Dillahunt-Aspillaga, Christina; Powell-Cope, Gail
Traumatic brain injury (TBI) has been called the signature injury of the post-9/11 wars in Iraq, Afghanistan, and neighboring countries. Although similarities exist between veterans and service members with TBI, levels of severity and different constellations of coexisting comorbid conditions affect them differently. These conditions affect physical, cognitive, and emotional function, which in turn can complicate community reintegration (CR), or the ability to return to family, vocational, and community life. This special supplement of the Archives of Physical Medicine and Rehabilitation consists of articles written by accomplished teams from multiple disciplines, including anthropology, neuropsychology, nursing, occupational therapy, psychology, and rehabilitation sciences. Each article brings a different perspective to bear on what CR means for veterans and service members from examination of predictors and perceptions of veterans and service members and others to measurement studies. Collectively, this group of articles represents current thinking about CR and lays the groundwork for testing interventions to improve CR outcomes for veterans and service members (eg, employment, living situation, family life). Published by Elsevier Inc.
Department of Veterans Affairs — Given a VeteranÆs File Number or Social Security Number the service will return information about the other people and organizations related to the Veteran (family...
The establishment of World Trade Organization is in line with the conclusion reached at the end of the Uruguay Round in April 1994 by the bulk of the world's trading nations. WTO is in charge of managing multilateral trading system. WTO's "General Agreement on Trade in Services" (GATS) requires member nations to comply with the following…
command, and degrades the morale of those still serving, as well as the American public.8 A shrinking number of qualified volunteers and reductions...to Sri Aurobindo’s Philosophy of Integral Non-Dualism,” in The Integral Philosophy of Sri Aurobindo, ed. Haridas Chaudhuri and Frederic Spiegelberg...potentially unsolvable problem should not prevent attempts to develop solutions. In a moral sense, service member suicide should elicit greater diligence
In 1964, in view of the increasingly important role of computers in atomic energy, the Nuclear Energy Agency of the Organization for Economic Co-operation and Development established a Computer Programme Library (CPL) at Ispra, Italy. The original purpose of this Library, then consisting chiefly of programmes for reactor calculations, was to improve communication between the originators of the computer programmes and the scientists and engineers in Member States of the OECD who used them, thus furthering the efficient and economic use of the many large and expensive computers in the countries concerned. During the first few years of the Library's operation, a growing interest in its activities became evident in countries which were not members of the OECD. The Director General of the International Atomic Energy Agency, aware that such countries which were Member States of the IAEA could benefit from the Library's services, concluded an agreement with the Nuclear Energy Agency in 1967 to the effect that these services would be extended to all IAEA Member States. In March 1968, the Director General announced by circular letter that these services were available, and requested the governments of Member States that were not members of OECD to nominate establishments to participate in the activities of the Computer Programme Library. By August 1973, 32 such establishments were regularly using the services of the CPL
... NATIONAL CAPITAL PLANNING COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service... Senior Executive Service. The PRB established for the National Capital Planning Commission also makes...
... NATIONAL CAPITAL PLANNING COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service... Senior Executive Service. The PRB established for the National Capital Planning Commission also makes...
... COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA Senior Executive Service; Performance Review Board; Members AGENCY: Court Services and Offender Supervision Agency for the... agency's Senior Executive Service. The PRB established for the Court Services and Offender Supervision...
Farmer, Jane; Nimegeer, Amy
This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.
Eckerlin, Denise M; Kovalesky, Andrea; Jakupcak, Matthew
: The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members as well as that of their family members, colleagues, and community members. Although a greater proportion of female than male service members are subjected to MST, the Department of Defense estimates that the absolute numbers of affected men and women, across all ranks and branches of military service, are nearly equal because roughly 85% of military members are men. Little research has explored the effects of MST on men. This article discusses the unique ways in which men may experience MST, and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man's interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care professionals.
Hibbert, SA; Piacentini, Maria; Hogg, Margaret
This article introduces the notion of dysfunctional consumer participation. It advances a theoretical model of service recovery for contexts in which the smooth functioning of a service has been disrupted by consumers’ dysfunctional contributions, founded on justice theory and cognitive appraisal theory. The model presents perceived justice as the core element of the evaluation of service recovery encounters. Stressful appraisal evokes emotions in consumers and inﬂuences the cooperative or re...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U. S. Small Business Administration. ACTION: Notice of Members for the FY 2014 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2011 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2012 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
... SMALL BUSINESS ADMINISTRATION Senior Executive Service: Performance Review Board Members AGENCY: U.S. Small Business Administration. ACTION: Notice of Members for the FY 2010 Performance Review Board. SUMMARY: Title 5 U.S.C. 4314(c)(4) requires each agency to publish notification of the appointment of...
these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy
lifting of the bans – remains alive and well, with some LGBT service members experiencing interpersonal and institutional discrimination ...being among LGBT service members and improve unit cohesion. The military has always been a leader in understanding and implementing gender and...matters. These should be people that you know and who know you. These should be people you have had contact with in the past 3 months or so – either in
provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently...phases. In Phase I we (a) convened an expert panel to advise the study and (b) interview a diverse set of military service members (n=42) using a...have convened our expert panel of advisors and have completed 38 interviews with LGBT military service members. 15. SUBJECT TERMS Military, LGBT
through multiple rounds of internal testing and quality assurance procedures. Recruitment for the Phase II survey was initiated on August 25, 2017...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators...burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis
intervention improves attitudes toward behavioral health treatment and initiation of treatment. Advertisements are used to recruit service members...involve guns, cutting, car accidents, and carbon monoxide poisoning. We have had four participants die during the trial. One participant died from
Danish, Steven J; Antonides, Bradley J
The ongoing wars in Afghanistan and Iraq have posed a number of reintegration challenges to service members. Much of the research focuses on those service members experiencing psychological problems and being treated at the VA. In this article, we contend that much of the distress service members experience occurs following deployment and is a consequence of the difficulties encountered during their efforts to successfully reintegrate into their families and communities. We propose a new conceptual framework for intervening in this reintegration distress that is psycho-educational in nature as well as a new delivery model for providing such services. An example of this new intervention framework is presented. © 2013 American Orthopsychiatric Association.
Military, LGBT, health disparities, minority stress , social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...physical and mental health needs of this community. This project includes LGBT service members from all four services, Army, Air Force, Navy and...acceptance and integration of sexual minorities into traditional heterosexual work environments. Further, the findings will address possible health
Model Agreements for the granting of Associate Member Status Implementation arrangements concerning eligibility for personnel appointments and industrial participation for Associate Member States Progress report by the Management
Model Agreements for the granting of Associate Member Status Implementation arrangements concerning eligibility for personnel appointments and industrial participation for Associate Member States Progress report by the Management
Edwards-Stewart, Amanda; Smolenski, Derek J; Reger, Greg M; Bush, Nigel; Workman, Don E
Personal technology use is ubiquitous in the United States today and technology, in general, continues to change the face of health care. However, little is known about the personal technology use of military service members and the behavioral health care providers that treat them. This study reports the technology use of 1,101 active duty service members and 45 behavioral health care providers at a large military installation. Participants reported Internet usage; ownership of smartphones, tablets, and e-readers; usage of mobile applications (apps); and basic demographic information. Compared with providers, service members reported higher rates of smartphone ownership, were more likely to own Android smartphones than iPhones, and spent more time gaming. Both groups spent a comparable amount of time using social media. With the exception of gaming, however, differences between service members and providers were not statistically significant when demographics were matched and controlled. Among service members, younger respondents (18-34) were statistically more likely than older respondents (35-58) to own smartphones, spend time gaming, and engage in social media. Our findings can help inform provider's technology-based education and intervention of their patients and guide the development of new technologies to support the psychological health of service members. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Cleveland, Sandi D.; Branscum, Adam J.; Bovbjerg, Viktor E.; Thorburn, Sheryl
Objective: The aim of this study was to investigate if and to what extent student service members/veterans differ from civilian college students in the prevalence of self-reported symptoms of poor mental health. Participants: The Fall 2011 implementation of the American College Health Association-National College Health Assessment included 27,774…
phone (including text message), mail or email, or online (e.g., through social media sites, such as Facebook, Twitter, Instagram, YouTube). You...0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202- 4302. Respondents should be aware that notwithstanding any other provision of...Ask, Don’t Tell (DADT); (b) describe the composition and structure of LGBT service members supportive social networks; (c) determine if there are
Logren, Aija; Ruusuvuori, Johanna; Laitinen, Jaana
This study examines how group members' questions shape member participation in health counselling and health education groups. The study applies conversation analytic principles as a method. The data consist of video-recorded health education lessons in secondary school and health counselling sessions for adults with a high risk of Type 2 diabetes. Group members' questions accomplish a temporary change in participatory roles. They are used to 1) request counselling, 2) do counselling or 3) challenge previous talk. They are usually treated as relevant and legitimate actions by the participants, but are occasionally interpreted as transitions outside the current action or topic. Group members' questions result in a shift from leader-driven to member-driven discussion. Thus they constitute a pivot point for detecting changes in participation in group interventions. Observing the occurrence of group members' questions helps group leaders to adjust their own actions accordingly and thus facilitate or guide group participation. Comparison of the type and frequency of members' questions is a way to detect different trajectories for delivering group interventions and can thus be used to develop methods for process evaluation of interventions. Copyright © 2017 Elsevier B.V. All rights reserved.
Smoley, Brian A; Smith, Nicholas L; Runkle, Guy P
Hypertension is a common condition, but little is known about its prevalence in the Armed Forces. Our purpose was to provide an estimate of the prevalence of hypertension in a large population of US service members. We reviewed the screening records for service members who completed health risk assessments at Fort Lewis in Tacoma, WA, in 2004. The prevalence of hypertension and prehypertension were estimated from single recorded blood pressure readings and subjects' reported use of blood pressure medications. Study subject characteristics associated with hypertension and prehypertension were examined by chi(2) tests and multivariate logistic regression. Thirteen percent of the 15,391 subjects met the study definition for hypertension; 62% met the study definition for prehypertension. Increasing age and body mass index, male sex, black race/ethnicity, and senior rank were associated with hypertension; only body mass index, male sex, and senior rank were associated with prehypertension. Hypertension and prehypertension are more prevalent in the US Armed Forces than has been previously reported, and prehypertension may be more common in the US Armed forces than in the general population. The high prevalence of prehypertension found in this young, fit population suggests a need to better define the risks and benefits associated with the diagnosis and treatment of prehypertension in low-risk populations.
Hearld, Larry R; Alexander, Jeffrey A; Shi, Yunfeng
Collaborative forms of organizations such as multisectoral health care alliances play an increasingly prominent role in the U.S. health care system. A key feature of these organizations highlighted in previous research is leadership, yet little research has examined what happens when there is a change in leadership. The aim of this study was to examine the relationship between leadership transitions in an alliance and member assessments of the benefits and costs of participation, indicators of the value that members derive from their involvement in the alliance. The study used quantitative data collected from three rounds of surveys of alliance members participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality Program. Qualitative interview data supplemented this analysis by providing examples of why leadership transitions may affect participation benefits and costs. Quantitative analysis indicated that alliance members who experienced a change in leadership reported both higher and lower levels of participation benefits and costs, depending on the type of leadership change (i.e., alliance leader vs. programmatic leader). Qualitative analysis suggested that the scope of responsibilities of different types of leaders plays an important role in how members perceive changes. Likewise, interviews indicated that timing influences how disruptive a leadership transition is and whether it is perceived positively or negatively. Leadership transitions present both challenges and opportunities; whether the effects are felt positively or negatively depends on when a transition occurs and how it is handled by incoming leaders and remaining members. Furthermore, different types of members report higher levels of participation benefits and lower levels of participation costs, suggesting that efforts to maintain a sense of alliance value during times of transitions may be able to target certain types of individuals.
different based on deployment status and exposure to an austere environment where antimalarial agents with MRSA/MSSA activity are used. However, the...adequate hygiene practices. Further, these deployments are often to geo- graphic regions that require antimalarial chemoprophy- laxis. The use of...genes. Methods Participants Two populations of healthy active duty service members (101 non-deployed personnel in San Antonio, Texas, USA and 100
... 42 Public Health 2 2010-10-01 2010-10-01 false Condition of participation: Food services. 403.734...-Benefits, Conditions of Participation, and Payment § 403.734 Condition of participation: Food services. The RNHCI must have an organized food service that is directed and adequately staffed by qualified personnel...
Bush, Nigel E; Wheeler, William M
Although personal electronic devices, such as mobile phones, computers, and tablets, increasingly are being leveraged as vehicles for health in the civilian world, almost nothing is known about personal technology use in the U.S. military. In 2012 we conducted a unique survey of personal technologies used by U.S. military service members. However, with the rapidly growing sophistication of personal technology and changes in consumer habits, that knowledge must be continuously updated to be useful. Accordingly, we recently surveyed new samples of active duty service members, National Guard and Reserve, and veterans. We collected data by online surveys in 2013 from 239 active, inactive, and former service members. Online surveys were completed in-person via laptop computers at a large military installation and remotely via Web-based surveys posted on the Army Knowledge Online Web site and on a Defense Center Facebook social media channel. We measured high rates of personal technology use by service members at home across popular electronic media. The most dramatic change since our earlier survey was the tremendous increase in mobile phone use at home for a wide variety of purposes. Participants also reported moderate non-work uses of computers and tablets while on recent deployment to Iraq and Afghanistan, but almost no mobile phone use, ostensibly because of military restrictions in the war zone. These latest results will enable researchers and technology developers target their efforts on the most promising and popular technologies for psychological health in the military.
Walker, Melissa S; Kaimal, Girija; Gonzaga, Adele M L; Myers-Coffman, Katherine A; DeGraba, Thomas J
Active-duty military service members have a significant risk of sustaining physical and psychological trauma resulting in traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Within an interdisciplinary treatment approach at the National Intrepid Center of Excellence, service members participated in mask making during art therapy sessions. This study presents an analysis of the mask-making experiences of service members (n = 370) with persistent symptoms from combat- and mission-related TBI, PTSD, and other concurrent mood issues. Data sources included mask images and therapist notes collected over a five-year period. The data were coded and analyzed using grounded theory methods. Findings indicated that mask making offered visual representations of the self related to individual personhood, relationships, community, and society. Imagery themes referenced the injury, relational supports/losses, identity transitions/questions, cultural metaphors, existential reflections, and conflicted sense of self. These visual insights provided an increased understanding of the experiences of service members, facilitating their recovery.
The 62 staff members who are celebrating 25 years' service at CERN in 2009 were invited by the Director-General to a reception in their honour on 17 November. ARNAUDON Luca/BE BEL Jean-François/TE BERTINELLI Francesco/TE BLAND Alastair/BE BLOCH Philippe/PH BORCIER Luc/EN BRUNEL Xavier/PH BURKIMSHER Paul/EN CAMPI Domenico/PH CATTAI Ariella/PH DALIN Jean-Michel/EN DANGOISSE Claude/IT DAVIDS Daniel/EN DI MAIO Franck/BE FERRARI Claude/EN FISCHER Klaus/TE FOLLEY Adrian/PH FORMENTI Fabio/TE GATIGNON Laurentius/EN GIACHINO Rossano/BE GONIDEC Allain/PH GRAFSTROM Per/PH HANCOCK Steven/BE HATCH Mark/PH HEMMER Frederic/IT HOURICAN Michael/TE ...
Amanda L. Vogel
Full Text Available The movement for greater civic engagement in higher education in the United States has taken hold across the core academic missions of teaching, research and service. One manifestation of this movement has been growing participation in service-learning, a teaching method grounded in community-university partnerships in which students provide services that simultaneously address community-identified concerns and meet key learning objectives. In order to assess the benefits of long-term sustained institutional involvement in service-learning, in 2007–2008 we interviewed 23 faculty members, staff and administrators from 16 academic institutions that had participated in a national demonstration program for service-learning, which ended in 1998. We found that 15 of these institutions had sustained service-learning to some degree and 12 had integrated service-learning into the curriculum, with varying degrees of institutional support. Interview participants described five main impacts of their institutions’ sustained participation in service-learning: 1 increased community engagement and community-engaged scholarship, and increased valuation of both, among participating faculty members; 2 greater capacity for community-university partnerships among academic and community partners; 3 improved community-university relations; 4 diffusion of service-learning and/or principles of community-university partnerships to other departments and schools; and 5 recruitment of students seeking community engagement opportunities. This study provides evidence that sustained institutional participation in service-learning can foster an understanding of the scholarly value of community-engaged teaching and research among participating faculty, and increase community-engaged activities at participating academic institutions. These findings suggest that funding agencies, faculty members and academic administrators can use service-learning as a strategy to foster a
Susan M. Love
Full Text Available Now that the financial needs of post 9/11 student service members/veterans have begun to be addressed, the attention has shifted to disabilities and recovery strategies of student service members/veterans. Therefore, in a cross sectional design, this study electronically surveyed 189 enrolled student service members/veterans attending a large urban state university about their experiences of returning to school. Specifically, this study described the students’ rates of Post-Traumatic Stress Disorder (PTSD and alcohol abuse, perceived stress, adaptive and non-adaptive coping strategies, social support, participation in campus activities, and perceived campus climate. Moreover, correlates of recovery were examined. Although the majority of the returning students were doing well, 36.1% reported a high level of stress, 15.1% reported a high level of anger, 17.3% reported active symptoms of PTSD, and 27.1% screened positive for alcohol problems. Social networks were found to be the most salient factor in recovery. The study’s limitations are discussed and specific support strategies are presented that can be employed by disability services, counseling services and college administrators.
The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.
Herrera, Catherine J; Owens, Gina P
Modern military missions place numerous demands on service members, including tactical, personal, and cultural challenges. The purpose of this study was to explore how domains of multicultural personality (cultural empathy, open-mindedness, social initiative, emotional stability, and flexibility) and combat exposure relate to posttraumatic stress disorder (PTSD) in service members. Participants (N = 163) completed the Multicultural Personality Questionnaire, Combat Exposure Scale, and PTSD Checklist-Military as part of an online survey. The majority of participants were Caucasian (87%), mean age was 33 years, and all were deployed at least once to Iraq or Afghanistan Regression results indicated that higher levels of combat exposure and open-mindedness and lower levels of flexibility and emotional stability were significant predictors of higher PTSD severity. The interactions between combat exposure and flexibility and combat exposure and openness were also significant. Higher levels of flexibility and emotional stability seem particularly important in their association with lower PTSD severity for service members. © 2014 Wiley Periodicals, Inc.
Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.
Giordano, Fanny Barbara
administrations are unable to provide valid answers to emerging everyday problems. Theses opportunities and challenges are related to the role designers could take to help generating new kinds of public services. Services that are sustainable, that take into account the technological innovations but most......This poster is part of an early investigation of a PhD-study in Service Design that started in February 2017. The poster identifies challenges and opportunities emerging from a gap between citizen’s needs and public offering to address such needs. Citizens often organize themselves when public...... importantly that are informed by the real needs of their users (citizens). How design may contribute to build capacity and bridge relations between citizens and public service providers?...
The following staff members with 25 years' service in 2003 were invited by the Director-General to a reception in their honour on 20 November 2003: ALLIOD Patrick/ATGESCHONKE Gunther/AB AYMON Marcel/HRGLASER Maurice/EP BAUDET Serge/TISHUGOT Bernard/AB BENOIT-JEANNIN Brigitte/SPLJOUVE Christian/AT BERRY Peter/HRJULLIARD André/ST BIERI Catherine/STLAFAGE Patrice/ST BLANC Didier/STLAJUST Danièle/DSU BLANC Michel/ITLEGRAND Dominique/AT BOCH Guy/ITLONG Serge/EST BONZANO Roberto/STLYONNET André/EP BURCKHART Doris/EPMALOD-DOGNIN Jean-Pierre/ST BURNS Alan/ABMAURY Stephan/AC BURTIN Gérard/ABMILES John/AT CARENA Wisla/EPMONET René/EST CASTEL André/ESTMULLER André/TIS CLIFF Frank/HRPERREAL Pierre/AT CUCCURU Giovanni/ATPETERSEN Jørgen/EP DAMIANI Michel/ABPETIT Patrick/EP DELUCINGE Evelyne/ATPIERRE Patrice/AB DHOTE Patrick/SPLROUX Jacques/EP FLUCKIGER François/ITSAMYN Dirk/EP FORESTE Antonio/ESTSAVIOZ Jean Jacques/AB FRAIS...
Krista B. Highland
Full Text Available The development of PTSD after military deployment is influenced by a combination of biopsychosocial risk and resilience factors. In particular, physiological factors may mark risk for symptom progression or resiliency. Research in civilian populations suggests elevated catecholamines after trauma are associated with PTSD months following the trauma. However, less is known regarding physiological markers of PTSD resilience among post-deployment service members (SM. We therefore assessed whether catecholamines obtained shortly after deployment were associated with combat-related PTSD symptoms three months later. Eighty-seven SMs completed the Clinician-Administered PTSD Scale for DSM-IV and blood draws within two months after return from deployment to Iraq or Afghanistan (“Time 1” or “T1” and three months later (“Time 2” or “T2”. Linear regression analyses demonstrated that lower norepinephrine at T1 was associated with lower PTSD symptoms at T2. In particular, T1 norepinephrine was positively associated with T2 symptom intensity and avoidance symptoms. The present findings represent a biologically-informed method of assessing PTSD resilience after deployment, which may aid clinicians in providing tailored treatments for those in the greatest need. Further research is needed to validate these findings and incorporate physiological measures within an assessment battery.
Rodriguez, Aubrey J; Margolin, Gayla
Although military service, and particularly absence due to deployment, has been linked to risk for depression and anxiety among some spouses and children of active duty service members, there is limited research to explain the heterogeneity in family members' reactions to military service stressors. The current investigation introduces the Timeline Followback Military Family Interview (TFMFI) as a clinically useful strategy to collect detailed time-linked information about the service member's absences. Two dimensions of parent absence--the extent to which absences coincide with important family events and cumulative time absent--were tested as potential risks to family members' mental health. Data from 70 mother-adolescent pairs revealed that the number of important family events missed by the service member was linked to elevated youth symptoms of depression, even when accounting for the number of deployments and cumulative duration of the service member's absence. However, youth who reported more frequent contact with the service member during absences were buffered from the effects of extensive absence. Mothers' symptoms were associated with the cumulative duration of the service members' time away, but not with family events missed by the service member. These results identify circumstances that increase the risk for mental health symptoms associated with military family life. The TFMFI provides an interview-based strategy for clinicians wishing to understand military family members' lived experience during periods of service-member absence. (c) 2015 APA, all rights reserved).
Nichols, Linda Olivia; Martindale-Adams, Jennifer; Graney, Marshall J; Zuber, Jeffrey; Burns, Robert
Spouses of returning Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) military service members report increased depression and anxiety post deployment as they work to reintegrate the family and service member. Reconnecting the family, renegotiating roles that have shifted, reestablishing communication patterns, and dealing with mental health concerns are all tasks that spouses must undertake as part of reintegration. We tested telephone support groups focusing on helping spouses with these basic reintegration tasks. Year-long telephone support groups focused on education, skills building (communication skills, problem solving training, cognitive behavioral techniques, stress management), and support. Spouse depression and anxiety were decreased and perceived social support was increased during the course of the study. In subgroup analyses, spouses with husbands whose injuries caused care difficulties had a positive response to the intervention. However, they were more likely to be depressed, be anxious, and have less social support compared to participants who had husbands who had no injury or whose injury did not cause care difficulty. Study findings suggest that this well-established, high-access intervention can help improve quality of life for military spouses who are struggling with reintegration of the service member and family.
Jeffs, Lianne; Abramovich, Ilona Alex; Hayes, Chris; Smith, Orla; Tregunno, Deborah; Chan, Wai-Hin; Reeves, Scott
Effective teamwork and interprofessional collaboration are vital for healthcare quality and safety; however, challenges persist in creating interprofessional teamwork and resilient professional teams. A study was undertaken to delineate perceptions of individuals involved with the implementation of an interprofessional patient safety competency-based intervention and intervention participants. The study employed a qualitative study design that triangulated data from interviews with six steering committee members and five members of the project team who developed and monitored the intervention and six focus groups with clinical team members who participated in the intervention and implemented local patient safety projects within a large teaching hospital in Canada. Our study findings reveal that healthcare professionals and support staff acquired patient safety competencies in an interprofessional context that can result in improved patient and work flow processes. However, key challenges exist including managing projects amidst competing priorities, lacking physician engagement and sustaining projects. Our findings point to leaders to provide opportunities for healthcare teams to engage in interprofessional teamwork and patient safety projects to improve quality of patient care. Further research efforts should examine the sustainability of interprofessional safety projects and how leaders can more fully engage the participation of all professions, specifically physicians.
McGarity, Suzanne; Barnett, Scott D; Lamberty, Greg; Kretzmer, Tracy; Powell-Cope, Gail; Patel, Nitin; Nakase-Richardson, Risa
To examine community reintegration problems among Veterans and military service members with mild or moderate/severe traumatic brain injury (TBI) at 1 year postinjury and to identify unique predictors that may contribute to these difficulties. VA Polytrauma Rehabilitation Centers. Participants were 154 inpatients enrolled in the VA TBI Model Systems Program with available injury severity data (mild = 28.6%; moderate/severe = 71.4%) and 1-year postinjury outcome data. Prospective, longitudinal cohort. Community reintegration outcomes included independent driving, employability, and general community participation. Additional measures assessed depression, posttraumatic stress, and cognitive and motor functioning. In the mild TBI (mTBI) group, posttraumatic stress disorder and depressive symptoms were associated with lower levels of various community reintegration outcomes. In the moderate/severe TBI group, cognition and motor skills were significantly associated with lower levels of community participation, independent driving, and employability. Community reintegration is problematic for Veterans and active duty service members with a history of TBI. Unique comorbidities across injury severity groups inhibit full reintegration into the community. These findings highlight the ongoing rehabilitation needs of persons with TBI, specifically evidence-based mental healthcare, in comprehensive rehabilitation programs consistent with a chronic disease management model.
Dawson, Frances Trigg
A study was made to determine the relationships between (1) satisfaction of members with service club management processes and member's perception of management systems, (2) perception of service club management system to selected independent variables, and (3) satisfaction to perception of service club management systems with independent…
... Boards of Medicine and Nursing about issues related to access to and the quality of emergency services in... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Emergency services. 485.618 Section 485.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...
... Nursing about issues related to access to and the quality of anesthesia services in the State and has... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Surgical services. 485.639 Section 485.639 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...
... of Medicine and Nursing about issues related to access to and the quality of anesthesia services in... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Anesthesia services. 482.52 Section 482.52 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...
... vigilant to eliminate continuing, evolving predatory lending practices targeting service members and their... predatory marketing practices, and other abuses identified by consumer protection advocates, including the...
This publication summarizes the status of radon programmes at the start of 2014 in the Member States in Europe participating in the IAEA technical cooperation project on establishing enhanced approaches to the control of public exposure to radon. The current status was determined from responses to a questionnaire covering the following elements of a national radon action plan: policies and strategies; radon measurement surveys; establishment of reference levels; managing radon in existing buildings and in future buildings; education and training of professionals; and public awareness initiatives.
Bonar, Erin E.; Bohnert, Kipling M.; Walters, Heather M.; Ganoczy, Dara; Valenstein, Marcia
Objective To compare mental health symptoms and service utilization among returning student and nonstudent Service Members/Veterans (SM/Vs). Participants SM/Vs (N=1439) were predominately white (83%) men (92%); half were over age 30 (48%) and 24% were students. Methods SM/Vs completed surveys six months post-deployment (October 2011–July 2013). Results Students and nonstudent SM/Vs did not differ in positive screens for depression, anxiety, hazardous drinking, or Post-traumatic Stress Disorder (PTSD). Students (n=81) and nonstudents (n=265) with mental health symptoms had low levels of mental health service use (e.g., VA, civilian, or military facilities), at 47% and 57% respectively. Fewer students used VA mental health services. Common barriers to treatment-seeking included not wanting treatment on military records and embarrassment. Conclusions Like other returning SM/Vs, student SM/Vs have unmet mental health needs. The discrepancy between potential need and treatment-seeking suggests that colleges might be helpful in further facilitating mental health service use for student SM/Vs. PMID:25337770
... least three members. In the case of an appraisal of a career appointee, more than half the members shall consist of career appointees. The names and titles of the PRB members are as follows: Nani A. Coloretti... Management Service and Bureau of the Public Debt Cynthia Z. Springer, Deputy Commissioner, Accounting and...
DeVoe, Ellen R; Paris, Ruth; Emmert-Aronson, Ben; Ross, Abigail; Acker, Michelle
Parenting through the deployment cycle presents unique stressors for military families. To date, few evidence-based and military-specific parenting programs are available to support parenting through cycles of deployment separation and reintegration, especially for National Guard/Reserve members. The purpose of this research was to test the efficacy of a parenting program developed specifically to support military families during reintegration. Within 1 year of returning from deployment to Afghanistan or Iraq, 115 service members with very young children were randomly assigned to receive either the Strong Families Strong Forces Parenting Program at baseline or after a 12-week waiting period. Using a home-based modality, service members, at-home parents, and their young child were assessed at baseline, 3 months posttreatment/wait period, and 6 months from baseline. Service member parents in Strong Families evidenced greater reductions in parenting stress and mental health distress relative to those in the waitlist comparison group. Service members with more posttraumatic stress symptoms reported higher levels of perceived parental efficacy in the intervention group than service members in the comparison group. Intervention also resulted in enhanced parental reflective capacity, including increased curiosity and interest in the young child among those in the intervention group relative to comparison. Service member parents and their spouses demonstrated high interest in participating in a postdeployment parenting program targeting families with very young children. Findings point to the feasibility, appeal, and efficacy of Strong Families in this initial trial and suggest promise for implementation in broader military and community service systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
... DEPARTMENT OF LABOR Office of the Secretary Senior Executive Service; Appointment of Members to the Performance Review Board Title 5 U.S.C. 4314(c)(4) provides that Notice of the Appointment of an individual to serve as a member of the Performance Review Board of the Senior Executive Service shall be...
Hooghe, M.; Marien, S.
Non-institutionalised forms of political participation are on the rise in Western societies, but thus far, we do not know all that much about their effectiveness. In this article we report on the perceived efficacy of non-institutionalised forms of political participation, among both citizens and
hour per response, including the time tor reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of...Member following SERE physical training. Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Capt Matthew A Pombo Se. TASK
The 38 staff members who are celebrating 25 years at CERN in 2010 were invited by the Director-General to a reception in their honour on 21 October. ASBURY David IT HEGARTY Seamus HR BAUDRENGHIEN Philippe BE ISNARD Christian IT BERGSMA Felix PH JONES Robert IT BERNAL Jean-Manuel TE JOUBERJEAN Franck IT BERRIG Olav Ejner BE LAGRANGE Thierry FP BONT Hillebrand GS MARIN Antonio BE BOURGEOIS Nicolas PH MESENGE Pascal EN BOURREL Thierry EN MISSIAEN Dominique BE ...
Yount, Rick A; Olmert, Meg D; Lee, Mary R
In July 2008, social worker and certified service dog trainer Rick Yount created the first Warrior dog-training program designed to be a safe, effective, nonpharmaceutical intervention to treat the symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury in Veterans and service members undergoing treatment at a large Veterans Administration residential treatment facility. In 2009, Yount was asked to establish the program at a prominent Department of Defense medical center. In October 2010, Yount was invited to create a service dog training program to support the research and treatment mission at the new National Intrepid Center of Excellence (NICoE), in Bethesda, Maryland. This program, now being offered through the nonprofit foundation Warrior Canine Connection, continues to produce anecdotal evidence that training service dogs reduces the PTSD symptoms of Warrior-trainers and that the presence of the dogs enhances the sense of wellness in the NICoE staff and the families of our Wounded Warriors. Under the research leadership of the NICoE, the Warrior Canine Connection research team plans to systematically investigate the physiological, psychological, and behavioral benefits of this program.
Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha
Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., "service users"), especially those with co-occurring issues, as well as their family members. We conducted structured interviews with 73 service users and 41 family members of service users in two Ontario communities (one urban, one rural) regarding their goals related to help-seeking, positive and negative experiences, and recommendations for improving systems of care. Overall, participants expressed a need for services that: (1) are respectful, nonjudgmental, and supportive, help service users to feel more 'normal' and include education to reduce stigma; (2) are accessible, varied and publicly funded, thereby meeting individual needs and addressing equity concerns at a systems level; and (3) are coordinated, holistic and inclusive of family members who often support service users. The findings provide a rich understanding of how service users and their families perceive services for MSD(V) issues and identify key ways to better meet their needs.
