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Sample records for ride home programs

  1. Examination of a University-Affiliated Safe Ride Program

    Science.gov (United States)

    Gieck, D. Joseph; Slagle, David M.

    2010-01-01

    A university-affiliated safe ride program was evaluated to determine whether these programs can reduce drunk-driving related costs. Data was collected from 187 safe ride passengers during three nights of operation. Among the passengers, 93% were enrolled at a local University, 31% were younger than 21, and 40% reported a prior alcohol-related…

  2. Ostomy Home Skills Program

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    Full Text Available ... ACS Careers at ACS About ACS Career Types Working at ACS ... Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy ...

  3. Ostomy Home Skills Program

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    Full Text Available ... JACS Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Careers at ACS Careers at ACS About ACS Career Types Working at ACS ... American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills ...

  5. Ostomy Home Skills Program

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    Full Text Available ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  6. Ostomy Home Skills Program

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    Full Text Available ... Advocate at Home Program State Legislative Action Center Leadership & Advocacy Summit Webinars Practice Management Practice Management Practice Management CPT Coding Bulletin Articles ...

  7. Ostomy Home Skills Program

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    Full Text Available ... Centers National Cancer Database National Accreditation Program for Rectal Cancer Oncology Medical Home Accreditation Program Stereotactic Breast ... collaboration with the American Society of Colon and Rectal Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal ...

  8. Home | SREL Herpetology Program

    Science.gov (United States)

    Savannah River Ecology Laboratory Herpetology Program Herp Home Research Publications Herps of SC /GA P.A.R.C. Outreach SREL Home powered by Google Search Herpetology at SREL The University of SREL herpetology research programs have always included faculty of the University of Georgia, post

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation ...

  10. Ostomy Home Skills Program

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    Full Text Available ... of Surgeons Professional Association Advocate at Home Program State Legislative Action Center Leadership & Advocacy Summit Webinars Practice Management Practice Management Practice Management CPT Coding Bulletin Articles ...

  11. Ostomy Home Skills Program

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    Full Text Available ... for Hospitals Ostomy Home Skills Hospital Quality Improvement Package The standardized interactive program has been developed by the American College of Surgeons ... and Associates Medical Students International Surgeons ...

  12. Ostomy Home Skills Program

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    Full Text Available ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement Package The standardized interactive program has been developed by the ...

  13. Ostomy Home Skills Program

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    Full Text Available ... at ACS ACS and Veterans Diversity at ACS Benefits ... Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  14. Ostomy Home Skills Program

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    Full Text Available ... Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in Surgery Medical Student Resources ... checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS Ostomy Home ...

  15. Ostomy Home Skills Program

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    Full Text Available ... Stay Up to Date with ACS Association Management Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  16. Ostomy Home Skills Program

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    Full Text Available ... Up to Date with ACS Association Management JACS Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  17. Ostomy Home Skills Program

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    Full Text Available ... ACS ACS and Veterans Diversity at ACS Benefits ... Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  18. Ostomy Home Skills Program

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    Full Text Available ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with quality, comprehensive education. The standardized interactive program has been ...

  19. Ostomy Home Skills Program

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    Full Text Available ... Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ... facs.org Copyright © 1996-2018 by the American College of Surgeons, Chicago, IL 60611-3295 | Privacy Policy | Terms of Use

  20. Ostomy Home Skills Program

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    Full Text Available ... Use Patient Opioid Use Position Statements and Task Force Patient Education Initiatives Advocacy and Health Policy Updates Selected Research ... at ACS ACS and Veterans Diversity at ACS Benefits ... Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues Stop Overregulating My OR ... American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). Program Overview The skills kit contains: A booklet with information on the operation, home skills such as emptying ...

  2. Economic analysis of the organisation of a riding centre; application of the linear programming approach

    Directory of Open Access Journals (Sweden)

    Jaka ŽGAJNAR

    2015-12-01

    Full Text Available In this contribution, the economics of an equestrian centre, which in addition to a variety of riding school activities also includes breeding and livery, are analysed. We consider the conditions for a hypothetical holding operating in central Slovenia. Methods of mathematical programming are applied in order to attempt to optimise the holding’s activities. Their use may in the given situation facilitate the evaluation of development prospects from different perspectives and indicate the opportunities of increasing value-added. On the basis of maximizing the gross margin, we try to address the various questions and challenges that arise in managing and planning for such an equestrian centre. The obtained results indicate that breeding is unfavourable in the given price-cost ratio, both for the renewal of the working horses herd and for sale. This reflects the current adverse situation in the field of horse breeding. Livery is an important activity on such holdings and through opportunity perspective provides an optimal set of activities. Activities of the riding school for children are interesting in terms of income diversification, as well as an additional source of revenue. A riding school with one riding instructor and an indoor arena needs 4.6 horses in order to cover the costs of full-time employment.

  3. Home safe home: Evaluation of a childhood home safety program.

    Science.gov (United States)

    Stewart, Tanya Charyk; Clark, Andrew; Gilliland, Jason; Miller, Michael R; Edwards, Jane; Haidar, Tania; Batey, Brandon; Vogt, Kelly N; Parry, Neil G; Fraser, Douglas D; Merritt, Neil

    2016-09-01

    The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. Therapeutic/care management study

  4. 77 FR 39208 - Information Collection: Ride-Along Program

    Science.gov (United States)

    2012-07-02

    ... accompany them in boats, cars, trucks, or other vehicles. The purpose of this program is for citizens to... minimize the burden of the collection of information on respondents, including the use of automated...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Overview The skills kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  7. Ostomy Home Skills Program

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    Full Text Available ... Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education ... Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed ...

  8. Ostomy Home Skills Program

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    Full Text Available ... Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the ...

  9. Ostomy Home Skills Program

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    Full Text Available ... Specific Registry Surgeon Specific Registry News and Updates Account Setup Resources and FAQs Features of the SSR ... Today Ostomy Home Skills Kit (login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy ...

  10. Ostomy Home Skills Program

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    Full Text Available ... skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking ...

  11. Ostomy Home Skills Program

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    Full Text Available ... Trauma Programs Trauma Programs About Trauma Programs Violence Prevention BleedingControl.org Trauma Quality Programs National Trauma Data ... Conference Publications and Posters National Trauma System Injury Prevention and Control Quality and Safety Conference Quality and ...

  12. Ostomy Home Skills Program

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    Full Text Available ... Trauma Trauma Programs Trauma Programs About Trauma Programs Violence Prevention BleedingControl.org Trauma Quality Programs National Trauma ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  13. Ostomy Home Skills Program

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    Full Text Available ... and Safety Conference Participant Use Data File Surgical Risk Calculator Frequently Asked Questions Participant Hub Contact Us ... Trauma Programs Trauma Programs About Trauma Programs Violence Prevention BleedingControl.org Trauma Quality Programs National Trauma Data ...

  14. Ostomy Home Skills Program

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    Full Text Available ... Membership Directory 2017 Annual Meeting 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact Us Quality Programs Quality Programs Overview About Quality Programs ACS ...

  15. Ostomy Home Skills Program

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    Full Text Available ... Continuous Certification Requirements SSR Login MIPS Resources and Education Quality and Safety Conference Trauma Trauma Programs Trauma Programs About Trauma Programs Violence Prevention BleedingControl.org Trauma Quality Programs National Trauma ...

  16. Ostomy Home Skills Program

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    Full Text Available ... Membership Directory 2017 Annual Meeting 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact Us Quality Programs Quality Programs Overview About Quality Programs ACS Leadership in Quality ACS Leadership in Quality Setting the ...

  17. Ostomy Home Skills Program

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    Full Text Available ... Trauma Quality Programs National Trauma Data Bank Trauma Quality Improvement Program Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals ...

  18. Ostomy Home Skills Program

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    Full Text Available ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ... and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with ...

  19. Ostomy Home Skills Program

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    Full Text Available ... Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards Cancer Programs News Quality in Geriatric ... Continuous Certification Requirements SSR Login MIPS Resources and Education Quality and Safety Conference Trauma Trauma Programs Trauma ...

  20. Ostomy Home Skills Program

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    Full Text Available ... and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ... Enrollment Webinars ACS NSQIP ACS National Surgical Quality Improvement Program ACS National Surgical Quality Improvement Program About ...

  1. Ostomy Home Skills Program

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    Full Text Available ... Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ... ISCR Enrollment Webinars ACS NSQIP ACS National Surgical Quality Improvement Program ACS National Surgical Quality Improvement Program About ...

  2. Ostomy Home Skills Program

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    Full Text Available ... Policy Updates Selected Research Findings Quality Program Initiatives Communications to the Profession Advocacy Advocacy Overview Quality Payment Program QPP Resource Center QPP Resource Center 2018 Information 2017 Information Program Rules Surgeon Specific Registry Metabolic ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Military Health System Strategic Partnership Military Health System Strategic Partnership About Excelsior Surgical Society ... Programs Quality Programs Overview About Quality Programs ACS Leadership in Quality ACS Leadership in Quality Setting the ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Membership Directory 2017 Annual Meeting 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact ... Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards Cancer Programs News Quality in Geriatric ...

  5. Ostomy Home Skills Program

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    Full Text Available ... Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters ...

  6. Ostomy Home Skills Program

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    Full Text Available ... in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths ...

  7. Ostomy Home Skills Program

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    Full Text Available ... Canada) International Fellows Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount Programs FACS Resources Career Connection Update ...

  8. Ostomy Home Skills Program

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    Full Text Available ... Validation Programs Accreditation, Verification, and Validation Programs Accredited Education Institutes ... Entering Resident Readiness Assessment Evidence-Based Decisions in ...

  9. Ostomy Home Skills Program

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    Full Text Available ... National Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards Cancer Programs News Quality in Geriatric Surgery Coalition for Quality in Geriatric ...

  10. Ostomy Home Skills Program

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    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... Overview The skills kit contains: A booklet with information on the ... and home management. A DVD with demonstration of each skill Stoma ...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... supports the entire surgical team with quality, comprehensive education. The ... A booklet with information on the operation, home skills such as emptying ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample pouch) Ostomy self-care checklist Evaluation (Complete the Ostomy Patient Survey . We ...

  13. Rapid emergence of free-riding behavior in new pediatric immunization programs.

    Directory of Open Access Journals (Sweden)

    Chris T Bauch

    Full Text Available BACKGROUND: Mathematical models have formalized how free-rider effects can threaten the stability of high vaccine coverage levels under established voluntary vaccination programs. However, little research has addressed the question of when free-riding begins to develop when a new vaccine is first introduced in a population. METHODOLOGY/PRINCIPAL FINDINGS: Here, we combine a game theoretical model of vaccinating behavior with an age-structured compartmental model to analyze rational vaccinating behavior in the first years of a universal immunization program, where a new vaccine is free to all children of a specified age. The model captures how successive birth cohorts face different epidemiological landscapes that have been shaped by the vaccinating decisions of previous birth cohorts, resulting in a strategic interaction between individuals in different birth cohorts. The model predicts a Nash equilibrium coverage level of for the first few birth cohorts under the new program. However, free-riding behavior emerges very quickly, with the Nash equilibrium vaccine coverage dropping significantly within 2-5 years after program initiation. Subsequently, a rich set of coupled dynamics between infection prevalence and vaccinating behaviors is possible, ranging from relatively stable (but reduced coverage in later birth cohorts to wide fluctuations in vaccine coverage from one birth cohort to the next. Individual tolerance for vaccine risk also starts out at relatively high levels before dropping significantly within a few years. CONCLUSIONS/SIGNIFICANCE: These results suggest that even relatively new immunization programs can be vulnerable to drops in vaccine coverage caused by vaccine scares and exacerbated by herd immunity effects, necessitating vigilance from the start.

  14. Ostomy Home Skills Program

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    Full Text Available ... Advocacy Efforts Cancer Liaison Program Cancer Programs Conference Clinical Research Program Commission on Cancer National Accreditation Program for ... and Safety Conference ACS Clinical Scholars in Residence Clinical Trials ... Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma ...

  15. Ostomy Home Skills Program

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    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues Stop Overregulating My OR ... Rectal Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). The skills kit contains: A booklet with information on the operation, home skills such as emptying ...

  16. Ostomy Home Skills Program

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    Full Text Available ... Quality Standard Optimal Resources for Surgical Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program for ISCR AHRQ Safety Program for ISCR ...

  17. Ostomy Home Skills Program

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    Full Text Available ... Member Fellows International Fellows Associate Fellows Residents Medical Students Affiliate Members Fees and Dues Realize the Potential ... and Canada) International Fellows Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount Programs ...

  18. Ostomy Home Skills Program

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    Full Text Available ... Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury Prevention and ... Division of Education ACS Education and Training Courses Publications Resources Education Program Videos Contact Us Clinical Congress ...

  19. Ostomy Home Skills Program

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    Full Text Available ... SESAP Sampler SRGS Resources in Surgical Education ACS Fundamentals of Surgery Curriculum Mastery in General Surgery Program ... Communications to the Profession Advocacy Advocacy Overview Quality Payment Program QPP Resource Center QPP Resource Center 2018 ...

  20. Ostomy Home Skills Program

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    Full Text Available ... Profession Member Benefits About Member Benefits About Member Benefits Fellows (US and Canada) International Fellows Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount Programs ...

  1. Ostomy Home Skills Program

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    Full Text Available ... Program State Legislation Tracked by the College Maintenance of Certification Quality Quality Quality Electronic Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use ...

  2. Ostomy Home Skills Program

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    Full Text Available ... About Quality Programs ACS Leadership in Quality ACS Leadership in Quality Setting the Quality Standard Optimal Resources for Surgical Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ...

  3. Ostomy Home Skills Program

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    Full Text Available ... My OR EHR Incentive Program Global Codes and Data Collection Patient Opioid Use New Medicare Card Project Medicare ... self-care checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Be a YFA Leader Meetings and Events YFA Mentor Programs YFA Speakers Bureau Top 10 Reasons to ... National Trauma Data Bank Trauma Quality Improvement Program Mentoring for Excellence in Trauma Surgery Advanced Trauma Life ...

  5. Ostomy Home Skills Program

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    Full Text Available ... Meetings and Events Scholarships, Competitions, Awards, and Project Work Top 10 Reasons to Participate Grand Rounds Webinar ... Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards Cancer Programs News Quality in Geriatric ...

  6. Ostomy Home Skills Program

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    Full Text Available ... About ACS NSQIP Join ACS NSQIP Now Collaboratives Hospital Compare Quality and Safety Conference Participant Use Data ... Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero ...

  7. Ostomy Home Skills Program

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    Full Text Available ... Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount Programs FACS Resources Career Connection ... and Awards Overview Scholarships, Fellowships, and Awards Overview Health Policy Scholarships Scholarships for International Surgeons Research Scholarships ...

  8. Ostomy Home Skills Program

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    Full Text Available ... Class Clinical Congress 2018 Events at Clinical Congress Child Care at Clinical Congress Info for International Attendees ... Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards Cancer Programs News Quality in Geriatric ...

  9. Ostomy Home Skills Program

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    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ... Research Findings Quality Program Initiatives Communications to the Profession Advocacy Advocacy Overview Quality Payment Program QPP Resource ...

  10. Ostomy Home Skills Program

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    Full Text Available ... State Requirements Contact Online Education Accreditation, Verification, and Validation Accreditation, Verification, and Validation Programs Accreditation, Verification, and ...

  11. Ostomy Home Skills Program

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    Full Text Available ... Trauma Programs About Trauma Programs Violence Prevention BleedingControl.org Trauma Quality Programs National Trauma Data Bank Trauma ... 5000 (F) 312-202-5001 (E) postmaster@facs.org Copyright © 1996-2018 by the American College of ...

  12. Ostomy Home Skills Program

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    Full Text Available ... Special Activities Resources Housing and Travel ... Contact Online Education Accreditation, Verification, and Validation Accreditation, Verification, and Validation Programs Accreditation, Verification, and ...

  13. Ostomy Home Skills Program

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    Full Text Available ... Life Support Verification, Review, and Consultation Program for Hospitals ... Injury Prevention and Control Quality and Safety Conference Quality and Safety Conference Quality ...

  14. Ostomy Home Skills Program

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    Full Text Available ... Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment ... Practice Management Practice Management Practice Management CPT Coding Bulletin Articles ...

  15. Ostomy Home Skills Program

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    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  16. Ostomy Home Skills Program

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    Full Text Available ... Program Federal Legislation Federal Legislation Federal Legislation Health Care Reform Summary Letters on Health Care Reform Medicare Physician Payment Medical Liability Reform Opioids ...

  17. Ostomy Home Skills Program

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    Full Text Available ... Program About ACS NSQIP Join ACS NSQIP Now Collaboratives Hospital Compare Quality and Safety Conference Participant Use ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ...

  18. Ostomy Home Skills Program

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    Full Text Available ... and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety ... Involved Get Involved SurgeonsVoice American College of Surgeons Professional Association State Legislative Action Center Leadership & Advocacy Summit ...

  19. Ostomy Home Skills Program

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    Full Text Available ... Congress Educational Program Events and Special Activities Resources Housing and Travel Exhibitors Media Information Clinical Congress 2017 ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

  20. Ostomy Home Skills Program

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    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ... ACS Fundamentals of Surgery Curriculum Mastery in General Surgery Program ...

  1. Ostomy Home Skills Program

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    Full Text Available ... in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation ... to SRGS Issues Contact and FAQs ACS Case Reviews in Surgery ACS Case Reviews in Surgery ACS ...

  2. Ostomy Home Skills Program

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    Full Text Available ... QPP Resource Center 2018 Information 2017 Information Program Rules Surgeon Specific Registry Metabolic and Bariatric Surgery Accreditation ... Card Project Medicare Enrollment and Participation Medicare Payment Rules Physician Quality Reporting System (PQRS) Value-Based Payment ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Chapter Competition Editorial Board Contact Resources in Surgical Education Newsletters Newsletters Overview Newsletters Overview ACS-AEI Consortium Quarterly ACS Chapter News Cancer Programs Brief Committee on Trauma News The Cutting Edge Philanthropy at Work ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety Resources About the Patient Education ... Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of ...

  5. Ostomy Home Skills Program

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  6. Ostomy Home Skills Program

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  7. Ostomy Home Skills Program

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  8. Ostomy Home Skills Program

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  9. Ostomy Home Skills Program

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  12. Ostomy Home Skills Program

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    Full Text Available ... ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). Program Overview The skills kit contains: A booklet with information on the ...

  13. Ostomy Home Skills Program

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    Full Text Available ... Patient Safety Resources About the Patient Education Program The Recovery Room ... ACS/ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical ...

  14. Ostomy Home Skills Program

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  15. Ostomy Home Skills Program

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  16. Ostomy Home Skills Program

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  17. Ostomy Home Skills Program

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    Full Text Available ... Program About ACS NSQIP Join ACS NSQIP Now Collaboratives Hospital Compare Quality and Safety Conference Participant Use ... Asked Questions Resources Educational Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in ...

  18. Ostomy Home Skills Program

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    Full Text Available ... Policy Updates Selected Research Findings Quality Program Initiatives Communications to the Profession Advocacy Advocacy Overview Quality Payment ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  19. Ostomy Home Skills Program

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    Full Text Available ... to Participate Resources Webinars for Young Surgeons YFA E-News YFA Advocacy Essay Contest Resident and Associate ... ACS Leader International Exchange Scholar Program Resources RAS E-News Medical Students Operation Giving Back Operation Giving ...

  20. Ostomy Home Skills Program

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    Full Text Available ... ASE Resident Prep Curriculum ACS/ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. ...

  1. Ostomy Home Skills Program

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    Full Text Available ... Membership Directory 2017 Annual Meeting 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  2. Ostomy Home Skills Program

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    Full Text Available ... Quality ACS Leadership in Quality Setting the Quality Standard Optimal Resources for Surgical Quality and Safety Inspiring ... Clinical Data Registry Quality and Safety Conference Resources Standards Manual Contact Us Breast Disease National Accreditation Program ...

  3. Ostomy Home Skills Program

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  4. Ostomy Home Skills Program

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    Full Text Available ... CME Accreditation PartnerCME Joint Providership Program Verification of Knowledge and Skills Academy of Master Surgeon Educators Academy ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Program About ACS NSQIP Join ACS NSQIP Now Collaboratives Hospital Compare Quality and Safety Conference Participant Use ... on Trauma News The Cutting Edge Philanthropy at Work RAS E-News YFA E-News Primers and ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Communications to the Profession Advocacy Advocacy Overview Quality Payment Program QPP Resource Center QPP Resource Center 2018 ... Summary Letters on Health Care Reform Medicare Physician Payment Medical Liability Reform Opioids and Surgical Care GME ...

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Membership Excelsior Surgical Society Officer Nominations ACS Clinical Congress Fitts Oration Contact MHSSPACS Society of Surgical Chairs ... Publications Resources Education Program Videos Contact Us Clinical Congress Clinical Congress 2018 Clinical Congress 2018 Postgraduate Courses ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Issues Stop Overregulating My OR EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation Medicare Payment Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Third Party ...

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury ... Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure ...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Policy Updates Selected Research Findings Quality Program Initiatives Communications to the Profession Advocacy Advocacy Overview Quality Payment ... Participation Medicare Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care Organizations ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Webinars Primers and Compendiums Quality Payment Program AMA House of Delegates ACS in the AMA House of Delegates ACS in the AMA House of Delegates Surgical Caucus of the AMA Committee ...

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports Physician Compare Website Phases of Surgical Care S- ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Advocacy Summit Webinars Practice Management Practice Management Practice Management CPT Coding Bulletin Articles CPT Coding Workshops ICD-10 Coding Physicians as Assistants at Surgery Webinars Primers and Compendiums Quality Payment Program AMA House of Delegates ACS in ...

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Programs YFA Speakers Bureau Advocacy Essays Top 10 Reasons to Participate Resources Webinars for Young Surgeons YFA ... Scholarships, Competitions, Awards, and Project Work Top 10 Reasons to Participate Grand Rounds Webinar Series RAS-JACS ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care Organizations Stark Law ... Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Nurses (CETN), and the United Ostomy Associations of America (UOAA). Program Overview The skills kit contains: A ... Nurses (CETN), and the United Ostomy Associations of America (UOAA). Back to Top Find A Surgeon Find ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Call for Abstracts Hotel Accommodations Travel Information 2017 Presentations Education Education Overview Division of Education About the ... the College Maintenance of Certification Quality Quality Quality Electronic Health Records (EHR) Incentive Program Physician Quality Reporting ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Geriatric Surgery Project Project Goals and Activities Stakeholder Organizations Project Team Resources News Contact Us Strong for ... Policy Updates Selected Research Findings Quality Program Initiatives Communications to the Profession Advocacy Advocacy Overview Quality Payment ...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ACS/ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Overview ACS-AEI Consortium Quarterly ACS Chapter News ... team with quality, comprehensive education. The standardized interactive program has been developed by the American College of Surgeons (ACS) in collaboration with the American Society of Colon and Rectal Surgeons (ASCRS), American Urological Association (AUA), ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues Stop Overregulating My OR ... Electronic Health Records (EHR) Incentive Program Physician Quality Reporting System ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Data Registry Quality and Safety Conference Resources ... interactive program has been developed by the American College of Surgeons (ACS) in collaboration with the American Society of Colon and Rectal Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ACS Meetings and Events Scholarships, Competitions, Awards, and Project Work Top 10 Reasons to Participate Grand Rounds Webinar Series RAS-JACS Journal Club Hangout Discussions Membership I Want to Be a RAS-ACS Leader International Exchange Scholar Program ...

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support ... Quality Program Initiatives Communications to the Profession ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. Interact. Transform. CoC Events Quality Education Quality Education Quality Education ...

  9. Never Riding the Tide

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 13; Issue 10. Never Riding the Tide - Seymour Benzer–The Founder of Neurogenetics. K VijayRaghavan Veronica Rodrigues. General Article Volume 13 Issue 10 October 2008 pp 909-915 ...

  10. Home audit program: management manual

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  11. ACED Allegheny Home Improvement Loan Program (AHILP)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Allegheny Home Improvement Loan Program (AHILP) is the most affordable way for eligible Allegheny County residents to rehabilitate and improve their homes....

  12. Comparison of Home Retrofit Programs in Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, Kerrie [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership; Hannigan, Eileen [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership

    2013-03-01

    To explore ways to reduce customer barriers and increase home retrofit completions, several different existing home retrofit models have been implemented in the state of Wisconsin. This study compared these programs' performance in terms of savings per home and program cost per home to assess the relative cost-effectiveness of each program design. However, given the many variations in these different programs, it is difficult to establish a fair comparison based on only a small number of metrics. Therefore, the overall purpose of the study is to document these programs' performance in a case study approach to look at general patterns of these metrics and other variables within the context of each program. This information can be used by energy efficiency program administrators and implementers to inform home retrofit program design. Six different program designs offered in Wisconsin for single-family energy efficiency improvements were included in the study. For each program, the research team provided information about the programs' approach and goals, characteristics, achievements and performance. The program models were then compared with performance results-program cost and energy savings-to help understand the overall strengths and weaknesses or challenges of each model.

  13. Comparison of Home Retrofit Programs in Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, K.; Hannigan, E.

    2013-03-01

    To explore ways to reduce customer barriers and increase home retrofit completions, several different existing home retrofit models have been implemented in the state of Wisconsin. This study compared these programs' performance in terms of savings per home and program cost per home to assess the relative cost-effectiveness of each program design. However, given the many variations in these different programs, it is difficult to establish a fair comparison based on only a small number of metrics. Therefore, the overall purpose of the study is to document these programs' performance in a case study approach to look at general patterns of these metrics and other variables within the context of each program. This information can be used by energy efficiency program administrators and implementers to inform home retrofit program design. Six different program designs offered in Wisconsin for single-family energy efficiency improvements were included in the study. For each program, the research team provided information about the programs' approach and goals, characteristics, achievements and performance. The program models were then compared with performance results -- program cost and energy savings -- to help understand the overall strengths and weaknesses or challenges of each model.

  14. Behavior and Development: Physical Development--"Riding Along" Outdoors!

    Science.gov (United States)

    Strickland, Eric

    2005-01-01

    Riding toys and push-pull toys are traditionally part of every early childhood program. Young children can develop a wide variety of skills and get numerous health benefits from riding toys if one is careful and thoughtful in setting up the riding-toy area. This article describes various types of riding toys and activity ideas to enhance…

  15. 45 CFR 1306.33 - Home-based program option.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33 Home-based program option. (a) Grantees implementing a home-based program option must: (1) Provide one home...

  16. The Hospital at Home program: no place like home.

    Science.gov (United States)

    Lippert, M; Semmens, S; Tacey, L; Rent, T; Defoe, K; Bucsis, M; Shykula, T; Crysdale, J; Lewis, V; Strother, D; Lafay-Cousin, L

    2017-02-01

    The treatment of children with cancer is associated with significant burden for the entire family. Frequent clinic visits and extended hospital stays can negatively affect quality of life for children and their families. Here, we describe the development of a Hospital at Home program (H@H) that delivers therapy to pediatric hematology, oncology, and blood and marrow transplant (bmt) patients in their homes. The services provided include short infusions of chemotherapy, supportive-care interventions, antibiotics, post-chemotherapy hydration, and teaching. From 2013 to 2015, the H@H program served 136 patients, making 1701 home visits, for patients mainly between the ages of 1 and 4 years. Referrals came from oncology in 82% of cases, from hematology in 11%, and from bmt in 7%. Since inception of the program, no adverse events have been reported. Family surveys suggested less disruption in daily routines and appreciation of specialized care by hematology and oncology nurses. Staff surveys highlighted a perceived benefit of H@H in contributing to early discharge of patients by supporting out-of-hospital monitoring and teaching. The development of a H@H program dedicated to the pediatric hematology, oncology, or bmt patient appears feasible. Our pilot program offers a potential contribution to improvement in patient quality of life and in cost-benefit for parents and the health care system.

  17. Home Parental Assistance for Underachieving Readers in Third Grade Using Read-at-Home Program Kits.

    Science.gov (United States)

    Izzo, Theresa Eleanor

    Sixty-four third-grade pupils who were underachieving in reading participated in a study to determine the effect of parental home instruction in reading. A four-cell experimental design was used with two treatment factors: programmed home reading instruction given by mothers trained to administer the program versus no instruction, and mother's…

  18. Dial-a-Ride

    DEFF Research Database (Denmark)

    Jørgensen, Rene Munk

    2003-01-01

    The Dial-a-Ride problem is a Vehicle Routing problem in its most general form. The problem was formulated in the beginning of the 1970's and since then a large number of researchers have worked on developing efficient algorithms for use in automated planning of Dial-a-Ride transportation systems....... In a Dial-a-Ride transportation system, passengers request a trip between two stops with either a desired time of departure from the pickup stop or a desired time of arrival at the destination. The time windows at the stops are then calculated by the operator based on additional parameters such as maximum...... to the problem. The metod used in this thesis is based on a clustering first insertion second technique developed at CRT in Canada in the mid 1980's. The algorithm is extended to include constraints imposed by a practical Dial-a-Ride problem at a Danish transportation operator. These constraints are mainly...

  19. Healthy Ride Trip Data

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — A dataset that shows trips taken using the Healthy Ride system by quarter. The dataset includes bike number, membership type, trip start and end timestamp, and...

  20. Strength at Home Couples Program to Prevent Military Partner Violence

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-15-1-0374 TITLE: Strength at Home Couples Program to Prevent Military Partner Violence PRINCIPAL INVESTIGATOR: Casey T...SUBTITLE 5a. CONTRACT NUMBER Strength at Home Couples Program to Prevent Military Partner Violence 5b. GRANT NUMBER W81XWH-15-1-0374 5c. PROGRAM...7 9. Appendices…………………………………………………………………………………..7 1 Annual Report for Period: Sep 30, 2016 to Sept 29, 2017 Strength at Home

  1. Creating a successful culturally sensitive home care program.

    Science.gov (United States)

    Blanter, R; Page, P M

    1995-12-01

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

  2. A Home Training Program for Young Mentally Ill Children.

    Science.gov (United States)

    Doernberg, Nanette; And Others

    To develop a meaningful intervention for waiting list families and their preschool emotionally disturbed children, a home training program for the parent and child was initiated. The focus of the program was on productive cooperation between parents and professionals. During a period of 2 years, 45 families completed the program. The program…

  3. Home-based intermediate care program vs hospitalization

    Science.gov (United States)

    Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

    2008-01-01

    OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

  4. Home Economics/Health Grades 6-12. Program Evaluation.

    Science.gov (United States)

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  5. Medicare Home Health Services: A Difficult Program to Control

    Science.gov (United States)

    1981-09-25

    represent about one-third of all visits provided under the program. Family and friends altio provide similar services to the elderly and consequently...example, that the individual is to be confined to his or her home but that this does not necessarily mean that the patient is bedridden . At the same...34feebleness" and "insecurity" cannot be considered home- bound. We believe that in many cases (particularly for the elderly ) it would be extremely

  6. Home visit program improves technique survival in peritoneal dialysis.

    Science.gov (United States)

    Martino, Francesca; Adıbelli, Z; Mason, G; Nayak, A; Ariyanon, W; Rettore, E; Crepaldi, Carlo; Rodighiero, Mariapia; Ronco, Claudio

    2014-01-01

    Peritoneal dialysis (PD) is a home therapy, and technique survival is related to the adherence to PD prescription at home. The presence of a home visit program could improve PD outcomes. We evaluated its effects on clinical outcome during 1 year of follow-up. This was a case-control study. The case group included all 96 patients who performed PD in our center on January 1, 2013, and who attended a home visit program; the control group included all 92 patients who performed PD on January 1, 2008. The home visit program consisted of several additional visits to reinforce patients' confidence in PD management in their own environment. Outcomes were defined as technique failure, peritonitis episode, and hospitalization. Clinical and dialysis features were evaluated for each patient. The case group was significantly older (p = 0.048), with a lower grade of autonomy (p = 0.033), but a better hemoglobin level (p = 0.02) than the control group. During the observational period, we had 11 episodes of technique failure. We found a significant reduction in the rate of technique failure in the case group (p = 0.004). Furthermore, survival analysis showed a significant extension of PD treatment in the patients supported by the home visit program (52 vs. 48.8 weeks, p = 0.018). We did not find any difference between the two groups in terms of peritonitis and hospitalization rate; however, trends toward a reduction of Gram-positive peritonitis rates as well as prevalence and duration of hospitalization related to PD problems were identified in the case group. The retrospective nature of the analysis was a limitation of this study. The home visit program improves the survival of PD patients and could reduce the rate of Gram-positive peritonitis and hospitalization. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=365168.

  7. Evaluation of the Pilot Program for Home School and ChalleNGe Program Recruits

    National Research Council Canada - National Science Library

    Garcia, F

    2001-01-01

    The National Defense Authorization Act for Fiscal Year 1999 (FY 99) directed a 5-year pilot program to treat graduates of home schools and graduates of the National Guard Youth ChalleNGe Program holding General Education Development (GED...

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

    Science.gov (United States)

    Goldfeld, Sharon; Price, Anna; Kemp, Lynn

    2018-05-01

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

  9. KERNELHR: A program for estimating animal home ranges

    Science.gov (United States)

    Seaman, D.E.; Griffith, B.; Powell, R.A.

    1998-01-01

    Kernel methods are state of the art for estimating animal home-range area and utilization distribution (UD). The KERNELHR program was developed to provide researchers and managers a tool to implement this extremely flexible set of methods with many variants. KERNELHR runs interactively or from the command line on any personal computer (PC) running DOS. KERNELHR provides output of fixed and adaptive kernel home-range estimates, as well as density values in a format suitable for in-depth statistical and spatial analyses. An additional package of programs creates contour files for plotting in geographic information systems (GIS) and estimates core areas of ranges.

  10. Accounting Programs' Home Pages: What's Happening.

    Science.gov (United States)

    Peek, Lucia E.; Roxas, Maria L.

    2002-01-01

    Content analysis of 62 accounting programs' websites indicated the following: 53% include mission statements; 62.9% list accreditation; many faculty biographies and personal pages used inconsistent formats; provision of information on financial aid, student organizations, career services, and certified public accountant requirements varied. Many…

  11. Development of an ultra-portable ride quality meter.

    Science.gov (United States)

    2012-12-01

    FRAs Office of Research and Development has funded the development of an ultra-portable ride quality meter (UPRQM) under the Small Business and Innovative Research (SBIR) program. Track inspectors can use the UPRQM to locate segments of track that...

  12. SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

    Science.gov (United States)

    Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

    2016-01-01

    The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction.

  13. Home

    Science.gov (United States)

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

  14. The Trajectory of Chronic Pain: Can a Community-Based Exercise/Education Program Soften the Ride?

    Directory of Open Access Journals (Sweden)

    Ruth Dubin

    2010-01-01

    Full Text Available The entire primary care record of six patients attending a community-based education/exercise self-management program for chronic noncancer pain (YMCA Pain Exercise/Education Program [Y-PEP] was reviewed. Medical visits, consultations and hospital admissions were coded as related or unrelated to their pain diagnoses. Mood disruption, financial concerns, conflicts with employers/insurers, analgesic doses, medication side effects and major life events were also recorded. The ‘chronic pain trajectory’ resembled a roller coaster with increased health care visits at the time of initial injuries and during ‘crises’ (reinjury, conflict with insurers/employers, failed back-to-work attempts and life events. Visits decreased when conflicts were resolved. Analgesic doses increased during ‘crises’ but did not fall after resolution. After attending Y-PEP, health care use fell for four of six patients and two returned to work. Primary care physicians need to recognize the functional limitations and psychosocial complications experienced by their chronic pain patients. A program such as Y-PEP may promote active self-management strategies resulting in lowered health care use.

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

    Science.gov (United States)

    Wasik, Barbara Hanna; Roberts, Richard N.

    1994-01-01

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

  16. [Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

    Science.gov (United States)

    Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

    2015-10-01

    The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

  17. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2013-10-01

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

  18. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

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

    Science.gov (United States)

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

    2011-01-01

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

  20. A Programming Language Approach to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Rye; Schultz, Ulrik Pagh

    , even in a worst-case scenario where an unauthorized user gains remote control of the facilities. We address this safety issue at the programming language level by restricting the operations that can be performed on devices according to the physical location of the user initiating the request......-based restrictions on operations. This model has been implemented in a middleware for home AV devices written in Java, using infrared communication and a FireWire network to implement location awareness....

  1. A Programming Language Approach to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Sofie Fogh; Schultz, Ulrik Pagh

    2003-01-01

    , even in a worst-case scenario where an unauthorized user gains remote control of the facilities. We address this safety issue at the programming language level by restricting the operations that can be performed on devices according to the physical location of the user initiating the request......-based restrictions on operations. This model has been implemented in a middleware for home AV devices written in Java, using infrared communication and a FireWire network to implement location awareness....

