedure. Staff may also move to different positions in the room in an attempt to reduce doses. Finally, staff should wear appropriate protective clothing to reduce their occupational doses. This paper will concentrate on the optimization of personal shielding in interventional radiology. The effect of changing the lead equivalence of various protective devices on effective dose to staff has been studied by modeling the exposure of staff to realistic scattered radiation. Both overcouch x-ray tube/undercouch image intensified and overcouch image intensifier/undercouch x-ray tube geometries were simulated. It was deduced from this simulation that increasing the lead apron thickness from 0.35 mm lead to 0.5 mm lead had only a small reducing effect. By contrast, wearing a lead rubber thyroid shield or face mask is a superior means of reducing the effective dose to staff. Standing back from the couch when the x-ray tube is emitting radiation is another good method of reducing doses, being better than exchanging a 0.35 mm lead apron for a 0.5 mm apron. In summary, it is always preferable to shield more organs than to increase the thickness of the lead apron. (author)

38 CFR 17.65 - Approvals and provisional approvals of community residential care facilities.

Science.gov (United States)

2010-07-01

... approvals of community residential care facilities. 17.65 Section 17.65 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Community Residential Care § 17.65 Approvals and provisional approvals of community residential care facilities. (a) An approval of a facility meeting all of...

The development of a healing model of care for an Indigenous drug and alcohol residential rehabilitation service: a community-based participatory research approach.

Science.gov (United States)

Munro, Alice; Shakeshaft, Anthony; Clifford, Anton

2017-12-04

Given the well-established evidence of disproportionately high rates of substance-related morbidity and mortality after release from incarceration for Indigenous Australians, access to comprehensive, effective and culturally safe residential rehabilitation treatment will likely assist in reducing recidivism to both prison and substance dependence for this population. In the absence of methodologically rigorous evidence, the delivery of Indigenous drug and alcohol residential rehabilitation services vary widely, and divergent views exist regarding the appropriateness and efficacy of different potential treatment components. One way to increase the methodological quality of evaluations of Indigenous residential rehabilitation services is to develop partnerships with researchers to better align models of care with the client's, and the community's, needs. An emerging research paradigm to guide the development of high quality evidence through a number of sequential steps that equitably involves services, stakeholders and researchers is community-based participatory research (CBPR). The purpose of this study is to articulate an Indigenous drug and alcohol residential rehabilitation service model of care, developed in collaboration between clients, service providers and researchers using a CBPR approach. This research adopted a mixed methods CBPR approach to triangulate collected data to inform the development of a model of care for a remote Indigenous drug and alcohol residential rehabilitation service. Four iterative CBPR steps of research activity were recorded during the 3-year research partnership. As a direct outcome of the CBPR framework, the service and researchers co-designed a Healing Model of Care that comprises six core treatment components, three core organisational components and is articulated in two program logics. The program logics were designed to specifically align each component and outcome with the mechanism of change for the client or organisation

Staff Group Trainer: Development of a Computer-Driven, Structured, Staff Training Environment

National Research Council Canada - National Science Library

Koger, Milton

1998-01-01

.... The project produced two training support packages (TSP)--battalion and brigade--designed to train these staffs to more effectively and efficiently communicate within and between staff sections, command post, and the unit commander...