Morrison, Cecily; Dearden, Andy
A number of recent policies promote public participation in health service design. Yet, a growing literature has articulated a gap between policy aims and actual practice resulting in public participation becoming tokenistic. Drawing on theory from participatory design, we argue that choosing appropriate artefacts to act as representations can structure discussions between public participants and health professionals in ways that both groups find meaningful and valid. Through a case study of a service improvement project in outpatient services for older people, we describe three representational artefacts: emotion maps, stories, and tracing paper, and explain how they helped to mediate interactions between public participants and health professionals. We suggest that using such representational artefacts can provide an alternative approach to participation that stands in contrast to the current focus on the professionalisation of public participants. We conclude that including participatory designers in projects, to chose or design appropriate representational artefacts, can help to address the policy-practice gap of including public participants in health service design. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
The 34 staff members who have spent 25 years within CERN in 2006 were invited by the Director-General to a reception in their honour on 1st November. BELLEMAN Jeroen / AB BERTOLA Dominique / DSU BOLDI Armand / TS BOLLET André / AT BRANDT Daniel / DSU CACCIOPPOLI Michel /TS CALDERONE Antonino / TS CLARET René /TS COSSEY PUGET Françoise / PH DALEXANDRO Noël / AT DECOMBAZ Michel / TS DELLA NEGRA Michel / PH DINIUS Arend / AB FOSTER David / IT FROMM Christine / DSU GROS Daniel / TS GUDET Denis / TS LEWIS Julian / AB MAPELLI Livio / PH MASSON Albert / TS MOINE Catherine / PH MÜLLER Hans / PH ODIER Patrick / AB PANMAN Jaap / PH POOLE John / AB PROLA-TESSAUR Maureen / AT RAPHOZ Jean-Pierre / IT ROSTANT Jeanne / PH RUGO Erminio / AB VAN HERWIJNEN Eric / PH WERNER Per / PH WILDNER Elena / AT WILKINSON Jonathan / DSU WISZNIOWSKI Thierry / AB
The 27 staff members who have spent 25 years within CERN in 2012 were invited by the Director-General to a reception in their honour on 2 November. BARRIN Laurence - PH BILLEN Ronald - BE BOUCHÉ Jean-Marc - HR BURKHARDT Helmut - BE CARLIER Etienne - TE CASS Antony - IT CHAN KWOK CHEON Anne Belinda - IT CHARRUE Pierre - BE COLLIER Paul - BE CUENCA PEREZ Antonio - GS DE JONGHE Jurgen - GS DEFERT Philippe - IT ELSENER Konrad - PH FROIDEVAUX Daniel - PH GRIGGS Christopher - PH MATHEYS Jean-Pol - HR MEIJERS Franciscus - PH MERTENS Volker - TE METRAL Gabriel - BE NECCA Rene - EN PACE Alberto&...
The 30 staff members who have spent 25 years within CERN in 2015 were invited by the Director-General to a reception in their honour on 10 December. Renaud Barillere EN Edgar Birker DG Sergio Calatroni TE Paola Catapano DG Christophe Delamare GS Philippe Farthouat PH Roger Forty PH Yves Gaillard TE Clara Gaspar PH Jean-Christophe Gayde EN Hubert Gerwig PH Simone Giani PH Jean-Pierre Granchelli EN Juan Guijarro IT Helene Haller PH John Harvey PH Vincenzo Innocente PH ...
Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura M J; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P
User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often
Marriott, A; Harris, I
The purpose of this paper is to critically review the effectiveness of a participative management approach within health service teams. It questions the reality of staff empowerment as an essential product of this approach, and examines the influence of power issues on the degree of empowerment that the organization may allow. The benefits and challenges of staff participation are highlighted, with reference to the manager's role in the participation process. The article concludes by advocating the positive use of power in order to maintain the integrity and effectiveness of a participative management approach.
The 24 staff members who have spent 25 years within CERN in 2007 were invited by the Director-General to a reception in their honour on 11 October. Mr.\tBLEUS Baudouin\tAB Mr.\tBRUNEL Bernard\tPH Mr.\tCAILLET Norbert\tHR Dr.\tCASPERS Friedhelm\tAB Mr.\tCHEVRET Thierry\tTS Mr.\tCUMER Gérard\tTS Mrs.\tDA COSTA Maryse\tIT Mrs.\tDELAMARE Catherine\tIT Mr.\tERIKSSON Tommy\tAB Mrs.\tFOFFANO Susan\tIT Mr.\tGONZALEZ José Luis\tAB Mr.\tHUTCHINS Stephen\tAB Dr.\tKLEMPT Wolfgang\tPH Mr.\tLEVRIER François\tTS Dr.\tMARCHIORO Alessandro\tPH Mr.\tNORMANN Lasse\tAB Dr.\tRAICH Ulrich\tAB Mr.\tREBUT Michel\tPH Mr.\tRUSSO Aniello\tAT Dr.\tSTAMPFLI Lorenz\tDSU Mrs.\tTUUVA Martine\tTS Dr.\tWEISZ Sylvain\tTS Mr.\tYVON Guy\tAB Mr.\tZIEGLER Patrice\tTS
The 74 staff members who have spent 25 years at CERN in 2005 were invited by the Director-General to a reception in their honour on 22 November. ADRIAN Gilbert / AB ALLIOD Marie-Noëlle / AB ANTOINET Gérard / SC AUBERT Marc / TS AUQUIER Christian / SC BAIRD Simon / AB BARRAS Suzanne / PH BAUD Richard / AT BELLONI Jean / SC BERTUOL Gilbert / SC BLANC Jean-Luc / AB BONVALLET Guy / SC BOSSUS Patrice / SC BROERE Johannes / AB BRU Yvon / TS BURDAIRON Alain / TS CANARD Philippe / AT CAVALLO Patrice / SC CHARRA Patrick / PH CHATAIGNEAU Marc / SC COLIN Gilles / SC DAHLEN Pierre / AB DE GROOT Johannes / PH DEDOBBELER Bernard / TS DELCAMBRE Jean Pierre / SC DELENCLOS Yves / TS DEROYER Patrick / SC DESBISSONS Christian / SC DRAPER Mick / AB DROUX Pascal / FI DUCASTEL Claude / TS DUMUR Alain / SC FOCKER Gerrit / AB FOFFANO Giuseppe / TS FORRAT Isabelle / IT FREI Marie-José / DSU FRESSARD Michel / TS GAGNIERE Daniel / TS GIUDICI Pierre-Ange / PH GOICOECHEA Bernard / TS GUEHO Alain / TS GUENEHEC François / SC JE...
... FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL FINANCIAL PARTICIPATION § 304.22 Federal financial participation in purchased support enforcement services. Federal financial participation is.... Support enforcement services which may be purchased with Federal financial participation are those for...
The 47 staff members who have spent 25 years within CERN in 2008 were invited by the Director-General to a reception in their honour on 24 October. Mr.\tAllen\tDavid John\tAB Dr.\tBailey\tRoger\tAB Mr.\tBlas\tAlfred\tAB Mr.\tBobbio\tPiero\tAB Dr.\tBona\tMaurizio\tSC Mr.\tBrachet\tJean-Pierre\tTS Dr.\tBurckhart\tHelfried\tPH Miss\tButtay\tCatherine\tFI Mr.\tCatherall\tRichard\tAB Mr.\tCoin\tAndré-Yvon\tTS Dr.\tCornelis\tKarel\tAB Dr.\tDavenport\tMartyn\tPH Mr.\tDehavay\tClaude\tAB Mr.\tDenblyden\tJean-Loup\tPH Mr.\tDenis\tBernard\tDSU Mr.\tDuret\tMax\tAT Mr.\tEvans\tJohn\tIT Mrs.\tFavrot\tVéronique\tIT Mr.\tFowler\tAntony\tAB Mrs.\tGalmant\tCatherine\tAB Mr.\tGuillaume\tJean-Claude\tTS Mrs.\tJerdelet\tJocelyne\tDSU Dr.\tKostro\tKrzysztof\tAB Mr.\tKuczerowski\tJoseph\tAB Mr.\tLappe\tJean-Pierre\tTS Mrs.\tLaverrière\tCatherine\tSC Mr.\tLeggiero\tLuigi\tTS Mr.\tManglunki\tDjango\tAB Mr.\tMartens\tReinoud\tIT Mr.\tMartinez\tGeorges\tSC Mr.\tMonchalin\tPhilippe\tSC Mr.\tMoret\tPhilippe\tDSU Mr.\tOlesen\tGert\tPH Mr.\tPasinelli\tSergi...
Mankowski, Mariann; Everett, Joyce E
The purpose of this paper is to highlight what we know now about female service members, veterans, and their families. The experiences of U.S. female service members and veterans are more complex than previous eras and significant demographic changes have taken place. U.S. female veterans are more likely to be younger, come from ethnic and racial minority groups, have children, and combat exposure. U.S. female service members report high rates of sexual violence and they are more vulnerable to homelessness and unemployment when compared to previous female military cohorts. U.S. female service members and veterans are also at higher risk for significant mental and health issues. Children and adolescents of women service members and veterans may also carry a heavy burden as a result of lengthy deployments. A majority of female service members and veterans will utilize community based healthcare and social services, therefore, it is essential that all healthcare providers understand the unique needs of this cohort of women. Practice implications at the micro, mezzo, and macro levels are discussed. Qualitative and quantitative studies that expand our understanding of women's experience in the military and as veterans are encouraged. Copyright © 2016 Elsevier Ltd. All rights reserved.
Compte Nunes, Guillem
[EN] In order to advance toward an understanding of the mechanisms of social transformation, overcoming the rhetoric about the importance of children’s participation and the marginalization of the knowledge on children’s issues, this paper identifies facilitating factors for and barriers against the institutionalization of children’s participation in a public child protective service. The results are interpreted through the 4I model of organizational learning. They highlight th...
Yildiz, Kadir; Polat, Ercan; Güzel, Pinar
The purpose of this study is to investigate sport center members' perceived service quality levels with a view to Kano customer expectations and requirements model. To that end, a descriptive approach and a correlational research design featuring survey method is adopted. Research group consists of 680 (300 women, 380 men) sport center members who…
Darby, Alexa; Newman, Gabrielle
This qualitative study provides a theoretical framework for understanding faculty members' motivation to persist in utilizing academic service-learning pedagogy. Twenty-four faculty members from a private liberal arts university in the southeastern United States were interviewed about the benefits and challenges of teaching academic…
External Relation, Clarity of Expression, Social Style, Subject Matter, and Aesthetics ). Each of these 10 subscales are rated on a scale of 0 to 5 where 0...Award Number: W81XWH-11-1-0635 TITLE: Treatment of Social Competence in Military Veterans, Service Members, and Civilians with Traumatic Brain...1Aug2014 - 31Jul2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Treatment of Social Competence in Military Veterans, Service Members, and Civilians with
Fronstin, Paul; Roebuck, M Christopher
This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the
Adopting a narrative approach with a dialogical framework, a longitudinal case study is presented that describes a service member's self in transition from active service into the civilian population. An analysis and interpretation of the case study leads to the hypothesis that if a dominant
Purpose. Guided by the World Health Organization\\'s International Classification of Functioning, Disability and Health (ICF), a measure of activity and participation (MAP) was developed and incorporated into the National Physical and Sensory Disability Database in Ireland. The aims of this article are to investigate and explore the relationship between the barriers, participation restriction and functioning levels experienced by people with disabilities. Method. Seven thousand five hundred and sixty-two personal interviews with people meeting specific eligibility criteria for registering onto the database were conducted across four health service executive regions in Ireland. Results. Overall, differences in barriers, participation restriction and activity limitations experienced by people with different types of disabilities were found to be significant. Furthermore, low functioning and experience of barriers were indicators of participation restriction. Conclusions. This article has shown that elements of the ICF have been successfully operationalised in a service planning tool through the development of the MAP. This provides a more holistic view of disability and will enable the impact of service interventions to be measured over time.
Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N
When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Norinder, Maria; Goliath, Ida; Alvariza, Anette
Patients who receive palliative home care are in need of support from family members, who take on great responsibility related to caregiving but who often feel unprepared for this task. Increasing numbers of interventions aimed at supporting family members in palliative care have been described and evaluated. It is not known whether and how these interventions actually affect the care or support provided to a patient, even though it has been suggested that family members would be likely to provide better care and support and thus allow for positive experiences for patients. However, this has not been studied from the perspective of the patients themselves. The objective of our study was to explore patients' experiences of care and support at home after family members' participation in a psychoeducational intervention during palliative care. Our study took a qualitative approach, and interviews were conducted with 11 patients whose family members had participated in a psychoeducational intervention during palliative home care. The interviews were analyzed employing interpretive description. Patients' experiences were represented by three themes: "safe at home," "facilitated and more honest communication," and "feeling like a unit of care." Patients felt that their needs were better met and that family members became more confident at home without risking their own health. Patients felt relieved when family members were given the opportunity to talk and reflect with others and hoped that the intervention would contribute to more honest communications between themselves and their family members. Further, it was of great importance to patients that family members receive attention from and be confirmed and supported by healthcare professionals. Our findings show how an intervention targeted at family members during palliative home care also benefits the patients.
Farmer, Jane; Currie, Margaret; Kenny, Amanda; Munoz, Sarah-Anne
This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008-2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project. Only one direct sustained service change was found - introduction of a volunteer first responder scheme in one community. Sustained changes in knowledge were found. The Health Authority that part-funded development of the community participation method, through the original project, had not adopted the new method. Community members tended to attribute lack of further impact to low participation and methods insufficiently attuned to the social nuances of very small rural communities. Managers tended to blame insufficient embedding in the healthcare system and issues around power over service change and budgets. In the absence of convincing formal community governance mechanisms for health issues, rural health practitioners tended to act as conduits between citizens and the Health Authority. The study provides new knowledge about what happens after community participation and highlights a need for more exploration. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available Purpose: To identify the main drivers that facilitate the successful deployment of a participation program aimed at improving competitiveness, as a prior step to analyze and discuss the implementation of these drivers in three services companies. Design/methodology/approach: The selection of the drivers was based on a “content analysis” of recent literature (2007-2017. To test the level of deployment of these drivers, the “case study” technique was choosen. The authors have selected two public transport companies and one bank, which have more than twenty years´ experience in the development of participation programs. Findings: From the case studies analysis, we conclude that participation can successfully improve a company’s competitiveness, provided that the drivers are developed with this specific aim. Thus, the analysis of these drivers allows to identify some gaps in aspects such as, the extension of participation throughout the company, the methodology adopted in the deployment of participation programs, the organizational structure for monitoring the program tasks, the reward/recognition systems and, especially, the implementation of KPIs for connecting participation and competitiveness. Research limitations/implications: This paper is based on a review of current literature, the analysis of three case studies, and our own personal experience. Our observations and comments may be qualified by future investigation with an increased sample of companies. Practical implications: This paper could be of interest to companies due to outlines the drivers that are critical to implementing participation programs focused on competitiveness. This could help companies that are thinking of implementing such programs, or those that are unhappy with their current programs, to re-design their plans in line with their business strategy. Originality/value: The main contribution of this paper lies in its theoretical and applied approach
Zhang, Jie; Yang, Dan; Deng, Yaotiao; Wang, Ying; Deng, Lei; Luo, Xinmei; Zhong, Wuning; Liu, Jie; Wang, Yuqing; Jiang, Yu
In China, not only patients and physicians are involved in medical decision-making (MDM) but also the patients' family members. The objective is to investigate the willingness and actual situation of cancer patients and their family members participating in the MDM process. In this cross-sectional study, questionnaires were administered to 247 pairs of cancer inpatients and their relatives. Information regarding participants' willingness and actual experience during the decision-making process was documented. Eligible participants were cancer inpatients or their relatives, 18 years of age or older, and informed of the cancer diagnosis. All the patients should have received chemotherapy. The effective response rate was 72.9% (180/247). Over half of the patients (53.3%) and family members (57.8%) were willing to be part of the MDM process. In contrast, only 35.0% of patients and 46.1% of family members actually experienced this process (p = 0.001 and p = 0.011, respectively). Fewer family members (42.2%) than patients (53.3%) believed that patients should be involved in the MDM process (p family (odds ratio 2.577, 95% CI 1.198-5.556, p = 0.015) experienced more involvement in MDM. Although more than half of Chinese cancer patients and family members wanted to be part of MDM, the actual participation was below their expectation. Majority of family members do not want the patients to be involved in the process of MDM. Copyright © 2015 John Wiley & Sons, Ltd.
Murtinho, Felipe; Hayes, Tanya
Payment for Environmental Service programs are increasingly applied in communal settings where resource users collectively join the program and agree to limit their shared use of a common-property resource. Who decides to join PES and the degree to which community members agree with the collective decision is critical for the success of said programs. Yet, we have limited understanding of the factors that influence communal participation and the collective decision process. This paper examines communal participation in a national payment for conservation program in Ecuador. We use quantitative and qualitative analysis to (i) identify the attributes of the communities that participate (or not), and factors that facilitate participation ( n = 67), and (ii) assess household preference and alignment with the collective decision to participate ( n = 212). Household participation preferences indicate varying degrees of consensus with the collective decision to participate, with those using the resource less likely to support participation. At the communal level, however, our results indicate that over time, those communities that depend more heavily on their resource systems may ultimately choose to participate. Our findings suggest that communal governance structures and outside organizations may be instrumental in gaining participation in resource-dependent communities and building consensus. Findings also point to the need for further research on communal decision-processes to ensure that the collective decision is based on an informed and democratic process.
Andersen, Ingrid Charlotte; Thomsen, Thora Grothe; Bruun, Poul
, knowledge of the significance of patient and family participation for recovery and subsequent everyday life is still limited. DESIGN: This study adopted a longitudinal design informed by ethnographic fieldwork principles. METHODS: Participant observations and interviews with 15 patients and 12 family......AIM AND OBJECTIVES: To explore the experiences of patients with chronic obstructive pulmonary disease (COPD) and their family members relating to both participation in care during hospitalization for an acute exacerbation in COPD, and to the subsequent day-to-day care at home. BACKGROUND: When...... recovering from an exacerbation, the challenges associated with an unpredictable health condition dominate everyday life for patients and can involve their family members. Proper patient and family participation in care during discharge and follow-up can help patients to improve self-management. However...
Pelts, Michael D; Albright, David L
Explore the mental health differences of student veterans by sexual orientation. Student service members/veterans (N = 702) from the Fall 2011 National College Health Assessment. Descriptive statistics and 2-sample proportion and mean tests were used to compare mental health characteristics. Student veterans who identify as lesbian, gay, bisexual, or unsure had higher levels of mental health symptoms and treatment. Results suggest a need for continued examination of student service members/veterans as related to disparities in mental health by sexual orientation.
Sæbø, Øystein; Rose, Jeremy; Nyvang, Tom
, content-generation and the development of loosely-coupled communities. They provide the forum for much discussion and interaction. In this respect social networking could contribute to solve some of the problems of engaging their users that eParticipation services often struggle with. This paper...... and social networking because democratic systems favour the interests of larger groups of citizens --- the more voices behind a political proposition, the greater its chances of success. In this context of challenges the study of social networking on the internet and social network theory offers valuable...... insights into the practices and theories of citizen engagement. Social network theory focuses on the chains of relationships that social actors communicate and act within. Some social networking services on the internet attract large numbers of users, and apparently sustain a great deal of interaction...
Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P
Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core
Beata M. Merickova
Full Text Available Participation as such is connected with political, social and civic dimensions. Through participation, citizens can directly or indirectly help to make the public process become more transparent and more efficient. It allows citizens “to see" into a decision-making process, to understand it, as well as contribute and be able to control it. In practice, civic participation has various forms; it includes both formal civic associations and informal groups of citizens that develop activities in order to solve local problems. In this paper we focus on civic participation in the innovation in the provision of public services, i.e. co-creation. Our objective is to map the best practices of co-creation in social innovations at the local government level in Slovakia. The main findings of our analysis are that co-created innovations are mostly initiated by non-governmental actors. Our study uses a qualitative approach and is based on original survey data from our own research, conducted mainly within the LIPSE research project.
Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying
Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members. PMID:28773347
Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying
Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members.
Claxton-Oldfield, Stephen; Gosselin, Natasha; Schmidt-Chamberlain, Kirsten; Claxton-Oldfield, Jane
A total of 22 family members, whose deceased loved ones had used the services of a hospice palliative care volunteer, responded to a brief survey designed to assess the importance of the different kinds of support offered to them (family members) by the volunteer, their impressions of the volunteers' personal qualities/characteristics, their general experiences with the volunteer, and their overall satisfaction with the volunteer services. The kind of support that received the highest importance rating from family members was the opportunity to take a much-needed break from the demands of caring for their loved one, closely followed by emotional support, the volunteer spending time with them, and the volunteer providing them with information. Family members rated volunteers highly on a list of qualities/characteristics that exemplify individuals who are effective in this role. In all, 85% of the family members felt that their volunteer was well trained and 95% did not feel that their or their loved one's privacy had been invaded by having a volunteer. Overall, family members were very satisfied with the volunteer support they received. Some limitations of the study are discussed.
Sapra, Katherine J; Crawford, Natalie D; Rudolph, Abby E; Jones, Kandice C; Benjamin, Ebele O; Fuller, Crystal M
Depression is more common among drug users (15-63 %) than the general population (5-16 %). Lack of social support network members may be associated with low mental health service (MHS) use rates observed among drug users. We investigated the relationship between social network members' roles and MHS use among frequent drug users using Social Ties Associated with Risk of Transition into Injection Drug Use data (NYC 2006-2009). Surveys assessed depression, MHS use, demographics, drug use and treatment, and social network members' roles. Participants reporting lifetime depressive episode with start/end dates and information on social/risk network members were included (n = 152). Adjusting for emotional support and HIV status, having one or more informational support network members remained associated with MHS use at last depressive episode (adjusted odds ratio (AOR) 3.37, 95 % confidence interval (CI) 1.38-8.19), as did history of drug treatment (AOR 2.75, 95 % CI 1.02-7.41) and no legal income (AOR 0.23, 95 % CI 0.08-0.64). These data suggest that informational support is associated with MHS utilization among depressed drug users.
This study aimed to understand and describe the views of family members and direct support staff regarding the use of Facebook by persons with intellectual disability (ID) within the context of social capital. In-depth, semistructured interviews conducted with 16 family members and direct support staff of persons with ID who use Facebook revealed that most participants favored Facebook use by persons with ID for bonding and bridging social capital and for normalization. Most participants noted the empowering effect of online activity on persons with ID, yet some reported risks and usage difficulties. Although Facebook use enhances the well-being of persons with ID, findings highlighted the participants' need for formal guidelines regarding social media best-practices for people with ID.
Bartolke, Klaus; And Others
A survey of 601 managers and workers in 10 German manufacturing companies studied the implications of workers' participation for the exercise of control. Statistical analysis of data on control over work environments, production organization, personnel, and finance indicated that, in more participative companies, distribution of control is more…
Reid, Matthew W; Cooper, Douglas B; Lu, Lisa H; Iverson, Grant L; Kennedy, Jan E
The objective of this study was to assess the associations between resilience, adversity, post-concussion symptoms, and post-traumatic stress symptom reporting after mild traumatic brain injury (mTBI). We hypothesized that resilience would be associated with less symptom reporting, and adversity would be associated with greater symptom reporting. This was a cross-sectional study of retrospective data collected for an ongoing TBI repository. United States military service members who screened positive for mTBI during a primary care visit completed the Trauma History Screen (THS), Connor-Davidson Resilience Scale (CD-RISC), Neurobehavioral Symptom Inventory (NSI), and post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C). Data collected from February 2015 to August 2016 were used for the present study. Only participants with complete data for the above measures were included, yielding a sample size of 165 participants. Adversity (THS) and resilience (CD-RISC) scores were each correlated significantly with post-concussion (NSI) and traumatic stress (PCL-C) total and subscale scores in the hypothesized direction. Interactions between adversity and resilience were absent for all measures except the NSI sensory subscale. Four traumatic event types were significantly associated positively with most NSI and PCL-C total and subscale scores, but the age at which traumatic events were first experienced showed few and mixed significant associations. In conclusion, resilience and adversity were significantly associated with symptom endorsement after mTBI. Screening for cumulative adversity may identify individuals at greater risk of developing persistent post-concussion symptoms and/or PTSD, and interventions that increase resilience may reduce symptom severity.
Olson, Dustin; Gabriel-Olson, Kirsten
With the troop levels in Iraq decreasing and more service members being discharged, the number of veterans on campuses is steadily increasing. On average, these warriors-turning-college-students will be 24 or older, ethnic minorities, and first-generation college students. It is important to make sure that departments, campuses and communities are…
Sunburn is caused by acute overexposure to ultraviolet (UV) radiation directly from the sun or from artificial UV sources. Service members are at risk of excessive exposure to sunlight due to the nature of their military duties, which often involve working and training outdoors, and deployment to environments where UV radiation is more intense. From January 2002 through December 2013, a total of 19,172 incident cases of clinically significant sunburn were diagnosed among active component service members. Most of the cases (80.2%) were first degree sunburn. The incidence rates of sunburn diagnoses were higher among females, white non-Hispanics, younger age groups, individuals in the Marine Corps or Army, and among enlisted service members. Additionally, the rate among recruits was more than 3.5 times the rate for non-recruits. Sixty-one percent of all diagnosed cases occurred from May through July. Sunburn cases occurred in all areas of the U.S., particularly near major recruit and combat training locations. Service members are strongly advised to practice sun safety as a part of heat illness prevention, including properly using broad-spectrum sunscreen, finding or constructing shade during work and rest, wearing protective clothing and military combat eye protection items, and avoiding tanning booths and sun lamps.
Research on the impact of mobility on children's academics has varied, although the majority indicated negative consequences. A gap in the current literature remains regarding how the mobility of children of service members, who attended public schools, relates to academic performance. The purpose of this study was to investigate the relationship…
Lewis, M. Jane; West, Bernadette; Bautista, Leyna; Greenberg, Alexandra M.; Done-Perez, Iris
This study examined perceptions regarding intimate partner abuse (IPV) in a largely Latino community in New Jersey through focus groups with Latino community members and key informant interviews with providers of services to this population. Questions examined definitions of partner abuse; perceptions of factors contributing to, or protecting…
Huizinga, Eelco; Hoencamp, Rigo; Van Dongen, Thijs; Leenen, Luke
Background: A systematic analysis of the complete medical support organization of the Dutch Armed Forces regarding repatriated service members from Afghanistan has not been performed so far. Methods: All information were collated in a specifically designed electronic database and gathered from the
... or Air Force, when ordered to annual training duty for at least 14 days and while performing official... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Who is a member of a uniformed service. 404.1330 Section 404.1330 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND...
Steenkamp, Maria M.; Litz, Brett T.; Gray, Matt J.; Lebowitz, Leslie; Nash, William; Conoscenti, Lauren; Amidon, Amy; Lang, Ariel
The growing number of service members in need of mental health care requires that empirically based interventions be tailored to the unique demands and exigencies of this population. We discuss a 6-session intervention for combat-related PTSD designed to foster willingness to engage with and disclose difficult deployment memories through a…
... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Senior Executive Service (SES) Performance Review... Performance Review Boards. The Board shall review the initial appraisal of a senior executive's performance by... senior executive performance. The members of the Performance Review Board for the National Archives and...
Buus, Niels; Delgado, Cynthia; Traynor, Michael; Gonge, Henrik
This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24 Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where an informant was in favour of supervision, but presented practical reasons for not participating; and (ii) 'deliberate rejection', where an informant intentionally chose to not to participate in supervision. Furthermore, we described two typical themes drawn upon by informants in their positioning: 'difficulties related to participating in supervision' and 'limited need for and benefits from supervision'. The findings indicated that group clinical supervision extended a space for group discussion that generated or accentuated anxiety because of already-existing conflicts and a fundamental lack of trust between group members. Many informants perceived group clinical supervision as an unacceptable intrusion, which could indicate a need for developing more acceptable types of post-registration clinical education and reflective practice for this group. © 2017 Australian College of Mental Health Nurses Inc.
Porcari, Carole; Koch, Ellen I; Rauch, Sheila A M; Hoodin, Flora; Ellison, Grant; McSweeney, Lauren
Despite significant numbers of Afghanistan and Iraqi veterans and service members who report symptoms of posttraumatic stress disorder, depression, anxiety, and substance abuse, the majority do not seek help for these problems. A better understanding of the help-seeking process might aid providers and administrators in outreach and provision of services for those who need them. Past research has shown several variables that influence an individual's help-seeking behavior: demographic variables, the nature and severity of a mental health problem, and psychological variables. The three goals of the study were to determine which variables predicted help-seeking intentions from various sources for a psychological problem, identify barriers to help seeking, and identify sources of help sought in the past year. All Operation Enduring Freedom and Operation Iraqi Freedom veterans and service members registered with a Midwestern VA Healthcare System between 2001 and 2007 received a letter requesting participation in an Internet-based survey. Participants completed nine questionnaires regarding their current physical and psychological health, social support, self-efficacy, public and self-stigma, and barriers to seeking help for a psychological problem. In addition, patterns of help seeking from informal (i.e., partner/spouse, family, friends) and formal (i.e., physician, psychiatrist, or psychologist, either from Veterans Affairs [VA] or the private sector) sources of help were examined. Results from the linear regression model including all formal and informal sources of help indicated a significant model fit with attitudes toward psychotherapy, social support, and current mental health status as significant coefficients. Of note, attitudes toward psychotherapy were a significant coefficient in all help-seeking models; stigma was a significant coefficient with formal and VA sources, and social support was found to be a significant predictor with informal sources
... develops formal arrangements with community-based providers, such as community mental health clinics... effectiveness of community partnerships in helping to meet the mental health needs of veterans in a timely way... networks that supports the use of community mental health services, including telehealth services and...
Lee, Hedwig; Porter, Lauren C; Comfort, Megan
Political participation and citizens' perceptions of the legitimacy and fairness of government are central components of democracy. In this article, we examine one possible threat to these markers of a just political system: family member incarceration. We offer a unique glimpse into the broader social consequences of punishment that are brought on by a partner's or parent's incarceration. We argue that the criminal justice system serves as an important institution for political socialization for the families of those imprisoned, affecting their attitudes and orientations toward the government and their will and capacity to become involved in political life. We draw from ethnographic data collected by one of the authors, quantitative data from the National Longitudinal Study of Adolescent Health, and interviews with recently released male prisoners and their female partners. Our findings suggest that experiences of a family member's incarceration complicate perceptions of government legitimacy and fairness and serve as a barrier to civic participation.
Ness, Bryan M.; Middleton, Michael J.; Hildebrandt, Michael J.
Objectives: To examine the relationships between self-reported posttraumatic stress disorder (PTSD) symptoms, perceived positive relations with others, self-regulation strategy use, and academic motivation among student service members/veterans (SSM/V) enrolled in postsecondary education. Participants: SSM/V (N = 214), defined as veterans, active…
Wallerstedt, Birgitta; Andershed, Birgitta; Benzein, Eva
To deepen the understanding of the variation of complexity in family members' caregiving situations, when the private home is the place for care, dying, and sitting service. Seven relatives to a deceased family member from four different families were interviewed twice. Data were analyzed by direct interpretation and categorical aggregation. Various patterns of becoming a caregiver were showed, but family members' willingness to become family caregivers was strongly related to fulfilling the dying persons' wishes to be cared for in their own homes. Important factors for coping with the caregiving situation were their needs of support, the possibility to prepare for death related to a need of communication and planning, the length and predictability of the illness trajectory, and experiences of losses and grief. Sitting service was experienced as supportive for family caregivers when they had possibility to hand over care responsibilities, but as non-supportive when expected help not was received. Family members' experiences of caregiving and their degree of vulnerability must be different, depending on whether it is a self-selected position or an imposed task. In general, family members in this study were willing to participate in caregiving for end-of life care, but subject to their own conditions. One way to decrease vulnerability is to assess the resources and competence in relation to the responsibility the person is expected to assume. The support and other efforts to help family caregivers must be related to their specific needs and reality, not only to what the care organization can offer as a standard solution.
Cobb, Enesha M; Gebremariam, Achamyeleh; Singer, Dianne; Davis, Matthew M
We determined national levels of public participation in medical research study design. We compared public interest in medical research participation (MRP) in studies overall, versus studies explicitly designed with public involvement. Cross-sectional household survey of US population in June 2013. Descriptive statistics estimated participation in medical research study design. Chi-square test compared levels of interest in MRP if respondent knew patients or community members helped design the study. Of 2,048 respondents (participation rate 60%), 5% knew someone who had helped design a medical research study. There was no association between having known someone or personal participation in study design and willingness to engage in MRP. Although the overall proportion of respondents who would consider MRP initially (51%) was similar to the proportion who would consider MRP with community member involvement in study design (49%), the changes in respondents' views across the different scenarios were significantly greater than what would have been expected by chance. We found similar levels of interest in MRP whether or not the public is involved in medical research study design. This finding may indicate that public involvement in study design, like community-based participatory research, may not affect overall rates of MRP. © 2015 Wiley Periodicals, Inc.