  2. Designing an Elderly Assistance Program Based-on Home Care

    Science.gov (United States)

    Umusya'adah, L.; Juwaedah, A.; Jubaedah, Y.; Ratnasusanti, H.; Puspita, R. H.

    2018-02-01

    PKH (Program Keluarga Harapan) is a program of Indonesia’s Government through the ministry of social directorate to accelerate the poverty reduction and the achievement of Millennium Development Goals (MDGs) target as well as the policies development in social protection and social welfare domain or commonly referred to as Indonesian Conditional Cash Transfer (CCT) Program. This research is motivated that existing participants of the family expectation program (PKH) that already exist in Sumedang, Indoensia, especially in the South Sumedang on the social welfare components is only limited to the health checking, while for assisting the elderly based Home Care program there has been no structured and systematic, where as the elderly still need assistance, especially from the family and community environment. This study uses a method of Research and Development with Model Addie which include analysis, design, development, implementation and evaluation. Participants in this study using purposive sampling, where selected families of PKH who provide active assistance to the elderly with 82 participants. The program is designed consists of program components: objectives, goals, forms of assistance, organizing institutions and implementing the program, besides, program modules include assisting the elderly. Form of assistance the elderly cover physical, social, mental and spiritual. Recommended for families and companions PKH, the program can be implemented to meet the various needs of the elderly. For the elderly should introspect, especially in the health and follow the advice recommended by related parties

  3. 78 FR 9936 - Federal Housing Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot Program...

    Science.gov (United States)

    2013-02-12

    ... Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot Program: Extension of Pilot Program AGENCY...: On March 31, 2011, HUD published a notice that announced HUD's FHA Home Energy Retrofit Loan Pilot Program (Retrofit Pilot Program) known as FHA PowerSaver, which is a pilot program conducted for loans...

  4. Cooperate or Free Ride?

    DEFF Research Database (Denmark)

    Hansen, Per H.

    2012-01-01

    of international cooperation. On the other hand, the evidence seems to confirm Kindleberger's hypothesis that small countries were free riding during the international financial crisis of 1931, and that therefore there is a need for some coordinating mechanism, or a hegemon, in such crises....... in the establishment of the BIS and free riders in the Austrian crisis, even though there were marked differences in their attitude to international cooperation. These results run counter to the views of those International Political Economy (IPE) theorists who argue that small states should be in favour......In this article, I discuss the role of the three Scandinavian central banks in the establishment of the Bank for International Settlements (BIS) in 1930, and in the international lender of last resort operation towards Austria in 1931. I argue that small central banks were reluctant supporters...

  5. Free Riding or Trust?

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard; Nilsson, Jerker

    2011-01-01

    It is often observed that members have little interest in monitoring their cooperatives. One explanation is that the members are free-riders, hoping that others will perform the task. Another explanation is that the weak member interest is a consequence of members having trust in the leadership....... These competing explanations refer to the theory of collective action and the social capital paradigm, respectively, and may be linked to the classical Gesellschaft and Gemeinschaft concepts. Hence, one may expect free-rider behavior when conditions of Gesellschaft exist and trustful behavior when Gemeinschaft...... conditions rule. These propositions get support from five studies of members’ readership of their cooperatives’ annual reports. In large and heterogeneous memberships there is free-riding behavior, which explains the members’ low interest in governing their cooperatives. To a limited extent a membership may...

  6. 77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees

    Science.gov (United States)

    2012-10-02

    ... Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources... expansion supplements of $100,000 to 10 Nursing Assistant and Home Health Aide (NAHHA) Program grantees to... Management; Care Coordination and Follow Up; and Behavioral Health and Social Support for Home Health Aides...

  7. 75 FR 81138 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2010-12-27

    ... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in... Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home...

  8. 76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-03-09

    ... and Early Childhood Home Visiting Program Evaluation will meet for its first session on Wednesday... Administration for Children and Families Advisory Committee on the Maternal, Infant and Early Childhood Home...: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. Date and...

  9. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lukachko, A.; Grin, A.; Bergey, D.

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. This report will detail the retrofit of 2 existing houses in the program. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district GSHP system to service the project. This draft report examines the energy efficiency recommendations for retrofit construction at these homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a Cold Climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project's affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  10. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lukachko, A. [Building Science Corporation (BSC), Somerville, MA (United States); Grin, A. [Building Science Corporation (BSC), Somerville, MA (United States); Bergey, D. [Building Science Corporation (BSC), Somerville, MA (United States)

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district ground source heat pump (GSHP) system to service the project. This report details the retrofit of two existing houses in the program, and examines the energy efficiency recommendations for the homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a cold climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project’s affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  11. Going to Bed with Captain Marvel and a Flashlight Is Not a Home Reading Program

    Science.gov (United States)

    Greenfeld, Stuart

    1971-01-01

    Described is a home reading program for educationally disadvantaged elementary school children who need motivation to read at home. Principles of behavior change and parent role are the major motivation factors used in developing the children's reading ability. (CB)

  12. Fancy a ride?

    CERN Multimedia

    Anaïs Schaeffer

    2014-01-01

    This Sunday 7 September, don’t miss your chance to climb into a supercar, one of those exceptional machines that tear up the tracks and that you sometimes hear revving their engines on the motorway. The 2014 supercar experience day, organised by members of CERN, will allow car lovers to go for a ride in style and all for a good cause!   Supercars at the 2013 experience day. Photo: Kevin Mazzilli. If you have always dreamt of sitting in a Ferrari, feeling the vibrations of a Lamborghini, or losing yourself in the hushed calm of a classic car, don’t miss the supercar experience day taking place on Sunday, 7 September! This event has been organised by CERN’s own car enthusiasts, in collaboration with the charity Kumansansa – Children of Zambia, founded by two CERN members. It will take place for the third consecutive year in the car park of the Macumba leisure centre in Saint-Julien-en-Genevois (France). From 9.30 a.m. to 6 p.m., visitors old and young (c...

  13. Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

    Energy Technology Data Exchange (ETDEWEB)

    Belzer, D.; Mosey, G.; Plympton, P.; Dagher, L.

    2007-07-01

    Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As one of HPwES's local sponsors, Austin Energy's HPwES program offers a complete home energy analysis and a list of recommendations for efficiency improvements, along with cost estimates. To determine the benefits of this program, the National Renewable Energy Laboratory (NREL) collaborated with the Pacific Northwest National Laboratory (PNNL) to conduct a statistical analysis using energy consumption data of HPwES homes provided by Austin Energy. This report provides preliminary estimates of average savings per home from the HPwES Loan Program for the period 1998 through 2006. The results from this preliminary analysis suggest that the HPwES program sponsored by Austin Energy had a very significant impact on reducing average cooling electricity for participating households. Overall, average savings were in the range of 25%-35%, and appear to be robust under various criteria for the number of households included in the analysis.

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

    Directory of Open Access Journals (Sweden)

    Thomas Saïas

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

  15. Effects of intensive home visiting programs for older people with poor health status: a systematic review.

    NARCIS (Netherlands)

    Bouman, A.; Rossum, E. van; Nelemans, P.; Kempen, G.I.J.M.; Knipschild, P.

    2008-01-01

    BACKGROUND: Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting

  16. 41 CFR 302-14.100 - How should we administer our home marketing incentive payment program?

    Science.gov (United States)

    2010-07-01

    ... reduce your overall relocation costs. You must not make a home marketing incentive payment that exceeds... our home marketing incentive payment program? 302-14.100 Section 302-14.100 Public Contracts and... 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.100 How should we administer...

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

    Energy Technology Data Exchange (ETDEWEB)

    Quarles, Stephen, L.; Sindelar, Melissa

    2011-12-13

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

  18. Weatherization and Indoor Air Quality: Measured Impacts in Single Family Homes Under the Weatherization Assistance Program

    Energy Technology Data Exchange (ETDEWEB)

    Pigg, Scott [Energy Center of Wisconsin, Madison, WI (United States); Cautley, Dan [Energy Center of Wisconsin, Madison, WI (United States); Francisco, Paul [Univ. of Illinois, Urbana-Champaign, IL (United States); Hawkins, Beth A [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brennan, Terry M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-09-01

    This report summarizes findings from a national field study of indoor air quality parameters in homes treated under the Weatherization Assistance Program (WAP). The study involved testing and monitoring in 514 single-family homes (including mobile homes) located in 35 states and served by 88 local weatherization agencies.

  19. A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.

    Science.gov (United States)

    Moor, C C; Wapenaar, M; Miedema, J R; Geelhoed, J J M; Chandoesing, P P; Wijsenbeek, M S

    2018-05-29

    In idiopathic pulmonary fibrosis (IPF), home monitoring experiences are limited, not yet real-time available nor implemented in daily care. We evaluated feasibility and potential barriers of a new home monitoring program with real-time wireless home spirometry in IPF. Ten patients with IPF were asked to test this home monitoring program, including daily home spirometry, for four weeks. Measurements of home and hospital spirometry showed good agreement. All patients considered real-time wireless spirometry useful and highly feasible. Both patients and researchers suggested relatively easy solutions for the identified potential barriers regarding real-time home monitoring in IPF.

  20. Preventing child maltreatment: Examination of an established statewide home-visiting program.

    Science.gov (United States)

    Chaiyachati, Barbara H; Gaither, Julie R; Hughes, Marcia; Foley-Schain, Karen; Leventhal, John M

    2018-05-01

    Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut's home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P home visiting. First substantiations also occurred later in the child's life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53-1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Home

    Science.gov (United States)

    Military Commission Seal VWAP Login Home Go ABOUT US Organization Overview Organizational Chart Families VWAP Login CCTV Sites Travel Media MC News CCTV Sites Travel Today at OMC Home Today at OMC Daily

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

    Science.gov (United States)

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

    2013-10-01

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

  3. Creating a meaningful infection control program: one home healthcare agency's lessons.

    Science.gov (United States)

    Poff, Renee McCoy; Browning, Sarah Via

    2014-03-01

    Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

  4. 14 CFR 27.1399 - Riding light.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Riding light. 27.1399 Section 27.1399... STANDARDS: NORMAL CATEGORY ROTORCRAFT Equipment Lights § 27.1399 Riding light. (a) Each riding light required for water operation must be installed so that it can— (1) Show a white light for at least two...

  5. 14 CFR 29.1399 - Riding light.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Riding light. 29.1399 Section 29.1399... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Equipment Lights § 29.1399 Riding light. (a) Each riding light required for water operation must be installed so that it can— (1) Show a white light for at least two...

  6. 14 CFR 25.1399 - Riding light.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Riding light. 25.1399 Section 25.1399... STANDARDS: TRANSPORT CATEGORY AIRPLANES Equipment Lights § 25.1399 Riding light. (a) Each riding (anchor) light required for a seaplane or amphibian must be installed so that it can— (1) Show a white light for...

  7. 14 CFR 23.1399 - Riding light.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Riding light. 23.1399 Section 23.1399... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Equipment Lights § 23.1399 Riding light. (a) Each riding (anchor) light required for a seaplane or amphibian, must be installed so that it...

  8. 75 FR 76293 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2010-12-08

    ... [CMS-1510-CN] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification... effective as if they had been included in the Medicare Program; Home Health Prospective Payment System Rate...

  9. Hippotherapy and Therapeutic Riding Highlight!

    Science.gov (United States)

    Apel, Laura, Comp.

    2007-01-01

    Horses have always been appreciated by humans for their strength, beauty, and gentle demeanor. Children, especially, have gravitated toward them and many experience their first horseback riding lesson at a young age. However, horses can play a very different role in the lives of children and adults with disabilities. Hippotherapy is physical,…

  10. "Paul Revere's Ride": Awakening Abolitionists

    Science.gov (United States)

    Lepore, Jill

    2011-01-01

    Henry Wadsworth Longfellow used to be both the best-known poet in the English-speaking world and the most beloved, adored by the learned and the lowly alike, read by everyone from Nathaniel Hawthorne and Abraham Lincoln to John Ruskin and Queen Victoria--and, just as avidly, by the queen's servants. "Paul Revere's Ride" is Longfellow's best-known…

  11. California Amusement Rides and Liability

    Science.gov (United States)

    Epstein, Adam

    2005-01-01

    Twenty-three-year-old Cristina Moreno traveled from Spain to California for her honeymoon in 2000. As part of her visit, she rode the Indiana Jones amusement ride at Disneyland with her new husband. On June 25, 2000, she suffered a brain injury, and she eventually died on September 1, 2000, as a result of injuries allegedly sustained while riding…

  12. Saturday Subway Ride: A Report on the Initial Tryout.

    Science.gov (United States)

    Quilling, Mary R.; And Others

    "Saturday Subway Ride," a program designed to teach pupils creative thinking techniques and positive attitudes toward creative ideas, is a 92-page workbook in a story-exercise format. Secondary objectives for the product include improving verbal fluency and creative writing. Three classrooms 61 sixth graders and 34 fifth graders at two…

  13. Driving self-regulation and ride service utilization in a multicommunity, multistate sample of U.S. older adults.

    Science.gov (United States)

    Bird, Donna C; Freund, Katherine; Fortinsky, Richard H; Staplin, Loren; West, Bethany A; Bergen, Gwen; Downs, Jonathan

    2017-04-03

    This study examined a multicommunity alternative transportation program available 24 hours a day, 7 days a week, for any purpose, offering door-through-door service in private automobiles to members who either do not drive or are transitioning away from driving. Specific aims were to describe the characteristics of members by driving status and ride service usage of these members. Data came from administrative records maintained by a nonprofit ride service program and include 2,661 individuals aged 65+ residing in 14 states who joined the program between April 1, 2010, and November 8, 2013. Latent class analysis was used to group current drivers into 3 classes of driving status of low, medium, and high self-regulation, based on their self-reported avoidance of certain driving situations and weekly driving frequency. Demographics and ride service use rate for rides taken through March 31, 2014, by type of ride (e.g., medical, social, etc.) were calculated for nondrivers and drivers in each driving status class. The majority of ride service users were female (77%) and aged 65-74 years (82%). The primary method of getting around when enrolling for the transportation service was by riding with a friend or family member (60%). Among the 67,883 rides given, nondrivers took the majority (69%) of rides. Medical rides were the most common, accounting for 40% of all rides. Reported ride usage suggests that older adults are willing to use such ride services for a variety of trips when these services are not limited to specific types (e.g., medical). Further research can help tailor strategies to encourage both nondrivers and drivers to make better use of alternative transportation that meets the special needs of older people.

  14. LHC@home takes centre stage : some of the people behind the CPSS and LHC@home programs

    CERN Multimedia

    maximilien Brice

    2005-01-01

    From left to right: Frank Schmidt (AB), Jukka Klem (Helsinki Institute of Physics), Andreas Wagner (IT), Eric McIntosh (IT) and Ben Segal (IT). The program of LHC@home, which aims to use the computing power of PCs when the screen saver is activated, is being relauched as part of the World Year of Physics.

  15. Let's Talk About Breastfeeding: The Importance of Delivering a Message in a Home Visiting Program.

    Science.gov (United States)

    McGinnis, Sandra; Lee, Eunju; Kirkland, Kristen; Miranda-Julian, Claudia; Greene, Rose

    2018-05-01

    To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. A secondary analysis of program data from a statewide home visitation program. Thirty-six Healthy Families New York sites across New York State. A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). Logistic regression. Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.

  16. The ALIVE program: developing a web-based professional development program for nursing leaders in the home healthcare sector.

    Science.gov (United States)

    Lankshear, Sara; Huckstep, Sherri; Lefebre, Nancy; Leiterman, Janis; Simon, Deborah

    2010-05-01

    Home healthcare nurses often work in isolation and rarely have the opportunity to meet or congregate in one location. As a result, nurse leaders must possess unique leadership skills to supervise and manage a dispersed employee base from a distance. The nature of this dispersed workforce creates an additional challenge in the ability to identify future leaders, facilitate leadership capacity, and enhance skill development to prepare them for future leadership positions. The ALIVE (Actively Leading In Virtual Environments) web-based program was developed to meet the needs of leaders working in virtual environments such as the home healthcare sector. The program, developed through a partnership of three home healthcare agencies, used nursing leaders as content experts to guide program development and as participants in the pilot. Evaluation findings include the identification of key competencies for nursing leaders in the home healthcare sector, development of program learning objectives and participant feedback regarding program content and delivery.

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

    Science.gov (United States)

    2016-11-03

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

  18. A university-sponsored home health nursing program in Karachi, Pakistan.

    Science.gov (United States)

    Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida

    2005-11-01

    This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.

  19. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2012-11-19

    ... (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request AGENCY.... DeBakey Home Care Program. DATES: Written comments and recommendations on the proposed collection of...: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number...

  20. 78 FR 6851 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2013-01-31

    ... (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request AGENCY... Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number: 2900-0775. Type... home care program staff. An agency may not conduct or sponsor, and a person is not required to respond...

  1. Home programs for upper extremity recovery post-stroke: a survey of occupational therapy practitioners.

    Science.gov (United States)

    Donoso Brown, Elena V; Fichter, Renae

    2017-12-01

    Upper extremity hemiparesis is an impairment post-stroke that impacts quality of life. Home programs are an intervention strategy used by many occupational therapists to support continued motor recovery post-stroke, yet little is known about how these programs are designed and implemented. The purpose of this study was to describe how occupational therapy practitioners approach this task and specifically what strategies they use to support adherence and what types of technology are most commonly used. An on-line survey methodology was used. Participants were recruited through multiple sources including state associations and occupational therapy educational program directors. A total of 73 occupational therapy practitioners submitted complete surveys. It was found that majority of occupational therapy practitioners in the sample (n = 53) reported creating home programs focused on upper extremity motor recovery more than 80% of the time. Range of motion and strengthening were reported as being in the top three most commonly used interventions by more than half the sample, however incorporating clients' goals and interests were reported most often as strategies to create meaning in the home program. Respondents also reported limited incorporation of technology and strategies to support adherence. Personal motivation was reported by occupational therapy practitioners to be a key moderator of adherence to a home program. Occupational therapy practitioners often provide home programs for individuals post-stroke focusing on upper extremity function. Future research that aims to understand stakeholders' perspectives on home programs and determine effective strategies for ensuring adherence is needed.

  2. Pilot Evaluation of a Home Visit Parent Training Program in Disadvantaged Families

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2013-01-01

    Objectives: The study reported the pilot evaluation of the Healthy Start Home Visit Program for disadvantaged Chinese parents with preschool children, delivered by trained parent assistants. Home visiting was used to make services more accessible to disadvantaged families. Method: The participants included 21 parent-child dyads. Outcome measures…

  3. Quantifying Carbon and distributional benefits of solar home system programs in Bangladesh

    OpenAIRE

    Wang, Limin; Bandyopadhyay, Sushenjit; Cosgrove-Davies, Mac; Samad, Hussain

    2011-01-01

    Scaling-up adoption of renewable energy technology, such as solar home systems, to expand electricity access in developing countries can accelerate the transition to low-carbon economic development. Using a purposely collected national household survey, this study quantifies the carbon and distributional benefits of solar home system programs in Bangladesh. Three key findings are generated...

  4. Enriched Home Environment Program for Preschool Children with Autism Spectrum Disorders

    Science.gov (United States)

    Sood, Divya; Szymanski, Monika; Schranz, Caren

    2015-01-01

    This study discusses the impact of the Enriched Home Environment Program (EHEP) on participation in home activities among two children with ASD using case study methodology. EHEP involves occupational therapists to collaborate with families of children with ASD to educate them about the impact of factors that influence child's participation within…

  5. Improving Older Adults' Functional Ability through Service Use in a Home Care Program in Hong Kong

    Science.gov (United States)

    Cheung, Chau-kiu; Ngan, Raymond Man-hung

    2005-01-01

    Objective: Despite past findings about the contribution of home care services to older users' functional ability, the effective processes and components of the services are not transparent. Such processes appear to rely on the actual use of component services of the home care program. Method: The study gathered 116 observations during 2 years…

  6. The Parent-Child Home Program in Western Manitoba: A 20-Year Evaluation

    Science.gov (United States)

    Gfellner, Barbara M.; McLaren, Lorraine; Metcalfe, Arron

    2008-01-01

    This article is a 20-year evaluation of the Parent-Child Home Program (PCHP) of Child and Family Services in Western Manitoba. Following Levenstein's (1979, 1988) approach, home visitors model parent-child interchanges using books and toys to enhance children's cognitive development through appropriate parenting behaviors. The evaluation provides…

  7. 76 FR 68525 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012

    Science.gov (United States)

    2011-11-04

    ... Prospective Payment System Rate Update for Calendar Year 2012; Final Rule #0;#0;Federal Register / Vol. 76, No... 0938-AQ30 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012... sets forth updates to the home health prospective payment system (HH PPS) rates, including: the...

  8. 76 FR 9502 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2011-02-18

    ... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The... the Medicare prospective payment system for HHAs. This correcting amendment corrects a technical error...

  9. A study of an intensive home-based treatment program and its ...

    African Journals Online (AJOL)

    Adele

    Key words: Intensive home based program, health services, admission, outpatient, inpatient, aged care. Received: ... vate agencies were sometimes also used and funded by APS or more .... result of other structural changes in the system.

  10. Asthma Education and Intervention Program: Partnership for Asthma Trigger-Free Homes (PATH)

    National Research Council Canada - National Science Library

    Golden, Cheryl

    2008-01-01

    ...) are the co-Principal Investigators for the Partnership for Asthma Trigger-Free Homes. The PATH study's goal is reducing the asthma disease burden on low-income housing residents by means of a peer-based education program...

  11. Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

    Science.gov (United States)

    Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

    2017-08-01

    This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

  12. Community-based home-care program for the management of pre-eclampsia: an alternative.

    OpenAIRE

    Helewa, M; Heaman, M; Robinson, M A; Thompson, L

    1993-01-01

    OBJECTIVE: To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia. DESIGN: A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989. SETTING: St. Boniface General Hospital, Winnipeg. PATIENTS: Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients of 1330 were enrolled in the program. INTERVENTION...

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

    Science.gov (United States)

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

    2016-10-10

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

  14. Home

    Science.gov (United States)

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

  15. Operation of Wastewater Treatment Plants: A Home Study Training Program.

    Science.gov (United States)

    California State Univ., Sacramento. Dept. of Civil Engineering.

    This manual was prepared by experienced wastewater treatment plant operators to provide a home study course to develop new qualified workers and expand the abilities of existing workers. The objective of this manual is to provide the knowledge and skills necessary for certification. Participants learn the basic operational aspects of treatment…

  16. 75 FR 62635 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2010-10-12

    ... Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request... determine patients' satisfaction with services provided by or through the Michael E. DeBakey Home Care...: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number...

  17. 76 FR 624 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2011-01-05

    ... Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request... satisfaction with the quality of services/care provided by home care program staff. An agency may not conduct... Form 10-0476).'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home...

  18. HOME VISIT QUALITY VARIATIONS IN TWO EARLY HEAD START PROGRAMS IN RELATION TO PARENTING AND CHILD VOCABULARY OUTCOMES.

    Science.gov (United States)

    Roggman, Lori A; Cook, Gina A; Innocenti, Mark S; Jump Norman, Vonda; Boyce, Lisa K; Christiansen, Katie; Peterson, Carla A

    2016-05-01

    Home-visiting programs aiming to improve early child development have demonstrated positive outcomes, but processes within home visits to individual families are rarely documented. We examined family-level variations in the home-visiting process (N = 71) from extant video recordings of home visits in two Early Head Start programs, using an observational measure of research-based quality indicators of home-visiting practices and family engagement, the Home Visit Rating Scales (HOVRS). HOVRS scores, showing good interrater agreement and internal consistency, were significantly associated with parent- and staff-reported positive characteristics of home visiting as well as with parenting and child language outcomes tested at program exit. When home-visiting processes were higher quality during the program, home visit content was more focused on child development, families were more involved in the overall program, and most important, scores on measures of the parenting environment and children's vocabulary were higher at the end of the program. Results showed that home visit quality was indirectly associated with child language outcomes through parenting outcomes. Observation ratings of home visit quality could be useful for guiding program improvement, supporting professional development, and increasing our understanding of the links between home-visiting processes and outcomes. © 2016 Michigan Association for Infant Mental Health.

  19. An Early Look at Families and Local Programs in the Mother and Infant Home Visiting Program Evaluation-Strong Start: Third Annual Report. OPRE Report 2016-37

    Science.gov (United States)

    Lee, Helen; Crowne, Sarah; Faucetta, Kristen; Hughes, Rebecca

    2016-01-01

    The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) is the largest random assignment study to date to examine the effectiveness of home visiting services on improving birth outcomes and infant and maternal health care use for expectant mothers. The study includes local home visiting programs that use one of…

  20. home

    Science.gov (United States)

    ... Find physicians and treatment programs providing buprenorphine for opioid addiction (heroin or pain relievers). Find programs providing methadone for the treatment of opioid addiction (heroin or pain relievers). /locator/widget/220 SAMHSA ...

  1. Building America: The Advanced Whole-Home Efficiency Program (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Engebrecht, C.

    2012-02-01

    This presentation discusses the Building America Program. This presentation discusses the background and goals of the program. A few hot topic technologies are discussed. Outreach activities are discussed as well.

  2. CAREGIVER COMPLIANCE WITH PHYSICAL THERAPY HOME PROGRAM: A PILOT STUDY IN PEDIATRIC OUTPATIENT CLINICS IN KUWAIT

    Directory of Open Access Journals (Sweden)

    Maryam M. Almandil

    2017-06-01

    Full Text Available Background: Compliance depends on the caregiver and the health care professional committing to the same objectives.Compliance with the prescribed physical therapy (PT home program is a significant contributor to treatment success. Methods: One hundred caregivers were invited to fill in a questionnaire after the explanation of the procedure, and signing the consent form. The questionnaire explored factors affecting compliance including nature of the exercise, physical and emotional stresses on the caregiver, and the role of PT in teaching and counseling the caregiver. Result: Ninety-one participants out of the 100 were committed to administering the exercises with their children. Despite this, there was a discrepancy in either the frequency of repeating the exercises per day or the content of the exercise program when compared with the exercise program prescribed by the therapist. Some of the primary reasons for these differences were the pain experienced by the child when exercising (71%, having other family commitments (57%, not having the time to administer the home program (37%, and lacking skills or equipment to administer the exercises (34%. Conclusion: Adherence to treatment is a complex act that requires an understanding of treatment approach, having the confidence in one’s skills to administer the unsupervised home program and the existence of a support system both in the hospital and at home that can provide aid when needed. It is the PT role to address all these issues when prescribing a home program to meet treatment objectives.

  3. Modified Ride-On Cars and Young Children with Disabilities: Effects of Combining Mobility and Social Training

    Directory of Open Access Journals (Sweden)

    Hsiang-Han Huang

    2018-01-01

    Full Text Available BackgroundResearch has shown that the use of power mobility devices is safe and beneficial for motor and cognitive development in children with motor disabilities; nevertheless, strong evidence of the benefits for social skill development is limited. This study aimed to examine the effects of combining ride-on car training with an adult-directed, social interaction program in a hospital-based environment on mobility and social functions in young children with motor disabilities.MethodsThis study used a prospective, nonequivalent pretest–posttest control group design. Twenty-nine young children with motor disabilities, aged between 1 and 3 years, were recruited from local hospitals in Taiwan. The treatment group (n = 15 underwent 2-h ride-on car training sessions twice per week for a total of 9 weeks in the hospital environment. The control group (n = 14 underwent a 9-week home education program (mean: 200 min/week focusing on mobility and social skills training. The Chinese version of the Pediatric Evaluation of Disability Inventory, Parenting Stress Index, and Goal Attainment Scaling were administered to all participants before and after the intervention, and at the end of the 9-week follow-up phase.ResultsMobility and social functions significantly improved in both groups after the 9-week intervention, but this improvement was not maintained at the follow-up phase. The treatment group showed significantly better improvement in social function, parenting stress levels, and goal achievement than the control group at posttest.ConclusionThis two-group design study showed the benefits of combining a ride-on car use with a family-centered, structured, social interaction program for positive impacts on mobility, social function, and parenting stress levels. The combination of a modified ride-on car and a social training program has the potential to enhance socialization in young children with motor disabilities.Clinical Trial

  4. New Homes, New Neighborhoods, New Schools: A Progress Report on the Baltimore Housing Mobility Program

    Science.gov (United States)

    Engdahl, Lora

    2009-01-01

    In the Baltimore region, a successful housing mobility program is providing families living in very disadvantaged inner city communities with a new home and a chance for a new life. Minority voucher holders in the federal Housing Choice Voucher Program (formerly titled Section 8) have often been limited to living in "voucher submarkets"…

  5. Female Intense Curricula: Fashion Merchandising in Home Economics and Associated Programs in Higher Education.

    Science.gov (United States)

    Mikitka, Kathleen Faith; Van Camp, Mary Lou

    A study was done of higher education curricula with substantial enrollment by women (such as fashion merchandising and home economics) to examine the context and substance of the curricula, to identify infrastructures that have supported these programs, and to probe issues that face administrators, faculty and students engaged in such programs.…

  6. Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects.

    Science.gov (United States)

    Youssef, Enas Fawzy; Shanb, Alsayed Abd Elhameed

    2016-11-01

    Aging is associated with a progressive decline in physical capabilities and a disturbance of both postural control and daily living activities. The aim of this study was to evaluate the effects of supervised versus home exercise programs on muscle strength, balance and functional activities in older participants. Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35-45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG). The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs ( P training programs significantly increased balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants.

  7. THE DEVELOPMENT OF A WORK ORIENTATION PROGRAM FOR HOME ECONOMICS RELATED OCCUPATIONS, 1964-1966.

    Science.gov (United States)

    FETTERMAN, ELSIE

    THE PURPOSE OF THIS STUDY, WHICH IS A SUMMARY OF A DOCTORAL DISSERTATION, WAS TO DEVELOP A WORK ORIENTATION PROGRAM FOR HOME ECONOMICS-RELATED OCCUPATIONS IN CONNECTICUT. QUESTIONNAIRES WERE SENT TO 43 TEACHERS OF SUCH PROGRAMS IN THE UNITED STATES AND ALL RESPONDED, GIVING INFORMATION ABOUT THEIR OBJECTIVES, COURSES, TEACHERS' BACKGROUNDS,…

  8. The cost of starting and maintaining a large home hemodialysis program.

    Science.gov (United States)

    Komenda, Paul; Copland, Michael; Makwana, Jay; Djurdjev, Ogdjenka; Sood, Manish M; Levin, Adeera

    2010-06-01

    Home extended hours hemodialysis improves some measurable biological and quality-of-life parameters over conventional renal replacement therapies in patients with end-stage renal disease. Published small studies evaluating costs have shown savings in terms of ongoing operating costs with this modality. However, all estimates need to include the total costs, including infrastructure, patient training, and maintenance; patient attrition by death, transplantation, technique failure; and the necessity of in-center dialysis. We describe a comprehensive funding model for a large centrally administered but locally delivered home hemodialysis program in British Columbia, Canada that covered 122 patients, of which 113 were still in the program at study end. The majority of patients performed home nocturnal hemodialysis in this 2-year retrospective study. All training periods, both in-center and in-home dialysis, medications, hospitalizations, and deaths were captured using our provincial renal database and vital statistics. Comparative data from the provincial database and pricing models were used for costing purposes. The total comprehensive costs per patient-incorporating startup, home, and in-center dialysis; medications; home remodeling; and consumables-was $59,179 for years 2004-2005 and $48,648 for 2005-2006. The home dialysis patients required multiple in-center dialysis runs, significantly contributing to the overall costs. Our study describes a valid, comprehensive funding model delineating reliable cost estimates of starting and maintaining a large home-based hemodialysis program. Consideration of hidden costs is important for administrators and planners to take into account when designing budgets for home hemodialysis.

  9. Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program.

    Science.gov (United States)

    Walus, Ashley N; Woloschuk, Donna M M

    2017-01-01

    Historically, pharmacists have not been included on home care teams, despite the fact that home care patients frequently experience medication errors. Literature describing Canadian models of pharmacy practice in home care settings is limited. The optimal service delivery model and distribution of clinical activities for home care pharmacists remain unclear. The primary objective was to describe the impact of a pharmacist based at a community home care office and providing home visits, group education, and telephone consultations. The secondary objective was to determine the utility of acute care clinical pharmacy key performance indicators (cpKPIs) in guiding home care pharmacy services, in the absence of validated cpKPIs for ambulatory care. The Winnipeg Regional Health Authority hired a pharmacist to develop and implement the pilot program from May 2015 to July 2016. A referral form, consisting of consultation criteria used in primary care practices, was developed. The pharmacist also reviewed all patient intakes and all patients waiting in acute care facilities for initiation of home care services, with the goal of addressing issues before admission to the Home Care Program. A password-protected database was built for data collection and analysis, and the data are presented in aggregate. A total of 197 referrals, involving 184 patients, were received during the pilot program; of these, 62 were excluded from analysis. The majority of referrals (95 [70.4%]) were for targeted medication reviews, and 271 drug therapy problems were identified. Acceptance rates for the pharmacist's recommendations were 90.2% (74 of 82 recommendations) among home care staff and 47.0% (55 of 117 recommendations) among prescribers and patients. On average, 1.5 cpKPIs were identified for each referral. The pilot program demonstrated a need for enhanced access to clinical pharmacy services for home care patients, although the best model of service provision remains unclear. More research

  10. Retrofit and preoccupancy radon mitigation program for homes

    International Nuclear Information System (INIS)

    Ibach, M.T.; Gallagher, J.H. Jr.

    1987-01-01

    A requirement was levied on a Maryland builder by the FHA to demonstrate acceptable radon levels in his homes before they would be approved for loans. This paper describes the use of products shown by appropriate tests to be effective radon barriers to meet this requirement. The sheet goods can be used in exterior and interior applications on foundation walls. The other is applied to the interior floors and/or walls of the basement area. Product installation procedures are straightforward and relatively simple. Problems encountered were routine and concerned primarily the complete sealing of floor and wall penetrations, window openings, sealing the top of the wall under the sill plate, and the location and mounting of permanent fixtures on walls and floors. Also discussed are methods of repairing ruptures of the seal, warranties to protect the homeowner, support systems and costs. Conclusions are that effective reductions in radon levels can be achieved by the application of sealants during the construction of new homes or as a retrofit to existing structures

  11. Cyclist's nodule: no smooth ride.

    Science.gov (United States)

    Stoneham, Adam; Thway, Khin; Messiou, Christina; Smith, Myles

    2016-03-10

    A fit and active amateur cyclist was referred by his general practitioner to a surgical oncology outpatient clinic with a slowly-growing perineal mass. Following clinical examination, the patient underwent imaging and biopsy at a tertiary soft tissue tumour centre, which diagnosed perineal nodular induration: a rare, benign tumour caused by repetitive trauma associated with 'saddle sports' such as cycling or horse riding. It is important to consider soft tissue tumours in patients who present with 'lumps and bumps'; they can occur anywhere in the body including the groin or perineum, where it is sometimes referred to as a 'third' or 'accessory' testicle in men. Although unusual, the case emphasises the importance of rapid specialist referral from primary care, and consideration of a patient's occupation and hobbies when formulating diagnoses. 2016 BMJ Publishing Group Ltd.

  12. Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

    OpenAIRE

    Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

    2015-01-01

    Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ?feasibility? of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physioth...

  13. Actualizing culture change: The Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK 2.0) program.

    Science.gov (United States)

    Doll, Gayle A; Cornelison, Laci J; Rath, Heath; Syme, Maggie L

    2017-08-01

    Nursing homes have been challenged in their attempts to achieve deep, organizational change (i.e., culture change) aimed at providing quality of care and quality of life for nursing home residents through person-centered care. To attain deep change, 2 well-defined components must be in place: a shared understanding of (a) the what, or content goals, and (b) the how, or process of change. However, there are few examples of this at a macro or micro level in long-term care. In an effort to enact true culture change in nursing homes statewide, the Kansas Department for Aging and Disability Services implemented the Promoting Excellent Alternatives in Kansas Nursing Homes program. This program is a Medicaid, pay-for-performance program that formalizes the content and process of achieving culture change through person-centered care principles. This article aims to detail the content (what) and process (how) of a model macro-level program of culture change throughout the State of Kansas. Applications to the micro level (individual homes) are presented, and implications for psychologists' roles in facilitating culture change are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

    Science.gov (United States)

    2015-11-05

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

  15. Time providing care outside visits in a home-based primary care program.

    Science.gov (United States)

    Pedowitz, Elizabeth J; Ornstein, Katherine A; Farber, Jeffrey; DeCherrie, Linda V

    2014-06-01

    To assess how much time physicians in a large home-based primary care (HBPC) program spend providing care outside of home visits. Unreimbursed time and patient and provider-related factors that may contribute to that time were considered. Mount Sinai Visiting Doctors (MSVD) providers filled out research forms for every interaction involving care provision outside of home visits. Data collected included length of interaction, mode, nature, and with whom the interaction was for 3 weeks. MSVD, an academic home-visit program in Manhattan, New York. All primary care physicians (PCPs) in MSVD (n = 14) agreed to participate. Time data were analyzed using a comprehensive estimate and conservative estimates to quantify unbillable time. Data on 1,151 interactions for 537 patients were collected. An average 8.2 h/wk was spent providing nonhome visit care for a full-time provider. Using the most conservative estimates, 3.6 h/wk was estimated to be unreimbursed per full-time provider. No significant differences in interaction times were found between patients with and without dementia, new and established patients, and primary-panel and covered patients. Home-based primary care providers spend substantial time providing care outside home visits, much of which goes unrecognized in the current reimbursement system. These findings may help guide practice development and creation of new payment systems for HBPC and similar models of care. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  16. Calling, texting, and searching for information while riding a motorcycle: A study of university students in Vietnam.

    Science.gov (United States)

    Truong, Long T; De Gruyter, Chris; Nguyen, Hang T T

    2017-08-18

    The objective of this study was to investigate the prevalence of calling, texting, and searching for information while riding a motorcycle among university students and the influences of sociodemographic characteristics, social norms, and risk perceptions on these behaviors. Students at 2 university campuses in Hanoi and Ho Chi Minh City, the 2 largest cities in Vietnam, were invited to participate in an anonymous online survey. Data collection was conducted during March and May 2016. There were 741 respondents, of whom nearly 90% of students (665) were motorcycle riders. Overall prevalence of mobile phone use while riding is 80.9% (95% confidence interval [CI], 77.9-83.9%) with calling having a higher level of prevalence than texting or searching for information while riding: 74% (95% CI, 70.7-77.3%) vs. 51.7% (95% CI, 47.9-55.5%) and 49.9% (95% CI, 46.1-53.7%), respectively. Random parameter ordered probit modeling results indicate that mobile phone use while riding is associated with gender, motorcycle license duration, perceived crash risk, perceived risk of mobile phone snatching, and perceptions of friends' mobile phone use while riding. Mobile phone use while riding a motorcycle is highly prevalent among university students. Educational programs should focus on the crash and economic risk of all types of mobile phone use while riding, including calling, texting, and searching for information. In addition, they should consider targeting the influence of social norms and peers on mobile phone use while riding.

  17. Effects of alcohol on motorcycle riding skills

    Science.gov (United States)

    2007-12-01

    Alcohol is known to disrupt the effect of neurotransmitters and impair various psychomotor skills. Indeed, alcohol intoxication is a significant risk factor for fatal traffic crashes, especially when riding a motorcycle. At present, there is sparse r...

  18. Palliative sedation for cancer patients included in a home care program: a retrospective study.

    Science.gov (United States)

    Calvo-Espinos, Claudio; Ruiz de Gaona, Estefania; Gonzalez, Cristina; Ruiz de Galarreta, Lucia; Lopez, Cristina

    2015-06-01

    Palliative sedation is a common treatment in palliative care. The home is a difficult environment for research, and there are few studies about sedation at home. Our aim was to analyze this practice in a home setting. We conducted a retrospective cross-sectional descriptive study in a home cohort during 2011. The inclusion criteria were as follows: 18 years or older and enrolled in the Palliative Home Care Program (PHCP) with advanced cancer. The variables employed were: sex, age, primary tumor location, and place of death. We also registered indication, type, drug and dose, awareness of diagnosis and prognosis, consent, survival, presence or absence of rales, painful mouth, and ulcers in patients sedated at home. We also collected the opinions of family members and professionals about the suffering of sedated patients. A total of 446 patients (56% at home) of the 617 admitted to the PHCP between January and December of 2011 passed away. The typical patient in our population was a 70-year-old man with a lung tumor. Some 35 (14%) home patients required sedation, compared to 93 (49%) at the hospital. The most frequent indication was delirium (70%), with midazolam the most common drug (mean dose, 40 mg). Survival was around three days. Rales were frequent (57%) as well as awareness of diagnosis and prognosis (77 and 71%, respectively). Perception of suffering after sedation was rare among relatives (17%) and professionals (8%). In most cases, the decision was made jointly by professionals and family members. Our study confirmed the role of palliative sedation as an appropriate therapeutic tool in the home environment.

  19. Spine fractures caused by horse riding

    OpenAIRE

    Siebenga, Jan; Segers, Michiel J. M.; Elzinga, Matthijs J.; Bakker, Fred C.; Haarman, Henk J. T. M.; Patka, Peter

    2006-01-01

    Study Design: Retrospective study and review of literature. Objectives: Study of demographic data concerning spinal fractures caused by horse riding, classification of fractures according to the AO and Load Sharing classifications, evaluation of mid-term radiological results and long-term functional results. Methods: A review of medical reports and radiological examinations of patients presented to our hospital with horse riding-related spine fractures over a 13-year period; long-term functio...

  20. Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

    Energy Technology Data Exchange (ETDEWEB)

    Grevatt, Jim [Energy Futures Group (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffmeyer, Dale [US Department of Energy, Washington, DC (United States)

    2017-07-05

    After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residential savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in

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

    NARCIS (Netherlands)

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

    2018-01-01

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

  2. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  3. The Effectiveness of Healthy Start Home Visit Program: Cluster Randomized Controlled Trial

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2015-01-01

    Purpose: The study reported the effectiveness of a home visit program for disadvantaged Chinese parents with preschool children, using cluster randomized controlled trial design. Method: Participants included 191 parents and their children from 24 preschools, with 84 dyads (12 preschools) in the intervention group and 107 dyads (12 preschools) in…

  4. Using Home Irrigation Users' Perceptions to Inform Water Conservation Programs

    Science.gov (United States)

    Warner, Laura A.; Chaudhary, Anil Kumar; Lamm, Alexa J.; Rumble, Joy N.; Momol, Esen

    2017-01-01

    Targeted agricultural education programs can play a role in solving complex water issues. This article applies importance-performance analysis to examine dimensions of water resources that may inform local water conservation campaigns in the United States. The purpose of this study was to generate a deep understanding of home irrigation users'…

  5. Home-based alcohol prevention program for parents and children: A randomized controlled trial

    NARCIS (Netherlands)

    Mares, S.H.W.; Lichtwarck-Aschoff, A.; Verdurmen, J.E.E.; Schulten, I.G.H.; Engels, R.C.M.E.

    2016-01-01

    Objective: To evaluate the effectiveness of a home-based alcohol prevention program to delay initiation of alcohol use in children. Methods: In 2011, a total of 1349 sixth-grade children (M = 12.15, SD = 0.47) and their mothers who could read and write Dutch were recruited from primary schools in

  6. The impact of a Caribbean home-visiting child development program on cognitive skills

    NARCIS (Netherlands)

    Janssens, W.; Rosemberg, C.

    2014-01-01

    This paper provides a short-term impact evaluation of a home-visiting Early Child Development (ECD) program in the Caribbean aimed at vulnerable children from birth to three years. The analysis is based on a quasi-experimental research design including approximately four hundred children in

  7. 76 FR 78343 - HOME Investment Partnerships Program: Improving Performance and Accountability; and Updating...

    Science.gov (United States)

    2011-12-16

    ... CFR Parts 91 and 92 HOME Investment Partnerships Program: Improving Performance and Accountability... Performance and Accountability; and Updating Property Standards AGENCY: Office of the Assistant Secretary for... regulatory requirements and establish new requirements designed to enhance accountability by States and units...

  8. Developing a Home-Based Early Intervention Personnel Training Program in Southeast China

    Science.gov (United States)

    Xie, Huichao; Chen, Ching-I; Chen, Chieh-Yu; Squires, Jane; Li, Wenge; Liu, Tian

    2017-01-01

    China is expected to have a rapid growth in specialized early intervention (EI) services for young children ages birth to 6 and their families. A major barrier in the provision of EI services in China is the shortage of well-trained EI personnel. In 2013, a Home-Based Early Intervention Program (HBEIP) was started at South China Normal University…

  9. Effectiveness of a Home Program Intervention for Young Children with Autism.

    Science.gov (United States)

    Ozonoff, Sally; Cathcart, Kristina

    1998-01-01

    This project evaluated the effectiveness of the Treatment and Education of Autistic and related Communication handicapped CHildren (TEACCH) home program intervention model for young children with autism, which encourages parents to be active, ongoing co-therapists. The 11 children in the treatment group, compared to the control, improved…

  10. 76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2011-03-18

    ... Services 42 CFR Part 488 [CMS-2435-F] Medicare and Medicaid Programs; Civil Money Penalties for Nursing... incentives for quality improvement, and to remove uncertainty for nursing homes, we proposed to set the... Vol. 76 Friday, No. 53 March 18, 2011 Part III Department of Health and Human Services Centers for...

  11. Promoting an Alcohol-Free Childhood: A Novel Home-Based Parenting Program

    Science.gov (United States)

    Dickinson, Denise M.; Hayes, Kim A.; Jackson, Christine; Ennett, Susan T.; Lawson, Caroline

    2014-01-01

    Few alcohol prevention programs focus on elementary school-aged youth, yet children develop expectancies and norms about alcohol use during the elementary school years, and many elementary school children are allowed to have sips or tastes of alcohol at home. Research on consequences of early alcohol use indicates that it can put children at…

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

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.

    2000-04-04

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

  13. 78 FR 41013 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Science.gov (United States)

    2013-07-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 431 [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...

  14. The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs.

    Science.gov (United States)

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

    2013-08-01

    Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting-the implementation of P4P for nursing homes by state Medicaid agencies. 2001-2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. © Health Research and Educational Trust.

  15. PrivateRide: A Privacy-Enhanced Ride-Hailing Service

    Directory of Open Access Journals (Sweden)

    Pham Anh

    2017-04-01

    Full Text Available In the past few years, we have witnessed a rise in the popularity of ride-hailing services (RHSs, an online marketplace that enables accredited drivers to use their own cars to drive ride-hailing users. Unlike other transportation services, RHSs raise significant privacy concerns, as providers are able to track the precise mobility patterns of millions of riders worldwide. We present the first survey and analysis of the privacy threats in RHSs. Our analysis exposes high-risk privacy threats that do not occur in conventional taxi services. Therefore, we propose PrivateRide, a privacy-enhancing and practical solution that offers anonymity and location privacy for riders, and protects drivers’ information from harvesting attacks. PrivateRide lowers the high-risk privacy threats in RHSs to a level that is at least as low as that of many taxi services. Using real data-sets from Uber and taxi rides, we show that PrivateRide significantly enhances riders’ privacy, while preserving tangible accuracy in ride matching and fare calculation, with only negligible effects on convenience. Moreover, by using our Android implementation for experimental evaluations, we show that PrivateRide’s overhead during ride setup is negligible. In short, we enable privacy-conscious riders to achieve levels of privacy that are not possible in current RHSs and even in some conventional taxi services, thereby offering a potential business differentiator.

  16. Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    McCurdy, BR

    2012-01-01

    Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients with Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Objective The objective of this analysis was to compare hospital-at-home care with inpatient hospital care for patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) who present to the emergency department (ED). Clinical Need: Condition and Target Population Acute Exacerbations of Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease is a disease

  17. Canadian contribution to the European Union Home Team program for ITER

    International Nuclear Information System (INIS)

    Murdoch, D.K.; Blevins, J.D.; Gierszewski, P.; Matsugu, R.

    1998-01-01

    Canadian participation in R and D and design tasks for the ITER project is predominantly in the fuel cycle, remote handling and safety fields. These tasks are carried out in Canada by Ontario Hydro, research institutes, industry and universities. In addition, Canada provides the services of a number of specialist engineers and scientists in key positions at the three ITER work sites and in the European Home Team. The Canadian contribution, which is coordinated by the Canadian Fusion Fuels Technology Project (CFFTP), forms an integral part of the European Union Home Team program. The key components of the Canadian contribution are described. (author)

  18. Bundle Payment Program Initiative: Roles of a Nurse Navigator and Home Health Professionals.

    Science.gov (United States)

    Peiritsch, Heather

    2017-06-01

    With the passage of the Affordable Care Act, The Centers for Medicare and Medicaid (CMS) introduced a new value-based payment model, the Bundle Payment Care Initiative. The CMS Innovation (Innovation Center) authorized hospitals to participate in a pilot to test innovative payment and service delivery models that have a potential to reduce Medicare expenditures while maintaining or improving the quality of care for beneficiaries. A hospital-based home care agency, Abington Jefferson Health Home Care Department, led the initiative for the development and implementation of the Bundled Payment Program. This was a creative and innovative method to improve care along the continuum while testing a value-based care model.

  19. The Impact of Home Visitation Program on Exercise Behaviour of Women with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Yasemin Gümüş Şekerci

    2017-03-01

    Full Text Available Aim: To examine the impact of home visitation program on exercise behaviour of women with type 2 diabetes. Methods: The study was performed in a district in Ankara. Power analysis was done for the sampling and the study was completed with type 2 diabetes 63 women who were determined via convenience sampling method. In the study, experimental design was used. The data are gathered with description form, exercise knowledge form and exercise self-efficacy scale. In the study, the nurse helped change the exercise behaviour of women with type 2 diabetes through home visits for six months. For the research were taken written permissions from Provincial Directorate of Health Public, University Ethics Commission and the individuals who accepted to participate in the study. Results: Sixty-three females with type 2 diabetes between 20-49 years old affiliated to community health centre completed the study. The demographic characteristics (age, education, marital status, income, employment status of the women in intervention and control groups were similar (p>0.05. Outcomes in intervention group were significantly improved between the first and last visits included exercise knowledge, exercise self-efficacy and exercise duration (minute/day (p<0.05. Fasting glucose level, non-fasting glucose levels and hemoglobin A1c values of the women in the intervention group significantly decreased after the home visitation program. Conclusion: This home visitation program is helpful in exercise behaviour improving among women with type 2 diabetes.

  20. Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

    Science.gov (United States)

    Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

    2016-01-01

    Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

  1. Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

    Science.gov (United States)

    Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

    2017-02-01

    Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

  2. Therapeutic Riding for a Student with Multiple Disabilities and Visual Impairment: A Case Study.

    Science.gov (United States)

    Lehrman, Jennifer; Ross, David B.

    2001-01-01

    A 9-year-old with multiple disabilities and visual impairments was the focus of a 10-week developmental therapeutic riding program incorporating hippotherapy. The program has led to increased mobility, an increase in visual attention span and fixation time, signs of greater verbal communication, and the acquisition of new functional signs.…

  3. Preliminary assessment of the Louisiana Home Energy Rebate Offer program using IPMVP guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, Mark J.; Pulsipher, Allan G. [Center for Energy Studies, Louisiana State University, Energy Coast and Environment Building, Nicholson Extension Drive, Baton Rouge, LA 70803 (United States)

    2010-02-15

    The Louisiana Home Energy Rebate Offer (HERO) is a residential energy conservation program established in 1999 to provide rebates for qualified applicants to build new homes that are more energy efficient or improve the energy efficiency of existing homes. Energy conservation programs require careful evaluation because of the high cost to implement the measures and the expectation that they will reduce energy use. The purpose of this paper is to demonstrate that residential energy conservation measures in a hot and humid climate can be evaluated using the International Performance Measurement and Verification Protocol (IPMVP), a best practice methodology commonly used in industrial and commercial performance-based contracts, but rarely, if ever, applied to residential programs. Using a random sample of 60 HERO participants, we were able to construct statistically significant electricity consumption baseline models for 90% of households. We determined that more than half of the sample participants consumed more electricity after their efficiency improvement, with an average net household savings of 172 kWh/yr, about 1% pre-retrofit consumption. A description of the baseline model construction, preliminary program evaluation, and recommendations are provided. All program conclusions are considered preliminary until a larger and more comprehensive study is conducted. (author)

  4. Preliminary assessment of the Louisiana Home Energy Rebate Offer program using IPMVP guidelines

    International Nuclear Information System (INIS)

    Kaiser, Mark J.; Pulsipher, Allan G.

    2010-01-01

    The Louisiana Home Energy Rebate Offer (HERO) is a residential energy conservation program established in 1999 to provide rebates for qualified applicants to build new homes that are more energy efficient or improve the energy efficiency of existing homes. Energy conservation programs require careful evaluation because of the high cost to implement the measures and the expectation that they will reduce energy use. The purpose of this paper is to demonstrate that residential energy conservation measures in a hot and humid climate can be evaluated using the International Performance Measurement and Verification Protocol (IPMVP), a best practice methodology commonly used in industrial and commercial performance-based contracts, but rarely, if ever, applied to residential programs. Using a random sample of 60 HERO participants, we were able to construct statistically significant electricity consumption baseline models for 90% of households. We determined that more than half of the sample participants consumed more electricity after their efficiency improvement, with an average net household savings of 172 kWh/yr, about 1% pre-retrofit consumption. A description of the baseline model construction, preliminary program evaluation, and recommendations are provided. All program conclusions are considered preliminary until a larger and more comprehensive study is conducted.

  5. The Importance of Trust in Successful Home Visit Programs for Older People

    Directory of Open Access Journals (Sweden)

    Maaike E. Muntinga

    2016-11-01

    Full Text Available Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we posit that a trusting relationship is pivotal for older people to accept care that is proactively offered to them. Trust can be build when nurses meet the relational needs of older people. Nurses can achieve insight in these needs by exploring older people’s value systems and life stories. We argue that a strong focus on older people’s relational needs might contribute to success of proactive home visits for frail, older people.

  6. [Perspective of informal caregivers on home care. Qualitative study with a computer program].

    Science.gov (United States)

    Prieto Rodríguez, M Angeles; Gil García, Eugenia; Heierle Valero, Cristina; Frías Osuna, Antonio

    2002-01-01

    A hot debate exists in our country as to the models of home care which must be developed. This study is aimed at ascertaining how the family caregivers of terminal cancer patients, of the elderly suffering from dementia and of individuals having undergone major operations in outpatient surgery programs rate the quality of the home care provided. A phenomenological type qualitative study based on discussion groups (9), triangular groups (5) and in-depth interviews (22). This study was conducted in Andalusia throughout the 1999-2000 period. The subjects of the study were the main caregivers of patients provided with home care through the healthcare centers. The information must be analyzed by means of a Nudist-4 software-aided content analysis. The analysis variables were those of the Servqual model. For the caregivers of cancer patients, the most important aspects of the quality of the home care provided were the Response Capacity and Accessibility. This analysis revealed that the patients suffered pain but the pain was not controlled. Negative aspects hindering accessibility were the lack of home care coverage outside of regular working hours, the difficulty of getting in touch by phone, the length of time it takes for someone to come and the visits solely on request. The caregivers of patients having undergone major outpatient surgery want Security and Reliability. They complain of the short length of time within which the patients are released from the hospital and of the home care provided by the health care center. The caregivers of the elderly with dementia place top priority on being provided with the materials they need to take care of these patients. Caregivers' and patients' expectations differ, depending on health problems, therefore, the type of home care provided should vary, according to the health problems involved. It is necessary to develop a flexible model, capable of adapting to different patient needs and the diverse circumstances that affect

  7. Therapeutic Effects of Horseback Riding Interventions: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Stergiou, Alexandra; Tzoufi, Meropi; Ntzani, Evangelia; Varvarousis, Dimitrios; Beris, Alexandros; Ploumis, Avraam

    2017-10-01

    Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life. In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool. Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs. Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.

  8. 'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.

    Science.gov (United States)

    Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

    2011-11-24

    It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge. Interventions, such as group and home based physical activity programs, have been widely reported upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact. 'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected. The planned 18 month follow-up post

  9. National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

    Science.gov (United States)

    Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

    2017-12-01

    To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  10. Evaluation of the U.S. Department of Energy Challenge Home Program Certification of Production Builders

    Energy Technology Data Exchange (ETDEWEB)

    Kerrigan, P. [Building Science Corporation, Somerville, MA (United States); Loomis, H. [Building Science Corporation, Somerville, MA (United States)

    2014-09-01

    The purpose of this project was to evaluate integrated packages of advanced measures in individual test homes to assess their performance with respect to Building America program goals, specifically compliance with the DOE Challenge Home Program. BSC consulted on the construction of five test houses by three cold climate production builders in three U.S. cities and worked with the builders to develop a design package tailored to the cost-related impacts for each builder. Also, BSC provided support through performance testing of the five test homes. Overall, the builders have concluded that the energy related upgrades (either through the prescriptive or performance path) represent reasonable upgrades. The builders commented that while not every improvement in specification was cost effective (as in a reasonable payback period), many were improvements that could improve the marketability of the homes and serve to attract more energy efficiency discerning prospective homeowners. However, the builders did express reservations on the associated checklists and added certifications. An increase in administrative time was observed with all builders. The checklists and certifications also inherently increase cost due to: adding services to the scope of work for various trades, such as HERS Rater, HVAC contractor; and increased material costs related to the checklists, especially the EPA Indoor airPLUS and EPA WaterSense® Efficient Hot Water Distribution requirement.

  11. Evaluation of the U.S. Department of Energy Challenge Home Program Certification of Production Builders

    Energy Technology Data Exchange (ETDEWEB)

    Kerrigan, P.; Loomis, H.

    2014-09-01

    The purpose of this project was to evaluate integrated packages of advanced measures in individual test homes to assess their performance with respect to Building America Program goals, specifically compliance with the DOE Challenge Home Program. BSC consulted on the construction of five test houses by three Cold Climate production builders in three separate US cities. BSC worked with the builders to develop a design package tailored to the cost-related impacts for each builder. Therefore, the resulting design packages do vary from builder to builder. BSC provided support through this research project on the design, construction and performance testing of the five test homes. Overall, the builders have concluded that the energy related upgrades (either through the prescriptive or performance path) represent reasonable upgrades. The builders commented that while not every improvement in specification was cost effective (as in a reasonable payback period), many were improvements that could improve the marketability of the homes and serve to attract more energy efficiency discerning prospective homeowners. However, the builders did express reservations on the associated checklists and added certifications. An increase in administrative time was observed with all builders. The checklists and certifications also inherently increase cost due to: 1. Adding services to the scope of work for various trades, such as HERS Rater, HVAC contractor; 2. Increased material costs related to the checklists, especially the EPA Indoor airPLUS and EPA WaterSense(R) Efficient Hot Water Distribution requirement.

  12. A Cost-Effectiveness Comparision of Two Types of Occupational Home Economics Programs in the State of Kentucky. Final Report.

    Science.gov (United States)

    Gabbard, Lydia Carol Moore

    A study compared the cost effectiveness of secondary child care and commercial foods occupational home economics programs in Kentucky. Identified as dependent variables in the study were program effectiveness, cost efficiency, and cost effectiveness ratio. Program expenditures, community size, and program age were considered as independent…

  13. Home visiting programs for HIV-affected families: a comparison of service quality between volunteer-driven and paraprofessional models.

    Science.gov (United States)

    Kidman, Rachel; Nice, Johanna; Taylor, Tory; Thurman, Tonya R

    2014-10-02

    Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting. Analysis focused on intervention exposure, including visit intensity, duration and the kinds of emotional, informational and tangible support provided. Few beneficiaries reported receiving home visits in program models primarily driven by lay volunteers; when visits did occur, they were shorter and more infrequent. Paraprofessional-driven programs not only provided significantly more home visits, but also provided greater interaction with the child, communication on a larger variety of topics, and more tangible support to caregivers. These results suggest that programs that invest in compensation and extensive training for home visitors are better able to serve and retain beneficiaries, and they support a move toward establishing a professional workforce of home visitors to support vulnerable children and families in South Africa.

  14. Neighborhood Effects on PND Symptom Severity for Women Enrolled in a Home Visiting Program.

    Science.gov (United States)

    Jones, David E; Tang, Mei; Folger, Alonzo; Ammerman, Robert T; Hossain, Md Monir; Short, Jodie; Van Ginkel, Judith B

    2018-05-01

    The aim of this study was to investigate the association between postnatal depression (PND) symptoms severity and structural neighborhood characteristics among women enrolled in a home visiting program. The sample included 295 mothers who were at risk for developing PND, observed as 3-month Edinburgh Postnatal Depression Scale (EPDS) scores ≥ 10. Two neighborhood predictor components (residential stability and social disadvantage) were analyzed as predictors of PND symptom severity using a generalized estimating equation. Residential stability was negatively associated with PND symptom severity. Social disadvantage was not found to be statistically significantly. The findings suggest that residential stability is associated with a reduction in PND symptom severity for women enrolled in home visiting program.

  15. Upaya Peningkatan Status Gizi Balita Malnutrisi Akut Berat Melalui Program Home Care

    Directory of Open Access Journals (Sweden)

    Fitri Haryanti

    2014-12-01

    Full Text Available Malnutrisi pada balita masih merupakan permasalahan di Indonesia termasuk di Daerah Istimewa Yogyakarta. Berdasarkan indikator berat badan menurut tinggi badan, 2,6% balita mengalami malnutrisi akut berat. Pada beberapa dekade terakhir, telah terjadi pergeseran paradigma dalam penanganan balita malnutrisi, yang sebelumnya berbasis pendekatan fasilitas kesehatan bergeser menjadi pendekatan berbasis komunitas. Tujuan penelitian ini adalah untuk menganalisis pengaruh program home care terhadap peningkatan status gizi balita malnutrisi pada anak usia 6-60 bulan. Penelitian menggunakan desain kuasi eksperimen dengan pretest dan posttest control group melalui tiga tahap pendampingan yaitu intensif, mandiri, dan penguatan dengan pendekatan asuhan keperawatan. Sampel adalah 56 balita malnutrisi akut di dua wilayah, yaitu 33 balita di Kota Yogyakarta (eksperimen dan 23 balita di Kabupaten Sleman (kontrol dengan teknik pengambilan sampel yaitu purposive sampling. Intervensi home care diberikan selama tiga 3 bulan (Januari sampai Maret 2013. Hasil penelitian menunjukkan setelah program home care, terjadi peningkatan yang signifikan pada status gizi balita (p < 0,05. Pada akhir intervensi, terjadi penurunan kejadian malnutrisi akut berat dari 100% menjadi 56,7% (p < 0,05. Improving Nutritional Status of Children with Severe Acute Malnutrition Through Home Care Program Children undernutrition is still an issue in Indonesia, including in the Special Region of Yogyakarta. Based on weight for height indicator, 2.6% children experience severe acute malnutrition. In the last few decades, there has been a paradigm shift in the management of acute malnutrition from a facility- based to community-centered approach. The purpose of this study was to analyze the effect of home care intervention on the improvement of nutritional status of severe acute malnutrition children aged 6-60 months. This study was designed with quasi-experimental and pretest-posttest control

  16. Results from the Evaluation of the Massachusetts Nursing Home Connection Program

    Science.gov (United States)

    1989-10-01

    For the rollovers, the midpoint data was collected at the time of transfer to the new system of care. The basic comparisons were from admission to...claims data from both the Medicare and Medicaid programs as well as nursing home data from the Massachusetts Medicaid Medical Information System ...Patients Rollovers )ieaes of nervus systern 13 15 Dementia 31 35 CVA 27 29 HIP 18 1 5 b Cancer 07 041) Neurologic disorders 6(30 62 )epression 03 04

  17. A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program.

    Science.gov (United States)

    Tzemis, Despina; Al-Qutub, Diana; Amlani, Ashraf; Kesselring, Sarah; Buxton, Jane A

    2014-07-01

    In August 2012, the British Columbia Take Home Naloxone (BCTHN) program was introduced to help to reduce opioid overdose and its consequences. This study evaluates the BCTHN program, identifying the successes and challenges of implementing a provincial program in Canada. In this cross-sectional study, we reviewed the records of the BCTHN administrative program to report on program outcomes (participation and overdose reversals). Focus groups and individual interviews were conducted with 40 clients in Vancouver; 12 individual interviews were completed with service providers, police officers and parents of people who use opioids from both the Vancouver and Interior regions of British Columbia. Qualitative data were analyzed using content analysis and a qualitative descriptive approach. As of March 13, 2014, the BCTHN program had been implemented at 40 sites, trained 1318 participants in overdose prevention, recognition and response, distributed 836 kits to clients and received reports of 85 overdose reversals. Stakeholders were supportive of the program, and clients reported greater confidence in response to overdose. Service providers found the program training materials easy to use and that training increased client engagement. Some of the challenges included difficulty in identifying physician willing to prescribe, recruitment of some at-risk populations (e.g., long-term opioid users and patients with chronic pain), and clients' reluctance to call 911. We also found that the police had some misconceptions about BCTHN. The BCTHN program was easy to implement, empowering for clients and was responsible for reversing 85 overdoses in its first 20 months. We suggest communities across Canada should consider implementing take-home naloxone programs and evaluate their findings.

  18. DAMPAK HOME PROGRAM PADA ANAK BALITA DENGAN HAMBATAN TUMBUH KEMBANG DI DAERAH ENDEMIK GAKI

    Directory of Open Access Journals (Sweden)

    Diah Yunitawati

    2013-02-01

    Full Text Available Background: Abnormalities that emerge because of lack of iodine will verv interfere and obstruct children's growth and development. Psycho-motor dysfunction children often experienciug difficulty perform developing tasks such as sit without help, standing, and walking. The hampered of psycho-motor developing process certainly will complicate next developiug processes.Objective: This study will examine the impact of home program-training for mothers in order 10 improve stunted growth children's motor abilities. Method: This study is using applied research by experimental quasi design. The location is in Kabupaten Magelang, precisely in Balai Penelitian dan Pengembangan CAKI Magelang throughout l O monthfrom March to December 2008. Questionnaires are used to measure identifying data, medical history, pre¬screening development and Bailey Scales of Infant Development, 2nd Edition to da ta ofmotor and men ta I development of ch i Idren.Result: Molor developing, mental developing, and nutritional status in treatment group (home program-tra in ed and control group (un-trained among before and after trained do es liat indicate sign ifican t difference (p>O. 05.Key words: Barriers of growth and developing, home program, iodine deficiency disorder. underfive children

  19. Affecting culture change and performance improvement in Medicaid nursing homes: the Promote Understanding, Leadership, and Learning (PULL) Program.

    Science.gov (United States)

    Eliopoulos, Charlotte

    2013-01-01

    A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.

  20. On-line single server dial-a-ride problems

    NARCIS (Netherlands)

    Feuerstein, E.; Stougie, L.

    1998-01-01

    In this paper results on the dial-a-ride problem with a single server are presented. Requests for rides consist of two points in a metric space, a source and a destination. A ride has to be made by the server from the source to the destination. The server travels at unit speed in the metric space

  1. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011-18257 appearin...

  2. Process Evaluation to Explore Internal and External Validity of the "Act in Case of Depression" Care Program in Nursing Homes

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.F.J.

    2012-01-01

    Background: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): " Act in case of Depression" (AiD). Objective: Before effect analyses, to evaluate AiD

  3. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD

  4. 41 CFR 302-14.101 - What policies must we establish to govern our home marketing incentive payment program?

    Science.gov (United States)

    2010-07-01

    ... establish to govern our home marketing incentive payment program? 302-14.101 Section 302-14.101 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.101 What policies...

  5. Long-term changes in parenting and child behavior after the Home-Start family support program

    NARCIS (Netherlands)

    Hermanns, J.M.A.; Asscher, J.J.; Zijlstra, B.J.H.; Hoffenaar, P.J.; Deković, M.

    2013-01-01

    Background: The intervention Home-Start is a wide spread program in a number of countries, among which the Netherlands. In Home-Start, trained volunteers visit families with young children in need of support once or twice a week to help them to deal with problems in family life and parenting. Little

  6. Structured social relationships: a review of volunteer home visiting programs for parents of young children.

    Science.gov (United States)

    Byrne, Fiona; Grace, Rebekah; Tredoux, Jaimie; Kemp, Lynn

    2016-06-01

    Objective The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods An integrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion In recognition of the importance of peer support for new parents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parents who are in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteer home visiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological

  7. Sustainable Passenger Transportation: Dynamic Ride-Sharing

    NARCIS (Netherlands)

    N.A.H. Agatz (Niels); A. Erera (Alan); M.W.P. Savelsbergh (Martin); X. Wang (Xing)

    2010-01-01

    textabstractRide-share systems, which aim to bring together travelers with similar itineraries and time schedules, may provide significant societal and environmental benefits by reducing the number of cars used for personal travel and improving the utilization of available seat capacity. Effective

  8. Braking Control for Improving Ride Comfort

    Directory of Open Access Journals (Sweden)

    Lee Jonghyup

    2018-01-01

    Full Text Available While many vehicle control systems focus on vehicle safety and vehicle performance at high speeds, most driving conditions are very low risk situations. In such a driving situation, the ride comfort of the vehicle is the most important performance index of the vehicle. Electro mechanical brake (EMB and other brake-by-wire (BBW systems have been actively researched. As a result, braking actuators in vehicles are more freely controllable, and research on improving ride comfort is also possible. In this study, we develop a control algorithm that dramatically improves ride comfort in low risk braking situations. A method for minimizing the inconvenience of a passenger due to a suddenly changing acceleration at the moment when the vehicle is stopped is presented. For this purpose, an acceleration trajectory is generated that minimizes the discomfort index defined by the change in acceleration, jerk. A controller is also designed to track this trajectory. The algorithm that updates the trajectory is designed considering the error due to the phase lag occurring in the controller and the plant. In order to verify the performance of this controller, simulation verification is completed using a car simulator, Carsim. As a result, it is confirmed that the ride comfort is dramatically improved.

  9. Stay Safe Riding Bikes or Skating Outside

    Centers for Disease Control (CDC) Podcasts

    2011-02-02

    In this podcast for kids, the Kidtastics talk about safety when outside, riding bikes or skating.  Created: 2/2/2011 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 2/2/2011.

  10. Free Riding Indexes for Ukrainian Economics Teachers.

    Science.gov (United States)

    McCorkle, Sarapage; Watts, Michael

    1996-01-01

    Reports on the adaptation and replication of Jane Leuthold's experiment concerning consumer choice, investments, and free riding indexes. A similar experiment, conducted in a Ukrainian classroom, produced similar results with a few notable exceptions. The exceptions reflected the Ukrainians' lack of familiarity with western economic thought. (MJP)

  11. Calming the Waters or Riding the Waves?

    DEFF Research Database (Denmark)

    Rydén, Pernille; Kottika, Efthymia; Hossain, Muhammad Ismail

    Traditional consumer anger management tends to be compromising rather than empowering the brand. This paper conceptualizes and provides a case example on how consumer empowerment and negative emotions can in fact create opportunities for companies to ride the waves of consumer anger in a way that...

  12. Riding Bikes: A Pastime for Every Child

    Science.gov (United States)

    Mathias, Michelle

    2011-01-01

    People have heard the expression "It's as easy as riding a bike." But the idea of a child with special needs balancing, steering, and pedaling a bike can seem out of reach for some; especially when he may be unable to walk unaided or hold his head up without support. Physical capabilities or stamina need not keep a child from this pleasurable…

  13. Mobile-phone-based home exercise training program decreases systemic inflammation in COPD: a pilot study.

    Science.gov (United States)

    Wang, Chun-Hua; Chou, Pai-Chien; Joa, Wen-Ching; Chen, Li-Fei; Sheng, Te-Fang; Ho, Shu-Chuan; Lin, Horng-Chyuan; Huang, Chien-Da; Chung, Fu-Tsai; Chung, Kian Fan; Kuo, Han-Pin

    2014-08-30

    Moderate-intensity exercise training improves skeletal muscle aerobic capacity and increased oxidative enzyme activity, as well as exercise tolerance in COPD patients. To investigate whether the home-based exercise training program can reduce inflammatory biomarkers in patients with COPD, twelve patients using mobile phone assistance and 14 with free walk were assessed by incremental shuttle walk test (ISWT), spirometry, strength of limb muscles, and serum C-reactive protein (CRP) and inflammatory cytokines. Patients in the mobile phone group improved their ISWT walking distance, with decrease in serum CRP after 2 months, and sustained at 6 months. Patients in the control group had no improvement. Serum IL-8 in the mobile phone group was significantly reduced at 2, 3 and 6 months after doing home exercise training compared to baseline. IL-6 and TNF-α were significantly elevated at 3 and 6 months in control group, while there were no changes in mobile phone group. The strength of limb muscles was significantly greater compared to baseline at 3 and 6 months in the mobile phone group. A mobile-phone-based system can provide an efficient home endurance exercise training program with improved exercise capacity, strength of limb muscles and a decrease in serum CRP and IL-8 in COPD patients. Decreased systemic inflammation may contribute to these clinical benefits. (Clinical trial registration No.: NCT01631019).