Wright, D. J.
We are all familiar with the three-legged stool of standard academic practice -- research, teaching, and service -- especially as it pertains to promotion and tenure. For example, many studies are emerging on the various ways that social media can be effectively used in teaching at all levels. Researchers are using analytical tools to turn social media feeds into useful indicators of human pattern and process. Darling et al. (2013) investigate the usefulness of Twitter for the development and distribution of scientific knowledge, including within the life cycle of scientific publication. However, the author focuses here on the use of social media as related to the traditional forms of academic "service:" i.e., participation on a committee or a board, in strategic planning or development of programs, in coordination of a seminar series or workshop, in professional reviews of books, papers, proposals, delivery of a public lectures to a civic group, giving an interview to a journalist on one's research or practice, even providing testimony to a group of policymakers. The author shares personal and institutional/organizational perspectives on how appropriate social media interaction in this context, can be viewed as a necessary (even daily) part of professional practice, and thus yet another moniker of good scientific behavior (especially as a model for students and early-career faculty), and of the "gift culture" of scholarship. For example, the "live tweeting" of ideas and summary points from paper sessions at scholarly meetings is gaining popularity, especially to inform those who could not attend. Other modes of contribution to intellectual communities range from advertising calls for special issues, proposals, participation in specialists meetings, to showcasing the real-time effects of natural disasters via social media feeds embedded in maps. Indeed, there is much discussion of "innovation" in research and in teaching, but can the speed and structure of social
Staff Members with 25 years service in 2002 were invited by the Director-General to a reception in their honnor on the 20th November 2002 : Baulet Yves / ST, Bornand Michel / SL, Burdet Georges / ST, Carena Francesco / EP, Chanut Robert / LHC, Chauchaix Bruno / SL, Chevrier François / SL, Chohan Vinod / LHC, Dahlerup-Petersen Knud / LHC, De Gennaro Michele Silvano / IT, De Rujula Alvaro / TH, Dury Jean-Marie / SL, Ferrara Sergio / TH, Fraser Gordon / ETT, Kolly Michel / ST, Korda Gwendoline / DSU, Lager Michel / ST, Michelon Jean-Claude / SL, Montuelle Jean / IT, Naudi Andre John / FI, Seis Irene / IT, Vascotto Alessandro / EP, Vernamonte Donatino / ST, Von Rüden Wolfgang / IT, Vullierme Bruno / LHC. Staff members with 25 years service in 2001 were also invited: Datta-Cockerill Sudeshna / HR, Frost-Ainley Lio / IT, Laurent Moniek / HR, Saban Roberto / AC.
Rohrbeck, Patricia; Hu, Zheng; Mallon, Col Timothy M
This study assessed the long-term health impact of environmental exposures associated with open pit burning in deployed US service members. Two hundred individuals deployed to Balad, Iraq, and Bagram, Afghanistan, with known exposure to open pits, were matched to 200 non-deployed service members. Both cohorts were observed for adverse health outcomes after returning from deployment. Slight increased risks were observed for respiratory diseases in the Bagram cohort (adj RR: 1.259), and for cardiovascular disease in the Balad cohort (adj RR: 1.072), but the findings were not significant. The combined deployed cohort showed lower risks for adverse health outcomes, suggesting a healthy deployer effect. In conclusion, this study did not find significantly increased risks for selected health outcomes after burn pit exposure during deployment among two deployed cohorts compared with a non-deployed cohort.
Staff Members with 25 years service in 2002 were invited by the Director-General to a reception in their honnor on the 20th November 2002 : Baulet Yves / ST Bornand Michel / SL Burdet Georges / ST Carena Francesco / EP Chanut Robert / LHC Chauchaix Bruno / SL Chevrier François / SL Chohan Vinod / LHC Dahlerup-Petersen Knud / LHC De Gennaro Michele Silvano / IT De Rujula Alvaro / TH Dury Jean-Marie / SL Ferrara Sergio / TH Fraser Gordon / ETT Kolly Michel / ST Korda Gwendoline / DSU Lager Michel / ST Michelon Jean-Claude / SL Montuelle Jean / IT Naudi Andre John / FI Seis Irene / IT Vascotto Alessandro / EP Vernamonte Donatino / ST Von Rüden Wolfgang / IT Vullierme Bruno / LHC Staff members with 25 years service in 2001 were also invited: Datta-Cockerill Sudeshna / HR Frost-Ainley Lio / IT Laurent Moniek / HR Saban Roberto / AC
... offered. (1) The director of the services must have the necessary knowledge, experience, and capabilities to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services...
Full Text Available The family’s role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.
this study. Third, additional demographic criteria such as job type, specific location, and sexual orientation are omitted from these data. These and...perceptions. 31 Fourth, additional demographic criteria not included in the data may indicate perceptual differences based on age or other characteristics...For example, it can be assumed that rank and age are highly correlated, as higher rank service members often have spent more time in the military
sector had a defined benefit pension plan. However, in the 1980s, due to the high cost of funding defined benefit plans, corporations began to favor a...rate in February 2017 was 5.6%. Dave Ramsey (n.d.), a personal finance expert, recommends individuals save at least 15% of their income for retirement...is explicitly clear that “service members are responsible for their personal finances ” (DOD, 2012, p. 15). The FRS offers personal financial
video conferencing can help remote service members and dependents access needed care. These two promising avenues for improving access to care can...Corporation ISBN 978-0-8330-8872-7 www.rand.org Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are...RAND Corporation View document details Support RAND Browse Reports & Bookstore Make a charitable contribution Limited Electronic Distribution Rights
Full Text Available Background: Improvement of medical education is necessary for meeting health care demands. Participation of private practice physicians in ambulatory care training is an effective method for enhancing medical students' skills. Purpose This study was undertaken to determine clinical professors' views about participation of physicians with private office in ambulatory care training. Methods: Participants composed of 162 Shiraz Medical University faculty members from 12 disciplines. A questionnaire requesting faculty members' views on different aspects of ambulat01y care teaching and interaction of community-based organizations was distributed. Results: Of 120 (74.1% respondents, 64 (54.2% believed that clinical settings of medical university are appropriate for ambulatory care training. Private practice physicians believed more than academic physicians without private office that private offices have wider range of patients, more common cases, and better follow up chance; and is also a better setting for learning ambulatory care compared with medical university clinical centers. Overall, 32 (29.1% respondent’s found the participation of physicians with private practice on medical education positive. Key words medical education, ambulatory medicine, private practice
Bakalar, Jennifer L; Barmine, Marissa; Druskin, Lindsay; Olsen, Cara H; Quinlan, Jeffrey; Sbrocco, Tracy; Tanofsky-Kraff, Marian
US service members appear to be at high-risk for disordered eating. Further, the military is experiencing unprecedented prevalence of overweight and obesity. US service members also report a high prevalence of childhood adverse life event (ALE) exposure. Despite consistent links between early adversity with eating disorders and obesity, there is a dearth of research examining the association between ALE exposure and disordered eating and weight in military personnel. An online survey study was conducted in active duty personnel to examine childhood ALE history using the Life Stressor Checklist - Revised, disordered eating using the Eating Disorder Examination - Questionnaire total score, and self-reported body mass index (BMI, kg/m 2 ). Among 179 respondents, multiple indices of childhood ALE were positively associated with disordered eating. Traumatic childhood ALE and subjective impact of childhood ALE were associated with higher BMI and these associations were mediated by disordered eating. Findings support evaluating childhood ALE exposure among service members with disordered eating and weight concerns. Moreover, findings support the need for prospective research to elucidate these relationships. © 2018 Wiley Periodicals, Inc.
Full Text Available The purpose of this study is to investigate the governance questions that board members in public service organizations ask as they go about fulfilling their responsibilities for the oversight of executive compensation. The research uses 24 of the questions – as proposed by the Canadian Institute of Chartered Accountants - that directors should ask about executive compensation and investigates both their usage and perceived importance by board members. The study is based on a usable sample of 47 board members from public service organizations who were attending a Canadian director training program. The research finds that, insofar as public service organizations are concerned, not all of the recommended executive compensation governance questions were asked with the same frequency nor were they considered equally important. Additionally, the relationship between a question’s usage frequency and its perceived importance was not perfect. However, there appears to be a significantly positive relationship among the number of executive compensation governance questions asked and selected elements of a board’s governance structure.
Bogner, Jennifer; French, Louis M; Lange, Rael T; Corrigan, John D
Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Service members (n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention.
Sundari, I. P.; Mariana, D.; Sjoraida, D. F.
This study examines the performance of the local representative members in serving and channeling people’s aspiration in Sumedang Regency, Indonesia. How the elected members serve their constituents and how they consider the people’s rights were the questions to be answered in this study. The study used a qualitative approach to get the natural settings in which there are many behaviors and events occurred. This study also uses an institutional theory (institutionalism), because the theory could lead the researchers to find the structure, regulation and institutional procedures which could have a significant impact on a public policy and cannot be ignored in policy analysis. This study found that to carry out their functions as elected representatives, the members of the provincial parliament always make themselves available for the community. In doing so, the members of the provincial parliament, among others, absorb and collect the constituents’ aspiration through regular working visits; accommodate and follow up the aspirations and complaints; morally and politically provide accountability to the constituencies. In addition, to receive complaints coming to the local parliament’s office, public aspiration was also obtained in working visits on a regular basis by the members of local parliament in Sumedang as their own region at recess time. In terms of rights, all the services were conducted to fulfill them. Even so, some people still doubt the veracity of such works.
Lee, Susan K; Thompson, Sandra C; Amorin-Woods, Deisy
Consumer participation in primary health care is important in providing quality consumer-focused care, but challenging when working with disadvantaged groups of diverse cultural and linguistic backgrounds. Women's Health Services (WHS) works with women from over 60 different nationalities, including many newly arrived migrants and refugees. New arrivals access a wide range of WHS programmes including medical services, counselling, information, community talks and workshops, referral, and outreach, but few ethnic women attended the alcohol and other drug (AOD) services offered by the organisation. To establish an active consumer reference group to assist understanding and reducing the barriers to AOD services for a heterogeneous disadvantaged group that includes individuals from different cultural, language and educational backgrounds. Leaning heavily on experiences from the mental health field, WHS overcame many practical and philosophical considerations which included: agreeing upon the purpose of the group and how it would operate within the structure of the organisation; the level of English language required by participants for the group to function; issues of resourcing the group; and ensuring an appropriate, workable demographic mix in terms of age, language, and migration experiences. The process and the outcome of establishing a consumer reference group (CRG) in a primary healthcare setting has been valuable for consumers' and health service providers within the organisation.
Lampert, Rachel; Cannom, David; Olshansky, Brian
Safety of Sports for ICD Patients. The safety of sports participation for patients with implantable cardioverter defibrillators (ICDs) is unknown, and recommendations among physicians may vary widely. The purposes of this study were to determine current practice among patients with ICDs and their physicians regarding sports participation, and to determine how many physicians have cared for patients who have sustained adverse events during sports participation. A survey was mailed to all 1,687 U.S. physician members of the Heart Rhythm Society. Among 614 respondent physicians, recommendations varied widely. Only 10% recommended avoidance of all sports more vigorous than golf. Seventy-six percent recommended avoidance of contact, and 45% recommend avoidance of competitive sports. Most (71%) based restrictions on patients' underlying heart disease. Regardless of recommendations, most physicians (71%) reported caring for patients who participated in sports, including many citing vigorous, competitive sports, most commonly cited were basketball, running, and skiing. ICD shocks during sports were common, cited by 40% of physicians. However, few adverse consequences were reported. One percent of physicians reported known injury to patient (all but 3 minor); 5%, injury to the ICD system, and weightlifting and golf. Physician recommendations for sports participation for patients with ICDs varies widely. Many patients with ICDs do participate in vigorous and even competitive sports. While shocks were common, significant adverse events were rare.
Nett, Beth; Brosky, Joseph A; Velarde, Lynnuel; Pariser, David P; Boyce, David A
Although it is common practice to administer pre-participation examinations (PPE) of athletes prior to training, there are no clearly established formats. Elements integral to the PPE fall within the scope of physical therapist practice, and are often categorized as a form of primary prevention for musculoskeletal disorders as defined in the Guide to Physical Therapist Practice. The purpose of this study is to describe the design and implementation of a PPE for a women's professional (gridiron) football team. The results and findings from this PPE provide one of the first musculoskeletal profiles and information about selected physical characteristics from members of a female professional football team. Players from the Kentucky Karma women's football team, a member of the National Women's Football League (NWFA), volunteered to participate in a PPE. Of twenty-five eligible team members, thirteen consented to participate. The PPE consisted of a health history questionnaire, a musculoskeletal screening, and a series of physical performance and agility tests. The players' average (± SD) age, height, weight, body mass index (BMI), and body fat percentage were 29.6 (± 5.6) yrs., 1.66 (± .05) m, 66.8 (± 12.6) kg, 24.1 (± 3.7), and 27.4 (± 6.6) %, respectively. Commonly reported injuries were similar to those reported in men's collegiate football. This is one of the first papers to report on a model PPE for a women's professional football team. Future research is needed to establish a standard PPE, recognize common injuries, and develop prevention strategies unique to women's professional football.
Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N
Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.
Brickell, Tracey A; Lippa, Sara M; French, Louis M; Kennedy, Jan E; Bailie, Jason M; Lange, Rael T
Females are often excluded from military-related mild traumatic brain injury (mTBI) research because of its relatively low prevalence in this population. The purpose of this study was to focus on outcome from mTBI in female service members, compared with males. Participants were 172 United States military service members selected from a larger sample that had sustained an mTBI, and were evaluated within 24 months of injury (Age: mean = 28.9, SD = 8.1) at one of six military medical centers. Eighty-six women were matched to 86 men on nine key variables: TBI severity, mechanism of injury, bodily injury severity, days post-injury, age, number of deployments, theater where wounded, branch of service, and rank. Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C). There were no meaningful gender differences across all demographic and injury-related variables (p > 0.05). There were significant group differences and medium effect sizes for the NSI total score and all four NSI cluster scores. Symptoms most affected related to nausea, sensitivity to light, change in taste/smell, change in appetite, fatigue, and poor sleep. There were significant group differences and small-medium effect sizes for the PCL-C total score and two of the three PCL-C cluster scores. Symptoms most affected related to poor concentration, trouble remembering a stressful event, and disturbing memories/thoughts/images. Females consistently experienced more symptoms than males. As females become more active in combat-related deployments, it is critical that future studies place more emphasis on this important military population.
Leach, Verity; Redwood, Sabi; Lasseter, Gemma; Walther, Axel; Reid, Colette; Blazeby, Jane; Martin, Richard; Donovan, Jenny
Members of the public and patients repeatedly indicate their willingness to take part in research, but current United Kingdom research governance involves complex rules about gaining consent. Research participation registers that seek consent from participants to be approached about future studies have several potential benefits, including: increased research participation across clinical and healthy populations; simplified recruitment to health care research; support for people's autonomy in decision making; and improved efficiency and generalizability of research. These potential benefits have to be balanced against ethical and governance considerations. With appropriate processes in place, seeking prospective consent from patients and members of the public to be approached about future studies could potentially increase public participation in health research without compromising informed consent and other ethical principles. © The Author(s) 2016.
... REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED... official extended duty as a member of the Foreign Service of the United States in Brazil. In 2015 B sells... period of ownership and use during his 8-year period of service with the Foreign Service in Brazil. If B...
Scott, Julia K; Leary, Sam D; Ness, Andy R; Sandy, Jonathan R; Persson, Martin; Kilpatrick, Nicky; Waylen, Andrea E
Cleft care provision in the United Kingdom has been centralized over the past 15 years to improve outcomes for children born with cleft lip and palate. However, to date, there have been no investigations to examine how well these multidisciplinary teams are performing. In this pilot study, a cross-sectional questionnaire surveyed members of all health care specialties working to provide cleft care in 11 services across the United Kingdom. Team members were asked to complete the Team Work Assessment (TWA) to investigate perceptions of team working in cleft services. The TWA comprises 55 items measuring seven constructs: team foundation, function, performance and skills, team climate and atmosphere, team leadership, and team identity; individual constructs were also aggregated to provide an overall TWA score. Items were measured using five-point Likert-type scales and were converted into percentage agreement for analysis. Responses were received from members of every cleft team. Ninety-nine of 138 cleft team questionnaires (71.7%) were returned and analyzed. The median (interquartile range) percentage of maximum possible score across teams was 75.5% (70.8, 88.2) for the sum of all items. Team performance and team identity were viewed most positively, with 82.0% (75.0, 88.2) and 88.4% (82.2, 91.4), respectively. Team foundation and leadership were viewed least positively with 79.0% (72.6, 84.6) and 76.6% (70.6, 85.4), respectively. Cleft team members perceive that their teams work well, but there are variations in response according to construct.
Hinton, Ladson; Aggarwal, Neil; Iosif, Ana-Maria; Weiss, Mitchell; Paralikar, Vasudeo; Deshpande, Smita; Jadhav, Sushrut; Ndetei, David; Nicasio, Andel; Boiler, Marit; Lam, Peter; Avelar, Yesi; Lewis-Fernández, Roberto
Despite the important roles families play in the lives of many individuals with mental illness across cultures, there is a dearth of data worldwide on how family members perceive the process of cultural assessment as well as to how to best include them. This study addresses this gap in our knowledge through analysis of data collected across six countries as part of a DSM-5 Field Trial of the Cultural Formulation Interview (CFI). At clinician discretion, individuals who accompanied patients to the clinic visit (i.e. patient companions) at the time the CFI was conducted were invited to participate in the cultural assessment and answer questions about their experience. The specific aims of this paper are (1) to describe patterns of participation of patient companions in the CFI across the six countries, and (2) to examine the comparative feasibility, acceptability, and clinical utility of the CFI from companion perspectives through analysis of both quantitative and qualitative data. Among the 321 patient interviews, only 86 (at four of 12 sites) included companions, all of whom were family members or other relatives. The utility, feasibility and acceptability of the CFI were rated favourably by relatives, supported by qualitative analyses of debriefing interviews. Cross-site differences in frequency of accompaniment merit further study.
Davies, Alicia; Wong, Carol A; Laschinger, Heather
The purpose of this study was to test Kanter's theory by examining relationships among structural empowerment, leader-member exchange (LMX) quality and nurses' participation in personal knowledge transfer activities. Despite the current emphasis on evidence-based practice in health care, research suggests that implementation of research findings in everyday clinical practice is unsystematic at best with mixed outcomes. This study was a secondary analysis of data collected using a non-experimental, predictive mailed survey design. A random sample of 400 registered nurses who worked in urban tertiary care hospitals in Ontario yielded a final sample of 234 for a 58.5% response rate. Hierarchical multiple linear regression analysis revealed that the combination of LMX and structural empowerment accounted for 9.1% of the variance in personal knowledge transfer but only total empowerment was a significant independent predictor of knowledge transfer (β=0.291, t=4.012, Pleader-member exchange quality resulted in increased participation in personal knowledge transfer in practice. The results reinforce the pivotal role of nurse managers in supporting empowering work environments that are conducive to transfer of knowledge in practice to provide evidence-based care. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Wortmann, Jennifer H; Jordan, Alexander H; Weathers, Frank W; Resick, Patricia A; Dondanville, Katherine A; Hall-Clark, Brittany; Foa, Edna B; Young-McCaughan, Stacey; Yarvis, Jeffrey S; Hembree, Elizabeth A; Mintz, Jim; Peterson, Alan L; Litz, Brett T
The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Osilla, Karen Chan; Pedersen, Eric R; Gore, Kristie; Trail, Thomas; Howard, Stefanie Stern
Alcohol misuse among military service members from the recent conflicts in Iraq and Afghanistan is over two times higher compared to misuse in the civilian population. Unfortunately, in addition to experiencing personal consequences from alcohol misuse, partners and family members of alcohol-misusing service members also suffer in negative ways from their loved one's drinking. These family members represent important catalysts for helping their loved ones identify problem drinking and overcoming the barriers to seeking care. This paper describes the protocol to a pilot study evaluating a 4-session, web-based intervention (WBI) for concerned partners (CPs) of service members with alcohol misuse. The WBI will be adapted from the Community Reinforcement and Family Training (CRAFT) intervention. In the first phase, we will develop and beta-test the WBI with 15-20 CPs. In the second phase, we will randomize CPs to WBI (n = 50) or to delayed-WBI (n = 50) and evaluate the impact of the WBI on CPs' perceptions of service member help-seeking and drinking, as well as the CP's well-being and relationship satisfaction 3 months after the intervention. In the third phase, we will recruit 15-20 service members whose partners have completed the study. We will interview the service members to learn how the CP-focused WBI affected them and to assess whether they would be receptive to a follow-on WBI module to help them. This project has the potential to benefit a large population of military service members who may be disproportionately affected by recent conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. NCT02073825.
... of medicine or osteopathy. (2) Licensed practical nurses (LPNs) and surgical technologists (operating... performing surgery in accordance with the competencies of each practitioner. The surgical service must...
... radiologic services, particularly ionizing radiology procedures, must be free from hazards for patients and... qualified full-time, part-time, or consulting radiologist must supervise the ionizing radiology services and... osteopathy who is qualified by education and experience in radiology. (2) Only personnel designated as...
.... Social work services must be based on the patient's psychosocial assessment and the patient's and family... must be available to the patient and family to assist the patient and family in minimizing the stress... bereavement services available to the family and other individuals in the bereavement plan of care up to 1...
Hoy, Janet M
Incorporating individuals' understandings and explanations of mental illness into service delivery offers benefits relating to increased service relevance and meaning. Existing research delineates explanatory models of mental illness held by individuals in home, outpatient, and hospital-based contexts; research on models held by those in peer-support contexts is notably absent. In this article, I describe themes identified within and across explanatory models of mental illness and recovery held by mental health consumers (N = 24) at one peer center, referred to as a consumer-operated service center (COSP). Participants held explanatory models inclusive of both developmental stressors and biomedical causes, consistent with a stress-diathesis model (although no participant explicitly referenced such). Explicit incorporation of stress-diathesis constructs into programming at this COSP offers the potential of increasing service meaning and relevance. Identifying and incorporating shared meanings across individuals' understandings of mental illness likewise can increase relevance and meaning for particular subgroups of service users. © The Author(s) 2014.
Worthen, Miranda; Rathod, Sujit D; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer
Violent behavior is an important problem for military service members and veterans. A representative cohort of U.S. Reserve and National Guard personnel ( N = 1,293) were interviewed to assess self-reported problems controlling violent behavior, deployment traumas, posttraumatic stress disorder (PTSD), alcohol abuse, and social support. Poisson regression models were used to estimate the associations of violent behavior with risk and protective factors. Problems controlling violent behavior were uncommon among male (3.3%) and female (1.7%) service members. Adjusted prevalence ratios (aPR) showed associations between violent behavior and deployment traumas (aPR = 1.67, 95% confidence interval [CI] = [1.34, 2.08]), PTSD (aPR = 9.95, 95% CI = [5.09, 19.48]), and PTSD symptom severity (aPR for each additional PTSD symptom = 1.07, 95% CI = [1.06, 1.09]). Social support was associated with lower prevalence of violent behavior (aPR = 0.62, 95% CI = [0.52, 0.76]). The association between violent behavior and alcohol abuse was not statistically significant (aPR = 1.94, 95% CI = [0.92, 4.09]). Results were consistent when the population was restricted to personnel who had deployed to a war zone. Problems controlling violent behavior were less common in this cohort than has been documented in other studies. Associations of violent behavior with risk and protective factors are consistent with prior research.
... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.713 Condition of participation: Physical therapy services. If the organization offers physical therapy services... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Physical therapy...
... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Speech pathology... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.715 Condition of participation: Speech pathology services. If speech pathology services are offered, the...
This study was an attempt to describe the characteristics of U.S. Air Force (USAF) members with stepfamily and divorce conditions who had received services from USAF substance abuse treatment programs...
Goldbach, Jeremy T; Castro, Carl Andrew
Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don't Ask, Don't Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving in the military remains under review. The health care needs of these populations remain for the most part unknown, with total acceptance and integration in the military yet to be achieved. In this paper, we review the literature on the health care needs of lesbian, gay, bisexual, and transgender (LGBT) service members, relying heavily on what is known about LGBT civilian and veteran populations. Significant research gaps about the health care needs of LGBT service members are identified, along with recommendations for closing those gaps. In addition, recommendations for improving LGBT acceptance and integration within the military are provided.
amount of spending has produced a market that has driven the development of technological products that integrate with media devices, cell phones and...of muscle strengthening and activity are important to a service-wide fitness program that would be designed to increase mobility and stamina ...member would be able to participate in daily fitness routines with reduced physical injuries and increased cardiovascular stamina . These would then become
MDW/SGVU SUBJECT: Professional Presentation Approvai 11APR 20 17 1. Your paper, entitled The Influence of Medical Evaluation Board Status on... influence o f medical evaluation board status on symptom reporting among service members w ith traumatic brain injury 7. FUNDING RECEIVED FOR THIS STUDY? D...Page 3 of 3 Pages Title: The influence of medical evaluation board status on symptom reporting among service members with traumatic brain injury
The issue of who is to undertake and sustain an efficient agricultural extension service delivery between the public and private sectors in sub-saharan Africa has continued to feature prominently among the extension stakeholders and professionals. This has become pertinent, especially in recent times where government's ...
Le, Tuan D; Gurney, Jennifer M; Nnamani, Nina S; Gross, Kirby R; Chung, Kevin K; Stockinger, Zsolt T; Nessen, Shawn C; Pusateri, Anthony E; Akers, Kevin S
Nonbattle injury (NBI) among deployed US service members increases the burden on medical systems and results in high rates of attrition, affecting the available force. The possible causes and trends of NBI in the Iraq and Afghanistan wars have, to date, not been comprehensively described. To describe NBI among service members deployed to Iraq and Afghanistan, quantify absolute numbers of NBIs and proportion of NBIs within the Department of Defense Trauma Registry, and document the characteristics of this injury category. In this retrospective cohort study, data from the Department of Defense Trauma Registry on 29 958 service members injured in Iraq and Afghanistan from January 1, 2003, through December 31, 2014, were obtained. Injury incidence, patterns, and severity were characterized by battle injury and NBI. Trends in NBI were modeled using time series analysis with autoregressive integrated moving average and the weighted moving average method. Statistical analysis was performed from January 1, 2003, to December 31, 2014. Primary outcomes were proportion of NBIs and the changes in NBI over time. Among 29 958 casualties (battle injury and NBI) analyzed, 29 003 were in men and 955 were in women; the median age at injury was 24 years (interquartile range, 21-29 years). Nonbattle injury caused 34.1% of total casualties (n = 10 203) and 11.5% of all deaths (206 of 1788). Rates of NBI were higher among women than among men (63.2% [604 of 955] vs 33.1% [9599 of 29 003]; P < .001) and in Operation New Dawn (71.0% [298 of 420]) and Operation Iraqi Freedom (36.3% [6655 of 18 334]) compared with Operation Enduring Freedom (29.0% [3250 of 11 204]) (P < .001). A higher proportion of NBIs occurred in members of the Air Force (66.3% [539 of 810]) and Navy (48.3% [394 of 815]) than in members of the Army (34.7% [7680 of 22 154]) and Marine Corps (25.7% [1584 of 6169]) (P < .001). Leading mechanisms of NBI included falls (2178 [21.3%]), motor vehicle crashes
Johnson, A; Silburn, K
This article briefly describes recent initiatives to improve consumer participation in health services that have led to the establishment of the National Resource Centre for Consumer Participation in Health. The results of a component of the needs assessment undertaken by the newly established Centre are presented. They provide a 'snapshot' of the types of feedback and participation processes mainly being utilised by Australian health services at the different levels of seeking information, information sharing and consultation, partnership, delegated power and consumer control. They also allow identification of the organisational commitment made by Australian health services to support a more coordinated approach to community and consumer feedback and participation at different levels of health services such as particular emphasis on determining the presence of community and consumer participation in key organisational statements, specific consumer policies and plans, identifiable leadership, inclusion into job descriptions, allocation of resources, and staff development and consumer training. Discussion centres around four key observations and some of the key perceived external barriers.
Guina, Jeffrey; Welton, Randon S; Broderick, Pamela J; Correll, Terry L; Peirson, Ryan P
This review addresses how changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 posttraumatic stress disorder (PTSD) criteria has the potential to affect the care and careers of those who have served in the military, where the diagnosis often determines fitness for duty and veterans' benefits. PTSD criteria changes were intended to integrate new knowledge acquired since previous DSM editions. Many believe the changes will improve diagnosis and treatment, but some worry these could have negative clinical, occupational, and legal consequences. We analyze the changes in classification, trauma definition, symptoms, symptom clusters, and subtypes and possible impacts on the military (e.g., over- and under-diagnosis, "drone" video exposure, subthreshold PTSD, and secondary PTSD). We also discuss critiques and proposals for future changes. Our objectives are to improve the screening, diagnosis, and treatment of those service members who have survived trauma and to improve policies related to the military mental healthcare and disability systems.
Clare, I C H; Madden, E M; Holland, A J; Farrington, C J T; Whitson, S; Broughton, S; Lillywhite, A; Jones, E; Wade, K A; Redley, M; Wagner, A P
In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Denise Hoffman; Kristin Andrews; Valerie Cheh
This study examined the characteristics and service use of Medicaid Buy-In participants with higher incomes (above 250 percent of the federal poverty line), relative to participants with lower incomes. The study found higher-income participants were less likely to enroll in Medicare and more likely to be enrolled in third-party insurance. Service use for higher-income Buy-In participants concentrated on prescription drugs and durable medical equipment, and Medicaid expenditures for a selected...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Correction--Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (USPSTF) The original date of publication for this Federal Register notice was March 28, 2012, Volume 77, Number 60, pages 18823...
Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong
Caring and supporting older people with dementia have become a major public health priority. Recent reports have also revealed a diminishing number of family carers to provide dementia care in the future. Carers who are engaged in the caring role are known to bear significant psychological, practical and economic challenges as the disease advances over time. Seemingly, evidence indicates that the burden of care can be relieved by formal services. This study aims to explore decision-making experiences of family members of older adults with moderate dementia towards the use of community support (CS) and residential care home (RCH) services. A large multi-site constructivist grounded theory in a range of non-government organizations and a private aged home will frame this Hong Kong study. Purposive sampling will begin the recruitment of family members, followed by theoretical sampling. It is estimated that more than 100 family members using CS and RCH services will participate in an interview. The process of successive constant comparative analysis will be undertaken. The final product, a theory, will generate an integrated and comprehensive conceptual understanding which will explain the processes associated with decision-making of family members for dementia sufferers. Deeper understanding of issues including, but not exclusive to, service needs, expectations and hopes among family carers for improving service support to serve dementia sufferers in CS and RCH services will also be revealed. Importantly, this study seeks to illustrate the practical and strategic aspects of the theory and how it may be useful to transfer its applicability to various service settings to better support those who deliver formal and informal care to the dementia population.
Jacobsen, Christian Bøtcher; De Lorent Gad, Mette; Kjeldsen, Anne Mette
The most widely used method to study individuals’ public service motivation is surveys. The validity and inferential power of such studies may, however, be harmed by survey participation bias, if highly public service motivated individuals are overrepresented among respondents. This paper examines...... the methodological critique of survey participation bias raised against the public service motivation literature and examines whether public service motivation increases the propensity to respond to surveys. By tracking more than 3,000 public service providers’ participation in a three-wave panel survey, our...... analysis shows that public service motivation does have a positive effect on survey participation. This suggests that future studies should pay attention to the characteristics of respondents/non-respondents and consider weighting the sample....
This study uses Facebook as a platform and arranges certain learning tasks to identify the feasibility of mobile collaborative learning for pre-service teachers. The pre-service teachers' sense of community and perceptions of collaborative learning are investigated. A total of 153 pre-service teachers volunteered to participate in an Intern Mobile…
... HOSPITALS Basic Hospital Functions § 482.28 Condition of participation: Food and dietetic services. The... employee who— (i) Serves as director of the food and dietetic service; (ii) Is responsible for the daily... must be readily available to all medical, nursing, and food service personnel. ...
... types of vocational rehabilitation services for which the unit has established a financial needs test... service. (3) The designated State unit may not apply a financial needs test, or require the financial... 34 Education 2 2010-07-01 2010-07-01 false Participation of individuals in cost of services based...
The Department of Defense's (DOD) Exceptional Family Member Program (EFMP) is a mandatory enrollment program for active duty servicemembers who have family members with special medical needs. The Ronald W...
Forrest, Laura; Delatycki, Martin; Curnow, Lisette; Gen Couns, M; Skene, Loane; Aitken, Maryanne
The aim of this study was to investigate the uptake of genetic testing by at-risk family members for four genetic conditions: chromosomal translocations, fragile X syndrome, Huntington disease, and spinal muscular atrophy. A clinical audit was undertaken using genetics files from Genetic Health Services Victoria. Data were extracted from the files regarding the number of at-risk family members and the proportion tested. Information was also collected about whether discussion of at-risk family members and family communication during the genetic consultation was recorded. The proportion of at-risk family members who had genetic testing ranged from 11% to 18%. First-degree family members were most frequently tested and the proportion of testing decreased by degree of relatedness to the proband. Smaller families were significantly more likely to have genetic testing for all conditions except Huntington disease. Female at-risk family members were significantly more likely to have testing for fragile X syndrome. The majority of at-risk family members do not have genetic testing. Family communication is likely to influence the uptake of genetic testing by at-risk family members and therefore it is important that families are supported while communicating to ensure that at-risk family members are able to make informed decisions about genetic testing.
Elnitsky, Christine A; Blevins, Cara L; Fisher, Michael P; Magruder, Kathryn
Returning military service members and veterans (MSMVs) experience a wide range of stress-related disorders in addition to social and occupational difficulties when reintegrating to the community. Facilitating reintegration of MSMVs following deployment is a societal priority. With an objective of identifying challenges and facilitators for reintegration of MSMVs of the current war era, we critically review and identify gaps in the literature. We searched 8 electronic databases and identified 1,764 articles. Screening of abstracts and full-text review based on our inclusion/exclusion criteria, yielded 186 articles for review. Two investigators evaluating relevant articles independently found a lack of clear definition or comprehensive theorizing about MSMV reintegration. To address these gaps, we linked the findings from the literature to provide a unified definition of reintegration and adapted the social ecological systems theory to guide research and practice aimed at MSMV reintegration. Furthermore, we identified individual, interpersonal, community, and societal challenges related to reintegration. The 186 studies published from 2001 (the start of the current war era) to 2015 included 6 experimental studies or clinical trials. Most studies do not adequately account for context or more than a narrow set of potential influences on MSMV reintegration. Little evidence was found that evaluated interventions for health conditions, rehabilitation, and employment, or effective models of integrated delivery systems. We recommend an ecological model of MSMV reintegration to advance research and practice processes and outcomes at 4 levels (individual, interpersonal, organizational, and societal). (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Rashid, Faisal M.; Dennis, Emily L.; Villalon-Reina, Julio E.; Jin, Yan; Lewis, Jeffrey D.; York, Gerald E.; Thompson, Paul M.; Tate, David F.
Mild traumatic brain injury (mTBI) is characterized clinically by a closed head injury involving differential or rotational movement of the brain inside the skull. Over 3 million mTBIs occur annually in the United States alone. Many of the individuals who sustain an mTBI go on to recover fully, but around 20% experience persistent symptoms. These symptoms often last for many weeks to several months. The thalamus, a structure known to serve as a global networking or relay system for the rest of the brain, may play a critical role in neurorehabiliation and its integrity and connectivity after injury may also affect cognitive outcomes. To examine the thalamus, conventional tractography methods to map corticothalamic pathways with diffusion-weighted MRI (DWI) lead to sparse reconstructions that may contain false positive fibers that are anatomically inaccurate. Using a specialized method to zero in on corticothalamic pathways with greater robustness, we noninvasively examined corticothalamic fiber projections using DWI, in 68 service members. We found significantly lower fractional anisotropy (FA), a measure of white matter microstructural integrity, in pathways projecting to the left pre- and postcentral gyri - consistent with sensorimotor deficits often found post-mTBI. Mapping of neural circuitry in mTBI may help to further our understanding of mechanisms underlying recovery post-TBI.
Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners
Andersen, Ingrid Charlotte; Thomsen, Thora Grothe; Bruun, Poul; Bødtger, Uffe; Hounsgaard, Lise
To explore the experiences of patients with chronic obstructive pulmonary disease and their family members relating both to participation in care during hospitalisation for an acute exacerbation in chronic obstructive pulmonary disease, and to the subsequent day-to-day care at home. When recovering from an exacerbation, the challenges associated with an unpredictable health condition dominate everyday life for patients and can involve their family members. Proper patient and family participation in care during discharge and follow-up can help patients to improve self-management. However, knowledge of the significance of patient and family participation for recovery and subsequent everyday life is still limited. This study adopted a longitudinal design informed by ethnographic fieldwork principles. Participant observations and interviews with 15 patients and 12 family members were conducted on a Danish hospital ward and twice at the participants' homes. A phenomenological-hermeneutic approach inspired by Ricoeur's theory of interpretation guided the data analysis. Participation in care was perceived as valuable, but could be associated with tensions and increased uncertainty. While patients mostly demonstrated a reactive approach to care, family members strived to be more proactive. In hospital, preparing for discharge included an effort to find a balance between powerlessness and influence during interactions with healthcare professionals. At home, managing further recovery and self-management were characterised by navigating between mutual pressure and consideration within the family. Family members play an important role in ensuring that patients are seen, heard and understood, but want to be acknowledged more by healthcare professionals. Appropriate interactions with healthcare professionals are crucial in order to support discharge and daily self-management. Knowledge of the challenges that patients with chronic obstructive pulmonary disease and their family
Teyhen, Deydre S; Riebel, Mark A; McArthur, Derrick R; Savini, Matthew; Jones, Mackenzie J; Goffar, Stephen L; Kiesel, Kyle B; Plisky, Phillip J
Determine the influence of age and sex and describe normative data on field expedient tests associated with power, balance, trunk stability, mobility, and functional movement in a military population. Participants (n = 247) completed a series of clinical and functional tests, including closed-chain ankle dorsiflexion (DF), Functional Movement Screen (FMS), Y-Balance Test Lower Quarter (YBT-LQ), Y-Balance Test Upper Quarter (YBT-UQ), single leg vertical jump (SLVJ), 6-m timed hop (6-m timed), and triple hop. Descriptive statistics were calculated. Analysis of variance tests were performed to compare the results based on sex and age (30 years). Service members demonstrated DF of 34.2 ± 6.1°, FMS composite score of 16.2 ± 2.2, YBT-LQ normalized composite score of 96.9 ± 8.6%, YBT-UQ normalized composite score of 87.6 ± 9.6%, SLVJ of 26.9 ± 8.6 cm, 6-m hop of 2.4 ± 0.5 seconds, and a triple hop of 390.9 ± 110.8 cm. Men performed greater than women (p power, balance, and trunk stability tests, whereas younger individuals performed better on power, balance, mobility, and functional movement. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Pollard, Lorraine; Agarwal, Shona; Harrad, Fawn; Lester, Louise; Cross, Ainsley; Wray, Paula; Smith, Gordon; Locke, Anthony; Sinfield, Paul
NHS policy documents continue to make a wide-ranging commitment to patient involvement. The Patient Participation Direct Enhanced Service (PP-DES), launched in 2011, aimed to ensure patients are involved in decisions about the range and quality of services provided and commissioned by their practice through patient reference groups (PRGs). The aim of this exploratory study is to review the impact of the PP-DES (2011-13) on a sample of PRGs and assess how far it has facilitated their involvement in decisions about the services of their general practices. A qualitative methods design, using semi- structured interviews and focus groups, was employed to explore the experiences and views of GP practice staff (n = 24), PRG members (n = 80) at 12 GP practices, and other stakeholders (n = 4). Wide variation in the role and remit of the participating PRGs was found, which broadly ranged from activities to improve practice resources to supporting health promotion activities. The majority of PRG members were unfamiliar with the PP-DES scheme and its aims and purpose. Stakeholders and practice staff felt strongly that the main success of the PP-DES was that it had led to an increase in the number of PRGs being established in the locality. The PP-DES scheme has been a catalyst to establish PRGs. However, the picture was mixed in terms of the PRGs involvement in decisions about the services provided at their general practice as there was wide variation in the PRGs role and remit. The financial incentive alone, provided via the DES scheme, did not secure greater depth of PRG activity and power, however, as social factors were identified as playing an important role in PRGs' level of participation in decision making. Many PRGs have to become more firmly established before they are involved as partners in commissioning decisions at their practice.
Poncet, Frédérique; Pradat-Diehl, Pascale; Lamontagne, Marie-Eve; Alifax, Anne; Fradelizi, Pascaline; Barette, Maude; Swaine, Bonnie
A holistic, intensive and interdisciplinary rehabilitation program for people with acquired brain injury (ABI) was developed at the Pitié-Salpêtrière Hospital, France (5 days/week for 7 weeks). This program, recently demonstrated effective, aimed to optimize the ability of people with ABI to perform activities and improve their participation by using individual and group interventions involving ecologically valid activities inside (e.g., in the gym and kitchen) and outside the hospital. However, the perception of the quality of the program by participants and service providers has not yet been reported. This study had 3 objectives: (1) report the perception of participants (adults with ABI) in terms of service quality of the program, (2) report the strengths, weaknesses, opportunities, and threats (SWOT analysis) of the program as perceived by service providers, and (3) triangulate findings to draw conclusions about the program's quality and provide recommendations for quality improvement. We used a mixed-methods design with a validated questionnaire (Perception of Quality of Rehabilitation Services [PQRS-Montreal]) and interviews (structured around a SWOT analysis) involving program participants and service providers. We included 33 program participants (mean age 43.6 years) and 12 service providers (mean years with program 7.6 years). In general, study participants showed a convergence of opinion about the high quality of the program, particularly regarding the team and its participant-focused approach. Specific aspects of the program were viewed more negatively by both participants and service providers (i.e., addressing sexuality, family involvement and return to work/volunteer work/school). Participant and service provider perceptions of the rehabilitation program under study were generally positive. A reliable and valid questionnaire and interviews helped identify aspects of the program that worked well and those that could be targeted for future quality
Seelig, Amber D; Rivera, Anna C; Powell, Teresa M; Williams, Emily C; Peterson, Arthur V; Littman, Alyson J; Maynard, Charles; Street, Amy E; Bricker, Jonathan B; Boyko, Edward J
In the first known longitudinal study of the topic, we examined whether experiencing sexual assault or sexual harassment while in the military was associated with increased risk for subsequent unhealthy alcohol use and smoking among U.S. service members in the Millennium Cohort Study (2001-2012). Adjusted complementary log-log models were fit to estimate the relative risk of (a) smoking relapse among former smokers (men: n = 4,610; women: n = 1,453); (b) initiation of unhealthy alcohol use (problem drinking and/or drinking over recommended limits) among those with no known history of unhealthy alcohol use (men: n = 8,459; women: n = 4,816); and (c) relapse among those previously reporting unhealthy alcohol use (men: n = 3,487; women: n = 1,318). Men who reported experiencing sexual assault while in the military had sixfold higher risk for smoking relapse: relative risk (RR) = 6.62; 95% confidence interval (CI) [2.34, 18.73], than men who did not. Women who reported experiencing sexual assault while in the military had almost twice the risk for alcohol relapse: RR = 1.73; 95% CI [1.06, 2.83]. There were no other significant associations. These findings suggest that men and women may respond differently following sexual trauma, and support future concerted policy efforts by military leadership to prevent, detect, and intervene on sexual assault. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Vento, Todd J; Calvano, Tatjana P; Cole, David W; Mende, Katrin; Rini, Elizabeth A; Tully, Charla C; Landrum, Michael L; Zera, Wendy; Guymon, Charles H; Yu, Xin; Beckius, Miriam L; Cheatle, Kristelle A; Murray, Clinton K
Staphylococcus aureus [methicillin-resistant and methicillin-susceptible (MRSA/MSSA)] is a leading cause of infections in military personnel, but there are limited data regarding baseline colonization of individuals while deployed. We conducted a pilot study to screen non-deployed and deployed healthy military service members for MRSA/MSSA colonization at various anatomic sites and assessed isolates for molecular differences. Colonization point-prevalence of 101 military personnel in the US and 100 in Afghanistan was determined by swabbing 7 anatomic sites. US-based individuals had received no antibiotics within 30 days, and Afghanistan-deployed personnel were taking doxycycline for malaria prophylaxis. Isolates underwent identification and testing for antimicrobial resistance, virulence factors, and pulsed-field type (PFT). 4 individuals in the US (4 isolates- 3 oropharynx, 1 perirectal) and 4 in Afghanistan (6 isolates- 2 oropharynx, 2 nare, 1 hand, 1 foot) were colonized with MRSA. Among US-based personnel, 3 had USA300 (1 PVL+) and 1 USA700. Among Afghanistan-based personnel, 1 had USA300 (PVL+), 1 USA800 and 2 USA1000. MSSA was present in 40 (71 isolates-25 oropharynx, 15 nare) of the US-based and 32 (65 isolates- 16 oropharynx, 24 nare) of the Afghanistan-based individuals. 56 (79%) US and 41(63%) Afghanistan-based individuals had MSSA isolates recovered from extra-nare sites. The most common MSSA PFTs were USA200 (9 isolates) in the US and USA800 (7 isolates) in Afghanistan. MRSA/MSSA isolates were susceptible to doxycycline in all but 3 personnel (1 US, 2 Afghanistan; all were MSSA isolates that carried tetM). MRSA and MSSA colonization of military personnel was not associated with deployment status or doxycycline exposure. Higher S. aureus oropharynx colonization rates were observed and may warrant changes in decolonization practices.
2. REPORT TYPE 10/07/2017 Presentation 4. TITLE AND SUBTITLE GENITOURINARY INJURIES SUSTAINED BY FEMALE U.S. SERVICE MEMBERS DURING OPERATION...for increased female GU injuries in future conflicts and the long-term sequelae from these injury patterns. Materials and Methods: The Department of
Whiteman, Shawn D; Barry, Adam E; Mroczek, Daniel K; Macdermid Wadsworth, Shelley
Student service members/veterans represent a growing population on college campuses. Despite this growth, scholarly investigations into their health- and adjustment-related issues are almost nonexistent. The limited research that is available suggests that student service members/veterans may have trouble connecting with their civilian counterparts and be at risk for social isolation. The present study compared the development and implications of emotional support from peers among 199 student service members/veterans and 181 civilian students through 3 distinct occasions over the course of 1 calendar year. Data were collected via electronic survey. Measured constructs included perceived emotional support from university friends, mental health, alcohol use, and academic functioning. A series of multilevel models revealed that student service members/veterans reported less emotional support from their peers compared with their civilian counterparts; yet, emotional support from peers increased similarly for both groups over time. Although, increasing peer emotional support was generally related to better academic and mental health outcomes for both groups, the links between emotional support and mental health were stronger for civilian students. Results suggest that mental health practitioners, particularly those on college campuses, should be prepared to deal with veteran-specific experiences that occur before and during college.
Stewart, Jamie C.
This study involved a one group pretest-posttest study to analyze the effectiveness of the Alpha Phi Omega leadership development course titled SERVE. This study focused on the collegiate members of this coeducational service fraternity. The Student Leadership Practices Inventory was administered as both a pretest and posttest; the posttest was…
... Force Reserve Officers Training Corps, when ordered to annual training duty for 14 days or more... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Work as a member of a uniformed service of the United States. 404.1019 Section 404.1019 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...
McLay, Robert N; Webb-Murphy, Jennifer A; Fesperman, Susan F; Delaney, Eileen M; Gerard, Steven K; Roesch, Scott C; Nebeker, Bonnie J; Pandzic, Ines; Vishnyak, Elizabeth A; Johnston, Scott L
Eye movement desensitization and reprocessing (EMDR) is one of the therapy interventions recommended by the Veterans Affairs and Department of Defense Clinical Practice Guidelines. However, the literature concerning the effectiveness of this treatment modality in military service members is sparse. This study investigated the efficacy of EMDR in active-duty service members. We conducted an effectiveness study with a record review from active-duty military mental health clinics where clinical outcomes had been monitored over a 10-week period using self-report measures of posttraumatic stress and disability. Symptom scores were examined over time in 331 service members who met presumptive criteria for the disorder on the PTSD Checklist-Military Version (PCL-M), who were in psychotherapy, and who received (n = 46) or didn't receive (n = 285) EMDR. Results indicated that patients receiving EMDR had significantly fewer therapy sessions over 10 weeks but had significantly greater gains in their PCL-M scores than did individuals not receiving EMDR. Randomized, controlled trials are still needed, but these findings provide further support for the use of EMDR in service members with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...
..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Conditions of participation... orientation about the hospice philosophy to all employees and contracted staff who have patient and family...
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
Mota, Natalie P; Medved, Maria; Whitney, Debbie; Hiebert-Murphy, Diane; Sareen, Jitender
Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations. Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed. In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant. Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members.
Park, Albert; Conway, Mike
Major depression is a serious challenge at both the individual and population levels. Although online health communities have shown the potential to reduce the symptoms of depression, emotional contagion theory suggests that negative emotion can spread within a community, and prolonged interactions with other depressed individuals has potential to worsen the symptoms of depression. The goals of our study were to investigate longitudinal changes in psychological states that are manifested through linguistic changes in depression community members who are interacting with other depressed individuals. We examined emotion-related language usages using the Linguistic Inquiry and Word Count (LIWC) program for each member of a depression community from Reddit. To measure the changes, we applied linear least-squares regression to the LIWC scores against the interaction sequence for each member. We measured the differences in linguistic changes against three online health communities focusing on positive emotion, diabetes, and irritable bowel syndrome. On average, members of an online depression community showed improvement in 9 of 10 prespecified linguistic dimensions: "positive emotion," "negative emotion," "anxiety," "anger," "sadness," "first person singular," "negation," "swear words," and "death." Moreover, these members improved either significantly or at least as much as members of other online health communities. We provide new insights into the impact of prolonged participation in an online depression community and highlight the positive emotion change in members. The findings of this study should be interpreted with caution, because participating in an online depression community is not the sole factor for improvement or worsening of depressive symptoms. Still, the consistent statistical results including comparative analyses with different communities could indicate that the emotion-related language usage of depression community members are improving either
Elsharnouby, Tamer H.
Purpose: The purpose of this paper is to integrate service marketing and higher education (HE) literature to develop and test a model that links customer participation behaviour with student overall satisfaction that stems from satisfaction with service augmentation elements. It also examines the influence of brand choice attainment on both…
Masanyiwa, Z.S.; Niehof, A.; Termeer, C.J.A.M.
Increasing participation in decision-making processes by service users is one of the objectives of decentralisation reforms in Tanzania. The argument is that decentralisation enhances participation by all sections of the community, and by women in particular, and results in decisions that better
Kwak, Yoonyoung; Lu, Ting; Christ, Sharon L.
Background: Many adolescents are referred to Child Protective Services for possible maltreatment every year, but not much is known about their organized and unstructured activity participation. Objective: The purposes of this study are to provide a description of organized and unstructured activity participation for adolescents who were possible…
Leung, Terry T. F.
"Client participation" is a popular ideal and object of rhetorical commitment in social work service. But the much-touted potential of this concept requires careful and critical scrutiny. This article reports on a study of client-participation initiatives in the Hong Kong welfare sector. The study identified significant differences in…
Montero Hernandez, Virginia
Since the 1990s, the federal government required public state universities in Mexico to recruit full time faculty members with doctoral degrees and research productivity to increase the academic competitiveness of higher education. After two decades of the implementation of federal mandates, public state universities have not improved their…
Manchester, Julianne; Eshel, Inbal; Marion, Donald W
Energy drinks (EDs) have become an integral part of the young adult, athletic, and military culture. Many athletes are convinced that EDs enhance performance, and service members as well as college students frequently use EDs as stimulants to counter sleep deprivation, or to improve academic performance. However, concerns have been raised by some military leaders about potential adverse effects of EDs. A needs assessment survey of a convenience sample of military health care providers was conducted and identified EDs as a top knowledge need for those providers working in the area of traumatic brain injury (TBI). The instrument demonstrated high interitem consistency (Cronbach's α > .80). To further explore the state of knowledge on EDs, and to prompt further discussion of ED use and how it may related to military treatment protocols and supporting educational products, we conducted a literature review of English language publications listed in the National Library of Medicine using the search term "energy drinks" and published during the last 5 years to determine what is known about EDs in terms of their potential benefits and health risks. The active ingredients in most EDs are caffeine, and to a lesser extent taurine and sugars. Several reports suggest that the combination of these ingredients is more active than the caffeine alone. Despite the positive attributes of EDs, there are increasing reports of serious and potentially life-threatening side effects. Most recently there also has been a dramatic increase in the use of ED/alcohol combination drinks, and there are preliminary studies that suggest important adverse effects with this combination. A 2013 National Institutes of Health expert workshop concluded that more clinical studies are needed to clearly define the health risks associated with ED use. The needs assessment points to a desire for more ED knowledge of health providers working with TBI patients. A few key themes emerged from the exploratory
Little, Jeanette R; Pavliscsak, Holly H; Cooper, Mabel R; Goldstein, Lois A; Fonda, Stephanie J
Research has shown that mobile phones can help with management of numerous health problems. As an adjunct to care management provided to injured service members rehabilitating in their communities, particularly those with mild traumatic brain injury (mTBI), post-traumatic stress (PTS), and/or behavioral health problems, the Army developed a mobile phone application called "mCare." This study examined whether service members who received mCare had higher well-being, were more satisfied with their care, and viewed mCare as a valuable part of their care management as compared with their counterparts who received standard care management alone, and whether those with mTBI, PTS, and/or behavioral health problems benefited differently from mCare. In-processing service members at four community-based warrior transition units were recruited for participation in a 36-wk, randomized, controlled trial and allocated to receive standard care management plus mCare (n = 95) or standard care management alone (n = 87). Participants in the mCare group received daily questionnaires, tips, and appointment reminders. All participants were asked to complete the General Well-being Schedule (GWS) at baseline, 12, 24, and 36 wk, and the Case Management Quality Questionnaire (CMQQ) at 12, 24, and 36 wk. All participants and care managers were approached to complete interviews about the usability/likeability of mCare or standard care management. The analyses tested for group differences in completion of the intervention, graphed means for the GWS and CMQQ by group/subgroup, and statistically compared the longitudinal trends in these outcomes using mixed models in which group, time, and group*time were included as regression variables. The analyses also tallied interview responses and identified thematic quotes. The study protocol was reviewed and approved by the Walter Reed National Military Medical Center's Institutional Review Board. Estimated rate of change in GWS scores was -2
Full Text Available This article examines the nature and degree of influence of service liberalization on the participation of the BRICS grouping of Brazil, Russia, India, China and South Africa in global value chains (GVCs. The inverse relationship between the barriers in infrastructure services and the degree of participation of countries in GVCs was determined using econometric analysis methods. Using data on the structure of trade in goods and services in terms of value added, the situation of developing countries was analyzed using the example of the BRICS in production and service GVCs. China and India are the most deeply integrated countries in the international production and service chains while Russia, Brazil and South Africa participate in the production value chains as suppliers of raw materials and intermediate goods with low added value. However, these countries have a significant potential to expand their participation in the system of international production by improving the infrastructure necessary for the operation of the GVC. This study of the experience of liberalization in certain service sectors in BRICS countries reveals the positive impact of reducing barriers in maritime, rail and air transportation sectors, as well as finance, for improving the quality and reducing the cost of services. The authors note that in many respects, these effects were the result not only of reducing barriers in services, but also the implementation of a set of measures aimed at increasing the investment attractiveness of countries. The article concludes that the liberalization of infrastructure services industries can become one of the tools for integrating BRICS countries into the GVC. However, this liberalization should be part of a broader development strategy that includes trade and investment policy measures aimed not only at increasing participation in global production, but also overall economic development of the country
Tang, Jessica Pui-Shan; Tse, Samson Shu-Ki; Davidson, Larry; Cheng, Patrick
Current models of user participation in mental health services were developed within Western culture and thus may not be applicable to Chinese communities. To present a new model of user participation, which emerged from research within a Chinese community, for understanding the processes of and factors influencing user participation in a non-Western culture. Multiple qualitative methods, including focus groups, individual in-depth interviews, and photovoice, were applied within the framework of constructivist grounded theory and collaborative research. Diverging from conceptualizations of user participation with emphasis on civil rights and the individual as a central agent, participants in the study highlighted the interpersonal dynamics between service users and different players affecting the participation intensity and outcomes. They valued a reciprocal relationship with their caregivers in making treatment decisions, cooperated with staff to observe power hierarchies and social harmony, identified the importance of peer support in enabling service engagement and delivery, and emphasized professional facilitation in advancing involvement at the policy level. User participation in Chinese culture embeds dynamic interdependence. The proposed model adds this new dimension to the existing frameworks and calls for attention to the complex local ecology and cultural consistency in realizing user participation.
Lange, Rael T; Brickell, Tracey A; Bailie, Jason M; Tulsky, David S; French, Louis M
To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population. One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively). Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9). Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale. The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.
Lu, Lisa H; Cooper, Doug B; Reid, Matthew W; Khokhar, Bilal; Tsagaratos, Jennifer E; Kennedy, Jan E
To compare symptom reporting patterns of service members with a history of concussion based on work status: full duty, limited duty, or in the Medical Evaluation Board (MEB)/disability process. Retrospective analysis of 181 service members with a history of concussion (MEB n = 56; limited duty n = 62; full duty n = 63). Neurobehavioral Symptom Inventory (NSI) Validity-10 cutoff (>22) and Mild Brain Injury Atypical Symptoms Scale (mBIAS) cutoffs (≥10 and ≥8) were used to evaluate potential over-reporting of symptoms. The MEB group displayed significantly higher NSI scores and significantly higher proportion scored above the mBIAS ≥10 cutoff (MEB = 15%; limited duty = 3%; full duty = 5%). Validity-10 cutoff did not distinguish between groups. MEB but not limited duty status was associated with increased risk of over-reporting symptoms in service members with a history of concussion. Results support the use of screening measures for over-reporting in the MEB/disability samples.
Collins, H. E.; Gathers, R.; Halstead, R. J.
According to the 1999 Draft Environmental Impact Statement (DEIS) for the proposed Yucca Mountain repository site, members of the public along transportation routes by which spent nuclear fuel (SNF) and high-level radioactive waste (HLW) is shipped will receive annual radiation doses less than 100 mrem/yr, the international (ICRP) and national (Department of Energy, Nuclear Regulatory Commission) radiation limit for members of the public. For the ''Mostly Truck'' national transportation scenario, the DEIS specifically concludes that the maximally exposed member of the public, a service station attendant along the primary shipping route will receive no more than 100 mrem/yr, or 2.4 rem over 24 years. Based on the assumptions in the DEIS scenarios, however, it is highly likely that service station attendants along shipping routes will be called upon to fuel and service the rigs carrying SNF and HLW to Yucca Mountain. After reevaluating the DEIS, and making realistic alternative assumptions where necessary, the authors conclude that these attendants are likely to receive substantially more than 100 mrem/yr external dose, and perhaps several times that dose (up to 500 mrem/yr), unless mitigating measures are adopted. This is particularly true in Western states where refueling opportunities are limited, and the distances between fuel sources in rural areas may be up to 100 miles
... Secretary for Human Resources and Chief Human Capital Officer Bynum, Nicole, Chief of Management Operations... CONTACT: Mario R. Minor, Senior Human Resources Specialist, 1500 Pennsylvania Avenue NW., ATTN: Room 6W529... career appointee, more than half the members shall consist of career appointees. The names and titles of...
Full Text Available Background: Occupational therapy can contribute to the health and well-being of people with human immunodeficiency virus (HIV who are experiencing health consequences of living long term with this disease. However, there are no comprehensive rehabilitation service delivery models to guide this emerging area of practice. The purpose of this study was to obtain critical feedback about a service delivery model to address the activity and social participation needs of people living with HIV. Method: We developed a service delivery model from a synthesis of the literature. Using a qualitative research design, we conducted individual and focus group interviews with 35 informants from diverse backgrounds and involvement in HIV-related research, service provision, and policymaking to provide critical feedback about the model. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative methods. Results: The informants identified the strengths and limitations of the model and supports and barriers to its implementation. They highlighted the importance of principle-based services, increasing resources for service navigation, building capacity of rehabilitation services to address the needs of people with HIV, and increasing research and program evaluation targeted to achieving activity and social participation outcomes. Conclusions: The model provides a framework for occupational therapists to design and evaluate services for this population.
... State Approving Agencies (SAAs) that work with the Department of Veterans Affairs to review participating institutions, provide a coordinated mechanism across SAAs to alert the Department of Veterans...
O'Haire, Marguerite E; Rodriguez, Kerri E
Psychiatric service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. The addition of trained service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Eddens, Katherine S; Alcaraz, Kassandra I; Kreuter, Matthew W; Rath, Suchitra; Greer, Regina
In times of crises, 2-1-1 serves as a lifeline in many ways. These crises often cause a spike in call volume that can challenge 2-1-1's ability to meet its service quality standards. For researchers gathering data through 2-1-1s, a sudden increase in call volume might reduce accrual as 2-1-1 has less time to administer study protocols. Research activities imbedded in 2-1-1 systems may affect directly 2-1-1 service quality indicators. Using data from a 2-1-1 research collaboration, this paper examines the impact of crises on call volume to 2-1-1, how call volume affects research participant accrual through 2-1-1, and how research recruitment efforts affect 2-1-1 service quality indicators. t-tests were used to examine the effect of call volume on research participant accrual. Linear and logistic regressions were used to examine the effect of research participant accrual on 2-1-1 service quality indicators. Data were collected June 2010-December 2011; data were analyzed in 2012. Findings from this collaboration suggest that crises causing spikes in call volume adversely affect 2-1-1 service quality indicators as well as accrual of research participants. Administering a brief (2-3 minute) health risk assessment did not affect service quality negatively, but administering a longer (15-18 minute) survey had a modest adverse effect on these indicators. In 2-1-1 research collaborations, both partners need to understand the dynamic relationship among call volume, research accrual, and service quality and adjust expectations accordingly. If research goals include administering a longer survey, increased staffing of 2-1-1 call centers may be needed to avoid compromising service quality. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Talgø, Therese; Rødsjø, Espen Liseth
Customer participation represents numerous positive effects for companies in terms of productivity gains and profitability. It has in recent years emerged as a powerful tool for companies to customize their service offerings and engage the customers in marketing activities. Still, the increased demand for customization also requires a great deal of flexibility and adaptations, making the risk of service defections higher as well. The question is whether companies should encourage customers t...
This thesis is about the metaphors of the rainbow and the fogbow, investigations and evaluations, public Internet monitors, writing women, reflections and discussions about politics, design and democracy. It is also about the ongoing re-structuring of participation in service design within the development of E-Government. The aim behind the drive towards E-Government is to modernise administration and make it more efficient. The transformation and modernisation of public services are proclaim...
MacMillan, Douglas C.
Incentive-based mechanisms cancontribute to rural development and deliver environmental services, but need to be attractive to landowners and communities to ensure their participation.Here we study the views of landowners and agrarian communities(ejidos)from central Jalisco in Mexico to identify characteristics that payment for environmental services (PES)programs conserving/enhancing forest cover could include in their design. A choice experiment was applied to 161 landowners and ejido-lando...
Zhang, Baohua; Hu, Weihao; Chen, Zhe
in the stochastic optimization to deal with the uncertainty of the up regulation price and the up regulation activation of the power system.The Danish short-term electricity market and a wind farm in western Denmark are chosen to evaluate the effect of the proposed strategy. Simulation results showthe proposed......As modern wind farmshave the ability to provideregulation service for the power system, wind power plant operators may be motivated to participate in the regulating market to maximize their profit.In this paper, anoptimal regulation servicestrategy for a wind farm to participate...... strategy can increase the revenue of wind farms by leavinga certain amount of wind powerfor regulation service....
Full Text Available This paper deals with public service obligation, a form of state aid that applies to air services. The paper first provides general information on the European legislation applying to this form of state aid, and elaborates the legal framework and general principles. The second part is dedicated to a comparison of a similar subsidizing programme in the USA and Australia. An examination of current imposed public service obligation routes in Europe is provided in the following section. The coefficients defining the number of imposed PSO routes per various geo-economic variables have been defined.
Knight, Louise; Cooper, Rhonda S; Hypki, Cinder
Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.