  14. Building Our Capacity to Forge Successful Home-School Partnerships: Programs That Support and Honor the Contributions of Families

    Science.gov (United States)

    Hindin, Alisa; Steiner, Lilly M.; Dougherty, Susan

    2017-01-01

    This article focuses on two programs that were created to enhance parent involvement practices in literacy. The goal of both programs was to create for parents enjoyable and rich experiences around literacy in the home, while demonstrating for parents how teachers approach reading instruction in the classroom. Programs to increase and support…

  15. Parents and Children through the School Years: The Effects of the Home Instruction Program for Preschool Youngsters.

    Science.gov (United States)

    Baker, Amy J. L.; Piotrkowski, Chaya S.

    The Home Instruction Program for Preschool Youngsters (HIPPY) is a free 2-year family oriented early childhood education and parent involvement program for parents with limited formal education to help them provide educational enrichment for their 4-year-old and 5-year-old children. As of 1996, HIPPY programs serve over 15,000 economically…

  16. [Riding therapy in the rehabilitation of mobility-impaired children].

    Science.gov (United States)

    Mäenpää, Helena; Kela, Katri; Sätilä, Heli

    2016-01-01

    Riding therapy is a comprehensive and functional form of rehabilitation, in which the rehabilitee, the horse and the riding therapist collaborate in order to achieve individually assigned goals that support rehabilitation. In Finland, riding therapy is therapeutic rehabilitation carried out by riding therapists who have undergone approved training. The therapy is mainly implemented in an individual form, but small group working is also applied, e.g. in the form of pair therapy and therapeutic vaulting. In Europe, this form of rehabilitation has been divided into hippotherapy supporting motor functions and heilpedagogical riding therapy functioning in support of upbringing.

  17. Greenbelt Homes Pilot Energy Efficiency Program Phase 1 Summary. Existing Conditions and Baseline Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [NAHB Research Center, Upper Marlboro, MD (United States); Del Bianco, M. [NAHB Research Center, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center, Upper Marlboro, MD (United States)

    2013-02-01

    A multi-year pilot energy efficiency retrofit project has been undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 co-operative of circa 1930 and '40 homes. The three predominate construction methods of the townhomes in the community are materials common to the area and climate zone including 8” CMU block, wood frame with brick veneer and wood frame with vinyl siding. GHI has established a pilot project that will serve as a basis for decision making for the roll out of a decade-long community upgrade program that will incorporate energy efficiency to the building envelope and equipment with the modernization of other systems like plumbing, mechanical equipment, and cladding.

  18. Greenbelt Homes Pilot Energy Efficiency Program Phase 1 Summary: Existing Conditions and Baseline Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J.; Del Bianco, M.; Wood, A.

    2013-02-01

    A multi-year pilot energy efficiency retrofit project has been undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 co-operative of circa 1930 and '40 homes. The three predominate construction methods of the townhomes in the community are materials common to the area and climate zone including 8" CMU block, wood frame with brick veneer and wood frame with vinyl siding. GHI has established a pilot project that will serve as a basis for decision making for the roll out of a decade-long community upgrade program that will incorporate energy efficiency to the building envelope and equipment with the modernization of other systems like plumbing, mechanical equipment, and cladding.

  19. Older persons' experiences of a home-based exercise program with behavioral change support.

    Science.gov (United States)

    Arkkukangas, Marina; Sundler, Annelie J; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

    2017-12-01

    It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  20. Qualitative assessment of take-home naloxone program participant and law enforcement interactions in British Columbia.

    Science.gov (United States)

    Deonarine, Andrew; Amlani, Ashraf; Ambrose, Graham; Buxton, Jane A

    2016-05-21

    The British Columbia take-home naloxone (BCTHN) program has been in operation since 2012 and has resulted in the successful reversal of over 581 opioid overdoses. The study aims to explore BCTHN program participant perspectives about the program, barriers to participants contacting emergency services (calling "911") during an overdose, and perspectives of law enforcement officials on naloxone administration by police officers. Two focus groups and four individual interviews were conducted with BCTHN program participants; interviews with two law enforcement officials were also conducted. Qualitative analysis of all transcripts was performed. Positive themes about the BCTHN program from participants included easy to understand training, correcting misperceptions in the community, and positive interactions with emergency services. Potential barriers to contacting emergency services during an overdose include concerns about being arrested for outstanding warrants or for other illegal activities (such as drug possession) and confiscation of kits. Law enforcement officials noted that warrants were complex situational issues, kits would normally not be confiscated, and admitted arrests for drug possession or other activities may not serve the public good in an overdose situation. Law enforcement officials were concerned about legal liability and jurisdictional/authorization issues if naloxone administration privileges were expanded to police. Program participants and law enforcement officials expressed differing perspectives about warrants, kit confiscation, and arrests. Facilitating communication between BCTHN program participants and other stakeholders may address some of the confusion and remove potential barriers to further improving program outcomes. Naloxone administration by law enforcement would require policies to address jurisdiction/authorization and liability issues.

  1. Cost Analysis of Physician Assistant Home Visit Program to Reduce Readmissions After Cardiac Surgery.

    Science.gov (United States)

    Nabagiez, John P; Shariff, Masood A; Molloy, William J; Demissie, Seleshi; McGinn, Joseph T

    2016-09-01

    A physician assistant home care (PAHC) program providing house calls was initiated to reduce hospital readmissions after adult cardiac surgery. The purpose of our study was to compare 30-day PAHC and pre-PAHC readmission rate, length of stay, and cost. Patients who underwent adult cardiac surgery in the 48 months from September 2008 through August 2012 were retrospectively reviewed using pre-PAHC patients as the control group. Readmission rate, length of stay, and health care cost, as measured by hospital billing, were compared between groups matched with propensity score. Of the 1,185 patients who were discharged directly home, 155 (13%) were readmitted. Total readmissions for the control group (n = 648) was 101 patients (16%) compared with the PAHC group (n = 537) total readmissions of 54 (10%), a 38% reduction in the rate of readmission (p = 0.0049). Propensity score matched groups showed a rate reduction of 41% with 17% (62 of 363) for the control compared with 10% (37 of 363) for the PAHC group (p = 0.0061). The average hospital bill per readmission was $39,100 for the control group and $56,600 for the PAHC group (p = 0.0547). The cost of providing home visits was $25,300 for 363 propensity score matched patients. The PAHC program reduced the 30-day readmission rate by 41% for propensity score matched patients. Analysis demonstrated a savings of $977,500 at a cost of $25,300 over 2 years, or $39 in health care saved, in terms of hospital billing, for every $1 spent. Therefore, a home visit by a cardiac surgical physician assistant is a cost-effective strategy to reduce readmissions after cardiac surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. How State-Funded Home Care Programs Respond to Changes in Medicare Home Health Care: Resource Allocation Decisions on the Front Line

    Science.gov (United States)

    Corazzini, Kirsten

    2003-01-01

    Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390

  3. Comparing Catheter-associated Urinary Tract Infection Prevention Programs Between VA and Non-VA Nursing Homes

    Science.gov (United States)

    Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.

    2018-01-01

    OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728

  4. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    Science.gov (United States)

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  5. [Results of a physical therapy program in nursing home residents: A randomized clinical trial].

    Science.gov (United States)

    Casilda-López, Jesús; Torres-Sánchez, Irene; Garzón-Moreno, Victor Manuel; Cabrera-Martos, Irene; Valenza, Marie Carmen

    2015-01-01

    The maintenance of the physical functionality is a key factor in the care of the elderly. Inactive people have a higher risk of death due to diseases associated with inactivity. In addition, the maintenance of optimal levels of physical and mental activity has been suggested as a protective factor against the development and progression of chronic illnesses and disability. The objective of this study is to assess the effectiveness of an 8-week exercise program with elastic bands, on exercise capacity, walking and balance in nursing home residents. A nursing home sample was divided into two groups, intervention group (n=26) and control group (n=25). The intervention group was included in an 8-week physical activity program using elastic bands, twice a week, while the control group was took part in a walking programme. Outcome measurements were descriptive variables (anthropometric characteristics, quality of life, fatigue, fear of movement) and fundamental variables (exercise capacity, walking and balance). A significant improvement in balance and walking speed was observed after the programme. Additionally, exercise capacity improved significantly (P≤.001), and the patients showed an improvement in perceived dyspnea after the physical activity programme in the intervention group. The exercise program was safe and effective in improving dyspnea, exercise capacity, walking, and balance in elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  6. Effects of a physical therapy home-based exercise program for Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Viviane Vieira Santos

    Full Text Available INTRODUCTION: Parkinson's disease (PD is a neurological disorder that causes loss of functional abilities and independence. The aim of this study was to evaluate the effects of a physical therapist-supervised home-based exercise program in patients with PD using the UPDRS scale. MATERIALS AND METHODS: Thirty-three PD patients in the 1.5 to 3 Hoehn and Yahr stages participated in the trial. The patients and their relatives received a booklet with a 12-week home program, with a series of strengthening, stretching and flexibility exercises. The patients were trained by a physical therapist, and each session took 60 minutes, three times a week. RESULTS: We classified our patients in four groups: Group 1 - patients under 60 years of age and less than five years of PD; Group 2 - patients under 60 years of age and more than five years of PD; Group 3 - patients over 60 years of age and less than five years of the disease; and Group 4 - patients over 60 years of age and more than five years of PD. Significant improvement was found in group 1 in mentation, activities of daily living and motor function (p > 0.05. Group 3 presented statistically significant differences in motor function subscale (p > 0.05 and Group 4 showed no worsening in mentation subscale (p > 0.05. Group 2, however, presented no difference in all subscales (p < 0.05. CONCLUSION: Although not all patients improved their UPDRS scores, our data support the use of a home program as an alternative method of physical therapy treatment for PD patients.

  7. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial.

    Science.gov (United States)

    Burton, Elissa; Lewin, Gill; Clemson, Lindy; Boldy, Duncan

    2013-01-01

    Restorative home care services are short-term and aimed at maximizing a person's ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults. A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention) or the structured exercise program currently being used in the service (control). Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability. There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program. Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes.

  8. Riding out a Financial Storm

    Science.gov (United States)

    Evans, Randy C.

    2012-01-01

    After two decades of steady growth and financial stability in the Rio Rancho Public Schools, New Mexico's fastest-growing school district found itself face to face with a $3.8 million budget deficit going into the 2008-09 school year. Because people in the district hesitated to change anything that would cut into student programming, and nobody…

  9. Home food safety program for the Georgia Older Americans Act Nutrition Program.

    Science.gov (United States)

    Sellers, Tiffany; Andress, Elizabeth; Fischer, Joan G; Johnson, Mary Ann

    2006-01-01

    This study examined the effects of an educational intervention on improving home food safety practices (HFSP) in 136 older adults (mean age: 79 years; 74% female; 61% Caucasian). At the pre-test, adherence to 16 HFSP was variable and ranged from or= 76% for other practices. Following the intervention, participants were more likely to wash their hands with warm water and soap for 20 seconds before eating (76% vs. 90%, P

  10. Greenbelt Homes Pilot Program: Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Del Bianco, M. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Mallay, D. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2015-05-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. It presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements.

  11. The Home Independence Program with non-health professionals as care managers: an evaluation

    Directory of Open Access Journals (Sweden)

    Lewin G

    2016-06-01

    Full Text Available Gill Lewin,1 Karyn Concanen,2 David Youens3 1School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia; 2Silver Chain Group, Osborne Park, WA, Australia; 3Faculty of Health Science, Curtin University, Perth, WA, Australia Abstract: The Home Independence Program (HIP, an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably

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

    Directory of Open Access Journals (Sweden)

    Jennifer Martin-Biggers

    2015-08-01

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

  13. Air riding seal with purge cavity

    Science.gov (United States)

    Sexton, Thomas D; Mills, Jacob A

    2017-08-15

    An air riding seal for a turbine in a gas turbine engine, where an annular piston is axial moveable within an annular piston chamber formed in a stator of the turbine and forms a seal with a surface on the rotor using pressurized air that forms a cushion in a pocket of the annular piston. A purge cavity is formed on the annular piston and is connected to a purge hole that extends through the annular piston to a lower pressure region around the annular piston or through the rotor to an opposite side. The annular piston is sealed also with inner and outer seals that can be a labyrinth seal to form an additional seal than the cushion of air in the pocket to prevent the face of the air riding seal from overheating.

  14. Scaling Law of Urban Ride Sharing

    Science.gov (United States)

    Tachet, R.; Sagarra, O.; Santi, P.; Resta, G.; Szell, M.; Strogatz, S. H.; Ratti, C.

    2017-03-01

    Sharing rides could drastically improve the efficiency of car and taxi transportation. Unleashing such potential, however, requires understanding how urban parameters affect the fraction of individual trips that can be shared, a quantity that we call shareability. Using data on millions of taxi trips in New York City, San Francisco, Singapore, and Vienna, we compute the shareability curves for each city, and find that a natural rescaling collapses them onto a single, universal curve. We explain this scaling law theoretically with a simple model that predicts the potential for ride sharing in any city, using a few basic urban quantities and no adjustable parameters. Accurate extrapolations of this type will help planners, transportation companies, and society at large to shape a sustainable path for urban growth.

  15. Riding Pontic--Aesthetic Journey Aesthetic Goal.

    Science.gov (United States)

    Rohilla, Byajit Kumar; Choudhary, Shweta; Manisha, Kukreja; Walia, Pawanjit Singh; Nafria, Anil

    2015-01-01

    The increasing concern for esthetics during the orthodontic treatment can be measured by the increasing popularity ofaesthetic brackets, lingual technique, smaller sized metal brackets, and clear alignment therapy. Many clients, especially adolescents, are self-conscious about their appearance in social and professional situations, and they refuse to tolerate the inevitable "black holes" of edentulous spaces during orthodontic treatment. This article describes the use, fabrication, modifications, and shortcomings of riding pontics; and illustrates how their use provides aesthetic, psychological and functional benefits.

  16. Effect of Home Exercise Program in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Anwer, Shahnawaz; Alghadir, Ahmad; Brismée, Jean-Michel

    2016-01-01

    The Osteoarthritis Research Society International recommended that nonpharmacological methods include patient education programs, weight reduction, coping strategies, and exercise programs for the management of knee osteoarthritis (OA). However, neither a systematic review nor a meta-analysis has been published regarding the effectiveness of home exercise programs for the management of knee OA. The purpose of this systematic review was to examine the evidence regarding the effect of home exercise programs with and without supervised clinic-based exercises in the management of knee OA. We searched PubMed, CINAHL, Embase, Scopus, and PEDro for research articles published prior to September 2014 using key words such as pain, exercise, home exercise program, rehabilitation, supervised exercise program, and physiotherapy in combination with Medical Subject Headings "Osteoarthritis knee." We selected randomized and case-controlled trials published in English language. To verify the quality of the selected studies, we applied the PEDro Scale. Two evaluators individually selected the studies based on titles, excluding those articles that were not related to the objectives of this review. One evaluator extracted data from the included studies. A second evaluator independently verified extracted data for accuracy. A total of 31 studies were found in the search. Of these, 19 studies met the inclusion criteria and were further analyzed. Seventeen of these 19 studies reached high methodological quality on the PEDro scale. Although the methods and home exercise program interventions varied widely in these studies, most found significant improvements in pain and function in individuals with knee OA. The analysis indicated that both home exercise programs with and without supervised clinic-based exercises were beneficial in the management of knee OA. The large evidence of high-quality trials supports the effectiveness of home exercise programs with and without supervised clinic

  17. Consumer perspectives of the Australian Home Medicines Review Program: benefits and barriers.

    Science.gov (United States)

    White, Lesley; Klinner, Christiane; Carter, Stephen

    2012-01-01

    The Australian Home Medicines Review (HMR) is a free consumer service to assist individuals living at home to maximize the benefits of their medicine regimen and prevent medication-related problems. It consists of a pharmacist reviewing a person's medicines and collaborating with the general practitioner to optimize the individual's medicine management. The uptake of this service has remained below the projected use, although the program has shown to successfully identify medication-related problems and improve drug knowledge and adherence of the patient. This study investigates the perceived benefits and barriers of the patients regarding the HMR service who have used the service and who are eligible for it but have never used it. Consumer perceptions were drawn from 14 semistructured focus groups, with patients and carers belonging to the general HMR target population and consumer segments that have been postulated to be underrepresented with regard to this service. The major benefits reported were acquisition of medicine information, reassurance, feeling valued and cared for, and willingness to advocate medication changes to the general practitioner. Perceived barriers were concerns regarding upsetting the general practitioner, pride and independence, confidence issues with an unknown pharmacist, privacy and safety concerns regarding the home visit, and lack of information about the program. Participants agreed that the potential benefits of the service outweighed its potential barriers. It is expected that direct-to-consumer promotion of HMRs would increase the uptake of this valuable service. It would be necessary to ensure that the process and benefits of the service are communicated clearly and sensitively to eligible patients and their carers to obviate common consumer misconceptions and/or barriers regarding the HMR service. Furthermore, any direct-to-consumer promotion of the service must enable patient/carer self-identification of eligibility. Copyright

  18. Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs.

    Science.gov (United States)

    Konetzka, R Tamara; Skira, Meghan M; Werner, Rachel M

    2018-01-01

    Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement.

  19. Needs and preference assessment for an in-home nutrition education program using social marketing theory.

    Science.gov (United States)

    Francis, Sarah L; Taylor, Martha L; Strickland, Amy Williams

    2004-01-01

    Nutrition education programs for elder caregivers (CG) and their elder care recipients (CR) are important in preventing malnutrition. Using Social Marketing Theory, this study assessed the needs and preferences for nutrition education in elder CGs and their CRs in Guilford County, NC. Thirty-two pairs of community-residing elder CGs/CRs and three focus groups (FGs) participated. Health and diet questionnaires were administered to all CGs/CRs during in-home interviews. CGs/CRs and FGs evaluated nutrition education materials. Questionnaires were analyzed using SPSS v9. Ethnograph v5.0 was used to code the interviews regarding the education materials. The CGs were middle age (58.9 years), overweight (BMI = 28.8) Caucasian women. The CRs were old (79.4 years), overweight (BMI = 26.0) Caucasian women. Identified malnutrition risk factors of CGs and CRs included inadequate fluid and dietary intake, polypharmacy, and chronic disease. Identified nutrition needs and education preferences of CGs/CRs were similar. Perceived nutrition education preferences of the FGs did not reflect the interests of the CGs/CRs. This information is being used to revise the education materials and develop an in-home nutrition education program for CGs and CRs in Guilford County, NC.

  20. Tracing changes in families who participated in Home-Start parenting program: parental sense of competence as mechanism of change

    NARCIS (Netherlands)

    Deković, M.; Asscher, J.J.; Hermanns, J.; Reitz, E.; Prinzie, P.; van den Akker, A.L.

    2010-01-01

    The present study aimed to (1) determine the long-term effectiveness of Home-Start, a preventive parenting program, and (2) test the hypothesis that changes in maternal sense of competence mediate the program's effects. Participants were 124 mothers (n = 66 intervention, n = 58 comparison). Four

  1. So, You Want to Move out?!--An Awareness Program of the Real Costs of Moving Away from Home

    Science.gov (United States)

    Hines, Steven L.; Hansen, Lyle; Falen, Christi

    2011-01-01

    The So, You Want To Move Out?! program was developed to help teens explore the financial realities of moving away from home. This 3-day camp program allows youth the opportunity to interview for a job, work, earn a paycheck, and pay financial obligations. After paying expenses and trying to put some money away in savings, the participants begin to…

  2. Reducing Children's Susceptibility to Alcohol Use: Effects of a Home-Based Parenting Program.

    Science.gov (United States)

    Jackson, Christine; Ennett, Susan T; Reyes, H Luz McNaughton; Hayes, Kim A; Dickinson, Denise M; Choi, Seulki; Bowling, J Michael

    2016-07-01

    This 4-year efficacy trial tested whether a home-based, self-administered parenting program could have a long-term effect on children's cognitive susceptibility to alcohol use, and it tested hypothesized moderators and mediators of any such program effect. Using a two-group randomized controlled design, 1076 children (540 treatment; 536 control; mean age of 9.2 years at baseline) completed telephone interviews prior to randomization and follow-up interviews 12, 24, 36, and 48 months post-baseline. Mothers of children randomized to treatment received a 5-month-long parenting program during year 1, followed by two 1-month-long boosters in years 2 and 3. Exposure to the program was significantly inversely associated with susceptibility to alcohol use 48 months post-baseline (b = -0.03, p = .04), with no variation in program effects by parental alcohol use or mother's race/ethnicity or education, suggesting broad public health relevance of the parenting program. Path analyses of simple indirect effects through each hypothesized mediator showed that program exposure positively influenced parental communication to counter pro-drinking influences in the family and media domains and parental rule setting 36 months post-baseline; these variables, in turn, predicted reduced susceptibility to alcohol use 48 months post-baseline. Parallel (multiple) mediation analysis showed that the program had a significant indirect effect on susceptibility through parental rule setting. Together, the findings indicate that internalization of protective alcohol-related expectancies and intentions is possible among children whose mothers provide early exposure to alcohol-specific socialization. Additional research is needed to link alcohol-specific socialization during childhood with adolescent drinking outcomes.

  3. Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program.

    Science.gov (United States)

    Shah, Nikhil; Reintjes, Frances; Courtney, Mark; Klarenbach, Scott W; Ye, Feng; Schick-Makaroff, Kara; Jindal, Kailash; Pauly, Robert P

    2017-07-24

    Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit. Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years; P =0.003) and were performing conventional versus a more intensive hemodialysis prescription (23 of 34 versus 23 of 60; P <0.01). In the 6 months before exit, the negative disposition group had significantly more in-center respite dialysis sessions, had more and longer hospitalizations, and required more on-call care team support in terms of phone calls and drop-in visits (each P <0.05). The most common reason for modality conversion was medical instability in 15 of 23 (65%) followed by caregiver or care partner burnout in three of 23 (13%) each. The 90-day mortality among patients undergoing modality conversion was 26%. Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization ( e.g. , hospitalization, respite treatments, nursing time, etc. ). Copyright © 2017 by the American Society of Nephrology.

  4. Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

    Science.gov (United States)

    Foebel, Andrea D; van Hout, Hein P; van der Roest, Henriëtte G; Topinkova, Eva; Garms-Homolova, Vjenka; Frijters, Dinnus; Finne-Soveri, Harriet; Jónsson, Pálmi V; Hirdes, John P; Bernabei, Roberto; Onder, Graziano

    2015-11-14

    Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

  5. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Burton E

    2013-12-01

    Full Text Available Elissa Burton,1,2 Gill Lewin,1,2 Lindy Clemson,3 Duncan Boldy41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Health and Work Research Unit, The University of Sydney, Sydney, NSW, Australia; 4School of Nursing and Midwifery, Curtin University, Perth, WA, AustraliaBackground: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults.Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention or the structured exercise program currently being used in the service (control. Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability.Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program.Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes

  6. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

    Science.gov (United States)

    Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

    2016-03-01

    In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia

    Directory of Open Access Journals (Sweden)

    Michelle M Lee

    2007-10-01

    Full Text Available Michelle M Lee1, Cameron J Camp2, Megan L Malone21Midwestern University, Department of Behavioral Medicine, Downers Grove, IL , USA; 2Myers Research Institute of Menorah Park Center for Senior Living, Beachwood, OH, USA Abstract: Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP with 15 preschool children from the facility’s on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose – the Myers Research Institute Engagement Scale (MRI-ES. These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented “lessons” to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.Keywords: Montessori-based activities, intergenerational programming, engagement, dementia

  8. Benefits of Hippotherapy and Horse Riding Simulation Exercise on Healthy Older Adults: A Systematic Review.

    Science.gov (United States)

    Hilliere, Camille; Collado-Mateo, Daniel; Villafaina, Santos; Duque-Fonseca, Paulo; Parraça, José A

    2018-04-05

    To provide an up-to-date research analysis on equine-assisted therapies and horse riding simulation exercise in older adults, and to suggest future directions in clinical practice and research. TYPE: Systematic review. A comprehensive search of studies was performed in 4 electronic databases (Cochrane, PubMed, PEDro, and Web of Science) regarding the effects of equine-assisted therapies and horse riding simulation exercise in older adults. Eight articles were selected, 5 of them focused on hippotherapy, 2 on horse riding simulation, and a single article that used the 2 types of therapy. PRISMA guidelines were followed for the data extraction process. The studies were all randomized controlled trials, but not double-blind, so they were classified as level of evidence B. Duration of hippotherapy programs ranged from 8-12 weeks. Sessions lasted between 15 and 60 minutes and were performed 2-5 times per week. Interventions using a horse simulator spanned 8 weeks and were conducted for 20 minutes 5 times per week. Results indicate that hippotherapy might improve balance, mobility, gait ability, and muscle strength, as well as could induce hormonal and cerebral activity changes in healthy older adults. Benefits of horse riding simulation could be limited to physical fitness and muscular activity. ▪▪▪. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  9. Does training people to administer take-home naloxone increase their knowledge? Evidence from Australian programs.

    Science.gov (United States)

    Dietze, Paul M; Draper, Bridget; Olsen, Anna; Chronister, Karen J; van Beek, Ingrid; Lintzeris, Nicholas; Dwyer, Robyn; Nelson, Marina; Lenton, Simon

    2018-02-22

    Take-home naloxone (THN) programs have been operating in Australia since 2012 in a variety of settings. We examine whether THN programs were effective in increasing knowledge about opioid overdose and appropriate responses in program participants. Data were obtained from pre- and post-training questionnaires administered as part of the early evaluations of THN naloxone programs operated in Sydney (n = 67), Melbourne (n = 280), Perth (n = 153) and Canberra (n = 183). Pooled data from comparable items, analysed in the domains specified in previously-developed evaluation scales, were compared using repeated-measures analysis of variance and random effects logistic regression. Results pre- and post-training were compared as well as results across sites. High levels of knowledge about overdose risks and signs and appropriate actions to take were observed at baseline and this generally improved over time. No substantial differences were identified across cities. Knowledge also increased with participant age but the improvements over time were similar in each age group. There were small differences by participant gender with knowledge generally higher among females. THN programs are effective in improving knowledge related to overdose response. Major improvements in knowledge were limited to overdose recognition and effect of naloxone suggesting that education may best be focused on overdose signs and the use of naloxone among populations accessed through these programs. A focus on younger people also appears warranted. Further work is needed to understand the impact of training and knowledge on actual behaviours around overdose events. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  10. Enhancing knowledge and attitudes in pain management: a pain management education program for nursing home staff.

    Science.gov (United States)

    Tse, Mimi Mun Yee; Ho, Suki S K

    2014-03-01

    The aim of the study was to examine the effectiveness of a pain management program (PMP) in enhancing the knowledge and attitudes of health care workers in pain management. Many nursing home residents suffer from pain, and treatment of pain is often inadequate. Failure of health care workers to assess pain and their insufficient knowledge of pain management are barriers to adequate treatment. It was a quasiexperimental pretest and posttest study. Four nursing homes were approached, and 88 staff joined the 8-week PMP. Demographics and the knowledge and attitudes regarding pain were collected with the use of the Nurse's Knowledge and Attitudes Survey Regarding Pain-Chinese version (NKASRP-C) before and after the PMP. A deficit in knowledge and attitudes related to pain management was prominent before the PMP, and there was a significant increase in pain knowledge and attitudes from 7.9 ± SD 3.52 to 19.2 ± SD4.4 (p nursing staff and enable them to provide adequate and appropriate care to older persons in pain. PMPs for nurses and all health care professionals are important in enhancing care for older adults and to inform policy on the provision of pain management. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  11. Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs.

    Science.gov (United States)

    Reicks, Marla; Trofholz, Amanda C; Stang, Jamie S; Laska, Melissa N

    2014-01-01

    Cooking programs are growing in popularity; however, an extensive review has not examined their overall impact. Therefore, this study reviewed previous research on cooking/home food preparation interventions and diet and health-related outcomes among adults and identified implications for practice and research. Literature review and descriptive summative method. Dietary intake, knowledge/skills, cooking attitudes and self-efficacy/confidence, health outcomes. Articles evaluating the effectiveness of interventions that included cooking/home food preparation as the primary aim (January, 1980 through December, 2011) were identified via Ovid MEDLINE, Agricola, and Web of Science databases. Studies grouped according to design and outcomes were reviewed for validity using an established coding system. Results were summarized for several outcome categories. Of 28 studies identified, 12 included a control group with 6 as nonrandomized and 6 as randomized controlled trials. Evaluation was done postintervention for 5 studies, pre- and postintervention for 23, and beyond postintervention for 15. Qualitative and quantitative measures suggested a positive influence on main outcomes. However, nonrigorous study designs, varying study populations, and the use of nonvalidated assessment tools limited stronger conclusions. Well-designed studies are needed that rigorously evaluate long-term impact on cooking behavior, dietary intake, obesity and other health outcomes. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs

    Science.gov (United States)

    Reicks, Marla; Trofholz, Amanda C.; Stang, Jamie S; Laska, Melissa N.

    2014-01-01

    Objective Cooking programs are growing in popularity; however an extensive review has not examined overall impact. Therefore, this study reviewed previous research on cooking/home food preparation interventions and diet and health-related outcomes among adults and identified implications for practice and research. Design Literature review and descriptive summative method. Main outcome measures Dietary intake, knowledge/skills, cooking attitudes and self-efficacy/confidence, health outcomes. Analysis Articles evaluating effectiveness of interventions that included cooking/home food preparation as the primary aim (January 1980 through December 2011) were identified via OVID MEDLINE, Agricola and Web of Science databases. Studies grouped according to design and outcomes were reviewed for validity using an established coding system. Results were summarized for several outcome categories. Results Of 28 studies identified, 12 included a control group with six as non-randomized and six as randomized controlled trials. Evaluation was done post-intervention for five studies, pre- and post-intervention for 23 and beyond post-intervention for 15. Qualitative and quantitative measures suggested a positive influence on main outcomes. However, non-rigorous study designs, varying study populations, and use of non-validated assessment tools limited stronger conclusions. Conclusions and Implications Well-designed studies are needed that rigorously evaluate long-term impact on cooking behavior, dietary intake, obesity and other health outcomes. PMID:24703245

  13. Introducing priority setting and resource allocation in home and community care programs.

    Science.gov (United States)

    Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

    2008-01-01

    To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

  14. ReRide: Performing Lower Back Rehabilitation While Riding Your Motorbike in Traffic

    DEFF Research Database (Denmark)

    Bagalkot, Naveen; Sokoler, Tomas; Baadkar, Suraj

    2016-01-01

    controlled mechanically moving display mounted on top of the bike's speedometer that alters the visibility of the speedometer to the rider indicating the correctness of back posture. Informed by embodied perception, the ReRide design emphasizes a rapid coupling between adjusting your back posture...

  15. Can opportunities be enhanced for vaccinating children in home visiting programs? A population-based cohort study.

    Science.gov (United States)

    Isaac, Michael R; Chartier, Mariette; Brownell, Marni; Chateau, Dan; Nickel, Nathan C; Martens, Patricia; Katz, Alan; Sarkar, Joykrishna; Hu, Milton; Burland, Elaine; Goh, ChunYan; Taylor, Carole

    2015-07-07

    Home visiting programs focused on improving early childhood environments are commonplace in North America. A goal of many of these programs is to improve the overall health of children, including promotion of age appropriate vaccination. In this study, population-based data are used to examine the effect of a home visiting program on vaccination rates in children. Home visiting program data from Manitoba, Canada were linked to several databases, including a provincial vaccination registry to examine vaccination rates in a cohort of children born between 2003 and 2009. Propensity score weights were used to balance potential confounders between a group of children enrolled in the program (n = 4,562) and those who were eligible but not enrolled (n = 5,184). Complete and partial vaccination rates for one and two year old children were compared between groups, including stratification into area-level income quintiles. Complete vaccination rates from birth to age 1 and 2 were higher for those enrolled in the Families First program [Average Treatment Effect Risk Ratio (ATE RR) 1.06 (95 % CI 1.03-1.08) and 1.10 (95 % CI 1.05-1.15) respectively]. No significant differences were found between groups having at least one vaccination at age 1 or 2 [ATE RR 1.01 (95 % CI 1.00-1.02) and 1.00 (95 % CI 1.00-1.01) respectively). The interaction between program and income quintiles was not statistically significant suggesting that the program effect did not differ by income quintile. Home visiting programs have the potential to increase vaccination rates for children enrolled, despite limited program content directed towards this end. Evidence-based program enhancements have the potential to increase these rates further, however more research is needed to inform policy makers of optimal approaches in this regard, especially with respect to cost-effectiveness.

  16. Watching Your Back While Riding Your Bike

    DEFF Research Database (Denmark)

    Sokoler, Tomas; Bagalkot, Naveen

    2017-01-01

    series of investigations looking into the broader notion of integrating measures for preventive self-care with existing everyday activities (e.g daily motorcycle commute) by means of digital technology. We are guided by the concept of embodied self-monitoring grounded in theories on the embodied...... for interaction design in the domain of preventive self-care. We report on the outcome of in-situ enactments performed by four motorbike riders as co-explorers engaging with our interactive soft&hardware sketches while actually riding in traffic. Insitu enactments and follow-up interviews with the riders...

  17. Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review.

    Science.gov (United States)

    Munns, Ailsa; Watts, Robin; Hegney, Desley; Walker, Roz

    2016-10-01

    Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support. The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors. Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program. Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies. Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors. The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered. Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate. Both quantitative and qualitative data were independently extracted by two reviewers

  18. Decreasing In-home Smoking of Adults-Results from a School-based Intervention Program in Viet Nam.

    Science.gov (United States)

    Huong, Le Thi Thanh; Long, Tran Khanh; Anh, Le Vu; Cook, Margaret; Capra, Mike

    2016-01-01

    It is indicated that children are involuntarily exposed to secondhand smoke from adults, mainly at their home environment. This study aimed at describing the effectiveness of the school-based intervention to decrease the in-home smoking situation of adults so as to decrease children's exposure to secondhand smoke at home during the year 2011-2012 in a rural district in Hanoi, Viet Nam. This school-based intervention program (intervention and control group) involved 804 children aged 8 to 11 years from August 2011 to May 2012 in a rural district of Hanoi, Viet Nam. Children were taught in class about the harmful effects of secondhand smoke and about how to negotiate with fathers not to smoke in-home. Then children applied what they learnt, including staying away from secondhand smoke and persuading fathers not to smoke in-home in order to decrease children's exposure to secondhand smoke. Chi square test, t-test and multinominal logistic regression were applied in data analysis. The results showed that children's reported their father's in-home smoking decreased from 83.0% pre-intervention to 59.8% post-intervention ( p Viet Nam to increase children's awareness on the adverse health effects of secondhand smoke and to help them to be able to avoid their exposure to secondhand smoke at their home environment.

  19. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia.

    Science.gov (United States)

    Lee, Michelle M; Camp, Cameron J; Malone, Megan L

    2007-01-01

    Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP) with 15 preschool children from the facility's on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose--the Myers Research Institute Engagement Scale (MRI-ES). These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented "lessons" to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.

  20. New Whole-House Solutions Case Study: Northwest Energy Efficient Manufactured Housing Program High-Performance Test Homes - Pacific Northwest

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-01

    This project represents the third phase of a multi-year effort to develop and bring to market a High Performance Manufactured Home (HPMH). In this project, the Northwest Energy Efficient Manufactured Housing Program worked with Building America Partnership for Improved Residential Construction and Bonneville Power Administration to help four factory homebuilders build prototype zero energy ready manufactured homes, resulting in what is expected to be a 30% savings relative to the Building America Benchmark. (The actual % savings varies depending on choice of heating equipment and climate zone). Previous phases of this project created a HPMH specification and prototyped individual measures from the package to obtain engineering approvals and develop preliminary factory construction processes. This case study describes the project team's work during 2014 to build prototype homes to the HPMH specifications and to monitor the homes for energy performance and durability. Monitoring is expected to continue into 2016.

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

    Science.gov (United States)

    2017-11-07

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

  2. Health care and social service professionals' perceptions of a home-visit program for young, first-time mothers.

    Science.gov (United States)

    Li, S A; Jack, S M; Gonzalez, A; Duku, E; MacMillan, H L

    2015-01-01

    Little is known about health care and social service professionals' perspective on the acceptability of long-term home-visit programs serving low-income, first-time mothers. This study describes the experiences and perspectives of these community care providers involved with program referrals or service delivery to mothers who participated in the Nurse-Family Partnership (NFP), a targeted nurse home-visit program. The study included two phases. Phase I was a secondary qualitative data analysis used to analyze a purposeful sample of 24 individual interviews of community care providers. This was part of a larger case study examining adaptations required to increase acceptability of the NFP in Hamilton, Ontario, Canada. In Phase II (n = 4), themes identified from Phase I were further explored through individual, semi-structured interviews with community health care and social service providers, giving qualitative description. Overall, the NFP was viewed as addressing an important service gap for first-time mothers. Providers suggested that frequent communication between the NFP and community agencies serving these mothers could help improve the referral process, avoid service duplication, and streamline the flow of service access. The findings can help determine key components required to enhance the success of integrating a home-visit program into an existing network of community services. The function of home-visit programs should not be viewed in isolation. Rather, their potential can be maximized when they collaborate and share information with other agencies to provide better services for first-time mothers.

  3. [Development of a web-based education program for nurses working in nursing homes on human rights of older adults].

    Science.gov (United States)

    Kim, Ki-Kyong

    2010-08-01

    This study was done to develop a web-based education program for nurses working in nursing homes. The focus was on the rights of older adults. The program was designed based on the Network-Based Instructional System Design (NBISD) model and was operated and evaluated between July 2007 and June 2008. Out of nursing records of 40 residents from a nursing home, the final 7 cases were deducted through classification using the Resource Utilization Group (RUG)-III. The data on needs for education was collected from 28 nurses working in 15 nursing homes located in Seoul and Gyeonggi Province, who agreed to complete a self-report questionnaire. A comprehensive review of the literature and two focus groups interviews were used to search for risk factors and guidelines for protection of human rights. The education program was developed based on Kolb's experiential learning model and composed of 5 units, which included content on types of human rights and rights to death with dignity, elder abuse, physical liberty, and self-determination. The program was positively evaluated showing a score of 3.35 (SD=0.37) out of 4. The educational program developed in this study should promote nurses' sensitivity to the rights of elders and improve nurses' behaviors in protecting the rights of elders residing in nursing homes.

  4. Analyzing Forces on Amusement Park Rides with Mobile Devices

    Science.gov (United States)

    Vieyra, Rebecca E.; Vieyra, Chrystian

    2014-01-01

    Mobile device accelerometers are a simple and easy way for students to collect accurate and detailed data on an amusement park ride. The resulting data can be graphed to assist in the creation of force diagrams to help students explain their physical sensations while on the ride. This type of activity can help students overcome some of the…

  5. Feasibility testing for dial-a-ride problems

    DEFF Research Database (Denmark)

    Haugland, Dag; Ho, Sin C.

    Hunsaker and Savelsbergh have proposed an algorithm for testing feasibility of a route in the solution to the dial-a-ride problem. The constraints that are checked are load capacity constraints, time windows, ride time bounds and wait time bounds. The algorithm has linear running time. By virtue...

  6. Feasibility Testing for Dial-a-Ride Problems

    DEFF Research Database (Denmark)

    Haugland, Dag; Ho, Sin C.

    2010-01-01

    Hunsaker and Savelsbergh have proposed an algorithm for testing feasibility of a route in the solution to the dial-a-ride problem. The constraints that are checked are load capacity constraints, time windows, ride time bounds and wait time bounds. The algorithm has linear running time. By virtue...

  7. Minimum Makespan Multi-Vehicle Dial-a-Ride

    DEFF Research Database (Denmark)

    Gørtz, Inge Li; Nagarajan, Viswanath; Ravi, R.

    2015-01-01

    of multi-vehicle Dial-a-Ride, in which an object may be left at intermediate vertices and transported by more than one vehicle, while being moved from source to destination. Our main results are an O(log(3) n)-approximation algorithm for preemptive multi-vehicle Dial-a-Ride, and an improved O(log t...

  8. 75 FR 29877 - Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority

    Science.gov (United States)

    2010-05-28

    ...: Federal Home Loan Bank Mortgage Refinancing Authority AGENCY: Federal Housing Finance Agency. ACTION... Federal Housing Finance Agency (FHFA) to permit the Federal Home Loan Banks (Banks) until July 30, 2010... Mae), Federal Home Loan Mortgage Corporation (Freddie Mac) (collectively, Enterprises), the Banks, and...

  9. Structures, processes and outcomes of the Aussie Heart Guide Program: A nurse mentor supported, home based cardiac rehabilitation program for rural patients with acute coronary syndrome.

    Science.gov (United States)

    Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

    2018-03-01

    Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia. To explore the impact of a home-based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program. This case study was underpinned by the structure, process and outcomes model and occurred in three Australian hospitals 2008-2011. Thirteen patients recovering from acute coronary syndrome were interviewed by telephone and seven nurse mentors completed a survey after completing the program. Mentor perceptions concerning the structures of the home-based CR program included the timely recruitment of patients, mentor training to operationalise the program, commitment to development of the mentor role, and the acquisition of knowledge and skills about cognitive behavioural therapy and patient centred care. Processes included the therapeutic relationship between mentors and patients, suitability of the program and the promotion of healthier lifestyle behaviours. Outcomes identified that patients were satisfied with the program's audiovisual resources, and the level of support and guidance provided by their nurse mentors. Mentors believed that the program was easy to use in terms of its delivery. Patients believed the program assisted their recovery and were satisfied with the information, guidance and support received from mentors. There were positive signs that the program influenced patients' decisions to change unhealthy lifestyle behaviours. Outcomes highlighted both rewards and barriers associated with mentoring patients in their homes by telephone. Experience gained from developing a therapeutic relationship with

  10. HOME Grantee Areas

    Data.gov (United States)

    Department of Housing and Urban Development — The HOME Investment Partnership Program (HOME) is authorized under Title II of the Cranston-Gonzalez National Affordable Housing Act. HOME provides formula grants to...

  11. Patients' mental models and adherence to outpatient physical therapy home exercise programs.

    Science.gov (United States)

    Rizzo, Jon

    2015-05-01

    Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.

  12. Differences among nursing homes in outcomes of a safe resident handling program.

    Science.gov (United States)

    Kurowski, Alicia; Gore, Rebecca; Buchholz, Bryan; Punnett, Laura

    2012-01-01

    A large nursing home corporation implemented a safe resident handling program (SRHP) in 2004-2007. We evaluated its efficacy over a 2-year period by examining differences among 5 centers in program outcomes and potential predictors of those differences. We observed nursing assistants (NAs), recording activities and body postures at 60-second intervals on personal digital assistants at baseline and at 3-month, 12-month, and 24-month follow-ups. The two outcomes computed were change in equipment use during resident handling and change in a physical workload index that estimated spinal loading due to body postures and handled loads. Potential explanatory factors were extracted from post-observation interviews, investigator surveys of the workforce, from administrative data, and employee satisfaction surveys. The facility with the most positive outcome measures was associated with many positive changes in explanatory factors and the facility with the fewest positive outcome measures experienced negative changes in the same factors. These findings suggest greater SRHP benefits where there was lower NA turnover and agency staffing; less time pressure; and better teamwork, staff communication, and supervisory support. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

  13. Service quality, satisfaction, and behavioral intention in home delivered meals program

    Science.gov (United States)

    Joung, Hyun-Woo; Yuan, Jingxue Jessica; Huffman, Lynn

    2011-01-01

    This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs. PMID:21556231

  14. Engaging military parents in a home-based reintegration program: a consideration of strategies.

    Science.gov (United States)

    Ross, Abigail M; DeVoe, Ellen R

    2014-02-01

    For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

  15. Service quality, satisfaction, and behavioral intention in home delivered meals program.

    Science.gov (United States)

    Joung, Hyun-Woo; Kim, Hak-Seon; Yuan, Jingxue Jessica; Huffman, Lynn

    2011-04-01

    This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs.

  16. Mechanism of Developmental Change in the PLAY Project Home Consultation Program: Evidence from a Randomized Control Trial

    Science.gov (United States)

    Mahoney, Gerald; Solomon, Richard

    2016-01-01

    This investigation is a secondary analysis of data from a randomized control trial of the PLAY Home Consultation Intervention Program which was conducted with 112 preschool children with Autism Spectrum Disorders and their parents (Solomon et al. in "J Dev Behav Pediatr" 35:475-485, 2014). Subjects were randomly assigned to either a…

  17. Evaluation of a Home-Based Hospice and Palliative Care Program in a Community Health Center in Korea

    Directory of Open Access Journals (Sweden)

    Su Hyun Kim

    2009-03-01

    Conclusions: A home-based palliative service program delivered by the community health center appears to be an appropriate care model for managing physical symptoms. Reinforcing services for psychosocial and spiritual counseling and encouraging affiliation with free-standing inpatient healthcare providers are warranted. [Asian Nursing Research 2009;3(1:24–30

  18. Reciprocal Learning in Partnership Practice: An Exploratory Study of a Home Visiting Program for Mothers with Depression

    Science.gov (United States)

    Fowler, Cathrine; Dunston, Roger; Lee, Alison; Rossiter, Chris; McKenzie, Jo

    2012-01-01

    This paper reports on a small exploratory study that investigates the place and role of reciprocal learning within a partnership-based home visiting program for mothers experiencing depression. The study is one important example of an increased focus on reciprocal learning within practice that has significant implications for the development of…

  19. [Effects of a fall prevention program on falls in frail elders living at home in rural communities].

    Science.gov (United States)

    Yoo, Jae-Soon; Jeon, Mi Yang; Kim, Chul-Gyu

    2013-10-01

    This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.

  20. 76 FR 41032 - Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy Changes and...

    Science.gov (United States)

    2011-07-12

    ... documentation must also describe how the health status of the recipient at the time of the face-to-face... [CMS 2348-P] RIN 0938-AQ36 Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy... document the existence of a face-to-face encounter (including through the use of telehealth) with the...

  1. Physiological demands of off-road vehicle riding.

    Science.gov (United States)

    Burr, Jamie F; Jamnik, Veronica K; Shaw, Jim A; Gledhill, Norman

    2010-07-01

    The purpose of this study was to characterize the physiological demands of recreational off-road vehicle riding under typical riding conditions using habitual recreational off-road vehicle riders (n = 128). Comparisons of the physical demands of off-road vehicle riding were made between vehicle types (all-terrain vehicle (ATV) and off-road motorcycle (ORM)) to the demands of common recreational activities. Habitual riders (ATV = 56, ORM = 72) performed strength assessments before and after a representative trail ride (48 +/- 24.2 min), and ambulatory oxygen consumption was measured during one lap (24.2 +/- 11.8 min) of the ride. The mean VO2 requirement (mL x kg(-1) x min(-1)) while riding an off-road vehicle was 12.1 +/- 4.9 for ATV and 21.3 +/- 7.1 for ORM (P = 0.002), which is comparable to the VO2 required of many common recreational activities. Temporal analysis of activity intensity revealed approximately 14% of an ATV ride and 38% of an ORM ride are within the intensity range (940% VO2 reserve) required to achieve changes in aerobic fitness. Riding on a representative course also led to muscular fatigue, particularly in the upper body. On the basis of the measured metabolic demands, evidence of muscular strength requirements, and the associated caloric expenditures with off-road vehicle riding, this alternative form of activity conforms to the recommended physical activity guidelines and can be effective for achieving beneficial changes in health and fitness.

  2. Effects of 4 Weeks of Horseback Riding on Anxiety, Depression, and Self-Esteem in Children with Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)

    Wi-Young So

    2017-09-01

    Full Text Available Background and Objective: There is no report on the effects of horseback riding on children with attention deficit hyperactivity disorder (ADHD. Therefore, the purpose of this study was to determine the effects of 4 weeks of horseback riding on anxiety, depression, self-esteem, attention, and learning disorder in children with ADHD. Material and Methods: Subjects comprised a convenience sample of 10 children aged 10-12 years with ADHD and 10 children without ADHD. Horseback riding sessions were performed 2 times (40 minutes/day per week for 4 weeks. Before and after the horseback riding program, we measured the children’s anxiety, depression, self-esteem, attention, and learning disorder. The pre-test and post-test scores were analyzed with repeated-measures analysis of variance. Results: After participating in the 4-week horseback riding program, anxiety (p = 0.013, depression (p = 0.007, attention (p < 0.001, and learning disorder (p < 0.001 were significantly improved in the ADHD group compared to the control group. However, self-esteem was not significantly different between the two groups (p=0.096. Conclusion: These results indicate that the 4-week horseback riding program used in this study was very effective for significantly improving anxiety, depression, and attention in children with ADHD.

  3. Therapeutic riding followed by rhythmic auditory stimulation to improve balance and gait in a subject with orthopedic pathologies.

    Science.gov (United States)

    Ungermann, Cathryn M; Gras, Laura Z

    2011-12-01

    The study objectives were to investigate the effect of therapeutic riding with a subject who had an orthopedic diagnosis. This is a single-subject case report. The study was conducted at an equestrian facility with an indoor riding arena. The subject was a 59-year-old woman with grade I spondylolisthesis at L4/L5 and multilevel lumbar spinal stenosis in central and foraminal canals. The subject had an anterior cervical fusion of C3-C7. The subject has been ambulating with a straight cane due to her history of frequent falls. Gait, agility, strength, range of motion, and balance testing were performed. The subject had impairments of bilateral lower extremities with an ataxic gait pattern and was at risk for continued falls according to the balance measures. The intervention comprised therapeutic riding sessions 3 times a week for 20 minutes for 4 weeks. Each riding session was immediately followed by a 10-minute independent walking program with a metronome for rhythmic auditory stimulation. The outcome measures were as follows: Manual muscle testing and range of motion of the lower extremities, Gait Speed Test, Dynamic Gait Index, Four-Square Step Test, Chair Stand Test, Single Leg Stance. Improvements were seen in lower extremity strength and range of motion and balance. The subject improved on balance scores, placing her out of the risk for falls category. Therapeutic riding followed by rhythmic auditory stimulation improved lower extremity range of motion, strength, and balance with this subject.

  4. Searching for ET with Help from Three Million Volunteers: The SETI@Home, Serendip, Sevendip and Spck SETI Programs

    Science.gov (United States)

    Werthimer, Dan; Anderson, David; Bowyer, Stuart; Cobb, Jeff; Demorest, Paul

    2002-01-01

    We summarize results from two radio and two optical SETI programs based at the University of California, Berkeley. We discuss the most promising candidate signals from these searches and present plans for future SETI searches, including SERENDIP V and SETI@home II. The ongoing SERENDIP sky survey searches for radio signals at the 300 meter Arecibo Observatory. SERENDIP IV uses a 168 million channel spectrum analyser and a dedicated receiver to take data 24 hours a day, year round. The sky survey covers a 100 MHz band centered at the 21 cm line (1420 MHz) and declinations from -2 to +38 degrees. SETI@home uses desktop computers of 3.5 million volunteers to analyse 50 Terabytes of data taken at Arecibo. The SETI@home sky survey is 10 times more sensitive and searches a much wider variety of signal types than SERRENDIP IV but covers only a 2.5 MHz band. SETI@home is the planet's largest supercomputer, averaging 25 Tflops. SETI@home participants have contributed over a million years of computing time so far. The SEVENDIP optical pulse search looks for nS time scale pulses at optical wavelengths. It utilizes an automated 30 inch telescope, three ultra fast photo multiplier tubes and a coincidence detector. The target list includes F,G,K and M stars, globular cluster and galaxies. The SPOCK optical SETI program searches for narrow band continuous signals using spectra taken by Marcy and his colleagues in their planet search at Keck observatory.

  5. Home discharge of technology-dependent children: evaluation of a respiratory-therapist driven family education program.

    Science.gov (United States)

    Tearl, Donna K; Hertzog, James H

    2007-02-01

    Initial hospital discharge to home of technology-dependent children requires extensive training and education of the family caregivers. Education of adult family members should promote positive interactions in a nonthreatening manner while facilitating the development of the knowledge and skills to competently and independently provide all aspects of the medical care. We utilize a training program for adult family members of children who have undergone tracheostomy to facilitate long-term mechanical ventilatory support and who are being prepared for their initial discharge from the hospital to home. A dedicated respiratory therapist family educator directs this program. Multiple teaching tools, activities, and training sessions, based on adult learning theory, are utilized to develop appropriate clinical skills to manage children with tracheostomies and the associated technological supports. We evaluated the effectiveness of our program by administering a written test to caregivers, at the start and the conclusion of their training. We also surveyed the caregivers about their satisfaction with the educational program and the respiratory therapist family educator's performance. We also surveyed employees of the durable medical equipment companies used by the families, regarding the caregivers' knowledge and competency in the home one month following discharge. Our program was associated with a statistically significant improvement in caregiver test performance, and the caregivers expressed a high degree of satisfaction with the program. The employees of the durable medical equipment companies perceived a high degree of knowledge and competence on the part of the home caregivers. Our training program appears to have a positive impact on the educational preparation of caregivers.

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

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

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

  7. Association Between Home Visit Programs and Emergency Preparedness Among Elderly Vulnerable People in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    W. Kathy Tannous PhD

    2017-03-01

    Full Text Available Objective: The purpose of this study is to examine the association between home visit programs and emergency preparedness among elderly vulnerable people in New South Wales, Australia. Method: The study used data acquired from an intervention program run by emergency agencies and consisted of 370 older people. Seven emergency outcome measures were examined by adjusting for key demographic factors, using a generalized estimating equation model, to examine the association between home visit programs and emergency preparedness. Results: The study revealed that knowledge demonstrated by participants during visits and post home visits showed significant improvements in the seven emergency outcome measures. The odds of finding out what emergencies might affect one’s area were significantly lower among older participants who were born outside Australia and those who were women. Discussion: The findings suggest that the intervention via home visits and periodic reminders post these visits may be a useful intervention in improving emergency preparedness among older people, especially among men and those who were born outside of Australia. In addition, other reminders such as safety messaging via mobile or landline telephone calls may also be a supplementary and useful intervention to improve emergency preparedness among older people.

  8. [Prevention of injuries associated with horseback riding].

    Science.gov (United States)

    ten Kate, Chantal A; de Kooter, Tabitha A; Kramer, William L M

    2015-01-01

    Each year 9,900 equestrians present at Accident and Emergency Departments, 40% of them 10-19 year old females. The most common horse-riding injuries are to the head, brain, neck and face, torso and extremities. Because of the relatively larger head, children more often fall on their head. Wearing a helmet gives considerable protection. Despite the common use of a helmet by horseback riders, serious head injury still occurs regularly. Further research into improvement of the protective function of the helmet is indicated. The current safety vest (body protector) does not significantly reduce the risk of torso injury. Improvement of its protective function is necessary. Injury to the lower extremities is caused when they become trapped in the stirrup in a fall from or with the horse. Safety stirrups and sturdy footwear are possible preventive measures. Investment in the quality and promotion of preventive measures could reduce the frequency and severity of equestrian injuries.

  9. Analisis Industri Bisnis Jasa Online Ride Sharing di Indonesia

    Directory of Open Access Journals (Sweden)

    Berto Mulia Wibawa

    2018-03-01

    Full Text Available Analysis of Online Ride Sharing Business Industry in IndonesiaInnovation in transportation sector with sharing economy principal has create new service sector which is named online ride sharing service. There are a lot of online ride-sharing service players in Indonesia such as Go-Jek, Grab, and Uber. Nowadays, government also have rules on changing the condition of online ride-sharing. Therefore, industry analysis is needed to be analyze further to know the industry attractiveness of the online-ride sharing service. This study aims to analyze the level of attractiveness in online ride-sharing industry in Indonesia. This study used descriptive-explorative method on identifying Porter’s Five Forces as tools in industry analysis. Data collection is using ghost interview method to the selected driver. The conclusion is online-ride sharing industry in Indonesia is quite attractive to be developed in the future because the number of customers has not reached the maximum point, moreover the industry may offer a very diverse product differentiationDOI: 10.15408/ess.v8i1.5739

  10. Feasibility of a web-based dementia feeding skills training program for nursing home staff.

    Science.gov (United States)

    Batchelor-Murphy, Melissa; Amella, Elaine J; Zapka, Jane; Mueller, Martina; Beck, Cornelia

    2015-01-01

    Nursing home (NH) staff do not receive adequate training for providing feeding assistance to residents with dementia who exhibit aversive feeding behaviors (e.g., clamping mouth shut). The result is often low meal intake for these residents. This feasibility study tested a web-based dementia feeding skills program for staff in two United States NHs. Randomly assigned, the intervention staff received web-based dementia feeding skills training with coaching. Both groups participated in web-based pre-/post-tests assessing staff knowledge and self-efficacy; and meal observations measured NH staff and resident feeding behaviors, time for meal assistance, and meal intake. Aversive feeding behaviors increased in both groups of residents; however, the intervention NH staff increased the amount of time spent providing assistance and meal intake doubled. In the control group, less time was spent providing assistance and meal intake decreased. This study suggests that training staff to use current clinical practice guidelines improves meal intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia.

    Science.gov (United States)

    Kurland, Jacquie; Liu, Anna; Stokes, Polly

    2018-05-17

    The aim of this study was to determine if a tablet-based home practice program with weekly telepractice support could enable long-term maintenance of recent treatment gains and foster new language gains in poststroke aphasia. In a pre-post group study of home practice outcomes, 21 individuals with chronic aphasia were examined before and after a 6-month home practice phase and again at follow-up 4 months later. The main outcome measure studied was change in naming previously treated or untreated, practiced or unpracticed pictures of objects and actions. Individualized home practice programs were created in iBooks Author with semantic, phonemic, and orthographic cueing in pictures, words, and videos in order to facilitate naming of previously treated or untreated pictures. Home practice was effective for all participants with severity moderating treatment effects, such that individuals with the most severe aphasia made and maintained fewer gains. There was a negative relationship between the amount of training required for iPad proficiency and improvements on practiced and unpracticed pictures and a positive relationship between practice compliance and same improvements. Unsupervised home practice with weekly video teleconferencing support is effective. This study demonstrates that even individuals with chronic severe aphasia, including those with no prior smart device or even computer experience, can attain independent proficiency to continue practicing and improving their language skills beyond therapy discharge. This could represent a low-cost therapy option for individuals without insurance coverage and/or those for whom mobility is an obstacle to obtaining traditional aphasia therapy.

  12. Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

    Science.gov (United States)

    2013-01-01

    Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process

  13. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  14. A Qualitative Evaluation of Engagement and Attrition in a Nurse Home Visiting Program: From the Participant and Provider Perspective.

    Science.gov (United States)

    Beasley, Lana O; Ridings, Leigh E; Smith, Tyler J; Shields, Jennifer D; Silovsky, Jane F; Beasley, William; Bard, David

    2018-05-01

    Beginning parenting programs in the prenatal and early postnatal periods have a large potential for impact on later child and maternal outcomes. Home-based parenting programs, such as the Nurse Family Partnership (NFP), have been established to help address this need. Program reach and impact is dependent on successful engagement of expecting mothers with significant risks; however, NFP attrition rates remain high. The current study qualitatively examined engagement and attrition from the perspectives of NFP nurses and mothers in order to identify mechanisms that enhance service engagement. Semi-structured interviews were conducted in focus groups composed of either engaged (27 total mothers) or unengaged (15 total mothers) mothers from the NFP program. NFP nurses (25 total nurses) were recruited for individual semi-structured interviews. Results suggest that understanding engagement in the NFP program requires addressing both initial and sustained engagement. Themes associated with enhanced initial engagement include nurse characteristics (e.g., flexible, supportive, caring) and establishment of a solid nurse-family relationship founded on these characteristics. Factors impacting sustained engagement include nurse characteristics, provision of educational materials on child development, individualized services for families, and available family support. Identified barriers to completing services include competing demands and lack of support. Findings of this study have direct relevance for workforce planning, including hiring and training through integrating results regarding effective nurse characteristics. Additional program supports to enhance parent engagement may be implemented across home-based parenting programs in light of the current study's findings.

  15. A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

    Science.gov (United States)

    Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

    Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for

  16. Port Authority of Allegheny County Park and Rides

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset includes the GIS shapefile for Port Authority of Allegheny County's Park and Ride facilities. This layer is updated annually or on an as-needed basis...

  17. Home-Based Palliative Care Program Relieves Chronic Pain in Kerala, India: Success Realized Through Patient, Family Narratives.

    Science.gov (United States)

    Ajjarapu, Aparna Sai; Broderick, Ann

    2018-06-14

    An estimated 1.5 billion people across the globe live with chronic pain, and an estimated 61 million people worldwide experience unrelieved serious health-related suffering. One-sixth of the global population lives in India, where approximately 10 million people endure unrelieved serious health-related suffering. The state of Kerala is home to Pallium India, one of the most sophisticated palliative care programs in the country. This private organization in Trivandrum provides palliative and hospice care to underresourced populations and emphasizes holistic pain treatment. The current project features the pain stories of six patients who received treatment from Pallium India. Basic patient demographic information was collected, and a Pallium India staff member who was fluent in Malayalam and English asked questions about each patient's pain experience. Pain narratives illustrate the substantial impact of Pallium India's home visit program and the role of total pain assessment in delivering high-quality palliative care.

  18. Parents of children with physical disabilities perceive that characteristics of home exercise programs and physiotherapists' teaching styles influence adherence: a qualitative study.

    Science.gov (United States)

    Lillo-Navarro, Carmen; Medina-Mirapeix, Francesc; Escolar-Reina, Pilar; Montilla-Herrador, Joaquina; Gomez-Arnaldos, Francisco; Oliveira-Sousa, Silvana L

    2015-04-01

    What are the perceptions of parents of children with physical disabilities about the home exercise programs that physiotherapists prescribe? How do these perceptions affect adherence to home exercise programs? Qualitative study using focus groups and a modified grounded theory approach. Parents of children with physical disabilities who have been prescribed a home exercise program by physiotherapists. Twenty-eight parents participated in the focus groups. Two key themes that related to adherence to home exercise programs in young children with physical disabilities were identified: the characteristics of the home exercise program; and the characteristics of the physiotherapist's teaching style. In the first theme, the participants described their experiences regarding their preference for exercises, which was related to the perceived effects of the exercises, their complexity, and the number of exercises undertaken. These factors determined the amount of time spent performing the exercises, the effect of the exercises on the family's relationships, and any sense of related burden. In the second theme, participants revealed that they adhered better to prescribed exercises when their physiotherapist made an effort to build their confidence in the exercises, helped the parents to incorporate the home exercise program into their daily routine, provided incentives and increased motivation. Parents perceive that their children's adherence to home-based exercises, which are supervised by the parents, is more successful when the physiotherapist's style and the content of the exercise program are positively experienced. These findings reveal which issues should be considered when prescribing home exercise programs to children with physical disabilities. [Lillo-Navarro C, Medina-Mirapeix F, Escolar-Reina P, Montilla-Herrador J, Gomez-Arnaldos F, Oliveira-Sousa SL (2015) Parents of children with physical disabilities perceive that characteristics of home exercise programs and

  19. Clinical and nutritional aspects of cystic fibrosis patients assisted by a home enteral nutrition program in Brazil

    OpenAIRE

    Haack, Adriana; Garbi Novaes, Maria Rita

    2013-01-01

    This study to assessed 47 cystic fibrosis (CF) patients assisted by a program of Home Enteral Nutrition. Anthropometric measurements included weight, height, triceps skinfold thickness, waist circunference and spirometry was also performed. Enzymes, nutritional and fat-soluble vitamin supplementations were recorded. There were no associations with enzymes and vitamin supplements between groups that did or did not have a nutritional deficit. Spirometry of patients without nutritional deficit, ...

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

    Science.gov (United States)

    2014-11-06

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

  1. Caregiver-Provided Physical Therapy Home Programs for Children with Motor Delay: A Scoping Review.

    Science.gov (United States)

    Gorgon, Edward James R

    2018-06-01

    Caregiver-provided physical therapy home programs (PTHP) play an important role in enhancing motor outcomes in pediatric patient populations. This scoping review systematically mapped clinical trials of caregiver-provided PTHP that were aimed at enhancing motor outcomes in children who have or who are at risk for motor delay, with the purpose of (1) describing trial characteristics; (2) assessing methodologic quality; and (3) examining the reporting of caregiver-related components. Physiotherapy Evidence Database (PEDro), Cochrane CENTRAL, PubMed, Scopus, ScienceDirect, ProQuest Central, CINAHL, LILACS, and OTseeker were searched up to July 31, 2017. Two reviewers independently assessed study eligibility. Randomized or quasi-randomized controlled trials on PTHP administered by parents, other family members, friends, or informal caregivers to children who had or who were at risk for motor delay were included. Two reviewers independently appraised trial quality on the PEDro scale and extracted data. Twenty-four articles representing 17 individual trials were identified. Populations and interventions investigated were heterogeneous. Most of the trials had important research design limitations and methodological issues that could limit usefulness in ascertaining the effectiveness of caregiver-provided PTHP. Few (4 of 17) trials indicated involvement of caregivers in the PTHP planning, assessed how the caregivers learned from the training or instructions provided, or carried out both. Included studies were heterogeneous, and unpublished data were excluded. Although caregiver-provided PTHP are important in addressing motor outcomes in this population, there is a lack of evidence at the level of clinical trials to guide practice. More research is urgently needed to determine the effectiveness of care-giver-provided PTHP. Future studies should address the many important issues identified in this scoping review to improve the usefulness of the trial results.

  2. Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

    Science.gov (United States)

    Wood, Siri; Foster, Jennifer; Kols, Adrienne

    2012-08-01

    In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not

  3. A physical workload index to evaluate a safe resident handling program for nursing home personnel.

    Science.gov (United States)

    Kurowski, Alicia; Buchholz, Bryan; Punnett, Laura

    2014-06-01

    The aim of this study was to obtain a comprehensive analysis of the physical workload of clinical staff in long-term care facilities, before and after a safe resident handling program (SRHP). Ergonomic exposures of health care workers include manual handling of patients and many non-neutral postures. A comprehensive assessment requires the integration of loads from these varied exposures into a single metric. The Postures, Activities, Tools, and Handling observational protocol, customized for health care, was used for direct observations of ergonomic exposures in clinical jobs at 12 nursing homes before the SRHP and 3, 12, 24, and 36 months afterward. Average compressive forces on the spine were estimated for observed combinations of body postures and manual handling and then weighted by frequencies of observed time for the combination. These values were summed to obtain a biomechanical index for nursing assistants and nurses across observation periods. The physical workload index (PWI) was much higher for nursing assistants than for nurses and decreased more after 3 years (-24% versus -2.5%). Specifically during resident handling, the PWI for nursing assistants decreased by 41% of baseline value. Spinal loading was higher for nursing assistants than for nurses in long-term care centers. Both job groups experienced reductions in physical loading from the SRHP, especially the nursing assistants and especially while resident handling. The PWI facilitates a comprehensive investigation of physical loading from both manual handling and non-neutral postures. It can be used in any work setting to identify high-risk tasks and determine whether reductions in one exposure are offset by increases in another.

  4. Elevator ride comfort monitoring and evaluation using smartphones

    Science.gov (United States)

    Zhang, Yang; Sun, Xiaowei; Zhao, Xuefeng; Su, Wensheng

    2018-05-01

    With rapid urbanization, the demand for elevators is increasing, and their level of safety and ride comfort under vibrating conditions has also aroused interest. It is therefore essential to monitor the ride comfort level of elevators. The traditional method for such monitoring depends significantly on regular professional inspections, and requires expensive equipment and professional skill. With this regard, a new method for elevator ride comfort monitoring using a smartphone is demonstrated herein in detail. A variety of high-precision sensors are installed in a smartphone with strong data processing and telecommunication capabilities. A series of validation tests were designed and completed, and the international organization for standardization ISO2631-1997 was applied to evaluate the level of elevator ride comfort. Experimental results indicate that the proposed method is stable and reliable, its precision meets the engineering requirements, and the elevator ride comfort level can be accurately monitored under various situations. The method is very economical and convenient, and provides the possibility for the public to participate in elevator ride comfort monitoring. In addition, the method can both provide a wide range of data support and eliminate data errors to a certain extent.

  5. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    Science.gov (United States)

    Leontjevas, Ruslan; Gerritsen, Debby L; Koopmans, Raymond T C M; Smalbrugge, Martin; Vernooij-Dassen, Myrra J F J

    2012-06-01

    A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). Before effect analyses, to evaluate AiD process data on sampling quality (recruitment and randomization, reach) and intervention quality (relevance and feasibility, extent to which AiD was performed), which can be used for understanding internal and external validity. In this article, a model is presented that divides process evaluation data into first- and second-order process data. Qualitative and quantitative data based on personal files of residents, interviews of nursing home professionals, and a research database were analyzed according to the following process evaluation components: sampling quality and intervention quality. Nursing home. The pattern of residents' informed consent rates differed for dementia special care units and somatic units during the study. The nursing home staff was satisfied with the AiD program and reported that the program was feasible and relevant. With the exception of the first screening step (nursing staff members using a short observer-based depression scale), AiD components were not performed fully by NH staff as prescribed in the AiD protocol. Although NH staff found the program relevant and feasible and was satisfied with the program content, individual AiD components may have different feasibility. The results on sampling quality implied that statistical analyses of AiD effectiveness should account for the type of unit, whereas the findings on intervention quality implied that, next to the type of unit, analyses should account for the extent to which individual AiD program components were performed. In general, our first-order process data evaluation confirmed internal and external validity of the AiD trial, and this evaluation enabled further statistical fine tuning. The importance of

  6. Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial.

    Science.gov (United States)

    Fulkerson, Jayne A; Friend, Sarah; Horning, Melissa; Flattum, Colleen; Draxten, Michelle; Neumark-Sztainer, Dianne; Gurvich, Olga; Garwick, Ann; Story, Mary; Kubik, Martha Y

    2018-02-01

    Research has demonstrated a significant positive association between frequent family meals and children's dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial. To describe family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment Plus program, the first rigorously tested family meals intervention targeting childhood obesity prevention. Randomized controlled trial. Baseline, postintervention (12 months, 93% retention), and follow-up (21 months, 89% retention) data (surveys and dietary recalls) were collected. Children aged 8 to 12 years (N=160) and their parents were randomized to intervention (n=81) or control (n=79) groups. The intervention included five parent goal-setting calls and 10 monthly sessions delivered to families in community settings that focused on experiential nutrition activities and education, meal planning, cooking skill development, and reducing screen time. Family home food environment outcomes and nutrition-related child and parent personal and behavioral outcomes. Analyses used generalized linear mixed models. Primary comparisons were contrasts between intervention and control groups at postintervention and follow-up, with adjustments for child age and parent education. Compared with control parents, intervention parents showed greater improvement over time in scores of self-efficacy for identifying appropriate portion sizes, with significant differences in adjusted means at both post-intervention (P=0.002) and follow-up (P=0.01). Intervention children were less likely to consume at least one sugar-sweetened beverage daily at post-intervention than control children (P=0.04). The Healthy Home Offerings via the Mealtime Environment Plus program involved the entire family and targeted personal, behavioral, and

  7. The Lifestyle Engagement Activity Program (LEAP): Implementing Social and Recreational Activity into Case-Managed Home Care.

    Science.gov (United States)

    Low, Lee-Fay; Baker, Jessica Rose; Harrison, Fleur; Jeon, Yun-Hee; Haertsch, Maggie; Camp, Cameron; Skropeta, Margaret

    2015-12-01

    The Lifestyle Engagement Activity Program (LEAP) incorporates social support and recreational activities into case-managed home care. This study's aim was to evaluate the effect of LEAP on engagement, mood, and behavior of home care clients, and on case managers and care workers. Quasi-experimental. Five Australian aged home care providers, including 2 specializing in care for ethnic minorities. Clients (n = 189) from 5 home care providers participated. The 12-month program had 3 components: (1) engaging support of management and staff; (2) a champion to drive practice change; (3) staff training. Case managers were trained to set meaningful social and/or recreational goals during care planning. Care workers were trained in good communication, to promote client independence and choice, and in techniques such as Montessori activities, reminiscence, music, physical activity, and humor. Data were collected 6 months before program commencement, at baseline, and 6 and 12 months. The Homecare Measure of Engagement Staff report and Client-Family interview were primary outcomes. Secondary outcomes were the Cohen-Mansfield Agitation Inventory; apathy, dysphoria, and agitation subscales of the Neuropsychiatric Inventory-Clinician Rating; the geriatric depression scale; UCLA loneliness scale; and home care satisfaction scale. Staff provided information on confidence in engaging clients and the Utrecht Work Engagement Scale. Twelve months after program commencement, clients showed a significant increase in self- or family-reported client engagement (b = 5.39, t[113.09] = 3.93, P recreationally engage clients (b = 0.52, t(21.33) = 2.80, P = .011, b = 0.29, t(198.69) = 2.58, P = .011, respectively). There were no significant changes in care worker-rated client engagement or client or family self-complete measures of depression or loneliness (P > .05). Client and family self-rated apathy increased over 12 months (b = 0.04, t(43.36) = 3.06, P = .004; b = 3.63, t(34.70) = 2.20, P

  8. Theory! The missing link in understanding the performance of neonate/infant home-visiting programs to prevent child maltreatment: a systematic review.