The report includes the proceedings and papers presented during the workshop on the experience with WASP/MAED computer programs among IAEA Member States participating in the regional co-operative agreement (RCA) in Asia and the Pacific Region, organized by the IAEA and held in Kuala Lumpur (Malaysia) between 5-9 December 1988. A separate abstract was prepared for each of the 14 papers presented. Refs, figs and tabs
McCaffrey, Tríona; Edwards, Jane
Mental health service development internationally is increasingly informed by the collaborative ethos of recovery. Service user evaluation of experiences within music therapy programs allows new phenomena about participation in services to be revealed that might otherwise remain unnoticed. The aim of this study was to demonstrate how asking service users about their experience of music therapy can generate useful information, and to reflect upon the feedback elicited from such processes in order to gain a deeper understanding of how music therapy is received among service users in mental health. Six mental health service users described their experiences of music therapy in one or two individual interviews. Transcripts of interviews were analyzed using the procedures and techniques of Interpretative Phenomenological Analysis. Interviews with mental health service users provided rich, in-depth accounts reflecting the complex nature of music therapy participation. Super-ordinate themes refer to the context in which music therapy was offered, the rich sound world of music in music therapy, the humanity of music therapy, and the strengths enhancing opportunities experienced by service users. Participants indicated that they each experienced music therapy in unique ways. Opinions about the value of music therapy were revealed through an interview process in which the researcher holds an open attitude, welcoming all narrative contributions respectfully. These findings can remind practitioners of the importance of closely tuning into the perspectives and understandings of those who have valuable expertise to share about their experience of music therapy services in mental health. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: email@example.com.
their families. Nothing that I do as the Secretary of the Army is more important than this [emphasis added] ( Harvey , 2009). According to the Army...to address the physical, material, mental and spiritual needs of each member of the Total Army Family [emphasis added] ( Harvey and Schoomaker, 2006...Laurie Weinstein and Christie C. White, eds., Wives and Warriors: Women and the Military in the United States and Canada, Westport, Conn.: Greenwood
.... Reagan National Defense Authorization Act for Fiscal Year 2005 directed us to evaluate the effect of EFMP on health, support, and education services in selected civilian communities with a high...
and others. Voluntary separations include end of term of Service, retirement, pregnancy , and others. DoDI 1336.01, “Certificate of Release or...Completion of Required Active Service - Weight Control Failure - Pregnancy or Childbirth - Parenthood/Custody of Minor Children - Disability...Serious Offense) - Alcohol Rehabilitation Failure - File Not Found - SPD Codes Used Less Than 75 Times Introduction 6 │ DODIG-2016-088 NDMC Separations Of
Full Text Available The purpose of this pilot study is 1 to develop an annotation schema and a training set of annotated notes to support the future development of a natural language processing (NLP system to automatically extract employment information, and 2 to determine if information about employment status, goals and work-related challenges reported by service members and Veterans with mild traumatic brain injury (mTBI and post-deployment stress can be identified in the Electronic Health Record (EHR.Retrospective cohort study using data from selected progress notes stored in the EHR.Post-deployment Rehabilitation and Evaluation Program (PREP, an in-patient rehabilitation program for Veterans with TBI at the James A. Haley Veterans' Hospital in Tampa, Florida.Service members and Veterans with TBI who participated in the PREP program (N = 60.Documentation of employment status, goals, and work-related challenges reported by service members and recorded in the EHR.Two hundred notes were examined and unique vocational information was found indicating a variety of self-reported employment challenges. Current employment status and future vocational goals along with information about cognitive, physical, and behavioral symptoms that may affect return-to-work were extracted from the EHR. The annotation schema developed for this study provides an excellent tool upon which NLP studies can be developed.Information related to employment status and vocational history is stored in text notes in the EHR system. Information stored in text does not lend itself to easy extraction or summarization for research and rehabilitation planning purposes. Development of NLP systems to automatically extract text-based employment information provides data that may improve the understanding and measurement of employment in this important cohort.
help outside their chain of command. 41 Your family member may also: • feel depressed • begin to abuse alcohol or drugs • have problems with...P.O. Box 5715 Helena, MT 59604 P.O. Box 95083 301 Centennial Mall South, 6th Floor Lincoln, NE 68509 5460 Reno Corporation Dr. Reno, NV 89511 275...main.htm or call the toll-free line at 1-800-444-5445. DoD Mental Health Self Assessment Program Anonymous self-assessments are available for depression
ABSTRACTBackground:Introduction: Jamkesda is pro- poor government policy to fulfill their health care right base on mandate of law. Departemen of Health in Nganjuk Regency run socialization by involving all local power Hence, in 2012 Jamkesda participation would reach highest in East Java. Purpose:This resaerch aimed to identify Jamkesda participation acceleration and Jamkesda member visit based on age group phenomenon in Nganjuk Regency year 2012. Method:Descriptive research with cross sectional design. Population was Nganjuk Regency government Agency with all Jamkesda managing agencies as sample. Analysis unit was institution. Respondents were officials who managed Jamkesda.Result:Jamkesda in Nganjuk Regency was integrate to Sub Divison of Special Service an Health Costing primary task. In 2012 it showed highest Jamkesda participation in East Java. Socialization strengthening in form of social support and advocacy and media use to accelerate local health coverage and to erase Poor Notification Letter to have medication. Medication visit phenomenon was varied in number in every district, the highest was Nganjuk District (11.18%. Women (56.1% who took medication in PHC was higher than men (43,99% particularly those at 15–< 54 years old age group. The commonest disease was hypertension. Conclusion: Participation acceleration through social support and advocacy strategy is able to obtain local public support both formal and non formal for its success. Highest medication visit to PHC was Nganjuk district by women with hypertension as commonest disease they complained. Suggestion:Social support and advocacy socialization strategy can be implemented in other places with similar situation and condition Key words: Jamkesda, Socialization, Social Support, Advocacy
The USDA summer food service program (SFSP) provides free lunches during the summer. This study examined the foods selected and consumed by participating children. Three hundred and two children were observed in 14 schools during a 4-week period in June, 2011; 50% were male; 75% were in elementary s...
Balderas Torres, Arturo; MacMillan, D.C.; Skutsch, Margaret; Lovett, Jonathan Cranidge
Incentive-based mechanisms can contribute to rural development and deliver environmental services, but need to be attractive to landowners and communities to ensure their participation. Here we study the views of landowners and agrarian communities (ejidos) from central Jalisco in Mexico to identify
Aarthun, Antje; Akerjordet, Kristin
To describe and synthesize previous research on parents' perceptions of their participation in decision making in child health-care services. Health policy in the area of user involvement emphasizes parent participation in decision-making (DM), thus ensuring that services are provided in accordance with their child's needs and enhancing parents' control over their child's health-care services. A systematic literature search, covering the period January 2000 to February 2011, found 18 studies that met the inclusion criteria. The analysis process involved data extraction, reduction, comparison and synthesizing. Three themes emerged: (1) relational factors and interdependence, (2) personal factors and attitudes and (3) organisational factors. Parents highlighted the importance of the parent-health professional relationship, professionals' competence and the possibility of varying the degree of participation in decision making. Challenges involved asymmetry in authority and power, professionals' attitudes and competence and organisational shortcomings in health-care services. Health professionals need to become more aware of their critical role and responsibility in involving parents in DM. Health professionals' attitudes and competence can be improved by knowledge of user involvement and research and facilitating the inclusion of parents in decision making by influencing the culture, routines and resources in the health service. © 2012 John Wiley & Sons Ltd.
Full Text Available This article presents results of the study of archival fi les from A. A. Dmitrievsky’s series (Manuscript Department, National Library of Russia which contain a number of records related to the history of Leningrad Theological Seminary. These records refl ect the fact that on October 18 (Memory day of the Four Holy Hierarchs of Moscow and December 13 (Memory day of Apostle Andrew 1926, four public church services in the name of Hieromartyr Isidore of Yurievsk took place with the help of the prominent scientist and liturgist A. A. Dmitrievsky at the Russian-Estonian church in Leningrad. Both the public church services and their preparation were probably employed by A. A. Dmitrievsky as a medium for achieving better results of his students in the process of liturgical study. It was the intention of students of the Theological Seminary and Higher Theological Courses to conduct these public services. A number of manuals were prepared for various categories of participants of the services (clergy, readers, choristers and laymen in order to conduct the service according to liturgical books. Each of these manuals explained what had to be done at certain moments of the service, who had to interact with each other, etc. The general course of the service was determined by a specifi cally designed document “The Order of Public Worship”, which listed the elements of the service from start to fi nish. These documents are published in modern orthography as a supplement to this article.
Cook, Bryan J.; Kim, Young
This report offers a first-of-its-kind national snapshot of the programs, services, and policies that campuses have in place to serve veterans and military personnel. The partner organizations hope that it will prompt colleges and universities to follow California State University Chancellor Charlie Reed's advice and take a close look at their own…
Johnson, Clair; Viljoen, Nina
Background: Systemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and Methods: This article presents part of a service evaluation of systemic consultations in a Community…
..., Associate CIO, Strategy and Planning (IT) Julieta Garcia, Director, Customer Assistance, Relationships and...) Debra L. Nelson, Director, Management Services (IT) Nina E. Olson, National Taxpayer Advocate (TAS... Management Office (IT) David W. Stender, Associate CIO, Cybersecurity (IT) Peter J. Stipek, Director...
..., Specialty Programs (SB/SE); Robin DelRey Jenkins, Director, Office of Business Modernization (SB/ SE... (CI); David W. Stender, Associate CIO, Cybersecurity (MITS); Peter J. Stipek, Director, Customer Accounts Services (W&I); Keith V. Taylor, Director, Human Resources (SB/SE); Peter C. Wade, Business...
Kai, Joe; Hedges, Clive
OBJECTIVES: To promote community participation in exploring perceptions of psychological distress amongst Pakistani and Bangladeshi people, in order to develop appropriate services. DESIGN: Training and facilitation of resident community members (as community project workers), to define and conduct qualitative research involving semistructured interviews in their own communities, informing primary care led commissioning and service decision making. Setting A socio-economically disadvantaged inner-city locality in the UK. Participants One-hundred and four South Asian people (49 of Pakistani and 55 of Bangladeshi origin), interviewed by 13 resident community members. RESULTS: All community project workers completed training leading to a National Vocational Qualification, and successfully executed the research. Most study respondents located their main sources of stress within pervasive experience of racism and socio-economic disadvantage. They were positive about 'talking' and neutral listening as helpful, but sought strategies beyond non-directive counselling services that embraced practical welfare advice and social support. The roles of primary health care professionals were believed to be restricted to physical ill health rather than personal distress. The importance of professionals' sex, age, ethnicity and social status were emphasized as affecting open communication. Practical recommendations for the re-orientation and provision of services were generated and implemented in response to the findings, through dialogue with a primary care commissioning group, Health and Local Authority, and voluntary agencies. CONCLUSIONS: The work illustrates the feasibility and value of a community participation approach to research and service development in addressing a challenging and neglected area of minority ethnic health need. It offers one model for generating responsive service change in the context of current health policy in the UK, whilst also imparting skills and
Cornelia D. IVAN (Trandafiroiu
Full Text Available The major transformations in the supply of goods and services during the last decades entailed the development of some interactive relations between the various participants engaged in commercial operations. These relations, although naturally conflictive as for the classic negotiations between the participants, became, in certain fields, cooperation relations or even partnerships in the service of the clients on the relevant market. In this work, we intend to analyse the most significant participants in the market of lighting sources and devices (SCI and to underline the importance of the cooperation between these participants in the satisfaction of the final client requirements. The specific of this market entails the preparation of some marketing strategies to prevent the conclusion of some partnership relations at the procurement-delivery chain level as well as between the participants in this chain and the so-called market „influencers” (architects, installation companies, builders. The purpose of this approach consists in the preparation of a proposal package dedicated to the companies participating in this market for the purpose of cooperating in providing intelligent lighting solutions.
...-learning program? 2516.300 Section 2516.300 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2516.300 Who may participate in a school-based service-learning program? Students...
...-learning program? 2517.300 Section 2517.300 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2517.300 Who may participate in a community-based service-learning program...
The Internet provides a new modality for health communication by facilitating the creation of virtual communities. These communities have the potential to influence health behavior beyond traditional FTF support groups. This study utilized content analysis of 1,424 e-mail messages posted to 2 online cancer communities to examine uses of these groups. Findings revealed (a) similarities in the content of communication in the 2 virtual communities, (b) gender differences in participation, and (c) differences in utilization of these online groups between patients and family members. These results are discussed in light of the diverse uses of online cancer communities that they reveal, the role of family members in support seeking and provision, and gender communication styles in health computer-mediated communication.
Kennedy, Norelee; Armstrong, Claire; Woodward, Oonagh; Cullen, Walter
Team working is an integral aspect of primary care, but barriers to effective team working can limit the effectiveness of a primary care team (PCT). The establishment of new PCTs in Ireland provides an excellent opportunity to explore team working in action. The aim of this qualitative study was to explore the experiences of team members working in a PCT. Team members (n = 19) from two PCTs were interviewed from May to June 2010 using a semi-structured interview guide. All interviews were audio-recorded and transcribed. Data were analysed using NVivo (version 8). Thematic analysis was used to explore the data. We identified five main themes that described the experiences of the team members. The themes were support for primary care, managing change, communication, evolution of roles and benefits of team working. Team members were generally supportive of primary care and had experienced benefits to their practice and to the care of their patients from participation in the team. Regular team meetings enabled communication and discussion of complex cases. Despite the significant scope for role conflict due to the varied employment arrangements of the team members, neither role nor interpersonal conflict was evident in the teams studied. In addition, despite the unusual team structure in Irish PCTs - where there is no formally appointed team leader or manager - general issues around team working and its benefits and challenges were very similar to those found in other international studies. This suggests, in contrast to some studies, that some aspects of the leadership role may not be as important in successful PCT functioning as previously thought. Nonetheless, team leadership was identified as an important issue in the further development of the teams. © 2014 John Wiley & Sons Ltd.
Montesanti, Stephanie R; Abelson, Julia; Lavis, John N; Dunn, James R
We examined efforts to engage marginalized populations in Ontario Community Health Centers (CHCs), which are primary health care organizations serving 74 high-risk communities. Qualitative case studies of community participation in four Ontario CHCs were carried out through key informant interviews with CHC staff to identify: (i) the approaches, strategies and methods used in participation initiatives aimed specifically at engaging marginalized populations in the planning of and decision making for health services; and (ii) the challenges and enablers for engaging these populations. The marginalized populations involved in the community participation initiatives studied included Low-German Speaking Mennonites in a rural town, newcomer immigrants and refugees in an urban downtown city, immigrant and francophone seniors in an inner city and refugee women in an inner city. Our analysis revealed that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. Key informants outlined the features of a 'community development approach' that they rely on to address the barriers to marginalized peoples' involvement by strengthening their skills, abilities and leadership in capacity-building activities. The community development approach also shaped the participation methods that were used in the engagement process of CHCs. However, key informants also described the challenges of applying this approach, influenced by the cultural values of some groups, which shaped their willingness and motivation to participate. This study provides further insight into the approach, strategies and methods used in the engagement process to enable the participation of marginalized populations, which may be transferable to other health services settings. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Dhond, R.V.; Worlikar, R.M.; Saralamma Nair, D.; Pathak, A.S.; Sankaran, M.P.; Shenoy, K.S.; Patel, P.H.
Radiation Protection Services Division participated in the intercomparison of personal monitoring services in Asia/Pacific region during 1991-92 organised by Australian Radiation Laboratory (ARL). The exposed films returned by ARL were processed in our laboratory. The nature and energies of the incident radiations were identified and doses evaluated in terms of new operational quantities. The doses evaluated were within ± 20% except in two cases where energy determination did not match with the ARL values. The results are presented in the paper. (author). 1 ref., 3 tabs
Sousa, Valmi D; Williams, Janet K; Barnette, Jack J; Reed, David A
RATIONALE, AIMS, AND OBJECTIVES: Huntington disease (HD) is a progressive genetic brain disease leading to disruptive cognitive, behavioural and physical impairments. Persons with the condition and their caregivers need appropriate and accessible health care services to help them manage the disease adequately. The purpose of this study was to evaluate the psychometric properties of a new scale that measures family members' perception of community health care services (CHCS) for persons with HD. A methodological design was used to examine the initial reliability and dimensionality of the CHCS scale among 245 family members of persons with a diagnosis of HD. Data analysis consisted of computing Cronbach's alpha coefficients, calculating the 95% confidence interval for alpha and performing item-analysis and exploratory factor analysis. Reliability of the scale based on Cronbach's alpha was 0.83. Factor analysis using principal component analysis and varimax rotation suggested that three interpretable factors underlie the scale. Factor 1, HD knowledge, had alpha = 0.82, eigenvalue of 4.67 and explained 33.42% of the variance; factor 2, HD community resources, had alpha = 0.62, eigenvalue of 1.68 and explained 12.02% of the variance; factor 3, individualized HD management, had alpha = 0.77, eigenvalue of 1.45 and explained 10.39% of the variance. Findings from this study provide evidence of both construct validity and internal consistency reliability of the CHCS scale. Further psychometric testing of the scale in other samples of family caregivers of persons with HD is warranted.
Braverman, S E; Spector, J; Warden, D L; Wilson, B C; Ellis, T E; Bamdad, M J; Salazar, A M
To design and describe an effective rehabilitation programme for use in an ongoing trial on the efficacy of multidisciplinary brain injury rehabilitation for moderately head injury military service members. Treatment arm of a randomized control trial. US military tertiary care hospital inpatient rehabilitation programme. Sixty seven active duty military with moderate to severe TBI who were randomized to the treatment arm of the protocol. Eight week rehabilitation programme combining group and individual therapies with an inpatient milieu-oriented neuropsychological focus. Group therapies included fitness, planning and organization, cognitive skills, work skills, medication, and milieu groups, and community re-entry outings. Individual therapy included neuropsychology, work therapy, occupational therapy, and speech and language pathology. Successful return to work and return to duty. At 1 year follow-up, 64 patients returned to work (96%) and 66% (44/67) returned to duty. The described rehabilitation programme demonstrates one successful effort to rehabilitate active duty military service members with TBI who have the potential to return to duty.
Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul
Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of
Full Text Available ABSTRACT In recently world creating opportunities under appropriate circumstances for people to manipulate decisions that affect them will increase the sense of ownership and care that is why participation has become a question of concern for any public and private project development and sustainability. The purpose of this study was to assessing the challenges affecting participation in provision of public services in Arusha city council. The specific objective of this study was to find out the challenges affecting public consultations and involvement in provision of public services at Arusha city council. The researcher use survey design technique in studying 150 samples from 416442 which included public citizens mayor councilors and employees at the Arusha city council office. The sample was selected through non- probability sampling techniques which was purposive and convenience. The data was collected through questionnaire and structured interview schedule and data was qualitatively analyzed where the factual and logical interpretation was explained through using of table and percentages. From the findings of the study provision of effective public services in Arusha city council is less effective and unsatisfactory because of insufficient number of staff poor technology conservatism bureaucracy culture relationship politics and poor communication. In order to address the issues the researcher recommends that the governance is weak and it needed to be reviewed in order to enhance the effectiveness of the entire process in provision of effective public services.
Angermeier, Ingo; Dunford, Benjamin B; Boss, Alan D; Boss, R Wayne
Numerous challenges confront managers in the healthcare industry, making it increasingly difficult for healthcare organizations to gain and sustain a competitive advantage. Contemporary management challenges in the industry have many different origins (e.g., economic, financial, clinical, and legal), but there is growing recognition that some of management's greatest problems have organizational roots. Thus, healthcare organizations must examine their personnel management strategies to ensure that they are optimized for fostering a highly committed and productive workforce. Drawing on a sample of 2,522 employees spread across 312 departments within a large U.S. healthcare organization, this article examines the impact of a participative management climate on four employee-level outcomes that represent some of the greatest challenges in the healthcare industry: customer service, medical errors, burnout, and turnover intentions. This study provides clear evidence that employee perceptions of the extent to which their work climate is participative rather than authoritarian have important implications for critical work attitudes and behavior. Specifically, employees in highly participative work climates provided 14 percent better customer service, committed 26 percent fewer clinical errors, demonstrated 79 percent lower burnout, and felt 61 percent lower likelihood of leaving the organization than employees in more authoritarian work climates. These findings suggest that participative management initiatives have a significant impact on the commitment and productivity of individual employees, likely improving the patient care and effectiveness of healthcare organizations as a whole.
Participant direction allows people with intellectual and developmental disabilities (IDD) and/or their families to direct services; in doing so, participant direction shifts participants from passive recipients to active consumers. Medicaid encourages, but does not require, states to allow participant direction. The aim of this study was to…
Lande, R Gregory; Bahroo, Bhagwan A; Soumoff, Alyssa
To explore the characteristics of military service tattoos a descriptive study was conducted at Walter Reed Army Medical Center to collect information from a convenience sample. An investigator-developed questionnaire provided the data for this study. Over the ensuing 12 month-period the researchers collected 126 questionnaires. Typical respondents were enlisted men with at least one deployment to an area of combat operations. Among the respondents, 57% acquired their tattoos before their deployment. One-quarter of the respondents reported only one tattoo, leaving the majority with multiple tattoos. Men received their first tattoo at an earlier age than women. The most common tattoo listed a person's name. Respondents did not regret their tattoos and rarely acquired the body art under the influence of alcohol or drugs. Little evidence was found to support a connection between tattoos and deployment. Few regretted their decisions and most all approached the tattoo experience free of any mind-altering substance. All this seems to suggest that military tattoos are a well-accepted means of self-expression. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul
Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public
Prendergast, Michael; Cartier, Jerome J
In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.
Ucar, Hasan; Yazici Bozkaya, Mujgan
This study examined the pre-service EFL teachers' self-efficacy beliefs, goal orientations, and participations in an online learning environment. Embedded mixed design was used in the study. In the quantitative part of the study, the participants were 186 senior pre-service EFL teachers and data were collected on two scales and a questionnaire.…
Schmidt, Jennifer A.; Shumow, Lee; Kackar, Hayal Z.
Youth who participate in service activities differ from those who do not on a number of key demographic characteristics like socio-economic status and other indicators of risk; and most studies demonstrating positive outcomes among service participants employ small non-representative samples. Thus, there is little evidence as to whether the…
Mathieu, Johanna L.; Dyson, Mark E.H.; Callaway, Duncan S.
Increasing penetrations of intermittent renewable energy resources will require additional power system services. California recently adopted an energy storage mandate to support its renewable portfolio standard, which requires 33% of delivered energy from renewables by 2020. The objective of this paper is to estimate the amount of energy storage that could be provided by residential thermostatically controlled loads, such as refrigerators and air conditioners, and the amount of revenue that could be earned by loads participating in ancillary services markets. We model load aggregations as virtual energy storage, and use simple dynamical system models and publicly available data to generate our resource and revenue estimates. We find that the resource potential is large: 10–40 GW/8–12 GWh, which is significantly more than that required by the mandate. We also find that regulation and spinning/non-spinning reserve revenues vary significantly depending upon type of load and, for heat pumps and air conditioners, climate zone. For example, mean regulation revenues for refrigerators are $11/year, for electric water heaters are $24/year, for air conditioners are $0-32/year, and for heat pumps are $22–56/year. Both consumer choices, such as appliance settings, and policy, such as the design of ancillary service compensation and appliance standards, could increase revenue potentials. - Highlights: • California's energy storage mandate requires 1.325 GW of energy storage by 2020. • Residential loads such as refrigerators have thermal energy storage. • California's residential loads could provide 10-40 GW/8-12 GWh of storage. • Loads participating in ancillary services markets could earn up to $56/load/year. • Consumer choices and policy mechanisms could increase revenue potentials
... physical therapy and speech pathology services to be performed by other than salaried organization... Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.719 Condition of participation: Arrangements for physical therapy and speech pathology services to be performed...
ankle brace. (Prepared by Knapik JJ, Spiess A, Darakjy S, Grier T, Manning F, Swedler D, Amoroso P, and Jones BH.) 29. USAPHC. 2011. USAPHC... Spiess A, Grier TL, Lester ME, Sharp MA, Tobler SK, Swedler DI, and Jones BH). 42. Bullock SH, Jones BH, Gilchrist J, and Marshall SW. 2010
sexual assault reporting. Such models would provide insight into the character- istics of the service members who experience these events ( age , pay grade...service members and who met Study Design and Analysis Approach 5 the study inclusion criteria requiring that they be age 18 or older , below the rank...to encour- age someone who experienced sexual assault both to report it (93.5 percent) and to seek counseling (93.9 percent). There were no service or
Agimi, Yll; Regasa, Lemma Ebssa; Ivins, Brian; Malik, Saafan; Helmick, Katherine; Marion, Donald
To examine the role of Department of Defense policies in identifying theater-sustained traumatic brain injuries (TBIs). We conducted a retrospective study of 48 172 US military service members who sustained their first lifetime TBIs between 2001 and 2016 while deployed to Afghanistan or Iraq. We used multivariable negative binomial models to examine the changes in TBI incidence rates following the introduction of Department of Defense policies. Two Army policies encouraging TBI reporting were associated with an increase of 251% and 97% in TBIs identified following their implementation, respectively. Among airmen, the introduction of TBI-specific screening questions to the Post-Deployment Health Assessment was associated with a 78% increase in reported TBIs. The 2010 Department of Defense Directive Type Memorandum 09-033 was associated with another increase of 80% in the likelihood of being identified with a TBI among soldiers, a 51% increase among sailors, and a 124% increase among Marines. Department of Defense and service-specific policies introduced between 2006 and 2013 significantly increased the number of battlefield TBIs identified, successfully improving the longstanding problem of underreporting of TBIs.
Lange, Rael T; Brickell, Tracey A; French, Louis M
The purpose of this study was to examine the clinical utility of two validity scales designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist-Civilian Version (PCL-C); the Mild Brain Injury Atypical Symptoms Scale (mBIAS) and Validity-10 scale. Participants were 63 U.S. military service members (age: M = 31.9 years, SD = 12.5; 90.5% male) who sustained a mild traumatic brain injury (MTBI) and were prospectively enrolled from Walter Reed National Military Medical Center. Participants were divided into two groups based on the validity scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF): (a) symptom validity test (SVT)-Fail (n = 24) and (b) SVT-Pass (n = 39). Participants were evaluated on average 19.4 months postinjury (SD = 27.6). Participants in the SVT-Fail group had significantly higher scores (p scales (d = 0.69 to d = 2.47). Sensitivity, specificity, and predictive power values were calculated across the range of mBIAS and Validity-10 scores to determine the optimal cutoff to detect symptom exaggeration. For the mBIAS, a cutoff score of ≥8 was considered optimal, which resulted in low sensitivity (.17), high specificity (1.0), high positive predictive power (1.0), and moderate negative predictive power (.69). For the Validity-10 scale, a cutoff score of ≥13 was considered optimal, which resulted in moderate-high sensitivity (.63), high specificity (.97), and high positive (.93) and negative predictive power (.83). These findings provide strong support for the use of the Validity-10 as a tool to screen for symptom exaggeration when administering the NSI and PCL-C. The mBIAS, however, was not a reliable tool for this purpose and failed to identify the vast majority of people who exaggerated symptoms.
This article explores the ideas about children's participation in decision-making held by government officials and non-government representatives engaged in promoting children's participation in the Philippines. It suggests that the ideas that policy-makers and service deliverers hold about children's participation are heterogeneous, diverse and…
Preliminary examination of the impact of traumatic brain injury and posttraumatic stress disorder on self-regulated learning and academic achievement among military service members enrolled in postsecondary education.
Ness, Bryan M; Vroman, Kerryellen
Delineate the effects of self-reported traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) on self-regulated learning and academic achievement for university-enrolled military Service members. Students (N = 192) from 8 regionally diverse universities, representing an estimated 6% of Service members enrolled across schools. Public universities that are members of the Servicemember Opportunity College consortium. Cross-sectional study evaluating the relationships between self-reported TBI, PTSD, and self-regulated learning variables and their contribution to academic achievement. Self-report of military service; symptoms of TBI and PTSD; self-regulation strategies including effort, time/environment regulation, and academic self-efficacy; and grade point average (GPA). There was no effect of self-reported TBI or PTSD on GPA, effort regulation, or time/environment regulation strategies; however, participants with TBI or PTSD reported significantly lower academic self-efficacy. Multiple regression analysis revealed self-efficacy was the strongest predictor of GPA among all participants, followed by military rank. The sample consisted of high achieving students responsive to a university administrator, which raises the possibility of sampling bias. Because of the low recruitment rate for this study and lack of published research on this subject, replicating the results is necessary before drawing generalizable conclusions about the population.
Fisher, Rohan; Lassa, Jonatan
Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and
Jen, Wen-Yuan; Hung, Ming-Chien
In an aging society, the issue of increased medical costs troubles both government agencies and families with aging parents. Many elderly people require long-term care, and the medical and financial problems associated with long-term care worry their entire family. Mobile healthcare service (MHS) has been widely applied by medical practitioners and researchers for years. Unfortunately, the elderly often fear both the technology and the cost its use incurs; hence, they seldom actively adopt MHS without the prompting and support of other family members. This study highlights this issue of long-term healthcare for the elderly and extracts the factors affecting their family's intentions in adopting MHS. Based on the integration of the Theory of Planned Behavior and the Technology Acceptance Model, the factors associated with the family's intention of the aging people toward MHS are explored. Data were collected from 200 students in the "Job Master" track in a local "Executive Master of Business Administration" program. Half of them had at least one immediate family member who was older than 65 years of age. A partial least squares (PLS) analysis shows that "attitude" significantly affected the behavioral intention of adopting MHS, and "perceived usefulness" and "perceived ease-of-use" had an indirect effect via "attitude." The PLS model explains the variance in intention (64.1%), attitude (58.1%), and perceived usefulness (33.8%). Overall, this study shows that attitude was an important determinant of MHS adoption. Gender also significantly affected the relationship between attitude and behavioral intention to adopt MHS.
Vik, Kjersti; Eide, Arne H
Older adults wish to stay at home, participate in society and manage on their own as long as possible. Many older adults will, however, eventually become dependent on care and help to maintain their daily living. Thus, to enhance activity and participation also among older adults that receive home-based services, there is a strong need for development of knowledge-based practice regarding participation. The specific aim of this study is to explore how service providers perceive that their working conditions influence on their possibilities to promote participation among older adults, and more specifically, how they perceive the influence of their working conditions. A purposeful sampling strategy was applied, and six focus groups with professionals in two municipalities were conducted. The focus groups comprised four and six participants of varying ages, length of working experience and professions. A total of 30 service providers participated. The data were analysed by a constant comparative method following the guidelines from Grounded Theory. The analysis identified the categories 'encountering needs that cannot be met', 'expectations about participation', 'organisation of services' and 'professional standards' influencing the service delivery. During this analytical process, 'being on the verge' emerged as a core category that describes the service providers' experience of a stressful workday, i.e. when they had the feeling of working against their own professional standards and being pushed to their limits. The findings indicate how the professional standards of service providers on the whole are in line with health policy for in-home services. Policy objectives are, however, not always followed owing to different constraints at the level of service delivery. Along the path from political ideals to the practical execution of services, external circumstances related to the organisation of services are perceived as crucial. © 2012 The Authors. Scandinavian
Hirst, E.; Goeltz, R.
The Hood River Conservation Project (HRCP) is a major residential retrofit demonstration project. HRCP is funded by the Bonneville Power Administration (BPA) and run by Pacific Power and Light Company. The project was conducted in the community of Hood River, Oregon, will cost $21 million, and will last for three years (mid-1983 through 1986). Installation of applicable retrofit measures was completed by the end of 1985; data collection, analysis, and report writing will continue through 1986. This report documents the extent to which households participated in HRCP. Differences between participants and eligible nonparticipants are examined. Similarly, differences among participants as a function of when they signed up for HRCP are analyzed. The report also examines the dynamics of program services (i.e., times between audit requests and audit, and between audit and installation of measures). These analyses are based on data from the roughly 3500 Hood River homes eligible for HRCP, 3189 of which received free home energy audits and 2988 of which received HRCP-financed retrofit measures.
Anshari, Muhammad; Almunawar, Mohammad Nabil; Low, Patrick Kim Cheng; Wint, Zaw; Younis, Mustafa Z
The aim of this article is to present an e-health model that embeds empowerment and social network intervention that may extend the role of customers in health care settings. A 25-item Likert-type survey instrument was specifically developed for this study and administered to a sample of 108 participants in Indonesia from October to November 2012. The data were analyzed to provide ideas on how to move forward with the e-health initiative as a means to improve e-health services. The survey revealed that there is a high demand for customers' empowerment and involvement in social networks to improve their health literacy and customer satisfaction. Regardless of the limitations of the study, the participants have responded with great support for the abilities of the prototype systems drawn from the survey. The survey results were used as requirements to develop a system prototype that incorporates the expectations of the people. The prototype (namely Clinic 2.0) was derived from the model and confirmed from the survey. Participants were selected to use the system for three months, after which we measured its impact towards their health literacy and customer satisfaction. The results show that the system intervention through Clinic 2.0 leads to a high level of customer satisfaction and health literacy.