    Science.gov (United States)

    Segal, Leonie; Sara Opie, Rachelle; Dalziel, Kim

    2012-03-01

    Home-visiting programs have been offered for more than sixty years to at-risk families of newborns and infants. But despite decades of experience with program delivery, more than sixty published controlled trials, and more than thirty published literature reviews, there is still uncertainty surrounding the performance of these programs. Our particular interest was the performance of home visiting in reducing child maltreatment. We developed a program logic framework to assist in understanding the neonate/infant home-visiting literature, identified through a systematic literature review. We tested whether success could be explained by the logic model using descriptive synthesis and statistical analysis. Having a stated objective of reducing child maltreatment-a theory or mechanism of change underpinning the home-visiting program consistent with the target population and their needs and program components that can deliver against the nominated theory of change-considerably increased the chance of success. We found that only seven of fifty-three programs demonstrated such consistency, all of which had a statistically significant positive outcome, whereas of the fifteen that had no match, none was successful. Programs with a partial match had an intermediate success rate. The relationship between program success and full, partial or no match was statistically significant. Employing a theory-driven approach provides a new way of understanding the disparate performance of neonate/infant home-visiting programs. Employing a similar theory-driven approach could also prove useful in the review of other programs that embody a diverse set of characteristics and may apply to diverse populations and settings. A program logic framework provides a rigorous approach to deriving policy-relevant meaning from effectiveness evidence of complex programs. For neonate/infant home-visiting programs, it means that in developing these programs, attention to consistency of objectives, theory

  9. Home Healthcare Program for Soil-Transmitted Helminthiasis in Schoolchildren along the Mekong River Basin.

    Science.gov (United States)

    Kaewpitoon, Soraya J; Loyd, Ryan A; Kaewpitoon, Natthawut

    2015-05-01

    Soil-transmitted helminths (STH) are among the most important groups of infectious agents responsible for physical and intellectual growth retardation in children worldwide. Current status is need requiredfor the development of control programs. To determine the STH infections among the schoolchildren in the Mekong River basin near rural Ubon Ratchathani, Thailand and Champassak, Laos PDR, including their caregiver knowledge and attitude concerning prevention of STH infections. A cross sectional survey was designed as a home healthcare programfrom October 2009 to April 2012. 1,957 fecal samples were collected from children aged 5-12 years in five districts of Ubon Ratchathani province (1,012 fecal samples; Khong Chiam, Si Mueang Mai, Phibun Mangsahan, Sirindhorn, and Pho Sai), Thailand, and one district of Champassak Province (945 fecal samples; Pakse), Lao PDR. Fecal samples were prepared by the modified formalin ethylacetate concentration technique, and determined by light microscope. The knowledge and attitude of children's caregivers concerning prevention of soil-transmitted helminth infections were completed interviewed by semi-structured questionnaires. The overall intestinal helminth prevalence rate was 11.88%. Classified by species the STHs were as follows: Ascaris lumbricoides (30.9%), Trichuris trichiura (21.7%), and hookworm (20.5%). The highest prevalence was recorded in children aged 9 years and above. The highest prevalence of STH infection was found in the Pakse district of Laos PDR (16.08%). The intensities of infection with A. lumbricoides, T trichiura, and Hookworm were 1.82 ± 0.36, 1.32 ± 0.30, and 1.29 ± 0.32, respectively. 1,077 of caregivers were completed interviewed and found that the caregivers had fair levels of knowledge and attitude regarding soil-transmitted helminthiasis. These results suggest that priority should be given to STH eradication, the development of control programs in the Mekong River Basin, and the provision of

  10. Modeling and evaluating evidence-based continuing education program in nursing home dementia care (MEDCED)--training of care home staff to reduce use of restraint in care home residents with dementia. A cluster randomized controlled trial.

    Science.gov (United States)

    Testad, Ingelin; Mekki, Tone Elin; Førland, Oddvar; Øye, Christine; Tveit, Eva Marie; Jacobsen, Frode; Kirkevold, Øyvind

    2016-01-01

    The aim of this study was to evaluate the effectiveness of a tailored 7-month training intervention "Trust Before Restraint," in reducing use of restraint, agitation, and antipsychotic medications in care home residents with dementia. This is a single-blind cluster randomized controlled trial in 24 care homes within the Western Norway Regional Health Authority 2011-2013. From 24 care homes, 274 residents were included in the study, with 118 in the intervention group and 156 in the control group. Use of restraint was significantly reduced in both the intervention group and the control group despite unexpected low baseline, with a tendency to a greater reduction in the control group. There was a significant reduction in Cohen-Mansfield Agitation Inventory score in both the intervention group and the follow-up group with a slightly higher reduction in the control group, although this did not reach significance and a small nonsignificant increase in use of antipsychotics (14.1-17.7%) and antidepressants (35.9-38.4%) in both groups. This study reports on the statistically significant reduction in use of restraint in care homes, both prior and during the 7-month intervention periods, in both intervention and control groups. When interpreted within the context of the current climate of educational initiatives to reduce restraint and a greater focus on the importance of person-centered care, the study also highlights the potential success achieved with national training programs for care staff and should be further evaluated to inform future training initiatives both in Norway and internationally. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Northwest Energy Efficient Manufactured Housing Program High-Performance Test Homes

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom; Peeks, Brady

    2015-09-15

    ?This project represents the third phase of a multi-year effort to develop and bring to market a High Performance Manufactured Home (HPMH). The scope of this project involved building four HPMH prototypes, resulting in what is expected to be a 30% savings relative to the Building America Benchmark. (The actual % savings varies depending on choice of heating equipment and climate zone). The HPMH home is intended to make significant progress toward performing as zero-net-energy ready. Previous phases of this project created a HPMH specification and prototyped individual measures from the package to obtain engineering approvals and develop preliminary factory construction processes. This report describes the project team's work during 2014 to build prototype homes to the HPMH specifications and to monitor the homes for energy performance and durability during 2014. Monitoring is expected to continue into 2016.

  12. Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.

    NARCIS (Netherlands)

    Bouman, A.; Rossum, E. van; Evers, S.; Ambergen, T.; Kempen, G.; Knipschild, P.

    2008-01-01

    BACKGROUND: Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services. The results of trials have been inconsistent and their cost-effectiveness uncertain. Home visits for a high-risk population

  13. A home-based body weight supported treadmill training program for children with cerebral palsy: A case series.

    Science.gov (United States)

    Kenyon, Lisa K; Westman, Marci; Hefferan, Ashley; McCrary, Peter; Baker, Barbara J

    2017-07-01

    Contemporary approaches to the treatment of cerebral palsy (CP) advocate a task-specific approach that emphasizes repetition and practice of specific tasks. Recent studies suggest that body-weight-supported treadmill training (BWSTT) programs may be beneficial in clinical settings. The purposes of this case series were to explore the outcomes and feasibility of a home-based BWSTT program for three children with CP. Three children with CP at Gross Motor Function Classification System (GMFCS) Levels III or IV participated in this case series. Examination included the Functional Assessment Questionnaire (FAQ), the 10-meter walk test, the Gross Motor Function Measure (GMFM-66), and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). A harness system was used to conduct the BWSTT program over an 8-12 week period. All of the families reported enjoying the BWSTT program and found the harness easy to use. Participant 2 increased from a 2 to a 4 on the FAQ, while Participant 3 increased from a 6 to a 7. Two of the participants demonstrated post-intervention improvements in functional mobility. In addition to mobility outcomes, future research should explore the potential health benefits of a home-based BWSTT program.

  14. Comparative study of radon exposure in Canadian homes and uranium mines - a discussion on the importance of national radon program

    International Nuclear Information System (INIS)

    Chen, Jing

    2017-01-01

    The history of lung cancer in uranium miners is well known for over hundreds of years when the disease was referred to as 'miner's disease' or 'mountain sickness'. Radon levels in uranium mines have decreased significantly over the past 30 years as a result of effective radiation protection measures at workplaces. For the most recent 10-year period, the average radon concentrations to underground and surface workers in Canadian uranium mines were 111 and 11 Bq m -3 , respectively. Based on the recent radon survey carried out in roughly 14 000 homes in 121 health regions across Canada and the more recent radon and thoron survey in 33 Canadian cities and 4000 homes, the average radon concentration in Canadian homes is 77 Bq m -3 . This study demonstrates that, nowadays, workers are exposed to radon in underground mines at a comparable radon level to what Canadians are exposed to at home. Since exposure to indoor radon is the main source of natural radiation exposure to the population, it is important for the National Radon Program to further increase radon awareness, and to encourage more Canadians to take appropriate actions to reduce radon exposure. (authors)

  15. "It's Changed Everything": Voices of Veterans in the Veteran-Directed Home and Community Based Services Program.

    Science.gov (United States)

    Mahoney, Ellen K; Milliken, Aimee; Mahoney, Kevin J; Edwards-Orr, Merle; Willis, Danny G

    2018-04-05

    The purpose of this study was to understand the value and impact of the Veteran-Directed Home and Community Based Services program (VD-HCBS) on Veterans' lives in their own voices. Focus groups and individual interviews by telephone were conducted to elicit participant perspectives on what was most meaningful, and what difference VD-HCBS made in their lives. Transcripts were analyzed using content analysis. The sample included 21 Veterans, with a mean age of 66±14, enrolled in VD-HCBS an average of 20.8 months. All were at risk of institutional placement based on their level of disability. Five major categories captured the information provided by participants: What a Difference Choice Makes; I'm a Person!; It's a Home-Saver; Coming Back to Life; and Keeping Me Healthy & Safe. Participants described the program as life changing. This study is the first time that Veterans themselves have identified the ways in which VD-HCBS impacted their lives, uncovering the mechanisms underlying positive outcomes. These categories revealed new ways of understanding VD-HCBS as an innovative approach to meeting the person-centered needs of Veterans wishing to remain at home, while experiencing quality care and leading meaningful lives, areas identified as priorities for improving long term services and supports.

  16. Pediatric fractures during skateboarding, roller skating, and scooter riding.

    Science.gov (United States)

    Zalavras, Charalampos; Nikolopoulou, Georgia; Essin, Daniel; Manjra, Nahid; Zionts, Lewis E

    2005-04-01

    Skateboarding, roller skating, and scooter riding are popular recreational and sporting activities for children and adolescents but can be associated with skeletal injury. The purpose of this study is to describe the frequency and characteristics of fractures resulting from these activities. Fractures from skateboarding, roller skating, and scooter riding compose a considerable proportion of pediatric musculoskeletal injuries. Case series; Level of evidence, 4. Demographic data and injury characteristics were analyzed for all patients who presented to the pediatric fracture clinic of the level I trauma center from January 2001 to May 2002 after sustaining fractures due to skateboarding, roller skating, and scooter riding. Among a total of 2371 fractures, the authors identified 325 fractures (13.7%) that occurred during one of these activities. There were 187 patients (mean age, 13 years; 95% male) who sustained 191 skateboard-related fractures, 64 patients (mean age, 10.8 years; 54% male) who sustained 65 fractures while roller skating, and 66 patients (mean age, 9.7 years; 64% male) who sustained 69 fractures while riding a scooter. The forearm was fractured most often, composing 48.2% of skate-boarding fractures, 63.1% of roller-skating fractures, and 50.7% of fractures due to scooter riding. Of the forearm fractures, 94% were located in the distal third. In the skateboarding group, 10 of 191 (5.2%) fractures were open injuries of the forearm, compared to 6 of 2046 (0.3%) fractures caused by other mechanisms of injury (significant odds ratio, 18.8). Skateboarding, roller-skating, and scooter-riding accidents result in a large proportion of pediatric fractures. An open fracture, especially of the forearm, was more likely to be caused by skateboarding than by other mechanisms of injury. Use of wrist and forearm protective equipment should be considered in all children who ride a skateboard.

  17. Internação domiciliar: o perfil dos pacientes assistidos pelo Programa HU em Casa Home care: profile of patients attended by a home care program

    Directory of Open Access Journals (Sweden)

    Daniella Reis Barbosa Martelli

    2011-01-01

    Full Text Available Internação domiciliar é uma modalidade de atendimento à saúde que está se transformando em uma alternativa importante para minimizar alguns dos principais problemas inerentes aos sistemas de saúde vigentes, especialmente os da rede pública. O objetivo do estudo foi descrever o perfil sociodemográfico e clínico da população assistida pelo Programa de Internação Domiciliar (PID HU em Casa do Hospital Universitário Clemente de Faria da Universidade Estadual de Montes Claros. O estudo foi descritivo e retrospectivo por meio da análise de prontuários, realizada de maio de 2005 a maio de 2008. Foram analisados 137 pacientes, sendo 75 do gênero feminino (54,7% e 62 do masculino (45,3%. O grupo de 61 a 80 anos foi mais prevalente (37,2% e 73% dos pacientes residiam em bairros periféricos do município de Montes Claros-MG. Dos agravos mais comuns na primeira internação, a pneumonia foi prevalente, 22 casos (16,1%. A maioria dos pacientes foi encaminhada ao PID pela clinica médica (84,7%, com intervalo de maior prevalência de duas a três internações (42,4%. Do total de pacientes, 120 (87,6% permaneceram internados por 16 a 30 dias e 51,8% não necessitaram passar novamente pelo PID para uma segunda internação. Com relação à resolutividade clínica, 130 (94,9% tiveram alta clínica, no PID, na primeira internação. O PID mostrou-se ser um programa de alta resolutividade, atendendo mais ao público idoso feminino, de baixa renda e com períodos de internação relativamente curtos.The home care is a modality of health care which is becoming an important alternative to minimize some of mainly relevant problems of world health, especially the public health network. This paper aimed to describe the socio-demographic and clinical population assisted by the Home Care Program HU em Casa, of the University Hospital Clemente de Faria, Universidade Estadual de Montes Claros. It is a descriptive and retrospective study analyzing

  18. Determining the Reach of a Home-Based Physical Activity Program for Older Adults within the Context of a Randomized Controlled Trial

    Science.gov (United States)

    Harden, Samantha M.; Fanning, Jason T.; Motl, Robert W.; McAuley, Edward; Estabrooks, Paul A.

    2014-01-01

    Determining the reach of physical activity (PA) programs is challenging due to inconsistent reporting across studies. The purpose of this study was to document multiple indicators of program reach for a 6-month, Digital Versatile Disc (DVD)-delivered home-based PA program. Radio, newspaper and direct mailing advertisements were tracked to…

  19. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ...This notice announces the annual adjustments to the national average payment rates for meals and snacks served in child care centers, outside-school-hours care centers, at-risk afterschool care centers, and adult day care centers; the food service payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates for sponsoring organizations of day care homes, to reflect changes in the Consumer Price Index. Further adjustments are made to these rates to reflect the higher costs of providing meals in the States of Alaska and Hawaii. The adjustments contained in this notice are made on an annual basis each July, as required by the laws and regulations governing the Child and Adult Care Food Program.

  20. The Feasibility of a Customized, In-Home, Game-Based Stroke Exercise Program Using the Microsoft Kinect Sensor

    Directory of Open Access Journals (Sweden)

    Rachel Proffitt

    2015-11-01

    Full Text Available The objective of this study was to determine the feasibility of a 6-week, game-based, in-home telerehabilitation exercise program using the Microsoft Kinect® for individuals with chronic stroke. Four participants with chronic stroke completed the intervention based on games designed with the customized Mystic Isle software. The games were tailored to each participant’s specific rehabilitation needs to facilitate the attainment of individualized goals determined through the Canadian Occupational Performance Measure. Likert scale questionnaires assessed the feasibility and utility of the game-based intervention. Supplementary clinical outcome data were collected. All participants played the games with moderately high enjoyment. Participant feedback helped identify barriers to use (especially, limited free time and possible improvements. An in-home, customized, virtual reality game intervention to provide rehabilitative exercises for persons with chronic stroke is practicable. However, future studies are necessary to determine the intervention’s impact on participant function, activity, and involvement.

  1. Evaluation of Early Performance Results for Massachusetts Homes in the National Grid Pilot Deep Energy Retrofit Program

    Energy Technology Data Exchange (ETDEWEB)

    Gates, C. [Building Science Corporation, Somerville, MA (United States); Neuhauser, K. [Building Science Corporation, Somerville, MA (United States)

    2013-11-01

    This research project evaluates post-retrofit performance measurements, energy use data and construction costs for 13 projects that participated in the National Grid Deep Energy Retrofit Pilot program. The projects implemented a package of measures defined by performance targets for building enclosure components and building enclosure air tightness. Nearly all of the homes reached a post-retrofit air tightness result of 1.5 ACH 50. Homes that used the chainsaw retrofit technique along with roof insulation, and wall insulation applied to the exterior had the best air tightness results and the lowest heating and cooling source energy use. Analysis of measure costs and project objectives yielded a categorization of costs relative to energy performance objectives. On average about 1/2 of the energy-related measure costs correspond primarily to energy-related objectives, and 20% of energy-related measure costs relate primarily to non-energy objectives.

  2. Evaluation of Early Performance Results for Massachusetts Homes in the National Grid Pilot Deep Energy Retrofit Program

    Energy Technology Data Exchange (ETDEWEB)

    Neuhauser, K. [Building Science Corporation, Somerville, MA (United States); Gates, C. [Building Science Corporation, Somerville, MA (United States)

    2013-11-01

    This research project evaluates post-retrofit performance measurements, energy use data and construction costs for 13 projects that participated in the National Grid Deep Energy Retrofit Pilot program. The projects implemented a package of measures defined by performance targets for building enclosure components and building enclosure air tightness. Nearly all of the homes reached a post-retrofit air tightness result of 1.5 ACH 50. Homes that used the chainsaw retrofit technique along with roof insulation, and wall insulation applied to the exterior had the best air tightness results and the lowest heating and cooling source energy use. Analysis of measure costs and project objectives yielded a categorization of costs relative to energy performance objectives. On average about ½ of the energy-related measure costs correspond primarily to energy-related objectives, and 20% of energy-related measure costs relate primarily to non-energy objectives.

  3. Northwest Energy Efficient Manufactured Housing Program High-Performance Test Homes

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [Building America Partnership for Improved Residential Construction, Corvallis, OR (United States); Peeks, Brady [Building America Partnership for Improved Residential Construction, Corvallis, OR (United States)

    2015-09-01

    This project represents the third phase of a multi-year effort to develop and bring to market a High Performance Manufactured Home (HPMH), which is intended to make significant progress toward performing as zero-net-energy ready. The scope of this project involved building four HPMH prototypes, resulting in what is expected to be a 30% savings relative to the Building America Benchmark. (The actual percent savings varies depending on choice of heating equipment and climate zone). Previous phases of this project created a HPMH specification and prototyped individual measures from the package to obtain engineering approvals and develop preliminary factory construction processes. This report describes the project team's work during 2014 to build prototype homes to the HPMH specifications and to monitor the homes for energy performance and durability during 2014. Monitoring is expected to continue into 2016.

  4. A home-based individualized information communication technology training program for older adults: a demonstration of effectiveness and value.

    Science.gov (United States)

    Arthanat, Sajay; Vroman, Kerryellen G; Lysack, Catherine

    2016-01-01

    To demonstrate the effectiveness and value of a home-based information communication technology (ICT) training program for older adults. Thirteen older adults were provided in-home ICT training by graduate occupational therapy students using an iPad. The breadth and frequency of ICT use, perspectives on technology, and perceived independence were recorded at baseline, during the 3-month training and at follow-up, along with an end-of-study questionnaire. Non-parametric Friedman analysis was conducted to verify trends in the outcome measures. The qualitative data were examined by content analysis. Participants' breadth of ICT activities showed a significant trend across 6 months. Leisure accounted for the significant increase, while health management and social connections activities increased modestly. A positive trend in participants' perspectives on technology was evident along with a marginal increase in perceived independence. Participants' perspectives were thematically categorized as technology experiences, interactions with coach, training approach, and specific activities. As reflection of the training program's value, 12 of the 13 participants took ownership of the iPad at the end of the study. Building capacity of older adults to utilize the multifaceted potential of ICT is critical in addressing declines in health, impending disabilities, and social isolation. Implications for Rehabilitation A one-on-one home-based individualized information communication technology (ICT) training program for older adults could result in a progressive increase in the breadth of online activities carried out by them. Specifically, the increase in their usage of ICT could be expected in leisure-based online activities. Individualized training programs designed based on needs, priorities, and learning style of older adults could have a positive impact on their technological perspectives and intrinsic motivation to adopt ICT.

  5. Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson

    Directory of Open Access Journals (Sweden)

    Ihana Thaís Guerra de Oliveira Gondim

    Full Text Available Abstract Introduction: Home therapeutic exercises have been a target of interest in the treatment of the Parkinson's disease (PD. The way that the physical therapist guides and monitors these exercises can impact the success of therapy. Objective: To evaluate the effects of individualized orientation and monitoring by telephone in a self-supervised home therapeutic exercise program on signs and symptoms of PD and quality of life (QoL. Methods: Single-blind randomized clinical trials with 28 people with PD (Hoehn and Yahr 1 to 3. Patients were randomized into two groups: experimental and control. The experimental group had a meeting with individualized guidance about physiotherapy exercises present in a manual, received the manual to guide their activities at home and obtained subsequent weekly monitoring by telephone. The control group received the usual cares by the service. Both were orientated to carry out exercises three times a week during 12 weeks. Was evaluated: (1 activities of daily living (ADL and motor examination sections of the Unified Parkinson's Disease Rating Scale (UPDRS and QoL by the Parkinson Disease Questionnaire 39 (PDQ-39. The analysis between groups was performed by the Mann-Whitney test and intragroup through the Wilcoxon (p < 0.05. Results: Significant improvement in ADL (p= 0.001 and motor examination (p= 0.0008 of the UPDRS, PDQ-39 total (p = 0.027 and dimensions mobility (p = 0.027, emotional well-being (p= 0.021 and bodily discomfort (p = 0.027 in the experimental group compared to the control group. Conclusion: The individualized guidance and weekly monitoring by telephone in a self-supervised home therapeutic exercises program promoted positive effects on ADL, motor examination and QoL of people in early stages of PD.

  6. Greenbelt Homes Pilot Program. Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [Home Innovation Research Labs, Marlboro, MD (United States); Del Bianco, M. [Home Innovation Research Labs, Marlboro, MD (United States); Mallay, D. [Home Innovation Research Labs, Marlboro, MD (United States)

    2015-05-22

    The U.S. Department of Energy Building America team Partnership for Home Innovation wrote a report on Phase 1 of the project that summarized a condition assessment of the homes and evaluated retrofit options within the constraints of the cooperative provided by GHI. Phase 2 was completed following monitoring in the 2013–2014 winter season; the results are summarized in this report. Phase 3 upgrades of heating equipment will be implemented in time for the 2014–2015 heating season and are not part of this report.

  7. Decreasing In-home Smoking of Adults—Results from a School-based Intervention Program in Viet Nam

    Directory of Open Access Journals (Sweden)

    Le Thi Thanh Huong

    2016-10-01

    Full Text Available It is indicated that children are involuntarily exposed to secondhand smoke from adults, mainly at their home environment. This study aimed at describing the effectiveness of the school-based intervention to decrease the in-home smoking situation of adults so as to decrease children’s exposure to secondhand smoke at home during the year 2011–2012 in a rural district in Hanoi, Viet Nam. This school-based intervention program (intervention and control group involved 804 children aged 8 to 11 years from August 2011 to May 2012 in a rural district of Hanoi, Viet Nam. Children were taught in class about the harmful effects of secondhand smoke and about how to negotiate with fathers not to smoke in-home. Then children applied what they learnt, including staying away from secondhand smoke and persuading fathers not to smoke in-home in order to decrease children’s exposure to secondhand smoke. Chi square test, t-test and multinominal logistic regression were applied in data analysis. The results showed that children’s reported their father’s in-home smoking decreased from 83.0% pre-intervention to 59.8% post-intervention (p < 0.001 in the intervention school while no change happened in the control school. The study found that the better changed smoking location of adult smokers as reported by children associated with the school who received intervention activities (adjusted OR = 2.04; 95% CI: 1.28–3.24. Poorer changed attitudes towards secondhand smoke of children associated with a lower percentage of better change in smoking location of their fathers/other adult smokers (aOR = 0.51, 95% CI: 0.28–0.96. Children’s poorer changed knowledge towards secondhand smoke also associated with poorer changed smoking location of adult smokers (aOR = 2.88, 95% CI: 1.07–7.76. It is recommended by this study that similar school based intervention approaches should be applied in primary schools in Viet Nam to increase children’s awareness on the

  8. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training at Home randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Amanda Bates

    2018-04-01

    Full Text Available Introduction: Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. Research questions: This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Design: Randomised, controlled trial. Participants and setting: A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Intervention: Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. Outcome measures: The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated

  9. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training) at Home randomised, controlled trial.

    Science.gov (United States)

    Bates, Amanda; Furber, Susan; Tiedemann, Anne; Ginn, Karen; van den Dolder, Paul; Howard, Kirsten; Bauman, Adrian; Chittenden, Catherine; Franco, Lisa; Kershaw, Michelle; Sherrington, Catherine

    2018-04-01

    Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Randomised, controlled trial. A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated. Negative binomial regression models will be used to estimate the between-group difference in fall rates. Modified

  10. PERANCANGAN PURWARUPA KOMIK INTERAKTIF SAFETY RIDING BERKONSEP DIGITAL STORYTELLING

    Directory of Open Access Journals (Sweden)

    Godham Eko Saputro

    2016-12-01

    Full Text Available Abstrak Di Indonesia khususnya kota besar, kecelakaan yang disebabkan kendaraan bermotor menjadi persoalan yang serius. Salah satunya disebabkan kurangnya pemahaman tentang safety riding. Berbagai upaya kampanye safety riding pun telah dilaksanakan oleh polisi lalu lintas melalui talkshow, siaran radio, serta media leaflet bagi masyarakat yang dilakukan berulang-ulang. Hal itu mendorong peneliti dalam upaya menemukan strategi baru, salah satunya memanfaatkan perkembangan teknologi yang sangat pesat guna mengembangkan media pendukung kampanye safety riding yang tidak hanya dapat menyampaikan pesan, tetapi juga disukai dan bersifat menghibur. Data diperoleh melalui wawancara, observasi, serta studi literatur sebagai sumber konten purwarupa komik interaktif. Melalui pendekatan digital storytelling dan model komunikasi SMCR serta mengacu pada Penelitian Pengembangan, konsep purwarupa komik interaktif bisa dijabarkan lebih detail serta dapat diimplementasikan dalam perangkat mobile khususnya tablet PC. Diharapkan purwarupa ini dapat dikembangkan lebih lanjut sehingga benar-benar dapat dipublish secara umum sebagai media pendukung kampanye safety riding. Kata Kunci: komik, interaktif, safety riding, digital storytelling Abstract In Indonesia especially in big cities, the accident which caused by rider is still become serious issue. One factor which cause accident is the lack of knowledge about safety riding. A lot of efforts which have been carried by traffic policeman are talkshow, radio broadcast, and leaflet media for public society. On the other hand, it courage the researchers in effort to find new startegy, one of them is using the advance of technology to develop another media campaign which not only can deliver the messages, but also can entertain user. This research is an effort to find unconventional media for safety riding campaign. Data was obtained through interview, observation, and study of literature as sources of content for

  11. The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

    Science.gov (United States)

    Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

    2018-05-09

    Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Effect of amusement park rides on programmable shunt valve settings.

    Science.gov (United States)

    Strahle, Jennifer; Collins, Kelly; Stetler, William R; Smith, Brandon W; Garton, Thomas; Garton, Catherine; Garton, Hugh J L; Maher, Cormac O

    2013-01-01

    Magnetically programmable shunt valves are susceptible to environmental factors including magnetic fields and accelerative forces. It is unknown if rollercoasters with or without magnetic brakes or linear induction motors (LIMs) are capable of altering the setting of a programmable shunt valve. Two different valve types (type A, n = 10; type B, n = 9) were tested at varying resistance settings in 2 trials on 6 different amusement park rides including 2 rides with LIMs, 2 rides with magnetic brakes, and 2 rides without magnetic technology. The performance level of valve type A and the setting of valve type B changed on rollercoasters with magnets (A = 2.5% [2/80]; B = 5.6% [4/72]) and without magnets (A = 7.5% [3/40]; B = 2.8% [1/36]). Neither valve setting changed when exposed to a Ferris wheel or during ambulation throughout the park. Magnetically programmable valves are susceptible to changes in pressure settings when exposed to amusement park rides with elevated vertical gravitational forces, irrespective of the presence of LIMs or magnetic brakes. © 2013 S. Karger AG, Basel.

  13. Effects of the Horse Riding Simulator and Ball Exercises on Balance of the Elderly

    Science.gov (United States)

    Kim, SeongGil; Yuk, Goon-chang; Gak, Hwangbo

    2013-01-01

    [Purpose] The aim of this study was to examine the effects of horse riding exercise using a horse riding simulator (HRS) and a ball on static and dynamic balance of elderly people. [Methods] Thirty-two elderly people hospitalized in geriatric hospitals were randomly assigned to the HRS exercise group or the ball exercise groups, and they performed exercise for eight weeks. [Results] The length of postural sway during quite standing with and without eyes closed significantly decreased in both groups after the exercises and there was no significant difference between both groups in the Romberg test. In the functional reach test (FRT), there were significant increases in distance in both groups after the exercises, and the distance of the HRS exercise group was significantly greater than that of the ball exercise group. In the Timed Up & Go test (TUG) and Timed 10-meter walk test (10MWT), the time significantly decreased in both groups, and there was a more significant decrease in the HRS exercise group than in the ball exercise group. [Conclusion] The results of this study indicate that HRS and ball exercises may improve the balance and gait ability of elderly people hospitalized in nursing homes or geriatric hospitals. PMID:24396203

  14. On the temperature dependence of H-U{sub iso} in the riding hydrogen model

    Energy Technology Data Exchange (ETDEWEB)

    Lübben, Jens; Volkmann, Christian [Institut für Anorganische Chemie, Georg-August-Universität, Tammannstrasse 4, D-37077 Göttingen (Germany); Grabowsky, Simon [School of Chemistry and Biochemistry, Stirling Highway 35, WA-6009 Crawley (Australia); Edwards, Alison [Bragg Institute, Australian Nuclear Science and Technology Organisation, Locked Bag 2001, Kirrawee DC, NSW 2232 (Australia); Morgenroth, Wolfgang [Institut für Geowissenschaften, Abteilung Kristallographie, Goethe-Universität, Altenhöferallee 1, 60438 Frankfurt am Main (Germany); Fabbiani, Francesca P. A. [GZG, Abteilung Kristallographie, Georg-August Universität, Goldschmidtstrasse 1, 37077 Göttingen (Germany); Sheldrick, George M. [Institut für Anorganische Chemie, Georg-August-Universität, Tammannstrasse 4, D-37077 Göttingen (Germany); Dittrich, Birger, E-mail: birger.dittrich@chemie.uni-hamburg.de [Institut für Anorganische und Angewandte Chemie, Martin-Luther-King-Platz 6, 20146 Hamburg (Germany); Institut für Anorganische Chemie, Georg-August-Universität, Tammannstrasse 4, D-37077 Göttingen (Germany)

    2014-07-01

    The temperature dependence of hydrogen U{sub iso} and parent U{sub eq} in the riding hydrogen model is investigated by neutron diffraction, aspherical-atom refinements and QM/MM and MO/MO cluster calculations. Fixed values of 1.2 or 1.5 appear to be underestimated, especially at temperatures below 100 K. The temperature dependence of H-U{sub iso} in N-acetyl-l-4-hydroxyproline monohydrate is investigated. Imposing a constant temperature-independent multiplier of 1.2 or 1.5 for the riding hydrogen model is found to be inaccurate, and severely underestimates H-U{sub iso} below 100 K. Neutron diffraction data at temperatures of 9, 150, 200 and 250 K provide benchmark results for this study. X-ray diffraction data to high resolution, collected at temperatures of 9, 30, 50, 75, 100, 150, 200 and 250 K (synchrotron and home source), reproduce neutron results only when evaluated by aspherical-atom refinement models, since these take into account bonding and lone-pair electron density; both invariom and Hirshfeld-atom refinement models enable a more precise determination of the magnitude of H-atom displacements than independent-atom model refinements. Experimental efforts are complemented by computing displacement parameters following the TLS+ONIOM approach. A satisfactory agreement between all approaches is found.

  15. On the temperature dependence of H-Uiso in the riding hydrogen model

    International Nuclear Information System (INIS)

    Lübben, Jens; Volkmann, Christian; Grabowsky, Simon; Edwards, Alison; Morgenroth, Wolfgang; Fabbiani, Francesca P. A.; Sheldrick, George M.; Dittrich, Birger

    2014-01-01

    The temperature dependence of hydrogen U iso and parent U eq in the riding hydrogen model is investigated by neutron diffraction, aspherical-atom refinements and QM/MM and MO/MO cluster calculations. Fixed values of 1.2 or 1.5 appear to be underestimated, especially at temperatures below 100 K. The temperature dependence of H-U iso in N-acetyl-l-4-hydroxyproline monohydrate is investigated. Imposing a constant temperature-independent multiplier of 1.2 or 1.5 for the riding hydrogen model is found to be inaccurate, and severely underestimates H-U iso below 100 K. Neutron diffraction data at temperatures of 9, 150, 200 and 250 K provide benchmark results for this study. X-ray diffraction data to high resolution, collected at temperatures of 9, 30, 50, 75, 100, 150, 200 and 250 K (synchrotron and home source), reproduce neutron results only when evaluated by aspherical-atom refinement models, since these take into account bonding and lone-pair electron density; both invariom and Hirshfeld-atom refinement models enable a more precise determination of the magnitude of H-atom displacements than independent-atom model refinements. Experimental efforts are complemented by computing displacement parameters following the TLS+ONIOM approach. A satisfactory agreement between all approaches is found

  16. Acceptability of an e-learning program to help nursing assistants manage relationship conflict in nursing homes.

    Science.gov (United States)

    Marziali, Elsa; Mackenzie, Corey Scott; Tchernikov, Illia

    2015-02-01

    Management of nursing assistants' (NAs) emotional stress from relationship conflicts with residents, families, and coworkers is rarely the focus of educational programs. Our objective was to gather feedback from NAs and their nursing supervisors (NSs) about the utility of our e-learning program for managing relationship stress. A total of 147 NAs and their NSs from 17 long-term care homes viewed the educational modules (DVD slides with voice-over), either individually or in small groups, and provided feedback using conference call focus groups. Qualitative analysis of NA feedback showed that workplace relationship conflict stress was associated with workload and the absence of a forum for discussing relationship conflicts that was not acknowledged by NSs. This accessible e-learning program provides NAs with strategies for managing stressful emotions arising from workplace relationship conflict situations and underscores the importance of supervisory support and team collaboration in coping with emotionally evoked workplace stress. © The Author(s) 2014.

  17. Effect of therapeutic horseback riding on balance in community-dwelling older adults with balance deficits.

    Science.gov (United States)

    Homnick, Douglas N; Henning, Kim M; Swain, Charlene V; Homnick, Tamara D

    2013-07-01

    Falls are an important cause of morbidity in older adults. Equine-assisted activities including therapeutic riding (TR) benefit balance and neuromuscular control in patients with neurological disabilities but have not been systematically studied in older adults at greater risk for falls due to balance deficits. The effect of an 8-week TR program on measures of balance and quality of life in community-dwelling older adults with established balance deficits was evaluated. This was a pretest-post-test single-group trial of a TR program on measures of balance and quality of life. The study was conducted at a Professional Association of Therapeutic Horsemanship (PATH) International Premier riding center. The subjects comprised 9 adults (5 female, 4 males) with a mean age 76.4 years (range 71-83 years). This included an 8-week observation period followed by an 8-week TR program consisting of 1 hour per week of supervised horseback riding and an 8-week follow-up period. SUBJECTS received balance testing at weeks 0, 8, 16, and 24 using the Fullerton Advanced Balance Scale (FABS), and quality of life was measured at weeks 8 and 16 using the Rand SF (short form) 36 quality-of-life measure. OUTCOME MEASURES were change in the FABS and Rand SF 36. There was no significant difference in balance scores between the start and end of the observation period. There was a significant improvement in the balance score and perception of general health from the start to the end of the intervention period, and no significant difference between the end of the intervention and the end of study, suggesting that improvements may have been sustained. TR is a safe activity for older adults with mild to moderate balance deficits and leads to both improvements in balance and quality of life. Longer and larger studies to assess the benefit of equine-assisted activities on improvements in balance and reduction in fall risk are needed.