Rice, Valerie; Liu, Baoxia
U.S. military personnel face challenging situations including frequent deployments, family separations, and exposure to war. Identifying coping strategies used by the most resilient service members and veterans could positively influence military resiliency training programs. The purposes of this paper are to investigate the relationship between coping and resilience among U.S. military active service members and veterans, to identify the coping strategies used by those considered most resilient, and to discuss coping and resilience as they relate to the workplace. U.S. military active service members and veterans (N = 191) completed a demographic survey and two self-report questionnaires: The 14-Item Resilience Scale  and the Brief COPE . Active duty service members had higher resilience scores than veterans (p 0.05). Active service members' resilience was predicted by their use of positive reframing and less use of self-blame as coping strategies, accounting for 52.3% of the variance (R2 = 0.523, F(2, 60) = 32.92, p = 0.000). Veterans' resilience was predicted by longer time-in-service, greater use of humor, and less use of self-blame as coping strategies, explaining 44.8% of the variance (R2 = 0.448, F(3, 116) = 31.408, p = 0.000). This research identifies the positive coping strategies, and least-used negative coping strategies, of the U.S. service members and veterans in our study population with higher resilience scores. Incorporating this information into military- or veteran-based resilience training is likely to increase training effectiveness.
Jamalzadeh, R.; Ardehali, M.M.; Rashidinejad, M.
The rational buyer auction is based on a simultaneous auction that is the redesigned auction mechanism for ancillary services by the California independent system operator (CAISO). The incentive for the rational buyer auction is CAISO's intent to adopt a common sense rule of substituting higher-quality lower-cost services for lower-quality higher-cost services, when it results in reduced total procurement cost. For the purposes of designing a desirable auction where the minimum cost for the objective function as well as prevention of price reversal are achieved, either the payment cost in marginal pricing auction must be lowered or price reversal in rational buyer auction must be avoided. The objectives of this study are (a) to develop a newly proposed 'modified rational buyer' auction that does not allow price reversal and (b) to propose and validate a solution procedure that is based on participation matrix and discrete programming. The validation of the proposed solution procedure is accomplished through examination of two case studies available in the literature. Based on the first case study data, it is shown that the newly developed modified rational buyer auction avoids price reversal occurrence, while the total payment of ISO is increased by 5.8%, as compared with rational buyer auction. Also in comparison with marginal pricing auction, the ISO payment is lowered by 38.8%, when the newly developed modified rational buyer auction is utilized. For future work, it is recommended that the application of the modified rational buyer auction to joint dispatch of energy and ancillary services is investigated
Fritz, Heather Ann; Lysack, Cathy; Luborsky, Mark R; Messinger, Seth D
Despite growing knowledge about medical and functional recovery in clinical settings, the long-term issue of community reintegration with a spinal cord injury (SCI) in the military context remains virtually unexamined. Thus, the U.S. Department of Defense created the SCI Qualitative Research Program to advance knowledge about service members' reintegration into civilian life. The purpose of this paper is to better characterize the long-term outcomes related to the community participation experienced and desired vis-à-vis a case study of a military veteran who suffered a service-related traumatic SCI. An in-depth anthropological interview was used with Jake, a 28-year old marine with a service-related C5/C6 SCI. Data were analyzed using content analysis. Three significant themes were identified: opportunities for better engaging socially meaningful others may not be adequately included in so-called "client-centered" interventions; how management of the social self in inter-personal interactions and public spaces is critical to gaining broader societal acceptance; and how meaningful age normative relationships and activities are essential to establish lasting inclusive social connections. Jake's case challenges existing models of rehabilitation predominantly focused on physical capacity building. Study findings point to the need for rehabilitation to invest more resources in efforts to address the existential and social elements of long-term social reintegration. Implications for Rehabilitation Both the veteran with SCI and their meaningful support network face challenges socially reintegrating after injury and rehabilitation. Empowering clients to envision future possibilities in terms of family, intimate relationships, and meaningful work are important to successful long-term social reintegration. Addressing the existential desires and social capacities of the individual may be as important as addressing physical functioning skills after SCI.
Brad R. Fulton
Full Text Available When congregations seek to address social needs, they often pursue this goal through acts of service and political engagement. Over the past three decades, a tremendous amount of research has been dedicated to analyzing congregation-based service provision and political participation. However, little is known about how congregations’ involvement in these arenas has changed during this period. To help fill this gap, this study analyzes three waves of data from a national survey of congregations to assess how congregations’ participation patterns in service-related and political activities have been changing since the 1990s. It also examines trends among subpopulations of congregations grouped by their religious tradition, ethnoracial composition, and ideological orientation. Overall, this study finds that among most types of congregations, the percentage participating in service-related activities is substantial and increasing, while the percentage participating in political activities is less substantial and decreasing. This decline in political participation has implications for the role congregations play in addressing social needs. Relieving immediate needs through service provision without also pursuing long-term solutions through political participation can limit congregations’ ability to comprehensively address social needs. Among the few types of congregations that have high and/or increasing participation rates in both service-related and political activities are Catholic, predominantly Hispanic, and politically liberal congregations.
Hammer, K A; Janes, F R
The objectives for developing the participative method of subject definition were to gain all the relevant information to a high level of fidelity in the earliest stages of the work and so be able to build a realistic model at reduced labour cost. In order to better integrate the two activities--information acquisition and mathematical modelling--a procedure was devised using the methods of interactive management to facilitate teamwork. This procedure provided the techniques to create suitable working relationships between the two groups, the informants and the modellers, so as to maximize their free and accurate intercommunication, both during the initial definition of the linen service and during the monitoring of the accuracy and reality of the draft models. The objectives of this project were met in that the final model was quickly validated and approved, at a low labour cost.
Frisch, Noreen; Atherton, Pat; Borycki, Elizabeth; Mickelson, Grace; Cordeiro, Jennifer; Novak Lauscher, Helen; Black, Agnes
Use of Web 2.0 and social media technologies has become a new area of research among health professionals. Much of this work has focused on the use of technologies for health self-management and the ways technologies support communication between care providers and consumers. This paper addresses a new use of technology in providing a platform for health professionals to support professional development, increase knowledge utilization, and promote formal/informal professional communication. Specifically, we report on factors necessary to attract and sustain health professionals' use of a network designed to increase nurses' interest in and use of health services research and to support knowledge utilization activities in British Columbia, Canada. "InspireNet", a virtual professional network for health professionals, is a living laboratory permitting documentation of when and how professionals take up Web 2.0 and social media. Ongoing evaluation documents our experiences in establishing, operating, and evaluating this network. Overall evaluation methods included (1) tracking website use, (2) conducting two member surveys, and (3) soliciting member feedback through focus groups and interviews with those who participated in electronic communities of practice (eCoPs) and other stakeholders. These data have been used to learn about the types of support that seem relevant to network growth. Network growth exceeded all expectations. Members engaged with varying aspects of the network's virtual technologies, such as teams of professionals sharing a common interest, research teams conducting their work, and instructional webinars open to network members. Members used wikis, blogs, and discussion groups to support professional work, as well as a members' database with contact information and areas of interest. The database is accessed approximately 10 times per day. InspireNet public blog posts are accessed roughly 500 times each. At the time of writing, 21 research teams
Bruin, de S.R.; Stoop, A.; Molema, C.C.M.; Vaandrager, L.; Hop, P.J.W.M.; Baan, C.A.
Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for
... AGED, BLIND, AND DISABLED Suspensions and Terminations § 416.1338 If you are participating in an... or blindness may be continued after your impairment is no longer disabling, you are no longer blind... services, or other support services; or (B) A public, private or parochial school that provides or...
... 42 Public Health 3 2010-10-01 2010-10-01 false Condition of participation: Nursing services-Waiver.... 418.66 Section 418.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... central office. The hospice must provide evidence to CMS that it has made a good faith effort to hire a...
Pape, Marcy M; Williams, Kathy; Kodosky, Paula N; Dretsch, Michael
To compare the capacity of the Community Balance and Mobility Scale (CB&M) to identify balance and mobility deficits in Service Members (SMs) with mild traumatic brain injury and comorbid psychological health conditions (mTBI/PH) to other commonly used balance assessments. A clinical research institute that provides a 4-week, outpatient, interdisciplinary program for active-duty SMs with mTBI/PH. A nonrandomized, cross-sectional design that compared multiple measures between 2 groups-active duty SMs with (n = 8) and without (n = 8) the dual diagnosis of mTBI/PH. Gait speed, Activities-specific Balance Confidence scale (ABC), Functional Gait Assessment (FGA), and CB&M to assess functional balance among the community-dwelling, TBI population. Across all measures, the mTBI/PH group performed significantly worse (P ≤ .01) with the exception of the FGA. The abilities of all objective measures to distinguish participants with mTBI/PH from healthy controls ranged from fair to excellent (area under the curve [AUC] = 0.66-0.94). However, the CB&M showed the largest group differences in effect size (d = 2.6) and had the highest discriminate ability (AUC = 0.98; sensitivity 100%; specificity 88%). The CB&M appears to have higher sensitivity and specificity than other measures of balance in SMs with mTBI/PH. A higher cut score for the CB&M is needed for this population.
Neuropsychological Performance and Subjective Symptom Reporting in Military Service Members With a History of Multiple Concussions: Comparison With a Single Concussion, Posttraumatic Stress Disorder, and Orthopedic Trauma.
Cooper, Douglas B; Curtiss, Glenn; Armistead-Jehle, Patrick; Belanger, Heather G; Tate, David F; Reid, Matthew; Bowles, Amy O; Velez, Carmen S; Kennedy, Jan E; Vanderploeg, Rodney D
To examine differences in objective neurocognitive performance and subjective cognitive symptoms in individuals with a history of a single concussion, multiple concussions, orthopedic injuries, and posttraumatic stress disorder (PTSD). Participants included 116 military service members who sustained a mild traumatic brain injury (mTBI) during combat deployment. Subjects were subdivided into groups based on concussion frequency: a single concussion (n = 42), 2 concussions (n = 21), and 3 or more concussions (n = 53). Eighty-one subjects sustained an orthopedic injury (n = 60) during deployment or were diagnosed with PTSD (n = 21), but had no history of mTBI. Subjects completed a battery of neuropsychological tests and self-report measures of postconcussive symptoms, PTSD symptoms, and psychopathology. No differences were found among the concussion groups on a composite neuropsychological measure. The PTSD group had the highest number of symptom complaints, with the 2-concussion and 3-plus-concussion groups being most similar to the PTSD group. The concussion groups showed a nonsignificant pattern of increasing distress with increasing number of concussions. The current findings are consistent with meta-analytic results showing no differential effect on neuropsychological functioning due to multiple concussions. Results also support the burden of adversity hypothesis suggesting increasing symptom levels with increasing psychological or physically traumatic exposures.
Ditchburn, Jae-Llane; Marshall, Alison
The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service. Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home. Home haemodialysis is known to provide benefits to patients, particularly in making them more independent. The use of a telemedicine video-link in Lancashire and South Cumbria, UK, further reduces patient dependence on the professional team. The purpose of this paper is to present the perspectives of the renal care team members using the renal telemedicine service to understand the perceived benefits and issues with the service. Ten semi-structured interviews with members of the renal care team (two renal specialists, one matron, two renal nurses, one business manager, one renal technical services manager, two IT technicians and one hardware maintenance technician) were conducted. Thematic analysis was undertaken to analyse the qualitative data. A range of incremental benefits to the renal team members were reported, including more efficient use of staff time, reduced travel, peace of mind and a strong sense of job satisfaction. Healthcare staff believed that remote renal care through video was useful, encouraged concordance and could nurture confidence in patients. Key technological issues and adjustments which would improve the renal telemedicine service were also identified. The impact of renal telemedicine was positive on the renal team members. The use of telemedicine has been demonstrated to make home dialysis delivery more efficient and safe. The learning from staff feedback could inform development of services elsewhere. © 2017
Scully, Michael S; Wessman, Dylan E; McKee, James M; Francisco, Gregory M; Nayak, Keshav R; Kobashigawa, Jon A
Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant. A 47-year-old active duty male initially evaluated for atypical chest pain was found to have severe concentric left ventricular hypertrophy on echocardiogram but normal voltage on electrocardiogram. Cardiac magnetic resonance imaging, laboratory studies, and bone marrow biopsy established the diagnosis of cardiac amyloidosis. At the time of diagnosis, the patient's prognosis was very poor with a median survival of 5 months on the basis of the Mayo Clinic revised prognostic staging system for amyloidosis. The patient developed rapidly progressive left ventricular dysfunction and heart failure leading to cardiac arrest. The patient received a total artificial heart as a bridge to orthotopic heart and kidney transplantation and eventual stem cell transplant. He continues to be in remission and has a fair functional capacity without restriction in activities of daily living or moderate exercise. Amyloid CM is a rare and devastating disease. The natural course of the disease has made heart transplant in these patients controversial. Modern advancements in chemotherapies and advanced heart failure treatments have improved outcomes for select patients with AL amyloid CM undergoing heart transplantation. There is ongoing research seeking improvement in treatment options and outcomes for patients with this deadly disease. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea.
... HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH... responsible after the provider of services has coordinated benefits and all other alternative resources have... consistent with part 136 of this title or section 503(a) of the Indian Health Care Improvement Act (IHCIA...
Page, Girija; Bellotti, Bill
Optimal participation in market-based instruments such as PES (payment for ecosystem services) schemes is a necessary precondition for achieving large scale cost-effective conservation goals from agricultural landscapes. However farmers' willingness to participate in voluntary conservation programmes is influenced by psychological, financial and social factors and these need to be assessed on a case-by-case basis. In this research farmers' values towards on-farm ecosystem services, motivations and perceived impediments to participation in conservation programmes are identified in two local land services regions in Australia using surveys. Results indicated that irrespective of demographics such as age, gender, years farmed, area owned and annual gross farm income, farmers valued ecosystem services important for future sustainability. Non-financial motivations had significant associations with farmer's perceptions regarding attitudes and values towards the environment and participation in conservation-related programmes. Farmer factors such as lack of awareness and unavailability of adequate information were correlated with non-participation in conservation-based programmes. In the current political context, government uncertainty regarding schemes especially around carbon sequestration and reduction was the most frequently cited impediment that could deter participation. Future research that explores willingness of farmers towards participation in various types of PES programmes developed around carbon reduction, water quality provision and biodiversity conservation, and, duration of the contract and payment levels that are attractive to the farmers will provide insights for developing farmer-friendly PES schemes in the region. Copyright © 2015 Elsevier B.V. All rights reserved.
Montenegro, Cristian R
Although the organisation of mental health service users and ex-users in Latin America is a recent and under-researched phenomenon, global calls for their involvement in policy have penetrated national agendas, shaping definitions and expectations about their role in mental health systems. In this context, how such groups react to these expectations and define their own goals, strategies and partnerships can reveal the specificity of the "user movement" in Chile and Latin America. This study draws on Jacques Rancière's theorisation of "police order" and "politics" to understand the emergence of users' collective identity and activism, highlighting the role of practices of disengagement and rejection. It is based on interviews and participant observation with a collective of users, ex-users and professionals in Chile. The findings show how the group's aims and self-understandings evolved through hesitations and reflexive engagements with the legal system, the mental health system, and wider society. The notion of a "politics of incommensurability" is proposed to thread together a reflexive rejection of external expectations and definitions and the development of a sense of being "outside" of the intelligibility of the mental health system and its frameworks of observation and proximity. This incommensurability problematises a technical definition of users' presence and influence and the generalisation of abstract parameters of engagement, calling for approaches that address how these groups constitute themselves meaningfully in specific situations.
Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.
Serxner, Seth; Alberti, Angela; Weinberger, Sarah
To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n = 49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.
Satar, H. Muge; Akcan, Sumru
Participation in online communities is an increasing need for future language teachers and their professional development. Through such participation, they can experience and develop an awareness of the behaviors required to facilitate their future learners' participation in online learning. This article investigates participation, interaction…
..., Chinese Taipei, Colombia, Costa Rica, European Union on behalf of its member states, Hong Kong China, Iceland, Israel, Japan, Korea, Mexico, New Zealand, Norway, Pakistan, Panama, Peru, Switzerland, and...
Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec
The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.
Grieb, Suzanne M; Crawford, Amelia; Fields, Julie; Smith, Horace; Harris, Richard; Matson, Pamela
The role of incarceration and community reentry after incarceration has been studied extensively for individual and community health; however, little attention has been given to the experiences of individuals who provide support to those in reentry. Through a community-academic partnership, seven focus groups were conducted with 39 individuals supporting a family member in reentry in the summer of 2012. The primary objectives of the focus groups were to explore community experiences and perspectives regarding providing support during a family member's reentry from a period of incarceration and any desired support for themselves during this time. Five themes emerged under a metatheme of stress, indicating that family members experience acute stress as a result of family reentry that adds to the chronic stress they already endure. Programs that acknowledge the difficult role of family members as supporters during an individual's reentry and provide support to them are desperately needed.
Ioan – Franc Valeriu
Full Text Available The enterprises' offensive in various markets is focused on a. package of "services" that integrates - more than ever before - the observance of terms and vivid contacts between enterprises and customers. Metaphorically, we could say that services rendere
Full Text Available Introduction: Due to the vital role of nurses and the effects of scientific advances on nursing care, providing high quality nursing services is not possible without participating in the in-service training programs and becoming familiar with the new techniques. This study aimed to determine the motivational factors influencing the participation in the in-service training courses among nurses working in the teaching hospitals affiliated to Shiraz University of Medical Sciences in 2013. Method: This was an applied, cross-sectional and descriptive-analytical study. A sample of 216 nurses working in the teaching hospitals affiliated to Shiraz University of Medical Sciences was selected using stratified sampling proportional to size and simple random sampling methods. The required data were collected using a questionnaire determining the motivational factors influencing the nurses’ participation in the in-service training courses, including personal factors, organizational factors, and those related to the profession and the training courses planning. SPSS 18.0 and some statistical tests including ANOVA, Independent-Samples T-Test, as well as Pearson Correlation Coefficient were used to analyze the collected data. Results: The results showed that the mean score of nurses’ motivation for participating in the in-service training programs was 3.41±0.5. Also, the highest and lowest means of motivational factors affecting the studied nurses’ participation in the in-service courses were associated with the factors related to the profession (3.75 ± 0.71, and those related to the training courses planning (3.20 ± 0.59, respectively. In addition, there were significant associations between the personal factors (p=0.037 and factors related to the profession (p=0.047 and the studied nurses’ positions, between the organizational factors and their employment status (p=0.007, and between the factors related to the training courses planning and the
... anesthesia services. (B) An updated examination of the patient, including any changes in the patient's... practitioners' orders, nursing notes, reports of treatment, medication records, radiology, and laboratory...
Hibbin, R A; Samuel, G; Derrick, G E
Social media (SM) research presents new challenges for research ethics committees (RECs) who must balance familiar ethical principles with new notions of public availability. This article qualitatively examines how U.K. REC members view this balance in terms of risk and consent. While it found significant variance overall, there were discernible experience-based trends. REC members with less experience of reviewing SM held inflexible notions of consent and risk that could be categorized as either relying on traditional notions of requiring direct consent, or viewing publicly available data as "fair game." More experienced REC members took a more nuanced approach to data use and consent. We conclude that the more nuanced approach should be best practice during ethical review of SM research.
Journal of Family Therapy, 21, 313-323. Behar, L.B. (1997). The Preschool Behavior Questionnaire. Journal of Abnormal Child Psychology , 5, 265-275... Psychological Health Problems Following Parent Deployment PRINCIPAL INVESTIGATOR: Julie Wargo Aikins, PhD CONTRACTING ORGANIZATION: Wayne State...Validating a Brief Assessment for Identifying Children of Service Members at Risk for Psychological Health Problems Following Parent Deployment 5b. GRANT
AWARD NUMBER: W81XWH-15-2-0072 TITLE: Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in...Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS 5b. GRANT NUMBER W81XWH-15...Figure 4. Mitochondrial activity is mostly preserved on the animals that were supported with ventilator devices and mesenchymal stem cells . Using a
refer to as rape, including penetration of the mouth, anus, or vagina by a penis , body part, or object. We describe the measure as penetrative sexual...thigh, breast, groin, anus, vagina, penis , and testicles. Table 3.2 Estimated Percentage of Active-Component Coast Guard Service Members Who...reporting. The survey included a link to an image of the form to enhance recall. Fif- teen percent of women who were sexually assaulted in the past year
... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE... level of understanding, involvement, and agreement with the plan of care, in accordance with the hospice... communication and integration, in accordance with the hospice's own policies and procedures, to— (1) Ensure that...
Talapatra, Devadrita; Roach, Andrew T.; Varjas, Kris; Houchins, David E.; Crimmins, Daniel B.
Transition services can be used to forge family, school, and community partnerships and foster a successful shift to adult life for students with intellectual disabilities (ID). School psychologists can play a valuable additive role in supporting the transition process due to their graduate training in interpersonal skills; consultation services;…
... services by or under the supervision of a registered nurse and in accordance with the plan of care. (a) Standard: Duties of the registered nurse. The registered nurse makes the initial evaluation visit..., furnishes those services requiring substantial and specialized nursing skill, initiates appropriate...
... in their entirety without regard to their timing. Other costs related to capital expenditures include..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES... personnel, and the staff; employs qualified personnel and ensures adequate staff education and evaluations...
Edwards, Joe; Vess, James; Reger, Greg; Cernich, Alison
Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.
D'Souza, Jennifer C.; James, Mary L.; Szafara, Kristina L.; Fries, Brant E.
Purpose: When government funding for long-term care is reduced, participant outcomes may be adversely affected. We investigated the effect of program resources on individuals enrolled in the Michigan Home- and Community-Based Services (HCBS) waiver program for elderly and disabled adults. Design and Methods: Using dates of major policy and budget…
resource noted that the program also assists veterans and their family members in purchasing food and clothes, explaining job application processes, and...of financial statements, and guidance on other such business-related activities as franchising and marketing. In addition to describing these
bruising. An MRI scan provides detailed images of the brain using magnetic energy rather than x-ray technology . Intracranial means within the...member/veteran is unable to swallow for many days to weeks, a per cutaneous gastronomy tube (PEG tube) will be placed directly into his or her
Declaration of income for 2006 Members of the personnel are invited to take note of the following information on the procedure for completing the 2006 declaration of income form, which must be returned by 31st May 2007 at the latest. Who is required to complete the form? Where can it be obtained? All members of the personnel1 residing in France, whether or not they are of French nationality2, are required to complete a declaration of income form for 2006 according to the following instructions and to return a signed copy to their local tax office by 31st May 2007 at the latest. Members of the personnel should receive a 2006 income declaration form at the end of April/ beginning of May. Failing this, they should procure one from their local tax office, public finance office ('Trésorerie') or town hall or download one from the Finance Ministry's website (www.finances.gouv.fr ). Completing the declaration form Members of the personnel must compete a HARD-COPY FORM only.It is not possible to make a decla...
Declaration of income for 2006 Members of the personnel are invited to take note of the following information on the procedure for completing the 2006 declaration of income form, which must be returned by 31st May 2007 at the latest. Who is required to complete the form? Where can it be obtained? All members of the personnel1 residing in France, whether or not they are of French nationality2, are required to complete a declaration of income form for 2006 according to the following instructions and to return a signed copy to their local tax office by 31st May 2007 at the latest. Members of the personnel should receive a 2006 income declaration form at the end of April/ beginning of May. Failing this, they should procure one from their local tax office, public finance office ('Trésorerie') or town hall or download one from the Finance Ministry's website (www.finances.gouv.fr ). Completing the declaration form Members of the personnel must compete a HARD-COPY FORM only.It is not possible to make a decla...
The speech, spatial and qualities of hearing scale (SSQ). International Journal of Audiology, 43(2), 85–99. 11 Quad Chart Diagnosing contributions... Service Members” PRINCIPAL INVESTIGATOR: Dr. Barbara Shinn-Cunningham CONTRACTING ORGANIZATION: Boston University Boston, MA 02215-1703 REPORT DATE...information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations
Full Text Available The purpose of this study is to examine the relationship, mediated through reinforcement contingency, between (a participation in budgeting, and (b organizational commitment, of those organizations in the service industry, listed in the Indonesian Stock Exchange and also having their branch offices in Bandar Lampung. We develop a new construct of reinforcement contingency, through focus group discussion and several pilot studies, and use it in the main survey. We analyse data from 42 respondents, using SmartPLS. We find that reinforcement contingency as the mediation variable affects the relation between participation in budgeting andn organizational commitment. This study suggests the “no reward and no punishment” system as the appropriate reinforcement contingency for employees, in order to enhance their commitment to their organization.Keywords: Participation in Budgeting, Reinforcement Contingency, Organizational Commitment, Service Sector
Qudais, Mahmoud Abu; Al-Omari, Aieman; Smadi, Rana
The present study aimed to identify and interpret concerns of the new faculty members in Jordanian universities. A total of 336 new faculty members who participated in this study were asked to rate their perceptions of issues related to teaching, research, service, balancing work and home life and the academic culture of their workplace. Means and…
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Types of annuities to members. 19.10 Section 19.10 Foreign Relations DEPARTMENT OF STATE PERSONNEL BENEFITS FOR SPOUSES AND FORMER SPOUSES OF PARTICIPANTS IN THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM § 19.10 Types of annuities to members. ...
Chuang, Chih; Khatri, Siddique H.; Gill, Manpal S.; Trehan, Naveen; Masineni, Silpa; Chikkam, Vineela; Farah, Guillaume G.; Khan, Amber; Levine, Diane L.
Background International Service Learning Trips (ISLT) provide health professional students the opportunity to provide healthcare, under the direction of trained faculty, to underserved populations in developing countries. Despite recent increases in international service learning trips, there is scant literature addressing concerns students have prior to attending such trips. This study focuses on identifying concerns before and after attending an ISLT and their impact on students. Methods A...
Gómez Martínez, M Eugenia; Pastor Moreno, Guadalupe; Pérez Corral, Olivia; Iriarte de Los Santos, M Teresa; Mena Jiménez, Ángel Luis; Escudero Espinosa, M Cecilia; García Romera, Inmaculada; Blanco García, Martín Germán; Martín Barato, Amelia
To discover good practices for inhabitant participation in the clinical management units (CMUs) of the Andalusian Health Service (AHS) (Spain) and to explore the reasons perceived by CMU and AHS professionals that may influence the presence and distribution of those good practices among the CMU. Study with mixed methodology carried out in Andalusia (Spain) in two phases (2013-2015). Firstly, an online survey was delivered to the Directors of the CMUs which had set up an inhabitant participation commission. In a second phase, a qualitative study was carried out through semi-structured interviews with professionals from the Andalusian Health Service with previous experience in inhabitant participation. A descriptive analysis of the quantitative information and a semantic content analysis of the qualitative information were carried out. 530 CMUs took part in the survey. The inhabitant participation practices more often implemented in the CMUs are those related to the informing and consultation levels. Twelve professionals were interviewed in the second phase. Other practices with higher inhabitant involvement and delegation are secondary. The barriers which were identified by professionals are related to the beliefs and attitudes of the inhabitants, the professionals, the health system and the environment. The main practices for inhabitant participation in the CMUs are related to the most basic levels of participation. The method and dynamics which facilitate inhabitant empowerment within the health system are not clearly recognised. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Soares, Tiago; Morais, Hugo; Pinson, Pierre
The impact of a high penetration of wind power generation in power systems motivates need for an assessment of its inte raction with electricity markets. With the continuous evolution of wind turbines technology, wind farms have today the ability to provide certain ancillary services...... with appropriate levels of security and reliability . The participation of wind f arms i n ancillary service market s ought to rely on market designs and offering strategies that satisfy power system needs, as well as their operating characteristics . Here we evaluate the system impact of different offering...... strategies that wind farms employ on ene rgy and ancillary service market. A lready proposed Proportional Wind Reserve Strategy (PWRS) and a Continuo us Wind Reserve Strategy (CWRS) are used to determine the amount of available power for ancillary services. A case study based on real and recent dat...
... assessments, developing and evaluating the plan of care, and contributing to patient and family counseling and education; and (c) Licensed professionals must participate in the hospice's quality assessment and...
Wynaden, Dianne; Barr, Lesley; Omari, Omar; Fulton, Anthony
Approximately 210 patients are admitted each year to the Western Australian State Forensic Mental Health Service, and most present with psychotic illness, along with other physical and mental comorbidities. In 2010, a healthy lifestyle programme, which included a formal exercise programme coordinated by an exercise physiologist, was introduced at the service. A self-report questionnaire was developed to obtain feedback on the programme, and 56 patients completed the questionnaire during the 6-month evaluation period. As well as providing patients with access to regular physical activity, the programme also supports the recovery philosophy, where patients work in partnership with forensic mental health staff. Overall, patients reported that the programme assisted them to manage their psychiatric symptoms, as well as improving their level of fitness, confidence, and self-esteem. In addition, patients received education about the importance of regular exercise to their mental health, and the role exercise plays in preventing chronic illness and obesity. While the benefits of exercise on mental health outcomes for people with depression and anxiety are well established, this evaluation adds to the evidence that such programmes provide similar benefits to people who have a psychotic illness and are hospitalized in an acute secure setting. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Weaver, Lindell K; Wilson, Steffanie H; Lindblad, Anne S; Churchill, Susan; Deru, Kayla; Price, Robert C; Williams, Chris S; Orrison, William W; Walker, James M; Meehan, Anna; Mirow, Susan
In prior military randomized trials, participants with persistent symptoms after mild traumatic brain injury (TBI) reported improvement regardless of receiving hyperbaric oxygen (HBO₂) or sham intervention. This study's objectives were to identify outcomes for future efficacy trials and describe changes by intervention. This Phase II, randomized, double-blind, sham-controlled trial enrolled military personnel with mild TBI and persistent post-concussive symptoms. Participants were randomized to receive 40 HBO₂ (1.5 atmospheres absolute (ATA), ⟩99% oxygen, 60 minutes) or sham chamber sessions (1.2 ATA, room air, 60 minutes) over 12 weeks. Participants and evaluators were blinded to allocation. Outcomes assessed at baseline, 13 weeks and six months included symptoms, quality of life, neuropsychological, neurological, electroencephalography, sleep, auditory, vestibular, autonomic, visual, neuroimaging, and laboratory testing. Participants completed 12-month questionnaires. Intention-to-treat results are reported. From 9/11/2012 to 5/19/2014, 71 randomized participants received HBO₂ (n=36) or sham (n=35). At baseline, 35 participants (49%) met post-traumatic stress disorder (PTSD) criteria. By the Neurobehavioral Symptom Inventory, the HBO₂ group had improved 13-week scores (mean change -3.6 points, P=0.03) compared to sham (+3.9 points). In participants with PTSD, change with HBO₂ was more pronounced (-8.6 vs. +4.8 points with sham, P=0.02). PTSD symptoms also improved in the HBO₂ group, and more so in the subgroup with PTSD. Improvements regressed at six and 12 months. Hyperbaric oxygen improved some cognitive processing speed and sleep measures. Participants with PTSD receiving HBO₂ had improved functional balance and reduced vestibular complaints at 13 weeks. By 13 weeks, HBO₂ improved post-concussive and PTSD symptoms, cognitive processing speed, sleep quality, and balance function, most dramatically in those with PTSD. Changes did not persist
Degrassi, Flori; Sopranzi, Cristina; Leto, Antonella; Amato, Simona; D'Urso, Antonio
Managing quality in health care whilst ensuring equity is a fundamental aspect of the provision of services by healthcare organizations. Measuring perceived quality of care is an important tool for evaluating the quality of healthcare delivery in that it allows the implementation of corrective actions to meet the healthcare needs of patients. The Rome B (ASL RMB) local health authority adopted the UNI EN 10006:2006 norms as a management tool, therefore introducing the evaluation of customer satisfaction as an opportunity to involve users in the creation of quality healthcare services with and for the citizens. This paper presents the activities implemented and the results achieved with regards to shared and integrated continuous improvement of services.
Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.
Drawing from the organizational behaviour and services marketing literature, we develop a conceptual model of self-managing team (SMT) service climate, taking into account characteristics of the organizational context, the SMT, and the individual employee. In order to assess the impact of SMT
Julianne M Kowalski, PharmD
Full Text Available Objectives: To identify characteristics of patients who accepted or declined an appointment for a transition of care service provided by an independent community pharmacist and identify the most common reasons patients declined the service. Methods: A transition of care service was offered by a community pharmacy to patients discharged to home from the cardiac unit of a local hospital. The community pharmacist approached patients prior to discharge for recruitment into the service. Outcomes included service acceptance rate, LACE score at discharge, readmission risk category, age, gender, geographic home location, and reason for refusing the service. Descriptive statistics and logistic regression were used to compare characteristics between those who accepted or declined the service. Reasons for decline were assessed using content analysis. Results: Of the 87 patients that were included in the analysis, 21 patients received the transitions of care service (24.1%. None of the characteristics were found to be statistically significant between patients who received or declined the service. Patients at a moderate risk for readmission seemed more likely to accept the pharmacist-run appointment than those at high risk (27.9% vs 15.3%; P = 0.29. Of the 66 patients who declined, 51 gave a reason (77.3%. Thirty-nine patients saw no benefit (76.5%, five patients had perceived barriers (10%, and seven patients gave reasons that fell into both categories (13.5%. Conclusions: This evaluation did not find a statistically significant difference in characteristics between those patients who accepted or declined participation in a pharmacist-run transition of care service. Patients may be less likely to accept pharmacist-run transition of care appointments primarily due to no perceived benefits. To increase participation, we need to understand the patient’s health beliefs, educate patients on pharmacy services, and implement changes to recruit potential
... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM..., and communication of basic needs), until it has been demonstrated that the client is developmentally... individual program plan and assessments and that contribute to an overall understanding of the client's...
... more doctors of medicine or osteopathy and one or more physician assistants, nurse practitioners, or... patients, including— (i) Inpatient hospital care; (ii) Services of doctors of medicine or osteopathy; and... supervision of a registered nurse, a doctor of medicine or osteopathy, or, where permitted by State law, a...
Liu Yen Lan,; Chang Kang-tsung,; Stoorvogel, J.J.; Verburg, P.H.; Sun Chin Hong,
Fallowing with green fertilizer can benefit agricultural ecosystem services (AES). Farmers in Taiwan do not implement fallow practices and plant green fertilizer because the current subsidy level (46,000 NT$ per ha) is too low to manage fallowing. This paper defines the objective of government
Liu, Y.L.; Chang, K.T.; Stoorvogel, J.; Verburg, P.H.; Sun, C.H.
Fallowing with green fertilizer can benefit agricultural ecosystem services (AES). Farmers in Taiwan do not implement fallow practices and plant green fertilizer because the current subsidy level (46,000 NT$ per ha) is too low to manage fallowing. This paper defines the objective of government
Background: Supported decision-making and personal budgets for services are the new paradigms. Method: Supported decision-making proposals from the Australian State of Victoria are analysed against international trends to determine the viability of laws reflecting new international norms of the United Nations Convention on the Rights of Persons…
Full Text Available Many payment for ecosystem services (PES programs, such as the Slope Land Conversion Program (SLCP, are passive and require full participation by impacted households. In contrast, this study considers the alternative of "active and incomplete" participation in PES programs, in which participants are not obliged to contract their own land, and have the right to select into the program or not. This type of program has been popular over the last decade in China; however, there have been few studies on the characteristics of willingness to participate and implementation. As such, this paper uses the Choice Experiment (CE method to explore ways for inducing effective program participation, by analyzing the effects of different regime attributes. The case study used to analyze participation utility was the Jing-Ji Afforestation Program for Ecological and Water Protection (JAPEWP, a typical active-participation forestry PES program, and a key source of water near Beijing in the Miyun Reservoir Catchment (MRC. Analyzing rural household survey data indicated that the program faces a variety of challenges, including long-term maintenance, implementation performance, cost-effectiveness, and monitoring approaches. There are also challenges with one-size-fits-all payment strategies, due to ineffective program participation or imperfect implementation regimes. In response, this study proposes several policies, including providing secure and complete land tenure to the participants, creating more local off-farm employment opportunities, designing performance-based monitoring systems that are integrated with financial incentives, applying differentiated payment strategies, providing capacity building to support forestation activities, and establishing a comprehensive implementation regime that would address these challenges. These policy conclusions provide valuable lessons for other active-participation PES programs as well.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Solicitation... policy Communication of scientific findings to multiple audiences including health care professionals, policy makers and the general public. Candidates with experience and skills in any of these areas should...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Solicitation... Application of science to health policy Communication of scientific findings to multiple audiences including health care professionals, policy makers and the general public. Candidates with experience and skills in...
Zhang Ruijin; Castel, Arnaud; Francois, Raoul
This paper deals with two corroded reinforcement concrete beams, which have been stored under sustained load in a chloride environment for 14 and 23 years respectively. The evolution of corrosion pattern of reinforcement and its influence on serviceability are studied. In chloride-induced corrosion process, corrosion cracking affects significantly the corrosion pattern. During the corrosion cracking initiation period, only local pitting corrosion occurs. At early stage of cracking propagation, localized pitting corrosion is still predominant as cracks widths are very small and cracks are not interconnected, but a general corrosion slowly develops as the cracks widen. At late cracking stage, interconnected cracking with wide width develops along large parts of the beam leading to a general corrosion pattern. Macrocells and microcells concepts are used for the interpretation of the results. Mechanical experiments and corrosion simulation tests are performed to clarify the influence of this corrosion pattern evolution on the serviceability of the beams (deflection increase). Experimental results show that, when the corrosion is localized (early cracking stage), the steel-concrete bond loss is the main factor affecting the beams serviceability. The local cross-section loss resulting from pitting attack does not significantly influence the deflection of the beam. When corrosion is generalized (late cracking stage), as the steel-concrete bond is already lost, the generalized steel cross-section reduction becomes the main factor affecting the beams serviceability. But, at this stage, the deflection increase is slower due to the low general corrosion rate.
... INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE Federal Insurance Contributions... 3121(r). N operates a seminary adjacent to a university. Students at the university obtain lodging and...
Mia Selvina; Yuliansyah Yuliansyah
The purpose of this study is to examine the relationship, mediated through reinforcement contingency, between (a) participation in budgeting, and (b) organizational commitment, of those organizations in the service industry, listed in the Indonesian Stock Exchange and also having their branch offices in Bandar Lampung. We develop a new construct of reinforcement contingency, through focus group discussion and several pilot studies, and use it in the main survey. We analyse data from 42 res...
Office of Inspector General (ED), Washington, DC.
All institutions participating in the Federal Student Financial Assistance Programs must have an annual financial aid compliance audit performed by an independent auditor. This guide is effective for fiscal years ending December 31, 1999, and thereafter, for institutions preparing for their yearly audit. The purpose of the document is to assist…
... BUREAU OF CONSUMER FINANCIAL PROTECTION 12 CFR Part 1090 [Docket No. CFPB-2013-0005] RIN 3170-AA35... Protection. ACTION: Proposed rule; request for public comment. SUMMARY: The Bureau of Consumer Financial Protection (Bureau or CFPB) proposes to amend the regulation defining larger participants of certain consumer...
Morales-Condea, M. J.
Full Text Available Drilling devices is used to get information about the cross-section properties and internal defects of structural members. Drill resistance is correlated with density which is often used to predict the mechanical properties of timber elements. However in situ a regression curve cannot be obtained and pre-existent curves provides unreliable predictions. The present paper proposes a procedure for in situ “calibration” of drill resistance data. The “calibration” is based on density values from wood cores taken in the close vicinity of drill holes. Two approaches were tested. One approach based on a regression curve built using wood cores density and drill resistance values obtained from a limited number of members. The other approach uses the information of one wood core to “calibrate” the drill resistance profile taken at the same member. Following this procedure a density prediction is obtained showing a low mean percentage error and a medium coefficient of determination.Los dispositivos de perforación se utilizan a menudo para obtener información sobre las propiedades de la sección transversal y defectos internos de los elementos estructurales de madera. La resistencia a la perforación se correlaciona con la densidad que, a menudo, se utiliza para obtener la predicción de las propiedades mecánicas de los elementos de madera. Sin embargo, una curva de regresión no puede ser obtenida in situ y las curvas de preexistentes proporcionan predicciones poco fiables. En el presente trabajo se propone un procedimiento de “calibración” in situ de los datos de resistencia de perforación obtenidos en cada caso. La “calibración” se basa en los valores de densidad de pequeñas probetas de madera tomadas en las inmediaciones de los taladros. Para ello se plantean 2 métodos: Un primer enfoque basado en obtener una curva de regresión a partir de los valores de densidad de pequeñas probetas de madera y los valores de resistencia a
Ross H. Miller
Full Text Available Background Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss. Methods Cross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW. Results Peak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s vs. controls (157% BW, 1,985% BW/s, with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters. Discussion Assuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.
Somech, Anit; Wenderow, Maayan
Purpose: The contingency model theory suggests that the effects of a leadership style cannot be studied without explicit attention to the given situation. Accordingly, the authors propose a model that allows them to examine simultaneously the relative impact of participative leadership and directive leadership on teachers' performance through the…
Prendergast, Michael; Cartier, Jerome J.
In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post...
Hamann, Johannes; Bühner, Markus; Rüsch, Nicolas
People with mental illness struggle with symptoms and with public stigma. Some accept common prejudices and lose self-esteem, resulting in shame and self-stigma, which may affect their interactions with mental health professionals. This study explored whether self-stigma and shame are associated with consumers' preferences for participation in medical decision making and their behavior in psychiatric consultations. In a cross-sectional study conducted in Germany, 329 individuals with a diagnosis of a schizophrenia spectrum disorder or an affective disorder and their psychiatrists provided sociodemographic and illness-related information. Self-stigma, shame, locus of control, and views about clinical decision making were assessed by self-report. Psychiatrists rated their impression of the decision-making behavior of consumers. Regression analyses and structural equation modeling were used to determine the association of self-stigma and shame with clinical decision making. Self-stigma was not related to consumers' participation preferences, but it was associated with some aspects of communicative behavior. Active and critical behavior (for example, expressing views, daring to challenge the doctor's opinion, and openly speaking out about disagreements with the doctor) was associated with less shame, less self-stigma, more self-responsibility, less attribution of external control to powerful others, and more years of education. Self-stigma and shame were associated with less participative and critical behavior, which probably leads to clinical encounters that involve less shared decision making and more paternalistic decision making. Paternalistic decision making may reinforce self-stigma and lead to poorer health outcomes. Therefore, interventions that reduce self-stigma and increase consumers' critical and participative communication may improve health outcomes.
Rantanen, Jorma; Lehtinen, Suvi; Valenti, Antonio; Iavicoli, Sergio
The United Nations General Assembly (UNGA), the International Labour Organization (ILO), the World Health Organization (WHO), the International Commission on Occupational Health (ICOH), and the European Union (EU) have encouraged countries to organize occupational health services (OHS) for all working people irrespective of the sector of economy, size of enterprise or mode of employment of the worker. The objective of this study was to survey the status of OHS in a sample of countries from all continents. A questionnaire focusing on the main aspects of OHS was developed on the basis of ILO Convention No. 161 and several other questionnaire surveys used in various target groups of OHS. The questionnaire was sent to 58 key informants: ICOH National Secretaries. A total of 49 National Secretaries responded (response rate 84.5%), from countries that employ 70% of the total world labour force. The majority of the respondent countries, 67%, had drawn up an OHS policy and implement it with the help of national occupational safety and health (OSH) authorities, institutes of occupational health or respective bodies, universities, and professional associations. Multidisciplinary expert OHS resources were available in the majority (82%) of countries, but varied widely in quantitative terms. The average OHS coverage of workers was 24.8%, with wide variation between countries. In over two thirds (69%) of the countries, the content of services was mixed, consisting of preventive and curative services, and in 29% preventive only. OHS financing was organized according to a mixed model among 63% and by employers only among 33% of the respondents. The majority of countries have drawn up policies, strategies and programmes for OHS. The infrastructures and institutional and human resources for the implementation of strategies, however, remain insufficient in the majority of countries (implementation gap). Qualitatively, the content and multidisciplinary nature of OHS corresponds to
Full Text Available The project aim was to establish an SDI (Selected Dissemination of Information service for the faculty members at University of Tehran, faculty of psychology and education. The project was carried out during the 2006-2007 period. First, a three stage survey was conducted to identify the information needs which were then served using a current awareness service over the period. Findings confirmed that the SDI project significantly impacted on the faculty information seeking behavior. Furthermore, there had been evidence supporting the fact that it has also influenced the quality of instruction by facilitating the overall efficacy of information sources collected. It was the intent of researchers to expand this project at later stages to include all humanities faculties in the university and if possible at a national level.
Walter, Kristen H; Glassman, Lisa H; Michael Hunt, W; Otis, Nicholas P; Thomsen, Cynthia J
Posttraumatic stress disorder (PTSD) commonly co-occurs with major depressive disorder (MDD) in both civilian and military/veteran populations. Existing, evidence-based PTSD treatments, such as cognitive processing therapy (CPT), often reduce symptoms of both PTSD and depression; however, findings related to the influence of comorbid MDD on PTSD treatment outcomes are mixed, and few studies use samples of individuals with both conditions. Behavioral activation (BA), an approach that relies on behavioral principles, is an effective treatment for depression. We have integrated BA into CPT (BA+CPT), a more cognitive approach, to address depressive symptoms among active duty service members with both PTSD and comorbid MDD. We describe an ongoing randomized controlled trial investigating the efficacy of our innovative, integrated BA+CPT intervention, compared with standard CPT, for active duty service members with PTSD and comorbid MDD. We detail the development of this integrated treatment, as well as the design and implementation of the randomized controlled trial, to evaluate its effect on symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.
Yi, Tae Im; Lee, Ko Eun; Ha, Seung A
Objective To clarify how participation in leisure activities and exercise by chronic stroke survivors differs before and after a stroke. Methods Sixty chronic stroke survivors receiving community-based rehabilitation services from a health center in Seongnam City were recruited. They completed a questionnaire survey regarding their demographic characteristics and accompanying diseases, and on the status of their leisure activities and exercise. In addition, their level of function (Korean version of Modified Barthel Index score), risk of depression (Beck Depression Inventory), and quality of life (SF-8) were measured. Results After their stroke, most of the respondents had not returned to their pre-stroke levels of leisure activity participation. The reported number of leisure activities declined from a mean of 3.9 activities before stroke to 1.9 activities post-stroke. In addition, many participants became home-bound, sedentary, and non-social after their stroke. The most common barriers to participation in leisure activities were weakness and poor balance, lack of transportation, and cost. The respondents reported a mean daily time spent on exercise of 2.6±1.3 hours. Pain was the most common barrier to exercise participation. Conclusion Chronic stroke survivors need information on leisure activities and appropriate pain management. PMID:25932420
Sheridan, Ann; O'Keeffe, Donal; Coughlan, Barbara; Frazer, Kate; Drennan, Johnathan; Kemple, Mary
Social opportunities can be limited in the lives of people with enduring mental illness (EMI) due to psychiatric stigma, restricted home environments and employment barriers. Supported socialisation programmes have the potential to redress the impact of social isolation. To explore the experiences of service users with EMI taking part in a supported socialisation programme, using written diary entries. This article reports on the qualitative component of a randomised controlled trial of supported socialisation for people with EMI (published previously in this journal). Trial participation involved (1) being matched with a volunteer partner and engaging in social/leisure activities while receiving a stipend of €20 or (2) receiving this stipend only and engaging in self-driven socialisation. Participants completed written diaries documenting their perspectives on their experiences of supported socialisation. Data were analysed using Thematic Analysis. Experiences of participation were characterised by involvement 'normalising' life, fostering a sense of connectedness, improving physical health, and facilitating engagement with culture. Taking part helped participants integrate socialising into their identity, enhanced their perceived capacity to be social, and cemented/expanded social networks. Participants also experienced significant obstacles to socialisation. Supported socialisation can increase confidence, social competence and self-agency; buffer against psychiatric stigma; build social capital; and afford opportunities to enhance social integration, inclusion and belonging.
Chuang, Chih; Khatri, Siddique H; Gill, Manpal S; Trehan, Naveen; Masineni, Silpa; Chikkam, Vineela; Farah, Guillaume G; Khan, Amber; Levine, Diane L
International Service Learning Trips (ISLT) provide health professional students the opportunity to provide healthcare, under the direction of trained faculty, to underserved populations in developing countries. Despite recent increases in international service learning trips, there is scant literature addressing concerns students have prior to attending such trips. This study focuses on identifying concerns before and after attending an ISLT and their impact on students. A survey comprised of closed and open-ended questions was developed to elucidate student concerns prior to attending an ISLT and experiences which might influence concerns. A five-point Likert-scale (extremely concerned = 1, minimally concerned = 5) was used to rate apprehension and satisfaction. Paired t-test was used to compare pre- and post-trip concerns; Chi-Square test was used to compare groups. Thirty-five students (27 medical, 8 pharmacy) attended ISLTs in December 2013. All completed pre and post-trip surveys. Significant decreases were seen in concerns related to cultural barriers (4.14 vs 4.46, P = .047), disease/epidemics (3.34 vs 4.60, P travel (3.86 vs 4.51, P food (3.83 vs 4.60, P students described benefits of attending an ISLT. Students had multiple concerns prior to attending an ISLT. Most decreased upon return. Addressing concerns has the potential to decrease student apprehension. The results of this study highlight the benefits of providing ISLTs and supporting development of a curriculum incorporating trip-related concerns.
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE uniform health maintenance organization (HMO) benefit--Prime enrollment fee exemption for survivors of active duty deceased sponsors and medically retired uniformed services members and their dependents. Final rule.
This final rule creates an exception to the usual rule that TRICARE Prime enrollment fees are uniform for all retirees and their dependents and responds to public comments received to the proposed rule published in the Federal Register on June 7, 2013. Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents are part of the retiree group under TRICARE rules. In acknowledgment and appreciation of the sacrifices of these two beneficiary categories, the Secretary of Defense has elected to exercise his authority under the United States Code to exempt Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents enrolled in TRICARE Prime from paying future increases to the TRICARE Prime annual enrollment fees. The Prime beneficiaries in these categories have made significant sacrifices for our country and are entitled to special recognition and benefits for their sacrifices. Therefore, the beneficiaries in these two TRICARE beneficiary categories who enrolled in TRICARE Prime prior to 10/1/2013, and those since that date, will have their annual enrollment fee frozen at the appropriate fiscal year rate: FY2011 rate $230 per single or $460 per family, FY2012 rate $260 or $520, FY2013 rate $269.38 or $538.56, or the FY2014 rate $273.84 or $547.68. The future beneficiaries added to these categories will have their fee frozen at the rate in effect at the time they are classified in either category and enroll in TRICARE Prime or, if not enrolling, at the rate in effect at the time of enrollment. The fee remains frozen as long as at least one family member remains enrolled in TRICARE Prime and there is not a break in enrollment. The fee charged for the dependent(s) of a Medically Retired Uniformed Services Member would not change if the dependent(s) was later re-classified a Survivor.
Schubert, Michael; Schian, Marcus; Viehmeier, Sarah
The federal participation law (Bundesteilhabegesetz - BTHG) is one of the largest efforts in the last 15 years to reform the legal participation rights of people with disabilities. In particular, a number of enhancements are planned in the overall benefits law in Part 1 of Book IX in the Social Code (Sozialgesetzbuch - SGB), which applies to all rehabilitation carriers including general provisions and standards for needs assessment. This paper deals with the implications of these provisions and interacting standards, based on the draft bill of April 2016.The discussion takes place against the background of the regulatory objectives formulated in the ministerial draft itself, jurisprudential expertise on the effects of the current legal norms of the SGB IX as well as relevant professional political developments and statements by various stakeholders.The analysis shows a clear political commitment to increase the requirements for needs assessment in the overall law of the SGB IX and to express these more effectively. The draft bill seeks not only to modify procedures subsequent to the application for rehabilitation benefits, but also to precisely set out provisions on instruments for needs assessment in a new § 13. Common principles for these instruments of needs assessment should increase the cooperation, coordination and convergence among rehabilitation carriers.Nevertheless, with regard to the proposed regulatory texts, there is doubt that the objectives set by the draft bill itself will be achieved. For example, the required common principles for needs assessment are to be agreed upon based on the existing special legislation for the different rehabilitation carriers, without the SGB IX setting its own binding standards or framework principles. In addition, it lacks clear legal guidelines for the professional practice to make use of the bio-psycho-social model of the WHO and the ICF in the process of needs assessment. As a consequence the ICF cannot
Näslindh-Ylispangar, Anita; Sihvonen, Marja; Kekki, Pertti
To explore health, use of health services, 'core' information and reasons for non-participation amongst males. Gender may provide an explanation for non-participation in the healthcare system. A growing body of research suggests that males are less likely than females to seek help from health professionals for their problems. The current research had its beginnings with the low response rate in a prior voluntary survey and health examination for Finnish males born in 1961. Data triangulation among 28 non-respondent middle-aged males in Helsinki was used. The methods involved structured and in-depth interviews and health measurements to explore the views of these males concerning their health-related behaviours and use of health services. Non-respondent males seldom used healthcare services. Despite clinical risk factors (e.g. obesity and blood pressure) and various symptoms, males perceived their health status as good. Work was widely experienced as excessively demanding, causing insomnia and other stress symptoms. Males expressed sensitive messages when a session was ending and when the participant was close to the door and leaving the room. This 'core' information included major causes of concern, anxiety, fears and loneliness. This triangulation study showed that by using an in-depth interview as one research strategy, more sensitive 'feminist' expressions in health and ill-health were got by men. The results emphasise a male's self-perception of his masculinity that may have relevance to the health experience of the male population. Nurses and physicians need to pay special attention to the requirements of gender-specific healthcare to be most effective in the delivery of healthcare to males.
Adriana Lira Rufino de Lucena
Full Text Available BACKGROUND: the detection of obesity is shown relevant considering that with aging there is progressive loss of lean body mass and increased the proportion of body fat, and also metabolic changes and reduced physical activities that require increased energy and weight loss, contributing to obesity installation, which in turn exert implications on health and social life of the elderly. Before with these consequences of obesity and its impact on the health of the elderly, the study aimed to identify the prevalence of obesity among elderly participants of a university extension project. METHOD: Exploratory and descriptive study with a quantitative approach. The sample is constituted by 96 elderly people of both sexes registered in the project. RESULT: It appears that the 37 elderly people (38.54% had some degree of obesity. Obesity classification prevailed 57.63% of non-obese overweight status, while among the obese, 67.57% is in obesity I. CONCLUSION: It is believed that knowing this reality helps medical and nursing actions in promotion of strategies of healthy lifestyles and encouragement, making interaction for personal responsibility in training for self-care and improved quality of life.
Full Text Available The purpose of this study is to examine the relationship, mediated through reinforcement contingency, between (a participation in budgeting, and (b organizational commitment, of those organizations in the service industry, listed in the Indonesian Stock Exchange and also having their branch offices in Bandar Lampung. We develop a new construct of reinforcement contingency, through focus group discussion and several pilot studies, and use it in the main survey. We analyse data from 42 respondents, using SmartPLS. We find that reinforcement contingency as the mediation variable affects the relation between participation in budgeting and organizational commitment. This study suggests the “no reward and no punishment” system as the appropriate reinforcement contingency for employees, in order to enhance their commitment to their organization.
Full Text Available Recent research on payments for environmental services (PES has observed that high transaction costs (TCs are incurred through the implementation of PES schemes and farmer participation. TCs incurred by households are considered to be an obstacle to the participation in and efficiency of PES policies. This study aims to understand transactions related to previous forest plantation programmes and to estimate the actual TCs incurred by farmers who participated in these programmes in a mountainous area of northwestern Vietnam. In addition, this study examines determinants of households’ TCs to test the hypothesis of whether the amount of TCs varies according to household characteristics. Results show that average TCs are not likely to be a constraint for participation since they are about 200,000 VND (USD 10 per household per contract, which is equivalent to one person’s average earnings for about two days of labour. However, TCs amount to more than one-third of the programmes’ benefits, which is relatively high compared to PES programmes in developed countries. This implies that rather than aiming to reduce TCs, an appropriate agenda for policy improvement is to balance the level of TCs with PES programme benefits to enhance the overall attractiveness of afforestation programmes for smallholder farmers. Regression analysis reveals that education, gender and perception towards PES programmes have significant effects on the magnitude of TCs. The analyses also points out the importance of local conditions on the level of TCs, with some unexpected results.
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ENGLISH ABSTRACT: Since the early days of computing, IT professionals have been struggling with their end users (customers to such an extent that end users became sceptic about the quality of service and support IT professionals can offer. As such, relationships between IT professionals and end users were in many cases very poor, which impacts negatively on the efforts to use information technology to the advantage of organizations or communities as a whole. This paper briefly describes the historical reasons therefor and gives a theoretical foundation for the establishment of IT-end user relationships. The paper describes IT-end user relationships as intriguing and complex and proposes a conceptual framework that explains all the important elements involved during the establishment and maintenance of sound relationships as well as for managing change. This paper is based on a research study conducted into the working relationship between IT departments and its end users. The research was done by means of a qualitative approach in which thought experiments were used to inductively refine the results of the research study.
AFRIKAANSE OPSOMMING:Sedert die ontstaan van die rekenaarwese en die gepaardgaande dienslewering via inligtingstegnologie bestaan die neiging by eindpuntgebruikers om skepties te staan teenoor die gehalte van diens wat deur inligtingstegnoloë gebied kan word. Dit het daartoe gelei dat die verhoudinge tussen eindpuntgebruikers en die inligtingstegnoloë vertroebel is. Voordelige gebruik van inligtingstegnologie deur ondernemings en die gemeenskap is gevolglik daardeur benadeel. Hierdie stuk behandel kortliks die historiese oorsake vir die toedrag van sake. Dit beskryf ook die teoretiese grondslae vir die skepping van wedersydse verhoudings vir die probleemsituasie. Die stuk ondersoek die aandagwekkende en komplekse verhoudingsmilieu. Dit beskryf vervolgens ’n voorgestelde konsepraamwerk waarmee die belangrik elemente
Vincent, Claude; Gagnon, Dany H; Dumont, Frédéric
To assess the effects of a mobility service dog (MSD) on pain, fatigue, wheelchair-related functional tasks, participation and satisfaction among manual wheelchair users over a nine-month period. A longitudinal study with repeated assessment times before and three, six and nine months after intervention was achieved. Intervention consisted in partnering each participant with a MSD. The setting is a well-established provincial service dog training school and participants homes. A convenience sample of 24 long-term manual wheelchair users with a spinal cord injury was involved. Outcome measures were: Wheelchair User's Shoulder Pain Index (WUSPI), Rate of Perceived Exertion (RPE), vitality scale from the SF-36, grip strength, Wheelchair Skills Test (WST), Canadian Occupational Performance Measure (COPM), Reintegration to Normal Living Index (RNLI), Life Space Assessment, Psychosocial Impact of Assistive Devices Scale (PIADS) and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0). Shoulder and wrist pain as well as fatigue decreased significantly over time with the use of a MSD as evidenced by scores from WUSPI, RPE and SF-36 (feeling less worn out). Manual wheelchair propulsion skills (steep slopes, soft surfaces and thresholds) improved significantly over time as confirmed by the WST. Participation increased significantly over time as revealed by the COPM (for five occupations) and the RNLI (for five items). Satisfaction with the MSD was high over time (QUEST: nine items) and with a high positive psychosocial impact (PIADS: 10 items). MSD represents a valuable mobility assistive technology option for manual wheelchair users. IMPLICATIONS FOR REHABILITATION For manual wheelchair users partenered with mobility service dog • Shoulder pain and fatigue significantly decreased and continued to decrease between the third and sixth month and the ninth month. • Performance with propelling the wheelchair up steep slopes
Turbyville, Joseph C; Dunford, James C; Nelson, Michael R
Insect venom hypersensitivity can pose a threat to personnel deployed to a combat zone but the exposure risk in Afghanistan is currently unknown. This study was designed to assess the threat of Hymenoptera stings and associated allergic reactions in Afghanistan. Hymenoptera species were collected during a deployment to southern Afghanistan from June 2010 through January 2011. The literature was also reviewed to determine species of medically important Hymenoptera recorded in the region. The U.S. Army theater electronic medical data system was mined for ICD-9 codes associated with insect stings to determine the number of theater medical clinic encounters addressing insect sting reactions. Three species of flying hymenoptera were commonly encountered during the study period: Vespa orientalis L., Polistes wattii Cameron, and Vespula germanica (F.). A literature review also confirms the presence of honeybees (Apidae), numerous velvet ant (Mutillidae) species, and various ant (Formicidae) species all capable of stinging. No evidence was identified to suggest that fire ants (Solenopsis ssp.) are a threat in the region. Based on electronic medical records from the U.S. Central Command area of operations over a 2-year period, roughly 1 in 500 clinic visits involved a patient with a diagnosis of insect bite or sting. Cross-reactive members of all five flying Hymenoptera species commonly assessed for in Hymenoptera allergy evaluations are present in Afghanistan. The review of in-theater medical records confirms that insect stings pose an environmental threat to deployed service members.
Hyacinth O. Ukuhor
Full Text Available Objective. The aim of this research was to explore the influence of service organisation and delivery on providers and users’ interactions and decision-making in the context of Down’s syndrome screening. Methods. A qualitative descriptive study involving online interviews conducted with a purposive sample of 34 community midwives, 35 pregnant women, and 15 partners from two maternity services in different health districts in England. Data were analysed using a combination of grounded theory principles and content analysis and a framework was developed. Results. The main emerging concepts were organisational constraints, power, routinisation, and tensions. Providers were concerned about being time-limited that encouraged routine, minimal information-giving and lacked skills to check users’ understanding. Users reported their participation was influenced by providers’ attitudes, the ambience of the environment, asymmetric power relations, and the offer and perception of screening as a routine test. Discordance between the national programme’s policy of nondirective informed choice and providers’ actions of recommending and arranging screening appointments was unexpected. Additionally, providers and users differing perceptions of emotional effects of information, beliefs, and expectations created tensions within them, between them, and in the antenatal environment. Conclusions. A move towards a social model of care may be beneficial to empower service users and create less tension for providers and users.
Armistead-Jehle, Patrick; Cooper, Douglas B; Grills, Chad E; Cole, Wesley R; Lippa, Sara M; Stegman, Robert L; Lange, Rael T
Self-report measures are commonly relied upon in military healthcare environments to assess service members following a mild traumatic brain injury (mTBI). However, such instruments are susceptible to over-reporting and rarely include validity scales. This study evaluated the utility of the mild Brain Injury Atypical Symptoms scale (mBIAS) and the Neurobehavioral Symptom Inventory Validity-10 scale to detect symptom over-reporting. A total of 359 service members with a reported history of mTBI were separated into two symptom reporting groups based on MMPI-2-RF validity scales (i.e., non-over-reporting versus symptom over-reporting). The clinical utility of the mBIAS and Validity-10 as diagnostic indicators and screens of symptom over-reporting were evaluated by calculating sensitivity, specificity, positive test rate, positive predictive power (PPP), and negative predictive power (NPP) values. An mBIAS cut score of ≥10 was optimal as a diagnostic indicator, which resulted in high specificity and PPP; however, sensitivity was low. The utility of the mBIAS as a screening instrument was limited. A Validity-10 cut score of ≥33 was optimal as a diagnostic indicator. This resulted in very high specificity and PPP, but low sensitivity. A Validity-10 cut score of ≥7 was considered optimal as a screener, which resulted in moderate sensitivity, specificity, NPP, but relatively low PPP. Owing to low sensitivity, the current data suggests that both the mBIAS and Validity-10 are insufficient as stand-alone measures of symptom over-reporting. However, Validity-10 scores above the identified cut-off of ≥7should be taken as an indication that further evaluation to rule out symptom over-reporting is necessary.
Ganz, Michael L; Tendulkar, Shalini A
To estimate the prevalence and correlates of unmet needs for mental health care services for children with special health care needs and their families. We use the National Survey of Children With Special Health Care Needs to estimate the prevalence of unmet mental health care needs among children with special health care needs (1-17 years old) and their families. Using logistic-regression models, we also assess the independent impact of child and family factors on unmet needs. Substantial numbers of children with special health care needs and members of their families have unmet needs for mental health care services. Children with special health care needs who were poor, uninsured, and were without a usual source of care were statistically significantly more likely to report that their mental health care needs were unmet. More severely affected children and those with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Families of severely affected children or of children with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Our results indicate that children with special health care needs and their families are at risk for not receiving needed mental health care services. Furthermore, we find that children in families of lower socioeconomic status are disproportionately reporting higher rates of unmet needs. These data suggest that broader policies to identify and connect families with needed services are warranted but that child- and family-centered approaches alone will not meet the needs of these children and their families. Other interventions such as anti-poverty and insurance expansion efforts may be needed as well.