  18. Welcome to the home page of the Decontamination and Decommissioning Program at Argonne National Laboratory

    International Nuclear Information System (INIS)

    1996-01-01

    This report presents the details of the Argonne National Laboratory Home Page. Topics discussed include decontamination and decommissioning of the following: hot cells; remedial action; Experimental Boiling Water Reactor; glove boxes; the Chicago Pile No. 5 Research Reactor Facility; the Janus Reactor; Building 310 Retention Tanks; Zero Power Reactors 6 and 9; Argonne Thermal Source Reactor; cyclotron facility; and Juggernaut reactor

  19. 77 FR 67067 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013...

    Science.gov (United States)

    2012-11-08

    ... Home Assessment Validation and Entry System HCC Hierarchical Condition Categories HCIS Health Care... cost basis and that such amounts be initially based on the most recent audited cost report data... case-mix growth are robust. We have not commissioned work analyzing case-mix change based on...

  20. 78 FR 69614 - Home Improvements and Structural Alterations (HISA) Benefits Program

    Science.gov (United States)

    2013-11-20

    ... more than one kitchen, we interpret the statutory reference to ``essential lavatory and sanitary... single kitchen facility is a reasonable interpretation of ``essential'' lavatory and sanitary facilities... continuation of treatment for the veteran's disability or to provide access to the home or to essential...

  1. 75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2010-07-12

    ... law judge (ALJ) reverses the civil money penalty determination in whole or in part, the escrowed..., widespread harm, or resulting in a resident's death is not eligible for the civil money penalty reduction... Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Proposed...

  2. Implementing Universal Maternal Depression Screening in Home Visiting Programs: A Pragmatic Overview

    Science.gov (United States)

    Segre, Lisa S.; Taylor, Darby

    2014-01-01

    Maternal depression, although prevalent in low-income women, is not an inevitable consequence of poverty. Nevertheless, depression is a double burden for impoverished women: compromising infant development and diminishing mothers' ability to benefit from or effectively use home visiting services. Without universal screening, depression is often…

  3. 75 FR 70371 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Science.gov (United States)

    2010-11-17

    ... patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face... Provisions for HHAs 1. HHA Capitalization 2. HHA Changes of Ownership F. Home Health Face-to-Face Encounter G... changes one at a time and phasing them in to allow time to determine the impact of those individual...

  4. The interdisciplinary approach to the implementation of a diabetes home care disease management program.

    Science.gov (United States)

    Rosa, Mary Ann; Lapides, Shawn; Hayden, Corrine; Santangelo, Roxanne

    2014-02-01

    Diabetes is a national epidemic and a leading cause of hospitalizations in the United States. Home care agencies need to be able to provide effective Diabetes Disease Management to help prevent avoidable hospitalizations and assist patients to live a good quality of life. This article describes one organization's journey toward providing patients with better diabetes care resulting in an improved quality of life.

  5. Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes.

    Science.gov (United States)

    Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav

    2017-10-01

    Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to

  6. Physical activity and nutrition behavioural outcomes of a home-based intervention program for seniors: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Burke Linda

    2013-01-01

    Full Text Available Abstract Background This intervention aimed to ascertain whether a low-cost, accessible, physical activity and nutrition program could improve physical activity and nutrition behaviours of insufficiently active 60–70 year olds residing in Perth, Australia. Methods A 6-month home-based randomised controlled trial was conducted on 478 older adults (intervention, n = 248; control, n = 230 of low to medium socioeconomic status. Both intervention and control groups completed postal questionnaires at baseline and post-program, but only the intervention participants received project materials. A modified fat and fibre questionnaire measured nutritional behaviours, whereas physical activity was measured using the International Physical Activity Questionnaire. Generalised estimating equation models were used to assess the repeated outcomes over both time points. Results The final sample consisted of 176 intervention participants and 199 controls (response rate 78.5% with complete data. After controlling for demographic and other confounding factors, the intervention group demonstrated increased participation in strength exercise (p Conclusions A minimal contact, low-cost and home-based physical activity program can positively influence seniors’ physical activity and nutrition behaviours. Trial registration anzctr.org.au Identifier: ACTRN12609000735257

  7. Analisis Sikap dan Pengetahuan Ibu Melalui Program Home Gardening dan Penyuluhan Gizi di Desa Binaan Tenayan Raya Pekanbaru

    Directory of Open Access Journals (Sweden)

    Rini Harianti

    2015-11-01

    Full Text Available Pemanfaatan pekarangan dapat mendukung penyediaan aneka ragam pangan di tingkat rumah tangga, sehingga terwujud pola konsumsi pangan keluarga yang beragam, bergizi seimbang dan aman. Saat ini, pemanfaatan pekarangan belum dilakukan secara maksimal. Melalui pemanfaatan pekarangan dan penyuluhan gizi diharapkan dapat memberikan nilai tambah dalam mencukupi kebutuhan pangan dan gizi keluarga serta dapat memperluas pengetahuan dan sikap gizi ibu. Oleh karena itu, untuk meningkatkan pemanfaatan pekarangan ini sangat diperlukan adanya penyuluhan, bimbingan dan penyediaan sarana yang diperlukan. Tujuan penelitian ini adalah untuk menganalisis sikap dan pengetahuan ibu melalui program home gardening dan penyuluhan gizi terhadap pemanfaatan pekarangan di desa binaan Tenayan Raya Pekanbaru. Penelitian ini adalah eksperimental. Subjek penelitian adalah 100 orang ibu, yang dipilih dari 4 kelurahan, di Kecamatan Tenayan Raya. Hasil menunjukkan bahwa (1 sosial ekonomi keluarga yaitu pendidikan terhadap pendapat memiliki hubungan yang signifikan p < 0.05 (p = 0.003, (2 konsumsi energi protein terhadap pendapatan memiliki hubungan yang signifikan p < 0.05 (p = 0.031, (3 analisis pengetahuan ibu terhadap program home gardening dengan pendidikan memiliki hubungan yang signifikan p < 0.05 (p = 0.004, (4 sikap ibu terhadap program home gardening dengan pendapatan dan pekerjaan ibu masing-masing memiliki hubungan yang signifikan p < 0.05 (p = 0.035 dan p = 0.006, (5 analisis pengetahuan dan sikap gizi ibu terhadap pendidikan memiliki hubungan yang signifikan p < 0.05 (p = 0.024, (6 pengetahuan dan sikap ibu yang diberi penyuluhan gizi setelah intervensi memiliki hubungan yang signifikan p < 0.05 (p = 0.000.

  8. Effects of a Peer-Led Pain Management Program for Nursing Home Residents with Chronic Pain: A Pilot Study.

    Science.gov (United States)

    Tse, Mimi Mun Yee; Yeung, Suey Shuk Yu; Lee, Paul Hong; Ng, Shamay Sheung Mei

    2016-09-01

    OBJECTIVES : To examine the feasibility of a peer-led pain management program among nursing home residents. DESIGN : A quasi-experimental design. SETTING : Two nursing homes. SUBJECTS : Fifty nursing home residents. METHODS : The experimental group (n = 32) was given a 12-week group-based peer-led pain management program. There were two 1-hour sessions per week. Education in pain and demonstrations of nonpharmacological pain management strategies were provided. The research team and 12 trained peers led the sessions. The control group (n = 18) received one 1-hour session of pain management program each week over 12 weeks from the research team only. Outcome measures for the participants were collected at baseline (P1) and at week 12 (P2). Data from peer volunteers were collected prior to training (V1) and at week 12 (V2). T-tests were used to compare the differences in outcome measures collected at two time points. RESULTS : There was a significant reduction in pain intensity from 5.8 ± 2.6 (P1) to 3.4 ± 2.5 (P2) for the experimental group (p = 0.003) and from 6.3 ± 3.0 (P1) to 3.1 ± 2.4 (P2) for the control group (p = 0.001). Activities of daily living significantly improved for both the experimental group (p = 0.008) and the control group (p = 0.014). There was an enhancement in happiness level for the experimental group (p pain management knowledge (2.9 ± 2.6 to 8.1 ± 1.2, p pain management program was feasible and has potential in relieving chronic pain and enhancing the physical and psychological health of nursing home residents. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Treatment-Induced Neuroplasticity Following Intensive Speech Therapy and a Home Practice Program in Fifteen Cases of Chronic Aphasia

    Directory of Open Access Journals (Sweden)

    Jacquie Kurland

    2015-04-01

    •\tActivity in R posSTG decreased over time for CORR pictures while increasing over time for TR/PR pictures Discussion Short-term intensive treatment followed by a home practice program can produce enduring language improvements that provide rich opportunities for investigating treatment-induced neuroplasticity in aphasia. Given the high degree of individual variability in lesion location/extent, and the resulting variability in aphasia type/severity, it makes sense to examine treatment-induced changes in neural activity patterns within subjects where ‘signature’ patterns of activity are remarkably reliable across time.

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

    Science.gov (United States)

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

    2010-01-01

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

  11. Topology Optimization of Vehicle Body Structure for Improved Ride & Handling

    OpenAIRE

    Lövgren, Sebastian; Norberg, Emil

    2011-01-01

    Ride and handling are important areas for safety and improved vehicle control during driving. To meet the demands on ride and handling a number of measures can be taken. This master thesis work has focused on the early design phase. At the early phases of design, the level of details is low and the design freedom is big. By introducing a tool to support the early vehicle body design, the potential of finding more efficient structures increases. In this study, topology optimization of a vehicl...

  12. Modified ride-on toy cars for early power mobility: a technical report.

    Science.gov (United States)

    Huang, Hsiang-Han; Galloway, James C

    2012-01-01

    Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility; however, no single device provides the level of functional mobility that children developing typically enjoy. The purpose of this technical report is to formally introduce a new power mobility option--the modified ride-on toy car. This report will provide (a) an overview of toy car features, (b) examples of basic electrical and mechanical modifications, and (c) a brief clinical case. With creative use and customized modifications, toy cars can function as a "general learning environment" for use in the clinic, home, and school. As such, we anticipate that these cars will become a multiuse clinical tool to address not only mobility goals but also goals involving body function and structure such as posture and movement impairments.

  13. Evaluation of Raising Adolescent Families Together Program: A Medical Home for Adolescent Mothers and Their Children

    Science.gov (United States)

    Buman, Matthew P.; Woods, Elizabeth R.; Famakinwa, Olatokunbo; Harris, Sion Kim

    2012-01-01

    Objectives. This study described a medical home model for adolescent mothers and their children, and their 1- and 2-year preventive care, repeat pregnancy, and psychosocial outcomes. Methods. In this prospective, single cohort demonstration project, adolescent mothers (14–18 years old) and their children received care in a medical home. Demographic, medical and social processes, and outcomes data were collected at enrollment through 24 months. Change over time and predictors of repeat pregnancy were analyzed. Results. A total of 181 adolescents enrolled, with 79.6% participating for 2 years. At 2 years, 90.2% of children were completely immunized. Children and adolescent mothers met standards for health care visits, and adolescent condom use improved. Rates of cumulative repeat pregnancy were 14.7% and 24.6%, school attendance 77.6% and 68.7%, and employment 21.2% and 32.3% at 1 and 2 years, respectively. Conclusions. A medical home model with comprehensive and integrated medical care and social services can effectively address the complex needs of adolescent parents and their children. PMID:22897537

  14. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Remedios López-Liria

    2015-01-01

    Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

  15. Curcumin homing to the nucleolus: mechanism for initiation of an apoptotic program.

    Science.gov (United States)

    Ghosh, Mistuni; Ryan, Robert O

    2014-11-01

    Curcumin is a plant-derived polyphenol that displays antitumor properties. Incubation of cultured SF-767 glioma cells with curcumin gave rise to intense intranuclear foci of curcumin fluorescence. In vitro studies revealed that nuclear homing by curcumin is not a result of DNA/chromatin binding. On the other hand, curcumin fluorescence colocalized with nucleophosmin, a nucleolus marker protein. To determine the temporal relationship between curcumin-induced apoptosis and nucleolar homing, confocal live cell imaging was performed. The data show that curcumin localization to the nucleolus occurs prior to cell surface exposure of phosphatidylserine. In studies of the mechanism of curcumin-induced apoptosis in SF-767 cells, its effect on the subcellular location of p14(ARF) was determined. Whereas p14(ARF) was confined to the nucleolus in untreated cells, 2 h following incubation with curcumin, it displayed a diffuse nuclear distribution. Given the role of nuclear p14(ARF) in binding the E3 ubiquitin ligase, mouse double minute 2 homolog (MDM2), the effect of curcumin treatment on cellular levels of the tumor suppressor protein, p53, was examined. Between 2 and 4 h following curcumin treatment, p53 levels increased with maximum levels reached by 8 h. Thus, curcumin homing to the nucleolus induces redistribution of p14(ARF) to the nucleoplasm where interaction with MDM2 leads to stabilization of p53, with subsequent initiation of apoptosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.

    Science.gov (United States)

    Geraedts, Hilde A E; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

    2014-06-07

    With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC. Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact. The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application of innovative technology in home

  17. Metaheuristics for the dynamic stochastic dial-a-ride problem with expected return transports.

    Science.gov (United States)

    Schilde, M; Doerner, K F; Hartl, R F

    2011-12-01

    The problem of transporting patients or elderly people has been widely studied in literature and is usually modeled as a dial-a-ride problem (DARP). In this paper we analyze the corresponding problem arising in the daily operation of the Austrian Red Cross. This nongovernmental organization is the largest organization performing patient transportation in Austria. The aim is to design vehicle routes to serve partially dynamic transportation requests using a fixed vehicle fleet. Each request requires transportation from a patient's home location to a hospital (outbound request) or back home from the hospital (inbound request). Some of these requests are known in advance. Some requests are dynamic in the sense that they appear during the day without any prior information. Finally, some inbound requests are stochastic. More precisely, with a certain probability each outbound request causes a corresponding inbound request on the same day. Some stochastic information about these return transports is available from historical data. The purpose of this study is to investigate, whether using this information in designing the routes has a significant positive effect on the solution quality. The problem is modeled as a dynamic stochastic dial-a-ride problem with expected return transports. We propose four different modifications of metaheuristic solution approaches for this problem. In detail, we test dynamic versions of variable neighborhood search (VNS) and stochastic VNS (S-VNS) as well as modified versions of the multiple plan approach (MPA) and the multiple scenario approach (MSA). Tests are performed using 12 sets of test instances based on a real road network. Various demand scenarios are generated based on the available real data. Results show that using the stochastic information on return transports leads to average improvements of around 15%. Moreover, improvements of up to 41% can be achieved for some test instances.

  18. Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial.

    Science.gov (United States)

    Bennell, Kim L; Campbell, Penny K; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S; Bunker, Stephen J; Hunter, David J; Brand, Caroline A; Hinman, Rana S

    2017-01-01

    To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data. A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes. The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program. © 2016, American College of Rheumatology.

  19. An international randomized study of a home-based self-management program for severe COPD: the COMET.

    Science.gov (United States)

    Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

    2016-01-01

    Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Multicenter parallel randomized controlled, open-label superiority trial. Thirty-three hospitals in four European countries. A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center's routine practice. Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs.

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

    Science.gov (United States)

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

    2015-01-01

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

  1. User Experience, Actual Use, and Effectiveness of an Information Communication Technology-Supported Home Exercise Program for Pre-Frail Older Adults

    NARCIS (Netherlands)

    Dekker-van Weering, Marit; Jansen-Kosterink, Stephanie; Frazer, Sanne; Vollenbroek-Hutten, Miriam

    2017-01-01

    Objective: The main objective of this study was to investigate the use and user experience of an Information Communication Technology-supported home exercise program when offered for independent use to pre-frail older adults. Our secondary aim was to explore whether the program improved quality of

  2. A home education program for older adults with hearing impairment and their significant others: a randomized trial evaluating short- and long-term effects

    NARCIS (Netherlands)

    Kramer, S.E.; Allessie, G.H.; Dondorp, A.W.; Zekveld, A.A.; Kapteyn, T.S.

    2005-01-01

    This paper addresses the development and effectiveness of a home education program. The program, designed for hearing-impaired elders and their significant others (SO), deals with communication strategies and speech reading. Participants were randomly assigned to a training group (hearing aid

  3. Incorporating Language Structure in a Communicative Task: An Analysis of the Language Component of a Communicative Task in the LINC Home Study Program

    Science.gov (United States)

    Lenchuk, Iryna

    2014-01-01

    The purpose of this article is to analyze a task included in the LINC Home Study (LHS) program. LHS is a federally funded distance education program offered to newcomers to Canada who are unable to attend regular LINC classes. A task, in which a language structure (a gerund) is chosen and analyzed, was selected from one instructional module of LHS…

  4. A community living management program for people with disabilities who have moved out of nursing homes: a pilot study.

    Science.gov (United States)

    Lee, Danbi; Hammel, Joy; Wilson, Tom

    2015-06-23

    This study describes implementation and evaluation of the Stepping Stones program, a community living management program designed to assist people with disabilities to gain community living skills after moving out of nursing homes. Thirteen people with diverse disabilities participated in the 10-week Stepping Stones program. The participants attended two sessions a day every week, over a 5-week period. Interviewer-administered surveys were used at baseline and 1 week post-intervention to evaluate the impact of the program. Focus group interviews were conducted at 1 week post-intervention. Analyses of quantitative data demonstrated improved self-efficacy in community living management skills, with medium-to-high effect sizes. Participants reported improved sense of empowerment and confidence in finding resources and managing community living. They also reported high satisfaction with the program. Preliminary findings suggest that the Stepping Stones program is beneficial to the target group. The study indicates that application of social learning and self-efficacy theories is effective to empower and enable people with disabilities to manage their lives in the community. The Stepping Stones program may be provided as a risk management intervention after individuals' transition into the community. Implications for Rehabilitation Long-term institutionalization negatively influences people with disabilities' self-esteem, autonomy and ability to independently live in the community. Successful community living requires complex management involving the coordination of personal, social, resource and environmental factors. This study shows that programming on choice and control and community living skill development improved participants' confidence in managing community living.

  5. Effect of a home-based exercise program on functional recovery following rehabilitation after hip fracture: a randomized clinical trial.

    Science.gov (United States)

    Latham, Nancy K; Harris, Bette Ann; Bean, Jonathan F; Heeren, Timothy; Goodyear, Christine; Zawacki, Stacey; Heislein, Diane M; Mustafa, Jabed; Pardasaney, Poonam; Giorgetti, Marie; Holt, Nicole; Goehring, Lori; Jette, Alan M

    2014-02-19

    For many older people, long-term functional limitations persist after a hip fracture. The efficacy of a home exercise program with minimal supervision after formal hip fracture rehabilitation ends has not been established. To determine whether a home exercise program with minimal contact with a physical therapist improved function after formal hip fracture rehabilitation ended. Randomized clinical trial conducted from September 2008 to October 2012 in the homes of 232 functionally limited older adults who had completed traditional rehabilitation after a hip fracture. The intervention group (n = 120) received functionally oriented exercises (such as standing from a chair, climbing a step) taught by a physical therapist and performed independently by the participants in their homes for 6 months. The attention control group (n = 112) received in-home and telephone-based cardiovascular nutrition education. Physical function assessed at baseline, 6 months (ie, at completion of the intervention), and 9 months by blinded assessors. The primary outcome was change in function at 6 months measured by the Short Physical Performance Battery (SPPB; range 0-12, higher score indicates better function) and the Activity Measure for Post-Acute Care (AM-PAC) mobility and daily activity (range, 23-85 and 9-101, higher score indicates better function). Among the 232 randomized patients, 195 were followed up at 6 months and included in the primary analysis. The intervention group (n=100) showed significant improvement relative to the control group (n=95) in functional mobility (mean SPPB scores for intervention group: 6.2 [SD, 2.7] at baseline, 7.2 [SD, 3] at 6 months; control group: 6.0 [SD, 2.8] at baseline, 6.2 [SD, 3] at 6 months; and between-group differences: 0.8 [95% CI, 0.4 to 1.2], P daily activity scores for intervention group: 57.4 [SD, 13.7] at baseline, 61.3 [SD, 15.7] at 6 months; control group: 58.2 [SD, 15.2] at baseline, 58.6 [SD, 15.3] at 6 months; and

  6. The political economy of a public health case management program's transition into medical homes.

    Science.gov (United States)

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

  7. [Effects of an infant/toddler health program on parenting knowledge, behavior, confidence, and home environment in low-income mothers].

    Science.gov (United States)

    Lee, Gyungjoo; Yang, Soo; Jang, Mi Heui; Yeom, Mijung

    2012-10-01

    This study was conducted to evaluate the effectiveness of a mother/infant-toddler health program developed to enhance parenting knowledge, behavior and confidence in low income mothers and home environment. A one-group pretest-posttest quasi-experimental design was used. Sixty-nine dyads of mothers and infant-toddlers (aged 0-36 months) were provided with weekly intervention for seven session. Each session consisted of three parts; first, educating to increase integrated knowledge related to the development of the infant/toddler including nutrition, first aid and home environment; second, counseling to share parenting experience among the mothers and to increase their nurturing confidence; third, playing with the infant/toddler to facilitate attachment-based parenting behavior for the mothers. Following the programs, there were significant increases in parenting knowledge on nutrition and first aid. A significant improvement was found in attachment-based parenting behavior, but not in home safety practice. Nurturing confidence was not significantly increased. The program led to more positive home environment for infant/toddler's health and development. The findings provide evidence for mother-infant/toddler health program to improve parenting knowledge, attachment-based parenting behavior and better home environment in low income mothers. Study of the long term effectiveness of this program is recommended for future research.

  8. Optimizing itineraries in public transportation with walks between rides

    NARCIS (Netherlands)

    de Jonge, Bram; Teunter, Ruud H.

    We study the problem of finding an optimal itinerary to travel from a starting location to a destination location using public transport, where we allow travelers to alternate rides with (short) walks. The main difference with previous research is that we take all possible walks that a traveler can

  9. mitigating mitigating free riding in peer-to-peer networks

    African Journals Online (AJOL)

    eobe

    The performance of peer-to-peer systems is based on the quality and quantity of resource contributions from peer systems ... riding [3]. There are several measurement studies ...... J. S. Hua, D. C. Huang, S M Yen, and C. W. Chena, “A dynamic.

  10. Undoing Quantitative Easing: Janet Yellen's Tiger Ride

    Science.gov (United States)

    Niederjohn, M. Scott; Schug, Mark C.; Wood, William C.

    2014-01-01

    "One who rides a tiger is afraid to dismount," says a colorful proverb from an earlier time. This may be an apt saying for the situation facing the new head of the Federal Reserve, Janet L. Yellen, who takes over at a time when successive rounds of Fed policy have taken the central bank into uncharted territory. By historical standards,…

  11. A participatory sensing approach to characterize ride quality

    Science.gov (United States)

    Bridgelall, Raj

    2014-03-01

    Rough roads increase vehicle operation and road maintenance costs. Consequently, transportation agencies spend a significant portion of their budgets on ride-quality characterization to forecast maintenance needs. The ubiquity of smartphones and social media, and the emergence of a connected vehicle environment present lucrative opportunities for cost-reduction and continuous, network-wide, ride-quality characterization. However, there is a lack of models to transform inertial and position information from voluminous data flows into indices that transportation agencies currently use. This work expands on theories of the Road Impact Factor introduced in previous research. The index characterizes road roughness by aggregating connected vehicle data and reporting roughness in direct proportion to the International Roughness Index. Their theoretical relationships are developed, and a case study is presented to compare the relative data quality from an inertial profiler and a regular passenger vehicle. Results demonstrate that the approach is a viable alternative to existing models that require substantially more resources and provide less network coverage. One significant benefit of the participatory sensing approach is that transportation agencies can monitor all network facilities continuously to locate distress symptoms, such as frost heaves, that appear and disappear between ride assessment cycles. Another benefit of the approach is continuous monitoring of all high-risk intersections such as rail grade crossings to better understand the relationship between ride-quality and traffic safety.

  12. Minimum Makespan Multi-vehicle Dial-a-Ride

    DEFF Research Database (Denmark)

    Gørtz, Inge Li; Nagarajan, Viswanath; Ravi, R.

    2009-01-01

    be left at intermediate vertices and transported by more than one vehicle, while being moved from source to destination. Approximation algorithms for the single vehicle Dial-a-Ride problem (q = 1) have been considered in [3,10]. Our main results are an O(log3n)-approximation algorithm for preemptive multi...

  13. Free riding and the provision of candy bars

    NARCIS (Netherlands)

    Haan, M.A.; Kooreman, P.

    A wealth of experimental literature studies the effect of repetition and group size on the extent of free riding in the provision of public goods. In this paper, we use data from honor systems for candy bars in 166 firms to test whether such effects can be found outside the laboratory. We find that

  14. Effect of Health Education on the Riding Habits of Commercial ...

    African Journals Online (AJOL)

    METHODS: The intervention study was conducted among commercial motorcyclists in Uyo with controls from another town in Akwa Ibom State. Baseline information was collected from both groups on their riding habits. Motorcyclists in Uyo were educated on appropriate road safety practices. Data was collected from both ...

  15. Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

    Science.gov (United States)

    Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

    2016-03-01

    Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

  16. Effectiveness of the home-based alcohol prevention program "In control: No alcohol!": study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Verdurmen Jacqueline EE

    2011-08-01

    Full Text Available Abstract Background In the Netherlands, children start to drink at an early age; of the Dutch 12-year olds, 40% reports lifetime alcohol use, while 9.7% reports last-month drinking. Starting to drink at an early age puts youth at risk of developing several alcohol-related problems later in life. Recently, a home-based prevention program called "In control: No alcohol!" was developed to delay the age of alcohol onset in children. The main aim of this project is to conduct a Randomized Controlled Trial (RCT to evaluate the effectiveness of the program. Methods/Design The prevention program will be tested with an RCT among mothers and their 6 grade primary school children (11-12 years old, randomly assigned to the prevention or control condition. The program consists of five printed magazines and an activity book designed to improve parental alcohol-specific socialization. Parent-child dyads in the control group receive a factsheet information brochure, which is the standard alcohol brochure of the Trimbos Institute (the Netherlands Institute for Mental Health and Addiction. Outcome measures are initiation of alcohol use (have been drinking at least one glass of alcohol, alcohol-specific parenting, susceptibility to drinking alcohol, alcohol expectancies, self-efficacy, and frequency and intensity of child alcohol use. Questionnaires will be administered online on secured Internet webpages, with personal login codes for both mothers and children. Mothers and children in both the experimental and control condition will be surveyed at baseline and after 6, 12, and 18 months (follow-ups. Discussion The present study protocol presents the design of an RCT evaluating the effectiveness of the home-based "In control: No alcohol!" program for 6 grade primary school children (11-12 years old. It is hypothesized that children in the prevention condition will be less likely to have their first glass of alcohol, compared to the control condition. When the

  17. Effect of a health coaching self-management program for older adults with multimorbidity in nursing homes

    Directory of Open Access Journals (Sweden)

    Park YH

    2014-07-01

    Full Text Available Yeon-Hwan Park,1,2 HeeKyung Chang31College of Nursing, 2The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea; 3Seoul Women’s College of Nursing, Seoul, South KoreaBackground and aims: Although a growing number of older people are suffering from multimorbidity, most of the health problems related to multimorbidity can be improved by self-management. The aim of this study was to examine the effectiveness of a health coaching self-management program for older adults with multimorbidity in nursing homes. Methods: Older adults with multimorbidity from one nursing home in Korea were randomly allocated to either an intervention group (n=22 or conventional group (n=21. Participants in the intervention group met face to face with the researchers twice a week for 8 weeks, during which time the researchers engaged them in goal setting and goal performance using the strategies in the health coaching self-management program. Regular care was provided to the other participants in the conventional group. Results: Participants in the intervention group had significantly better outcomes in exercise behaviors (P=0.015, cognitive symptom management (P=0.004, mental stress management/relaxation (P=0.023, self-rated health (P=0.002, reduced illness intrusiveness (P<0.001, depression (P<0.001, and social/role activities limitations (P<0.001. In addition, there was a significant time-by-group interaction in self-efficacy (P=0.036. According to the goal attainment scales, their individual goals of oral health and stress reduction were achieved.Conclusion: The health coaching self-management program was successfully implemented in older adults with multimorbidity in a nursing home. Further research is needed to develop and evaluate the long-term effects of an intervention to enhance adherence to self-management and quality of life for older adults with multimorbidity.Keywords: chronic diseases, nursing intervention, older adults

  18. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    Science.gov (United States)

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs. © 2017 Michigan Association for Infant Mental Health.

  19. Pregnancy and Village Outreach Tibet: a descriptive report of a community- and home-based maternal-newborn outreach program in rural Tibet.

    Science.gov (United States)

    Dickerson, Ty; Crookston, Benjamin; Simonsen, Sara E; Sheng, Xiaoming; Samen, Arlene; Nkoy, Flory

    2010-01-01

    The Pregnancy and Village Outreach Tibet (PAVOT) program, a model for community- and home-based maternal-newborn outreach in rural Tibet, is presented. This article describes PAVOT, including the history, structure, content, and activities of the program, as well as selected program outcome measures and demographic characteristics, health behaviors, and pregnancy outcomes of women who recently participated in the program. The PAVOT program was developed to provide health-related services to pregnant rural Tibetan women at risk of having an unattended home birth. The program involves training local healthcare workers and laypersons to outreach pregnant women and family members. Outreach includes basic maternal-newborn health education and simple obstetric and neonatal life-saving skills training. In addition, the program distributes safe and clean birth kits, newborn hats, blankets, and maternal micronutrient supplements (eg, prenatal vitamins and minerals). More than 980 pregnant women received outreach during the study period. More than 92% of outreach recipients reported receiving safe pregnancy and birth education, clean birthing and uterine massage skills instruction, and clean umbilical cord care training. Nearly 80% reported basic newborn resuscitation skills training. Finally, nearly 100% of outreach recipients received maternal micronutrient supplements and safe and clean birth kits. The PAVOT program is a model program that has been proven to successfully provide outreach to rural-living Tibetans by delivering maternal-newborn health education, skills training, and resources to the home.

  20. Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Morris Meg E

    2012-07-01

    Full Text Available Abstract Background The high incidence of falls associated with Parkinson’s disease (PD increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated. Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education or a home-based life skills program (control intervention. Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined. Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD. Trial registration The trial is registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12608000390381.

  1. 76 FR 22713 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-04-22

    ... specified in the Affordable Care Act (such as maternal and child health status, school readiness, and domestic violence, among others); (b) the effectiveness of such programs on different populations...

  2. Mental models of adherence: parallels in perceptions, values, and expectations in adherence to prescribed home exercise programs and other personal regimens.

    Science.gov (United States)

    Rizzo, Jon; Bell, Alexandra

    2018-05-09

    A mental model is the collection of an individual's perceptions, values, and expectations about a particular aspect of their life, which strongly influences behaviors. This study explored orthopedic outpatients mental models of adherence to prescribed home exercise programs and how they related to mental models of adherence to other types of personal regimens. The study followed an interpretive description qualitative design. Data were collected via two semi-structured interviews. Interview One focused on participants prior experiences adhering to personal regimens. Interview Two focused on experiences adhering to their current prescribed home exercise program. Data analysis followed a constant comparative method. Findings revealed similarity in perceptions, values, and expectations that informed individuals mental models of adherence to personal regimens and prescribed home exercise programs. Perceived realized results, expected results, perceived social supports, and value of convenience characterized mental models of adherence. Parallels between mental models of adherence for prescribed home exercise and other personal regimens suggest that patients adherence behavior to prescribed routines may be influenced by adherence experiences in other aspects of their lives. By gaining insight into patients adherence experiences, values, and expectations across life domains, clinicians may tailor supports that enhance home exercise adherence. Implications for Rehabilitation A mental model is the collection of an individual's perceptions, values, and expectations about a particular aspect of their life, which is based on prior experiences and strongly influences behaviors. This study demonstrated similarity in orthopedic outpatients mental models of adherence to prescribed home exercise programs and adherence to personal regimens in other aspects of their lives. Physical therapists should inquire about patients non-medical adherence experiences, as strategies patients

  3. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: study protocol for a pragmatic randomised controlled trial.

    Science.gov (United States)

    Burton, Elissa; Lewin, Gill; Clemson, Lindy; Boldy, Duncan

    2013-10-18

    Restorative home care services help older people maximise their independence using a multi-dimensional approach. They usually include an exercise program designed to improve the older person's strength, balance and function. The types of programs currently offered require allocation of time during the day to complete specific exercises. This is not how the majority of home care clients prefer to be active and may be one of the reasons that few older people do the exercises regularly and continue the exercises post discharge.This paper describes the study protocol to test whether a Lifestyle Functional Exercise (LiFE) program: 1) is undertaken more often; 2) is more likely to be continued over the longer term; and, 3) will result in greater functional gains compared to a standard exercise program for older people receiving a restorative home care service. A pragmatic randomised controlled trial (RCT) design was employed with two study arms: LiFE program (intervention) and the current exercise program (control). Silver Chain, a health and community care organisation in Perth, Western Australia. One hundred and fifty restorative home care clients, aged 65 years and older. The primary outcome is a composite measure incorporating balance, strength and mobility. Other outcome measures include: physical functioning, falls efficacy, and levels of disability and functioning. If LiFE is more effective than the current exercise program, the evidence will be presented to the service management accompanied by the recommendation that it be adopted as the generic exercise program to be used within the restorative home care service. Australian and New Zealand Clinical Trials Registry ACTRN12611000788976.

  4. A home program of strength training, movement strategy training and education did not prevent falls in people with Parkinson’s disease: a randomised trial

    Directory of Open Access Journals (Sweden)

    Meg E Morris

    2017-04-01

    Conclusion: A home program of strength and movement strategy training and falls education does not prevent falls when applied at the dose used in this study. Arguably, the dosage of therapy was insufficient. Future trials need to explore further therapy content, repetitions and duration, in order to optimise outcomes and cost-effectiveness. [Morris ME, Taylor NF, Watts JJ, Evans A, Horne M, Kempster P, Danoudis M, McGinley J, Martin C, Menz HB (2017 A home program of strength training, movement strategy training and education did not prevent falls in people with Parkinson’s disease: a randomised trial. Journal of Physiotherapy 63: 94–100

  5. Masalah-Masalah yang Dihadapi Siswa yang Berasal dari Keluarga Broken Home dan Implikasinya terhadap Program Layanan Bimbingan dan Konseling

    Directory of Open Access Journals (Sweden)

    Sharfina Rahmi

    2016-12-01

    Full Text Available Abstract, broken home’s family is the family that function of father and mother do not work functionally. Child that experience this situation called broken home child. This research aim’s to look at the description of the problems that face by student who wellborn in broken home’s family in SMA N 1 Banuhampu. This research is descriptive research, that see problems which are faced by student who wellborn in broken home’s family. The subject of this research is 39 students. Research instrument is questionnaire. The results of this research is the student have a problems in academic, themselves, family lives and peer relations. In this situation guidance and counseling teacher could arrange guidance and counseling service program that match with problems of students who from broken home’s family.

  6. Outcomes of home-based employment service programs for people with disabilities and their related factors--a preliminary study in Taiwan.

    Science.gov (United States)

    Lin, Yi-Jiun; Huang, I-Chun; Wang, Yun-Tung

    2014-01-01

    The aim of this exploratory study is to gain an understanding of the outcomes of home-based employment service programs for people with disabilities and their related factors in Taiwan. This study used survey method to collect 132 questionnaires. Descriptive and two-variable statistics including chi-square (χ(2)), independent sample t-test and analysis of variance were employed. The results found that 36.5% of the subjects improved their employment status and 75.8% of them improved in employability. Educational level and and vocational categories including "web page production", "e-commerce", "internet marketing", "on-line store" and "website set-up and management" were significantly "positively" associated with either of the two outcome indicators - change of employment status and employability. This study is the first evidence-based study about the outcomes of home-based employment service programs and their related factors for people with disabilities in Taiwan. The outcomes of the home-based employment service programs for people with disabilities were presented. Implications for Rehabilitation Home-based rehabilitation for people with disabilities can be effective. A programme of this kind supports participants in improving or gaining employment status as well as developing employability skills. Further consideration should be given to developing cost-effective home-based programmes and evaluating their effectiveness.

  7. Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol.

    Science.gov (United States)

    Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

    2015-10-01

    To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care. The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care. Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups. During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014. Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300. © 2015 John Wiley & Sons Ltd.

  8. Effectiveness of a San Francisco Bay area community education program on reducing home energy use

    Science.gov (United States)

    Wilkinson, Ellen M.

    In order to promote the adoption of home energy reduction practices and mitigate the climate impact of the collective greenhouse gas emissions generated by consumers, it is critical to identify an effective educational approach. A community-based educational intervention model that employs norms, information, commitment, feedback, and face-to-face communication strategies was examined for its ability to motivate changes in everyday energy-use behavior in two communities compared to a control group. A follow up study was also conducted to evaluate whether behaviors adopted as a result of the intervention were long lasting, and whether the community-focused features of the intervention were motivating to participants. Results showed that a greater number of individuals participated in the intervention over its five-month duration, reported significantly higher numbers of adopted behaviors, and maintained more adopted behaviors post-intervention than did people in the control group. In addition, intervention participants reported that some of the community-based features of the intervention motivated their behavior changes. These findings lend support to a number of social and community psychology theories about how to design effective interventions by leveraging social awareness and support.

  9. Does the Texas First Dental Home Program Improve Parental Oral Care Knowledge and Practices?

    Science.gov (United States)

    Thompson, Charmaine L; McCann, Ann L; Schneiderman, Emet D

    2017-03-15

    This study evaluated the effectiveness of the Texas Medicaid First Dental Home (FDH) by comparing the oral health knowledge, practices, and opinions of participating vs. non-participating parents. A 29-question survey (English & Spanish) was developed and administered to 165 parents of children under three years old (FDH=49, Non-FDH=116) who visited qualifying Medicaid clinics in Texas. Mann Whitney U tests showed that FDH parents scored higher on overall knowledge (P=0.001) and practice scores (Pparents responded correctly more often than non-FDH about the recommended amount of toothpaste for toddlers (Pparents knew tap water was a potential source of fluoride (Pparents scored marginally higher about when a child should have the first dental visit (P=0.051). More Non-FDH parents let their child go to sleep with a bottle, sippy cup or pacifier (Pparents by increasing their oral healthcare knowledge and practices. This is the first step towards improving the oral health of children.

  10. Hospital-at-home Integrated Care Program for Older Patients With Orthopedic Processes: An Efficient Alternative to Usual Hospital-Based Care.

    Science.gov (United States)

    Closa, Conxita; Mas, Miquel À; Santaeugènia, Sebastià J; Inzitari, Marco; Ribera, Aida; Gallofré, Miquel

    2017-09-01

    To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. Quasi-experimental longitudinal study. An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty. Patients were referred to a hospital-at-home integrated care unit or to standard hospital-based postacute orthogeriatric unit, based on their social support and availability of the resource. We compared home-based care versus hospital-based care for Relative Functional Gain (gain/loss of function measured by the Barthel Index), mean direct costs, and potential savings in terms of reduction of stay in the acute care hospital. No differences were found in Relative Functional Gain, median (Q25-Q75) = 0.92 (0.64-1.09) in the home-based group versus 0.93 (0.59-1) in the hospital-based group, P =.333. Total health service direct cost [mean (standard deviation)] was significantly lower for patients receiving home-based care: €7120 (3381) versus €12,149 (6322), P home-based care [10.1 (7)] than in patients discharged to the postacute orthogeriatric hospital-based unit [15.3 (12) days, P home integrated care program was suitable for managing older patients with orthopedic conditions who have good social support for home care. It provided clinical care comparable to the hospital-based model, and it seems to enable earlier acute hospital discharge and lower direct costs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  11. Reaching mothers and babies with early postnatal home visits: the implementation realities of achieving high coverage in large-scale programs.

    Directory of Open Access Journals (Sweden)

    Deborah Sitrin

    Full Text Available BACKGROUND: Nearly half of births in low-income countries occur without a skilled attendant, and even fewer mothers and babies have postnatal contact with providers who can deliver preventive or curative services that save lives. Community-based maternal and newborn care programs with postnatal home visits have been tested in Bangladesh, Malawi, and Nepal. This paper examines coverage and content of home visits in pilot areas and factors associated with receipt of postnatal visits. METHODS: Using data from cross-sectional surveys of women with live births (Bangladesh 398, Malawi: 900, Nepal: 615, generalized linear models were used to assess the strength of association between three factors - receipt of home visits during pregnancy, birth place, birth notification - and receipt of home visits within three days after birth. Meta-analytic techniques were used to generate pooled relative risks for each factor adjusting for other independent variables, maternal age, and education. FINDINGS: The proportion of mothers and newborns receiving home visits within three days after birth was 57% in Bangladesh, 11% in Malawi, and 50% in Nepal. Mothers and newborns were more likely to receive a postnatal home visit within three days if the mother received at least one home visit during pregnancy (OR2.18, CI1.46-3.25, the birth occurred outside a facility (OR1.48, CI1.28-1.73, and the mother reported a CHW was notified of the birth (OR2.66, CI1.40-5.08. Checking the cord was the most frequently reported action; most mothers reported at least one action for newborns. CONCLUSIONS: Reaching mothers and babies with home visits during pregnancy and within three days after birth is achievable using existing community health systems if workers are available; linked to communities; and receive training, supplies, and supervision. In all settings, programs must evaluate what community delivery systems can handle and how to best utilize them to improve postnatal care

  12. A Mobile Health App-Based Postnatal Educational Program (Home-but not Alone): Descriptive Qualitative Study.

    Science.gov (United States)

    Shorey, Shefaly; Yang, Yen Yen; Dennis, Cindy-Lee

    2018-04-19

    The postnatal period poses numerous challenges for new parents. Various educational programs are available to support new parents during this stressful period. However, the usefulness of educational programs must be evaluated to ascertain their credibility. The aim of this descriptive, qualitative study was to explore the views of parents of newborns with regard to the content and delivery of a mobile health (mHealth) app-based postnatal educational program. A qualitative semistructured interview guide was used to collect data from 17 participants who belonged to the intervention group of a randomized controlled trial. The intervention, a 4-week-long access to a mHealth app-based educational program, was evaluated. The interviews were conducted in English and at the participants' homes. Thematic analysis was used to analyze the data. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the findings. The interviews revealed 4 main themes: (1) positive features of the mHealth app, (2) advice from midwives, (3) experiences gained from using the mHealth app, and (4) recommendations for the future. The participants evaluated the educational program to be a good source of information that was tailored to the local context. The different modes of delivery, including audio and video, accentuated the accessibility of information. The parents evaluated that the facilitator of the featured communication platform, a midwife, provided trustworthy advice. Belongingness to a virtual community beyond the hospital endowed the parents the confidence that they were not alone and were supported by other parents and health care professionals. According to the parents, the mHealth app-based educational program was helpful in supporting a multi-ethnic sample of parents during the postnatal period. This insight indicates that the program could be implemented in a wide community of parents in the postnatal period. The helpfulness of the educational

  13. Outcomes and Pharmacoeconomic Analysis of a Home Intravenous Antibiotic Infusion Program in Veterans.

    Science.gov (United States)

    Ruh, Christine A; Parameswaran, Ganapathi I; Wojciechowski, Amy L; Mergenhagen, Kari A

    2015-11-01

    The use of outpatient parenteral antibiotic therapy (OPAT) programs has become more frequent because of benefits in costs with equivalent clinical outcomes compared with inpatient care. The purpose of this study was to evaluate the outcomes of our program. A modified pharmacoeconomic analysis was performed to compare costs of our program with hospital or rehabilitation facility care. This was a retrospective chart review of 96 courses of OPAT between April 1, 2011, and July 31, 2013. Clinical failures were defined as readmission or death due to worsening infection or readmission secondary to adverse drug event (ADE) to antibiotic therapy. This does not include those patients readmitted for reasons not associated with OPAT therapy, including comorbidities or elective procedures. Baseline characteristics and program-specific data were analyzed. Statistically significant variables were built into a multivariate logistic regression model to determine predictors of failure. A pharmacoeconomic analysis was performed with the use of billing records. Of the total episodes evaluated, 17 (17.71%) clinically failed therapy, and 79 (82.29%) were considered a success. In the multivariate analysis, number of laboratory draws (P = 0.02) and occurrence of drug reaction were significant in the final model, P = 0.02 and P = 0.001, respectively. The presence an adverse drug reaction increases the odds of failure (OR = 10.10; 95% CI, 2.69-44.90). Compared with inpatient or rehabilitation care, the cost savings was $6,932,552.03 or $2,649,870.68, respectively. In our study, patients tolerated OPAT well, with a low number of failures due to ADE. The clinical outcomes and cost savings of our program indicate that OPAT can be a viable alternative to long-term inpatient antimicrobial therapy. Published by Elsevier Inc.

  14. Ride control of surface effect ships using distributed control

    Directory of Open Access Journals (Sweden)

    Asgeir J. Sørensen

    1994-04-01

    Full Text Available A ride control system for active damping of heave and pitch accelerations of Surface Effect Ships (SES is presented. It is demonstrated that distributed effects that are due to a spatially varying pressure in the air cushion result in significant vertical vibrations in low and moderate sea states. In order to achieve a high quality human comfort and crew workability it is necessary to reduce these vibrations using a control system which accounts for distributed effects due to spatial pressure variations in the air cushion. A mathematical model of the process is presented, and collocated sensor and actuator pairs are used. The process stability is ensured using a controller with appropriate passivity properties. Sensor and actuator location is also discussed. The performance of the ride control system is shown by power spectra of the vertical accelerations obtained from full scale experiments with a 35 m SES.

  15. Radiative inflation and dark energy RIDEs again after BICEP2

    International Nuclear Information System (INIS)

    Bari, Pasquale Di; King, Stephen F.; Merle, Alexander; Luhn, Christoph; Schmidt-May, Angnis

    2014-01-01

    Following the ground-breaking measurement of the tensor-to-scalar ratio r=0.20 +0.07 -0.05 by the BICEP2 collaboration, we perform a statistical analysis of a model that combines Radiative Inflation with Dark Energy (RIDE) based on the M 2 |Φ| 2 ln(|Φ| 2 /Λ 2 ) potential and compare its predictions to those based on the traditional chaotic inflation M 2 |Φ| 2 potential. We find a best-fit value in the RIDE model of r=0.18 as compared to r=0.17 in the chaotic model, with the spectral index being n S =0.96 in both models

  16. Hardness of Preemptive Finite Capacity Dial-a-Ride

    DEFF Research Database (Denmark)

    Gørtz, Inge Li

    2006-01-01

    In the Finite Capacity Dial-a-Ride problem the input is a metric space, a set of objects, each specifying a source and a destination, and an integer k---the capacity of the vehicle used for making the deliveries. The goal is to compute a shortest tour for the vehicle in which all objects can...... and Raghavachari [FOCS '98] gave a min{O(log N),O(k)}-approximation algorithm for the preemptive version of the problem. In this paper we show that the preemptive Finite Capacity Dial-a-Ride problem has no $min{O(log^{1/4-\\epsilon}N),k^{1-\\epsilon}}$-approximation algorithm for any $\\epsilon>0$ unless all problems...

  17. Tracing changes in families who participated in the home-start parenting program: parental sense of competence as mechanism of change.

    Science.gov (United States)

    Deković, Maja; Asscher, Jessica J; Hermanns, Jo; Reitz, Ellen; Prinzie, Peter; van den Akker, Alithe L

    2010-09-01

    The present study aimed to (1) determine the long-term effectiveness of Home-Start, a preventive parenting program, and (2) test the hypothesis that changes in maternal sense of competence mediate the program's effects. Participants were 124 mothers (n = 66 intervention, n = 58 comparison). Four assessments took place during a 1-year period. Latent growth modeling showed that Home-Start enhanced growth in maternal sense of competence and supportive parenting, and led to a decrease in the use of inept discipline. Results of mediational and cross-lagged analyses were consistent with the hypothesized model: Participation in Home-Start was related to the changes in maternal sense of competence, which in turn predicted changes in parenting. The results affirm the importance of directly targeting parental sense of competence in the context of prevention work with parents.

  18. The Use of Computer-Assisted Home Exercises to Preserve Physical Function after a Vestibular Rehabilitation Program: A Randomized Controlled Study

    DEFF Research Database (Denmark)

    Brandt, Michael Smærup; Læssøe, Uffe; Grönvall, Erik

    2016-01-01

    . Materials and Methods. Single-blind, randomized, controlled follow-up study. Fifty-seven elderly patients with chronic dizziness were randomly assigned to a computer-assisted home exercise program or to home exercises as described in printed instructions and followed for tree month after discharge from......, and quality of life three months following discharge from hospital. In this specific setup, no greater effect was found by introducing a computer-assisted training program, when compared to standard home training guided by printed instructions. This trial is registered with NCT01344408.......Objective. The purpose of this study was to evaluate whether elderly patients with vestibular dysfunction are able to preserve physical functional level, reduction in dizziness, and the patient's quality of life when assistive computer technology is used in comparison with printed instructions...

  19. Solving the Dial-a-Ride Problem using Genetic algorithms

    DEFF Research Database (Denmark)

    Bergvinsdottir, Kristin Berg; Larsen, Jesper; Jørgensen, Rene Munk

    In the Dial-a-Ride problem (DARP) customers send transportation requests to an operator. A request consists of a specified pickup location and destination location along with a desired departure or arrival time and demand. The aim of DARP is to minimize transportation cost while satisfying custom...... routing problems for the vehicles using a routing heuristic. The algorithm is implemented in Java and tested on publicly available data sets....

  20. Union Free-Riding in Britain and New Zealand

    OpenAIRE

    Alex Bryson

    2006-01-01

    The percentage of workers who choose not to join the union available to them at their workplace has been rising in Britain and New Zealand. Social custom, union instrumentality, the fixed costs of joining, employee perceptions of management attitudes to unionization and employee problems at work all influence the propensity to free-ride. Ideological convictions regarding the role of unions also play some role, as do private excludable goods. There is little indication of employer-inspired pol...

  1. Process evaluation of two home-based bimanual training programs in children with unilateral cerebral palsy (the COAD-study): protocol for a mixed methods study.

    Science.gov (United States)

    Beckers, Laura; van der Burg, Jan; Janssen-Potten, Yvonne; Rameckers, Eugène; Aarts, Pauline; Smeets, Rob

    2018-04-24

    As part of the COAD-study two home-based bimanual training programs for young children with unilateral Cerebral Palsy (uCP) have been developed, both consisting of a preparation phase and a home-based training phase. Parents are coached to use either an explicit or implicit motor learning approach while teaching bimanual activities to their child. A process evaluation of these complex interventions is crucial in order to draw accurate conclusions and provide recommendations for implementation in clinical practice and further research. The aim of the process evaluation is to systematically assess fidelity of the home-based training programs, to examine the mechanisms that contribute to their effects on child-related and parent-related outcomes, and to explore the influence of contextual factors. A mixed methods embedded design is used that emerges from a pragmatism paradigm. The qualitative strand involves a generic qualitative approach. The process evaluation components fidelity (quality), dose delivered (completeness), dose received (exposure and satisfaction), recruitment and context will be investigated. Data collection includes registration of attendance of therapists and remedial educationalists to a course regarding the home-based training programs; a questionnaire to evaluate this course by the instructor; a report form concerning the preparation phase to be completed by the therapist; registration and video analyses of the home-based training; interviews with parents and questionnaires to be filled out by the therapist and remedial educationalist regarding the process of training; and focus groups with therapists and remedial educationalists as well as registration of drop-out rates and reasons, to evaluate the overall home-based training programs. Inductive thematic analysis will be used to analyse qualitative data. Qualitative and quantitative findings are merged through meta-inference. So far, effects of home-based training programs in paediatric

  2. A multicomponent exercise program improves physical function in long-term nursing home residents: A randomized controlled trial.

    Science.gov (United States)

    Arrieta, Haritz; Rezola-Pardo, Chloe; Zarrazquin, Idoia; Echeverria, Iñaki; Yanguas, Jose Javier; Iturburu, Miren; Gil, Susana Maria; Rodriguez-Larrad, Ana; Irazusta, Jon

    2018-03-01

    To investigate the impact of a multicomponent exercise program on anthropometry, physical function, and physical activity on older adults living in long-term nursing homes (LTNH), we conducted a randomized controlled trial involving 112 participants aged 84.9 ± 6.9 years. Participants were randomly assigned to an intervention (IG) or control group (CG). The IG participated in a 3-month multicomponent exercise intervention focused on strength, balance, stretching exercises, and walking recommendations. Subjects in the CG participated in routine activities. Analyses of outcome parameters were performed in the entire sample and in two subgroups, classified according to participants' physical function score at baseline. The group-by-time interaction, favoring the IG, was significant for the entire sample and for the participants in the low physical function subgroup for the following parameters: waist circumference, 30-s chair-stand, arm-curl, 8-ft timed up-and-go, SPPB score, gait speed, and Berg scale (p < .05). In participants with higher physical function at baseline, significant group-by-time interaction was observed in the SPPB score and Berg scale (p < .05). When differences were analyzed within groups, the IG maintained or improved in all assessed parameters, while participants in the CG showed a marked decline. Our study showed that a multicomponent exercise program is effective for older people living in LTNH. This is especially relevant in those with lower physical function scores. The lower efficacy of the program in participants with better function might be due to the insufficient exercise demands of our intervention for more fit residents. Future studies should analyze the effects of programs with higher intensities in older people with intermediate to high physical function. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Effects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Batchelor, Frances A; Hill, Keith D; Mackintosh, Shylie F; Said, Catherine M; Whitehead, Craig H

    2012-09-01

    To determine whether a multifactorial falls prevention program reduces falls in people with stroke at risk of recurrent falls and whether this program leads to improvements in gait, balance, strength, and fall-related efficacy. A single blind, multicenter, randomized controlled trial with 12-month follow-up. Participants were recruited after discharge from rehabilitation and followed up in the community. Participants (N=156) were people with stroke at risk of recurrent falls being discharged home from rehabilitation. Tailored multifactorial falls prevention program and usual care (n=71) or control (usual care, n=85). Primary outcomes were rate of falls and proportion of fallers. Secondary outcomes included injurious falls, falls risk, participation, activity, leg strength, gait speed, balance, and falls efficacy. There was no significant difference in fall rate (intervention: 1.89 falls/person-year, control: 1.76 falls/person-year, incidence rate ratio=1.10, P=.74) or the proportion of fallers between the groups (risk ratio=.83, 95% confidence interval=.60-1.14). There was no significant difference in injurious fall rate (intervention: .74 injurious falls/person-year, control: .49 injurious falls/person-year, incidence rate ratio=1.57, P=.25), and there were no significant differences between groups on any other secondary outcome. This multifactorial falls prevention program was not effective in reducing falls in people with stroke who are at risk of falls nor was it more effective than usual care in improving gait, balance, and strength in people with stroke. Further research is required to identify effective interventions for this high-risk group. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Speech Auditory Alerts Promote Memory for Alerted Events in a Video-Simulated Self-Driving Car Ride.

    Science.gov (United States)

    Nees, Michael A; Helbein, Benji; Porter, Anna

    2016-05-01

    Auditory displays could be essential to helping drivers maintain situation awareness in autonomous vehicles, but to date, few or no studies have examined the effectiveness of different types of auditory displays for this application scenario. Recent advances in the development of autonomous vehicles (i.e., self-driving cars) have suggested that widespread automation of driving may be tenable in the near future. Drivers may be required to monitor the status of automation programs and vehicle conditions as they engage in secondary leisure or work tasks (entertainment, communication, etc.) in autonomous vehicles. An experiment compared memory for alerted events-a component of Level 1 situation awareness-using speech alerts, auditory icons, and a visual control condition during a video-simulated self-driving car ride with a visual secondary task. The alerts gave information about the vehicle's operating status and the driving scenario. Speech alerts resulted in better memory for alerted events. Both auditory display types resulted in less perceived effort devoted toward the study tasks but also greater perceived annoyance with the alerts. Speech auditory displays promoted Level 1 situation awareness during a simulation of a ride in a self-driving vehicle under routine conditions, but annoyance remains a concern with auditory displays. Speech auditory displays showed promise as a means of increasing Level 1 situation awareness of routine scenarios during an autonomous vehicle ride with an unrelated secondary task. © 2016, Human Factors and Ergonomics Society.

  5. The effect of therapeutic horseback riding on balance in community-dwelling older adults: a pilot study.

    Science.gov (United States)

    Homnick, Tamara D; Henning, Kim M; Swain, Charlene V; Homnick, Douglas N

    2015-02-01

    Equine assisted activities (hippotherapy and therapeutic riding) improve balance in patients with disabilities such as cerebral palsy, but have not been systematically studied in older adults, at risk of falls due to balance deficits. We conducted a 10-week, single blind, controlled trial of the effect of a therapeutic horseback riding course on measures of balance in community-dwelling adults 65 years and older. Nine riders and six controls completed the trial. Controls were age matched to riders and all participants were recruited from the local community. Both groups showed improvements in balance during the trial, but did not reach statistical significance. Sample size was small, participants had relatively high initial balance scores, and controls tended to increase their physical activities, likely influencing outcomes. No adverse events occurred and the supervised therapeutic riding program appeared to be a safe and effective form of exercise to improve balance in older adults. A power analysis was performed to estimate numbers of participants needed for a larger study. © The Author(s) 2012.

  6. From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya.

    Science.gov (United States)

    Tomedi, Angelo; Stroud, Sophia R; Maya, Tania Ruiz; Plaman, Christopher R; Mwanthi, Mutuku A

    2015-07-16

    To assess the effectiveness of a traditional birth attendant (TBA) referral program on increasing the number of deliveries overseen by skilled birth attendants (SBA) in rural Kenyan health facilities before and after the implementation of a free maternity care policy. In a rural region of Kenya, TBAs were recruited to educate pregnant women about the importance of delivering in healthcare facilities and were offered a stipend for every pregnant woman whom they brought to the healthcare facility. We evaluated the percentage of prenatal care (PNC) patients who delivered at the intervention site compared with the percentage of PNC patients who delivered at rural control facilities, before and after the referral program was implemented, and before and after the Kenya government implemented a policy of free maternity care. The window period of the study was from July of 2011 through September 2013, with a TBA referral intervention conducted from March to September 2013. The absolute increases from the pre-intervention period to the TBA referral intervention period in SBA deliveries were 5.7 and 24.0% in the control and intervention groups, respectively (p facility significantly increased compared to control health facilities when TBAs educated women about the need to deliver with a SBA and when TBAs received a stipend for bringing women to local health facilities to deliver. Furthermore, this TBA referral program proved to be far more effective in the target region of Kenya than a policy change to provide free obstetric care.

  7. Postural balance and falls in elderly nursing home residents enrolled in a ballroom dancing program.

    Science.gov (United States)

    da Silva Borges, Eliane Gomes; de Souza Vale, Rodrigo Gomes; Cader, Samária Ali; Leal, Silvania; Miguel, Francisco; Pernambuco, Carlos Soares; Dantas, Estélio H M

    2014-01-01

    The aim of this study was to investigate the influence of a ballroom dancing program on the postural balance of institutionalized elderly residents. The sample consisted of 59 sedentary elderly residents of long-stay institutions who were randomly assigned to a ballroom dancing experimental group (EG, n=30) or a control group (CG, n=29). The ballroom dancing program consisted of three 50-min sessions each week on alternate days over a 12-week period. The dances included the foxtrot, waltz, rumba, swing, samba and bolero. The medical records of the subjects were reviewed to determine the number of falls they experienced in the three months prior to the intervention. Postural static balance was assessed using a Lizard (Med. EU., Italy, 2010) stabilometric and posturometric platform. Only patients in the EG lost a significant amount of weight (Δ=-2.85 kg) when comparing the pre- and post-test postural balance assessments. The intergroup comparison revealed a reduced lower limb weight distribution difference in the EG post-test compared to the CG post-test (p=0.012). In the intragroup comparison, the EG patients experienced significantly fewer falls post-test relative to pre-test (pfalls in the EG post-test compared to the CG post-test (pbalance via a ballroom dancing program. This activity improved balance and reduced the number of falls in this elderly population. Copyright © 2014. Published by Elsevier Ireland Ltd.

  8. Harvesting Energy from the Counterbalancing (Weaving Movement in Bicycle Riding

    Directory of Open Access Journals (Sweden)

    Shashank Priya

    2012-07-01

    Full Text Available Bicycles are known to be rich source of kinetic energy, some of which is available for harvesting during speedy and balanced maneuvers by the user. A conventional dynamo attached to the rim can generate a large amount of output power at an expense of extra energy input from the user. However, when applying energy conversion technology to human powered equipments, it is important to minimize the increase in extra muscular activity and to maximize the efficiency of human movements. This study proposes a novel energy harvesting methodology that utilizes lateral oscillation of bicycle frame (weaving caused by user weight shifting movements in order to increase the pedaling force in uphill riding or during quick speed-up. Based on the 3D motion analysis, we designed and implemented the prototype of an electro-dynamic energy harvester that can be mounted on the bicycle’s handlebar to collect energy from the side-to-side movement. The harvester was found to generate substantial electric output power of 6.6 mW from normal road riding. It was able to generate power even during uphill riding which has never been shown with other approaches. Moreover, harvesting of energy from weaving motion seems to increase the economy of cycling by helping efficient usage of human power.

  9. Leisure riding horses: research topics versus the needs of stakeholders.

    Science.gov (United States)

    Janczarek, Iwona; Wilk, Izabela

    2017-07-01

    Horses intended for leisure riding do not undergo any selection and most often retired sports horses or defective horses are chosen, as a low selling price determines their purchase by a leisure riding center. Unfortunately, horses bought at low prices usually have low utility value, are difficult to handle, require a special or individual approach and do not provide satisfaction in riding. However, neither modern horse breeding nor scientific research address the need to breed horses for leisure activities. There is no clear definition of a model leisure horse and criteria or information for its selection are not readily available in scientific publications. A wide spectrum of research methods may be used to evaluate various performance traits in horses intended for leisure activities. The fact that the population of recreational horses and their riders outnumber sporting horses should attract the special attention of scientific research. Their utility traits need to be determined with modern technology and methods in the same way they are for sporting horses. Such a system of evaluation would be very helpful for riders. © 2017 Japanese Society of Animal Science.

  10. Harvesting energy from the counterbalancing (weaving) movement in bicycle riding.

    Science.gov (United States)

    Yang, Yoonseok; Yeo, Jeongjin; Priya, Shashank

    2012-01-01

    Bicycles are known to be rich source of kinetic energy, some of which is available for harvesting during speedy and balanced maneuvers by the user. A conventional dynamo attached to the rim can generate a large amount of output power at an expense of extra energy input from the user. However, when applying energy conversion technology to human powered equipments, it is important to minimize the increase in extra muscular activity and to maximize the efficiency of human movements. This study proposes a novel energy harvesting methodology that utilizes lateral oscillation of bicycle frame (weaving) caused by user weight shifting movements in order to increase the pedaling force in uphill riding or during quick speed-up. Based on the 3D motion analysis, we designed and implemented the prototype of an electro-dynamic energy harvester that can be mounted on the bicycle's handlebar to collect energy from the side-to-side movement. The harvester was found to generate substantial electric output power of 6.6 mW from normal road riding. It was able to generate power even during uphill riding which has never been shown with other approaches. Moreover, harvesting of energy from weaving motion seems to increase the economy of cycling by helping efficient usage of human power.

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  12. Effect of Home Exercise Program Performance in Patients with Osteoarthritis of the Knee or the Spine on the Visual Analog Scale after Discharge from Physical Therapy

    Science.gov (United States)

    Chen, Hamilton; Onishi, Kentaro

    2012-01-01

    The aim of our study was to assess the effect of the frequency of home exercise program (HEP) performance on pain [10-point visual analog scale (VAS)] in patients with osteoarthritis of the spine or knee after more than 6 months discharge from physical therapy (PT). We performed a retrospective chart review of 48 adult patients with a clinical…

  13. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring : design of a prospective cohort study

    NARCIS (Netherlands)

    Geraedts, Hilde A. E.; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

    2014-01-01

    Background: With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older

  14. A Home-Based Exercise Program Driven by Tablet Application and Mobility Monitoring for Frail Older Adults : Feasibility and Practical Implications

    NARCIS (Netherlands)

    Geraedts, Hilde A. E.; Zijlstra, Wiebren; Zhang, Wei; Spoorenberg, Sophie L. W.; Baez, Marcos; Far, Iman Khaghani; Baldus, Heribert; Stevens, Martin

    2017-01-01

    INTRODUCTION: Stimulation of a physically active lifestyle among older adults is essential to health and well-being. The objective of this study was to evaluate the feasibility and user opinion of a home-based exercise program supported by a sensor and tablet application for frail older adults.

  15. Delaying second births among adolescent mothers: a randomized, controlled trial of a home-based mentoring program.

    Science.gov (United States)

    Black, Maureen M; Bentley, Margaret E; Papas, Mia A; Oberlander, Sarah; Teti, Laureen O; McNary, Scot; Le, Katherine; O'Connell, Melissa

    2006-10-01

    were no differences in marital rates (2%), risk practices, or contraceptive use between mothers who did and did not have a second infant. Mothers who did not have a second infant were marginally more likely to report no plans for contraception in their next sexual contact compared with mothers who had a second infant (22% vs 8%, respectively). A home-based intervention founded on a mentorship model and targeted toward adolescent development, including negotiation skills, was effective in preventing rapid repeat births among low-income, black adolescent mothers. The effectiveness of the intervention could be seen after only 2 visits and increased over time. There were no second births among mothers who attended > or = 8 sessions. There was no evidence that risk behavior or contraceptive use was related to rapid second births. There was some evidence that rapid second births among adolescent mothers were regarded as desirable and as part of a move toward increasing autonomy and family formation, thereby undermining intervention programs that focus on risk avoidance. Findings suggest the merits of a mentoring program for low-income, black adolescent mothers, based on a relatively brief (6-8 sessions) curriculum targeted toward adolescent development and interpersonal negotiation skills.

  16. Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: the CAPEDP randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Romain Dugravier

    Full Text Available Postnatal maternal depression (PND is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed.This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties.440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child's second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS.At three months postpartum, mean (SD EPDS scores were 9.4 (5.4 for the control group and 8.6 (5.4 for the intervention group (p = 0.18. The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34. The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8: difference = 1.66 (95%CI: 0.17; 3.15, p = 0.05, adjusted for baseline EPDS score, women who were planning to raise the child with the child's father: difference = 1.45 (95%CI: 0.27; 2.62, p = 0.04 (adjusted; women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68 p = 0.05 (adjusted.CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction of PND symptomatology for young, first-time mothers presenting additional

  17. A group randomized controlled trial integrating obesity prevention and control for postpartum adolescents in a home visiting program.

    Science.gov (United States)

    Haire-Joshu, Debra L; Schwarz, Cynthia D; Peskoe, Sarah B; Budd, Elizabeth L; Brownson, Ross C; Joshu, Corinne E

    2015-06-26

    Adolescence represents a critical period for the development of overweight that tracks into adulthood. This risk is significantly heightened for adolescents that become pregnant, many of whom experience postpartum weight retention. The aim of this study was to evaluate Balance Adolescent Lifestyle Activities and Nutrition Choices for Energy (BALANCE), a multicomponent obesity prevention intervention targeting postpartum adolescents participating in a national home visiting child development-parent education program. A group randomized, nested cohort design was used with 1325 adolescents, 694 intervention and 490 control, (mean age = 17.8 years, 52 % underrepresented minorities) located across 30 states. Participatory methods were used to integrate lifestyle behavior change strategies within standard parent education practice. Content targeted replacement of high-risk obesogenic patterns (e.g. sweetened drink and high fat snack consumption, sedentary activity) with positive behaviors (e.g. water intake, fruit and vegetables, increased walking). Parent educators delivered BALANCE through home visits, school based classroom-group meetings, and website activities. Control adolescents received standard child development information. Phase I included baseline to posttest (12 months); Phase II included baseline to follow-up (24 months). When compared to the control group, BALANCE adolescents who were ≥12 weeks postpartum were 89 % more likely (p = 0.02) to maintain a normal BMI or improve an overweight/obese BMI by 12 months; this change was not sustained at 24 months. When compared to the control group, BALANCE adolescents significantly improved fruit and vegetable intake (p = .03). In stratified analyses, water intake improved among younger BALANCE teens (p = .001) and overweight/obese BALANCE teens (p = .05) when compared to control counterparts. There were no significant differences between groups in sweetened drink and snack consumption

  18. Effectiveness and cost-effectiveness of an in-home respite care program in supporting informal caregivers of people with dementia: design of a comparative study.

    Science.gov (United States)

    Vandepitte, Sophie; Van Den Noortgate, Nele; Putman, Koen; Verhaeghe, Sofie; Annemans, Lieven

    2016-12-02

    Frequent hospitalization and permanent nursing home placement not only affect the well-being of persons with dementia, but also place great financial strain on society. Therefore, it is important to create effective strategies to support informal caregivers so that they can continue to perform their demanding role. Preliminary qualitative evidence suggests that community-based respite services can actually be important for caregivers, and that the level of evidence should be further established in terms of effectiveness. Therefore, a comparative study to assess the effectiveness and cost-effectiveness of an in-home respite care program will be initiated. This manuscript described a quasi-experimental study to assess (cost)-effectiveness of an in-home respite care program to support informal caregivers of persons with dementia. 124 informal caregivers and persons with dementia will be included in the intervention group and will receive an in-home respite care program by an organization called Baluchon Alzheimer. 248 dyads will be included in the control group and will receive standard dementia care. The primary outcome is caregiver burden. Secondary outcomes are: quality of life of caregivers, frequency of behavioral problems of persons with dementia and the reactions of caregivers to those problems, intention to institutionalize the care-recipient, time to nursing home placement, resource use of the care-recipient, and willingness to pay for in-home respite care. When the trial demonstrates a difference in outcomes between both groups, within-trial and modeled cost-effectiveness analyses will be conducted in a separate economic evaluation plan to evaluate possible cost-effectiveness of the in-home respite care program compared to the control group receiving standard dementia care. Finally, the model based cost-effectiveness analyses will allow to extrapolate effects over a longer time horizon than the duration of the trial. This study will have great added value

  19. Nurse mentor perceptions in the delivery of a home-based cardiac rehabilitation program to support patients living in rural areas: An interpretive study.

    Science.gov (United States)

    Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

    2017-05-01

    Home-based cardiac rehabilitation (CR) programs improve health outcomes for people diagnosed with heart disease. Mentoring of patients by nurses trained in CR has been proposed as an innovative model of cardiac care. Little is known however, about the experience of mentors facilitating such programs and adapting to this new role. The aim of this qualitative study was to explore nurse mentor perceptions of their role in the delivery of a home-based CR program for rural patients unable to attend a hospital or outpatient CR program. Seven nurses mentored patients by telephone providing patients with education, psychosocial support and lifestyle advice during their recovery. An open-ended survey was administered to mentors by email and findings revealed mentors perceived their role to be integral to the success of the program. Nurses were satisfied with the development of their new role as patient mentors. They believed their collaborative skills, knowledge and experience in coronary care, timely support and guidance of patients during their recovery and use of innovative audiovisual resources improved the health outcomes of patients not able to attend traditional programs. Cardiac nurses in this study perceived that they were able to successfully transition from their normal work practices in hospital to mentoring patients in their homes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  20. Effectiveness of a multidimensional home nurse led heart failure disease management program--a French nationwide time-series comparison.

    Science.gov (United States)

    Agrinier, Nelly; Altieri, Christelle; Alla, François; Jay, Nicolas; Dobre, Daniela; Thilly, Nathalie; Zannad, Faiez

    2013-10-09

    The purpose of this study was to assess the effectiveness of a disease management program (DMP) in heart failure (HF) on the incidence of HF hospitalizations and related costs in a real-world population-based setting. Insuffisance CArdiaque en LORraine (ICALOR), a DMP for HF was established in 2006 in the French region of Lorraine. Patients were enrolled after an index HF hospitalization. They received educational and home-visit monitoring programs by HF-trained nurses. General physicians received automatic alerts about patients' significant clinical or biological changes. We used the ICALOR and the national diagnostic related group databases to conduct a comparison of time-series trends in HF hospitalizations in France. The economic impact was obtained using the national scale of costs in France. The median age of the 1222 patients recruited before 2010 was 76 years, and 65% were male. Upon enrollment, patients essentially presented with NYHA class II (n=537, 48%) or class III (n=359, 32%) symptoms. One-year mortality rate was 20.3%. The implementation of the ICALOR program was associated with a reduction in HF hospitalizations in Lorraine estimated by an absolute difference between the number of hospitalizations observed in the Lorraine region and that expected had it been similar to that observed in the whole country of -7.19% in 2010. The estimated annual hospital cost saved by ICALOR was €1,927,648 in 2010. Coordinated DMP of HF might improve outcome cost-effectively when implemented in a real-world population setting, and was associated in Lorraine with a substantial modification of the trend of HF hospitalizations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.