Norhayati Abdullah; Taiman Kadni
In this paper, we report the dosimetry methodology used and the results of 22 Malaysian radiotherapy centres participated in the Thermoluminescent Dosimeter (TLD) Postal Dose Quality Audit Service organised by the International Atomic Energy Agency (IAEA) in collaboration with World Health Organisation (WHO) from 2011 to 2015. In this audit, a set of three capsules of TLD (encapsulated with Lithium Flouride powder) including a control TLD were sent to the participating centres for irradiation with 2 Gy of absorbed dose to water under reference condition. In this period, a total of 70 photon beams consists of 43 beams and 27 beams produced by 6 MV and 10 MV photon beams, respectively have been audited. The results demonstrated that all participating centres comply with the acceptance limits of ±5 % as recommended by the International Commission on Radiation Units and Measurements (ICRU) Report 24, except eight photon beams from six centres. However, these centres presented better compliance results after followed up with a second round of TLD irradiation. (author)
Full Text Available This paper presents collaborative tools for public participation across multiple networking sites. The tools are part of the Comuno networking site for public governance and services, which is particularly targeted at the public sector (currently in alpha testing at http://comuno.org. The Broadcast tool allows cross-posting content from Comuno to a wide variety of other networking sites, such as Facebook or Twitter. The UserFeed and TopicFeed tools build RSS feeds from content published by a specific user or under a specific topic. The LifeStream tool gathers a user’s activities across multiple networking sites in the private account section at Comuno. These tools and related aspects of the Comuno networking site are discussed and presented in the context of deliberation and opinion-forming in a Swiss bilingual city.
This article explores the overlapping and conflicting points of contact between 'consumerism', collectivism and participation in Britain's National Health Service during a period of relatively well-funded expansion during the economic 'golden age' of the 1960s and 1970s. Despite recent neo-liberal attempts to define 'consumerism' around the wishes and choices of the individual, and to conceptualise areas such as individual hospital referrals as particularly 'consumerist', this article demonstrates that collective provision, the protection of disadvantaged groups and the concept of 'participatory' citizen involvement were all alternative meanings of the concept during this period, co-existing uneasily with the competitive concepts that have become more familiar since the late 1980s. This insight is then utilised to show how health care debates today might become better informed, ignoring extreme claims for all three concepts and focusing instead on a theoretically informed but ultimately empirical grasp of constant flux in any health care system.
Baillot, Helen; Murray, Nina; Connelly, Elaine; Howard, Natasha
Public and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews. A scoping study design was selected, using Arksey and O'Malley's six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government's '4Ps' framework for tackling violence against women (i.e. participation, prevention, protection, providing services). Seventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches. This scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.
Steigen, Anne Mari; Bergh, Daniel
This article analyses the psychometric properties of the Social Provisions Scale 10-items version. The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied to data on 93 young adults (16-30 years) out of school or work, participating in different nature-based services, due to mental or drug-related problems. The psychometric analysis concludes that the original scale has difficulties related to targeting and construct validity. In order to improve the psychometric properties, the scale was modified to include eight items measuring functional support. The modification was based on theoretical and statistical considerations. After modifications the scale showed not only satisfying psychometric properties, but it also clarified uncertainties regarding construct validity of the measure. However, further analysis on larger samples are required. Implications for Rehabilitation Social support is important for a variety of rehabilitation outcomes and for different patient groups in the rehabilitation context, including people with mental health or drug-related problems. Social Provisions Scale may be used as a screening tool to assess social support of participants in rehabilitation, and the scale may also be an important instrument in rehabilitation research. There might be issues measuring structural support using a 10-items version of the Social Provisions Scale but it seemed to work well as an 8-item scale measuring functional support.
O'Hara, Blythe J.; Phongsavan, Philayrath; Venugopal, Kamalesh; Bauman, Adrian E.
To address increasing rates of overweight and obesity, a population-based telephone intervention was introduced in New South Wales, Australia. The Get Healthy Information and Coaching Service[R] (GHS) offered participants a 6-month coaching program or detailed self-help information. Determining the population reach of GHS is of public health…
D'Abundo, Michelle Lee; Fugate-Whitlock, Elizabeth; Fiala, Kelly Ann; Covan, Eleanor Krassen
Purpose: The purpose of this research was to assess the knowledge, attitudes and practices of both students and older adults that participated in a service-learning, environmental health education program called Recycling Mentors (RM). Methods: Surveys were conducted before and after participation in RM. Quantitative data were analyzed using SPSS.…
Wolf, Erika J; Lunney, Carole A; Schnurr, Paula P
A dissociative subtype of posttraumatic stress disorder (PTSD) was recently added to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and is thought to be associated with poor PTSD treatment response. We used latent growth curve modeling to examine data from a randomized controlled trial of prolonged exposure and present-centered therapy for PTSD in a sample of 284 female veterans and active duty service members with PTSD to test the association between the dissociative subtype and treatment response. Individuals with the dissociative subtype (defined using latent profile analysis) had a flatter slope (p = .008) compared with those with high PTSD symptoms and no dissociation, such that the former group showed, on average, a 9.75 (95% confidence interval [-16.94, -2.57]) lesser decrease in PTSD severity scores on the Clinician Administered PTSD Scale (Blake et al., 1995) over the course of the trial. However, this effect was small in magnitude. Dissociative symptoms decreased markedly among those with the subtype, though neither treatment explicitly addressed such symptoms. There were no differences as a function of treatment type. Results raise doubt about the common clinical perception that exposure therapy is not effective or appropriate for individuals who have PTSD and dissociation, and provide empirical support for the use of exposure treatment for individuals with the dissociative subtype of PTSD. (c) 2015 APA, all rights reserved).
Miller, Rachel K; Michener, Jennifer; Yang, Phyllis; Goldstein, Karen; Groce-Martin, Jennine; True, Gala; Johnson, Jerry
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Full Text Available Abstract Background Balancing medical workforce supply with demand requires good information about factors affecting retention. Overseas qualified doctors comprise 30% of the National Health Service (NHS workforce in England yet little is known about the impact of country of qualification on length of stay. We aimed to address this need. Methods Using NHS annual census data, we calculated the duration of 'episodes of work' for doctors entering the workforce between 1992 and 2003. Survival analysis was used to examine variations in retention by country of qualification. The extent to which differences in retention could be explained by differences in doctors' age, sex and medical specialty was examined by logistic regression. Results Countries supplying doctors to the NHS could be divided into those with better or worse long-term retention than domestically trained doctors. Countries in the former category were generally located in the Middle East, non-European Economic Area Europe, Northern Africa and Asia, and tended to be poorer with fewer doctors per head of population, but stronger economic growth. A doctor's age and medical specialty, but not sex, influenced patterns of retention. Conclusion Adjusting workforce participation by country of qualification can improve estimates of the number of medical school places needed to balance supply with demand. Developing countries undergoing strong economic growth are likely to be the most important suppliers of long stay medical migrants.
Titaley, Christiana R; Hunter, Cynthia L; Heywood, Peter; Dibley, Michael J
Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives on antenatal and postnatal care services, including reasons for using or not using these services, the services received during antenatal and postnatal care, and cultural practices during antenatal and postnatal periods in Garut, Sukabumi and Ciamis districts of West Java province. A qualitative study was conducted from March to July 2009 in six villages in three districts of West Java province. Twenty focus group discussions (FGDs) and 165 in-depth interviews were carried out involving a total of 295 respondents. The guidelines for FGDs and in-depth interviews included the topics of community experiences with antenatal and postnatal care services, reasons for not attending the services, and cultural practices during antenatal and postnatal periods. Our study found that the main reason women attended antenatal and postnatal care services was to ensure the safe health of both mother and infant. Financial difficulty emerged as the major issue among women who did not fulfil the minimum requirements of four antenatal care services or two postnatal care services within the first month after delivery. This was related to the cost of health services, transportation costs, or both. In remote areas, the limited availability of health services was also a problem, especially if the village midwife frequently travelled out of the village. The distances from health facilities, in addition to poor road conditions were major concerns, particularly for those living in remote areas. Lack of community awareness about the importance of these services was also found, as some community members perceived
Hempe, Eva-Maria; Morrison, Cecily; Holland, Anthony
There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups. The study reported here quantitatively investigates divergence in stakeholders' views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development. A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels. There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers. This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the
Armistead-Jehle, Patrick; Cole, Wesley R; Stegman, Robert L
The study was designed to replicate and extend pervious findings demonstrating the high rates of invalid neuropsychological testing in military service members (SMs) with a history of mild traumatic brain injury (mTBI) assessed in the context of a medical evaluation board (MEB). Two hundred thirty-one active duty SMs (61 of which were undergoing an MEB) underwent neuropsychological assessment. Performance validity (Word Memory Test) and symptom validity (MMPI-2-RF) test data were compared across those evaluated within disability (MEB) and clinical contexts. As with previous studies, there were significantly more individuals in an MEB context that failed performance (MEB = 57%, non-MEB = 31%) and symptom validity testing (MEB = 57%, non-MEB = 22%) and performance validity testing had a notable affect on cognitive test scores. Performance and symptom validity test failure rates did not vary as a function of the reason for disability evaluation when divided into behavioral versus physical health conditions. These data are consistent with past studies, and extends those studies by including symptom validity testing and investigating the effect of reason for MEB. This and previous studies demonstrate that more than 50% of SMs seen in the context of an MEB will fail performance validity tests and over-report on symptom validity measures. These results emphasize the importance of using both performance and symptom validity testing when evaluating SMs with a history of mTBI, especially if they are being seen for disability evaluations, in order to ensure the accuracy of cognitive and psychological test data. Published by Oxford University Press 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
VA Education Benefits: Actions Taken, but Outreach and Oversight Could Be Improved. Report to the Ranking Member, Subcommittee on Military Personnel, Committee on Armed Services, House of Representatives. GAO-11-256
The U.S. Department of Veterans Affairs (VA) provided $9 billion in education benefits to service-members and veterans in fiscal year 2010, mostly through the new Post-9/11 GI Bill. In providing education benefits, VA relies on State Approving Agencies (SAA) to approve schools; and on schools to report students' enrollment status. US Government…
Alipour, Manijeh; Mohammadi-Ivatloo, Behnam; Moradi-Dalvand, Mohammad; Zare, Kazem
Plug-in electric vehicles are expected to play a major role in the transportation system as the environmental problems and energy crisis are being more and more urgent recently. Implementing a large number of vehicles with proper control could bring an opportunity of large storage and flexibility for power systems. The plug-in electric vehicle aggregator is responsible for providing power and controlling the charging pattern of the plug-in electric vehicles under its contracted area. This paper deals with the problem of optimal scheduling problem of plug-in electric vehicle aggregators in electricity market considering the uncertainties of market prices, availability of vehicles and status of being called by the ISO in the reserve market. The impact of the market price and reserve market uncertainties on the electric vehicle scheduling problem is characterized through a stochastic programming framework. The objective of the aggregator is to maximize its profit by charging the plug-in electric vehicles on the low price time intervals as well as participating in ancillary service markets. The operational constraints of plug-in electric vehicles and constraints of vehicle to grid are modeled in the proposed framework. An illustrative example is provided to confirm the performance of the proposed model. - Highlights: • Optimal scheduling of vehicle aggregators in electricity market has been addressed. • The operational constraints of plug-in vehicle to grid are considered. • The uncertainties of calling status in reserve market and market prices are modeled. • Vehicles' driving patterns and availability uncertainty are modeled. • The effect of risk measure weight in the vehicle to grid model has been studied.
Parkinson, S; Dunn, V; Stapley, E; Midgley, N
IMPACT-My Experience (IMPACT-ME) is a qualitative study, which aimed to explore adolescents' experiences of depression and receiving therapy, as well as their parents' experiences. As researchers working on the study, our focus was on writing academic papers to disseminate what we were learning from the qualitative interviews with the young people and families. However, over the course of the project we started to think about how we could share our findings with a wider audience. In consultation with our advisory group of parents and young people, the idea of making short animated films based on our findings, which would be freely available on YouTube, came about. In four-day creative, participatory workshops, young people, parents, researchers, filmmakers and a group-work facilitator worked together to co-produce a trilogy of short films. The first film, “Facing Shadows”, shares the experiences of the young people. The second film, “Journey Through the Shadows”, shares the perspectives of their parents. We also created a third short film to document the process of making these films, to share with a wider audience the value and process of service user participation in mental health research. The young people and parents were involved in all aspects of creating the films, which were premiered at the British Film Institute. Following an active social media campaign, the films have since been viewed over 10,000 times on YouTube. This presentation will share our reflections on working collaboratively with young people and families in mental health research.
Tadic, Valerie; Hamblion, Esther Louise; Keeley, Sarah; Cumberland, Phillippa; Lewando Hundt, Gillian; Rahi, Jugnoo Sangeeta
Purpose. To investigate patterns of participation of visually impaired (VI) children and their families in health services research. Methods. The authors compared clinical and sociodemographic characteristics of children and their families who participated with those who did not participate in two studies of quality of life (QoL) of VI children. In Study 1, the authors interviewed VI children and adolescents, aged 10 to 15 years, about their vision-related quality of life (VRQoL) as the first phase of a program to develop a VRQoL instrument for this population. One hundred seven children with visual impairment (visual acuity in the better eye LogMar worse than 0.51) were invited to participate in the interviews. Study 2 investigated health-related quality of life (HRQoL) of VI children using an existing generic instrument, administered in a postal survey. 151 VI children and adolescents, aged 2 to 16 years, with hereditary retinal disorders were invited to participate in the survey. Results. The overall participation level was below 50%. In both studies, participants from white ethnic and more affluent socioeconomic backgrounds were overrepresented. Participation did not vary by age, sex, or clinical characteristics. Conclusions. The authors suggest that there are barriers to participation in child- and family-centered research on childhood visual disability for children from socioeconomically deprived or ethnic minority groups. They urge assessment and reporting of participation patterns in further health services research on childhood visual disability. Failure to recognize that there are "silent voices" is likely to have important implications for equitable and appropriate service planning and provision for VI children.
van der Sanden, Remko L M; Stutterheim, Sarah E; Pryor, John B; Kok, Gerjo; Bos, Arjan E R
In this study, we explored stigma by association, family burden, and their impact on the family members of people with mental illness. We also studied the ways in which family members coped with these phenomena. We conducted semistructured interviews with 23 immediate family members of people with mental illness. Participants reported various experiences of stigma by association and family burden. Social exclusion, being blamed, not being taken seriously, time-consuming caregiving activities, and exhaustion appeared to be the predominant forms of stigma by association and family burden experienced by the participants. The participants used problem-focused and emotion-focused coping strategies, separately or simultaneously, to cope with the negative impact of stigma by association and family burden. The results suggest that family members should have access to services to address these problems. Social, instrumental, and emotional support should be given to family members by community members and mental health professionals.
O'Connor, Kathryn L; Dain Allred, C; Cameron, Kenneth L; Campbell, Darren E; D'Lauro, Christopher J; Houston, Megan N; Johnson, Brian R; Kelly, Tim F; McGinty, Gerald; O'Donnell, Patrick G; Peck, Karen Y; Svoboda, Steven J; Pasquina, Paul; McAllister, Thomas; McCrea, Michael; Broglio, Steven P
The prevalence and possible long-term consequences of concussion remain an increasing concern to the U.S. military, particularly as it pertains to maintaining a medically ready force. Baseline testing is being used both in the civilian and military domains to assess concussion injury and recovery. Accurate interpretation of these baseline assessments requires one to consider other influencing factors not related to concussion. To date, there is limited understanding, especially within the military, of what factors influence normative test performance. Given the significant physical and mental demands placed on service academy members (SAM), and their relatively high risk for concussion, it is important to describe demographics and normative profile of SAMs. Furthermore, the absence of available baseline normative data on female and non-varsity SAMs makes interpretation of post-injury assessments challenging. Understanding how individuals perform at baseline, given their unique individual characteristics (e.g., concussion history, sex, competition level), will inform post-concussion assessment and management. Thus, the primary aim of this manuscript is to characterize the SAM population and determine normative values on a concussion baseline testing battery. All data were collected as part of the Concussion Assessment, Research and Education (CARE) Consortium. The baseline test battery included a post-concussion symptom checklist (Sport Concussion Assessment Tool (SCAT), psychological health screening inventory (Brief Symptom Inventory (BSI-18) and neurocognitive evaluation (ImPACT), Balance Error Scoring System (BESS), and Standardized Assessment of Concussion (SAC). Linear regression models were used to examine differences across sexes, competition levels, and varsity contact levels while controlling for academy, freshman status, race, and previous concussion. Zero inflated negative binomial models estimated symptom scores due to the high frequency of zero scores
Chung, Sukyung; Lesser, Lenard I; Lauderdale, Diane S; Johns, Nicole E; Palaniappan, Latha P; Luft, Harold S
Under the Affordable Care Act (ACA), Medicare coverage expanded in 2011 to fully cover annual preventive care visits. We assessed the impact of coverage expansion, using 2007-13 data from primary care patients of Medicare-eligible age at the Palo Alto Medical Foundation (204,388 patient-years), which serves people in four counties near San Francisco, California. We compared trends in preventive visits and recommended preventive services among Medicare fee-for-service and Medicare health maintenance organization (HMO) patients as well as non-Medicare patients ages 65-75 who were covered by private fee-for-service and private HMO plans. Among Medicare fee-for-service patients, the annual use of preventive visits rose from 1.4 percent before the implementation of the ACA to 27.5 percent afterward. This increase was significantly larger than was seen for patients in the other insurance groups. Nevertheless, rates of annual preventive care visit use among Medicare fee-for-service patients remained 10-20 percentage points lower than was the case for people with private coverage (43-44 percent) or those in a Medicare HMO (53 percent). ACA policy changes led to increased preventive service use by Medicare fee-for-service beneficiaries, which suggests that Medicare coverage expansion is an effective way to increase seniors' use of preventive services. Project HOPE—The People-to-People Health Foundation, Inc.
.... The purpose of the investigation was to make a comparative study of a number of approximate methods for the design of members under combined loads to ascertain their relative degrees of conservatism...
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This article analyses customer’s level of participation in co-production of service. A client’s, known as a co-producer’s involvement is a pretty new conception of participation in creation of service where customers participate in projects, in direct, all-round and not only physical ways, together with professional representatives of service providers. A customer’s activity is becoming an important factor in order to achieve the results of effective creation of service, considering that client’s level while participating plays an essential role in the creation of service. To accomplish an empirical investigation, two quality methods were selected (observation and interview, which were performed in the company, which provides the services of furniture design. Theoretical literature analyses showed that there are three levels of customer’s participation: low, average and high, which usually appear in creation of co-productive service. Empirical investigation reve-aled that while co-producing services of furniture design customer’s level of participation can be: low, average, average high and high. This shows that “pure” level of participation in co-production of furniture design service appears rarely, while intermediate (“impure” level of participation can be observed more frequently. It is established that customer’s personality, temper, stress, lack of designer’s attention, preliminary decisions, and goods peculiarities determine causes of customer’s involvement/ devolvement. It is established that it is hard to elucidate and reveal customer’s needs, wishes and motives when the level of participation in co-production of furniture design service is low, and, as a result of that, a chance that the results of a service could not correspond to all customers expectations, rises. It is
Crook, Bradley; Tomlins, Rose; Bancroft, Ann; Ogi, Laura
The importance of making research participation accessible for people with learning disabilities is emphasised in government and NHS research strategies. This evaluation explored the realities of this goal from the perceptions of people with learning disabilities and clinicians within an NHS learning disability service. People with learning…
Yourkavitch, Jennifer; Hassmiller Lich, Kristen; Flax, Valerie L; Okello, Elialilia S; Kadzandira, John; Katahoire, Anne Ruhweza; Munthali, Alister C; Thomas, James C
Retention in care remains an important issue for prevention of mother-to-child transmission (PMTCT) programs according to WHO guidelines, formerly called the "Option B+" approach. The objective of this study was to examine how poverty, gender, and health system factors interact to influence women's participation in PMTCT services. We used qualitative research, literature, and hypothesized variable connections to diagram causes and effects in causal loop models. We found that many factors, including antiretroviral therapy (ART) use, service design and quality, stigma, disclosure, spouse/partner influence, decision-making autonomy, and knowledge about PMTCT, influence psychosocial health, which in turn affects women's participation in PMTCT services. Thus, interventions to improve psychosocial health need to address many factors to be successful. We also found that the design of PMTCT services, a modifiable factor, is important because it affects several other factors. We identified 66 feedback loops that may contribute to policy resistance-that is, a policy's failure to have its intended effect. Our findings point to the need for a multipronged intervention to encourage women's continued participation in PMTCT services and for longitudinal research to quantify and test our causal loop model.
Koopman, G.; Batenburg, R.
This paper theoretically and empirically addresses the notion that user participation and involvement is one of the important factors for IS success. Different models and studies are reviewed to define and classify types of early end-user involvement and participation. Next, five case studies are
Turnhout, E.; Behagel, J.H.; Ferranti, F.; Beunen, R.
In environmental governance, the European Union draws on norms of effectiveness, decentralisation, and participation to ensure that its policies and regulations are considered legitimate. This article analyses how the construction of legitimacy in European nature policy has changed over time.
Understanding health-related quality of life in caregivers of civilians and service members/veterans with traumatic brain injury: Establishing the reliability and validity of PROMIS Fatigue and Sleep Disturbance item banks.
Carlozzi, Noelle E; Ianni, Phillip A; Tulsky, David S; Brickell, Tracey A; Lange, Rael T; French, Louis M; Cella, David; Kallen, Michael A; Miner, Jennifer A; Kratz, Anna L
To examine the reliability and validity of Patient Reported Outcomes Measurement Information System (PROMIS) measures of sleep disturbance and fatigue in TBI caregivers and to determine the severity of fatigue and sleep disturbance in these caregivers. Cross-sectional survey data collected through an online data capture platform. Four rehabilitation hospitals and Walter Reed National Military Medical Center. Caregivers (N=560) of civilians (n=344) and service member/veterans (n=216) with TBI. Not Applicable MAIN OUTCOME MEASURES: PROMIS sleep and fatigue measures administered as both computerized adaptive tests (CATs) and 4-item short forms (SFs). For both samples, floor and ceiling effects for the PROMIS measures were low (internal consistency was very good (all alphas ≥0.80), and test-retest reliability was acceptable (all r≥0.70 except for the fatigue CAT in the service member/veteran sample r=0.63). Convergent validity was supported by moderate correlations between the PROMIS and related measures. Discriminant validity was supported by low correlations between PROMIS measures and measures of dissimilar constructs. PROMIS scores indicated significantly worse sleep and fatigue for those caring for someone with high levels versus low levels of impairment. Findings support the reliability and validity of the PROMIS CAT and SF measures of sleep disturbance and fatigue in caregivers of civilians and service members/veterans with TBI. Copyright © 2018. Published by Elsevier Inc.
Zhilyaev, E.G.; Goncharov, S.F.; Vorontsov, I.V.; Legeza, V.I.; Berzin, I.A.
The paper presented calculations of manpower and money funds for rendering aid to the injured persons in case of radiation accident. The authors offered a scheme of using medical anti-radial aids on various stages of radiation accident; immediately after the accident in case of non-predicted and controlled radiation exposure. Army Medical Service is capable of solving promptly the tasks of medical aid with the help of highly mobile specialized medical units, the use of which is stipulated in the system of the Russian Service of disaster medicine. 10 refs.; 1 tab
Bordy, J.M.; Stadtmann, H.; Ambrosi, P.
of the dosimetry of routine services. It was assumed that each service would have already done a type test before performing routine dosimetry: the radiation fields were chosen to simulate, as far as possible, workplace radiation fields by mixing combining energies and incident angles. The results of photon...... for External Radiation. The other two papers are included in this issue of Radiation Protection Dosimetry....
Full Text Available Cet article documente la manière dont s'est renouvelé et s'est transformé au fil du temps le projet de faire participer les usagers aux exercices de planification et d'organisation des services de santé mentale au Québec (Canada. Pour ce faire, les auteurs reviennent sur l'ensemble des documents ministériels qui ont traité de cette question et dégage, pour les principaux moment-clés, les principales modalités de participation des usagers.
Townsend, Anne; Cox, Susan M
Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. A predominant theme to emerge was 'participation in health research to access health services.' Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a "trial and error" process akin to research, which further blurred the boundaries between research and treatment. Our findings have implications for recruitment, informed consent, and the dichotomizing of medical/health procedures as either research or
Background Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. Methods This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. Results A predominant theme to emerge was 'participation in health research to access health services.’ Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a “trial and error” process akin to research, which further blurred the boundaries between research and treatment. Conclusions Our findings have implications for recruitment, informed consent, and the dichotomizing of medical
Kim, Minkee; Cavas, Bulent
As a key to decide a success or risk of a community of practice, legitimacy of a participant has been conceptually discussed in abundant theoretical literature. Achieving legitimacy is interpreted as gaining credibility from peers, enlarging divisions of labor in a social environment, collecting reinforcement from colleague teachers in the…
through the Affordable Healthcare Act ( ACA ) and other sources. Most veterans are not seen in VA facilities. The Geisinger Clinic, the community partner...group practice, ten hospital campuses, a 467,000-member health plan, and is one of the largest employers in the state. The knowledge gained from...Complete Analyses for Study Aim 3 ( Effectiveness ) and for Aim 4 (Genetics), Prepare Final Manuscripts for Review and Submission, Convene Final Conferences
waking up in between. Some things are triggers for seizures. These include: • Stress • Overuse of alcohol and/or other drugs • Being overworked and/or...weight gain. In severe cases, both men and women may experience thoughts of suicide . If you suspect that your family member is depressed, ask your...personal appearance • Thoughts of suicide , suicide attempts. How you can help: • Offer emotional support, understanding, patience, and encouragement
Carmen Lúcia Alves Filzola
Full Text Available OBJETIVO: Compreender a vivência de familiares que frequentam o grupo de apoio Al-Anon diante da experiência do alcoolismo. MÉTODO: A pesquisa foi realizada com 6 mulheres, das 10 convidadas, que frequentam o grupo de autoajuda Al-Anon. A coleta de dados se deu através de entrevistas semiestruturadas. Os referenciais teórico e metodológico que embasaram a análise qualitativa foram o Interacionismo Simbólico e a Teoria Fundamentada nos Dados, em seus passos iniciais. RESULTADOS: Os dados resultaram em 3 categorias conceituais: 1 Negando o alcoolismo e sofrendo suas consequências; 2 Buscando ajuda, aprendendo com o grupo; e 3 Esperando a cura, experimentando a sobriedade e enfrentando as recaídas. Além do apoio da própria família e da religião, as mulheres apontaram a importância do grupo de autoajuda para ampará-las no enfrentamento dos problemas decorrentes do alcoolismo. CONCLUSÃO: Esperamos que os resultados desta pesquisa possam contribuir para a valorização do suporte oferecido pelo Al-Anon, estimular novos estudos na área e fortalecer, entre os profissionais de saúde, o reconhecimento do grupo como recurso importante de apoio efetivo às famílias.OBJECTIVE: To investigate the experience of family members who participate in Al-Anon support group in relation to alcoholism. METHOD: The research was accomplished with 6 women, 10 invited, attending the group of self-help Al-Anon. The data collection was through semi-structured interviews. The theoretical and methodological reference to the qualitative analysis was based on Symbolic Interactionism and Grounded Theory in Data, in its initial steps. RESULTS: The data resulted in 3 conceptual categories: 1 Denying alcoholism and suffering yours consequences; 2 Searching for help, learning with the support group; 3 Waiting for cure, experiencing sobriety and facing relapses. Besides the support of family and religion, women pointed to the importance of self-help group to support
... and application as is given to the term for income tax purposes. (3) (i) If a minister is performing..., is engaged by N University to teach history and mathematics. He performs no other service for N...
... term “religious organization” has the same meaning and application as is given to the term for income... minister, is engaged by N University to teach history and mathematics. He performs no other service for N...
Hong, Young-Rock; Sonawane, Kalyani; Larson, Samantha; Mainous, Arch G; Marlow, Nicole M
Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64. To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans. A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey. Survey respondents aged 18-64 with an identified USC and continuous health insurance coverage during 2015. Preventative care services (routine checkup, flu vaccination, and cancer screening), patient experiences with health care (access to care, interaction quality with providers, and global satisfaction), and health care expenditures (total and out-of-pocket expenditures) for respondents with USC by ACO and non-ACO provider groups. Among 1563, nonelderly Americans having a USC, we found that nearly 62.7% [95% confidence interval (CI), 58.6%-66.7%; representing 15,722,208 Americans] were cared for by ACO providers. Our analysis showed no significant differences in preventive care services or patient experiences between ACO and non-ACO groups. Adjusted mean total health expenditures were slightly higher for the ACO than non-ACO group [$7016 (95% CI, $4949-$9914) vs. $6796 (95% CI, $4724-$9892)]; however, this difference was not statistically significant (P=0.250). Our findings suggest that having a USC provider participating in an ACO is not associated with preventive care services use, patient experiences, or health care expenditures among a nonelderly population.
Full Text Available Abstract Background Prevention of Mother-to-Child Transmission of HIV (PMTCT is among the key HIV prevention strategies in Zimbabwe. A decrease in use of antenatal care (ANC services with an increase in home deliveries is affecting the coverage of PMTCT interventions in a context of accelerated economic crisis. The main objective was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs in family and child health services through their participation in PMTCT programmes in Zimbabwe. Methods A community based cross-sectional survey was undertaken using multistage cluster sampling in two rural districts through interviews and focus group discussions among women who delivered at home with a TBA, those who had an institutional delivery and TBAs. Results 45% of TBAs interviewed knew the principles of PMTCT and 8% delivered a woman with known HIV-positive status in previous year. Of the complete package of PMTCT services, more than 75% of TBAs agreed to participate in most activities with the exception of performing a blood test (17%, accompanying new-borns to closest health centre to receive medication (15% and assisting health centres in documentation of the link ANC-PMTCT services (18%. Women who delivered at home were less likely to have received more than one ANC service or have had contact with a health centre compared to women who delivered in a health centre (91.0% vs 72.6%; P Conclusion Although the long-term goal of ANC service delivery in Zimbabwe remains the provision of skilled delivery attendance, PMTCT programmes will benefit from complementary approaches to prevent missed opportunities. TBAs are willing to expand their scope of work regarding activities related to PMTCT. There is a need to reinforce their knowledge on MTCT prevention measures and better integrate them into the health system.
Choi, Seul Ki; Fram, Maryah S; Frongillo, Edward A
Background: Very low food security (VLFS) happens at the intersection of nuanced and complex patterns of risk characteristics across multiple domains. Little is known about the idiosyncratic situations that lead households to experience VLFS. Objective: We used classification and regression tree (CART) analysis, which can handle complex combinations of predictors, to identify patterns of characteristics that distinguish VLFS households in the United States from other households. Methods: Data came from 3 surveys, the 2011-2014 National Health Interview Survey (NHIS), the 2005-2012 NHANES, and the 2002-2012 Current Population Survey (CPS), with sample participants aged ≥18 y and households with income Survey participants were stratified into households with children, adult-only households, and older-adult households (NHIS, CPS) or individuals aged 18-64 y and individuals aged ≥65 y (NHANES). Household food security was measured with the use of the 10-item US Adult Food Security Scale. Variables from multiple domains, including sociodemographic characteristics, health, health care, and participation in social welfare and food assistance programs, were considered as predictors. The 3 data sources were analyzed separately with the use of CART analysis. Results: Household experiences of VLFS were associated with different predictors for different types of households and often occurred at the intersection of multiple characteristics spanning unmet medical needs, poor health, disability, limitation, depressive symptoms, low income, and food assistance program participation. These predictors built complex trees with various combinations in different types of households. Conclusions: This study showed that multiple characteristics across multiple domains distinguished VLFS households. Flexible and nonlinear methods focusing on a wide range of risk characteristics should be used to identify VLFS households and to inform policies and programs that can address VLFS
Pinto, Alessandra Maria Silva; Najar, Alberto Lopes
The analysis of institutions is a widely researched area of health. The culture of organizations is understood as a symbolic possibility contained in a larger dimension, called "national culture". This premise justifies the incorporation of the social anthropological approach to the study of organizational culture. This study sought to establish the perceptions of employees of two primary healthcare services in Niterói, State of Rio de Janeiro, regarding commonly used social navigation strategies from the theory developed by Roberto DaMatta. The results showed the relational character associated with the stereotype of the Brazilian people manifested by conflicts arising from the existence of values based on the `individual' and the `person'. Among them are the distortions observed between discourse and practice, and the mobilization strategies of social navigation like "making do" - to establish a mediation between the person and the impersonal law. The organization of the services of the Niterói Family Medical Program apparently sets its employees the concrete challenge of balancing the egalitarian principle that underpins the Unified Health System (SSU) with the set of values upon which personal relations are based in Brazilian society.
Giguere, Rebecca; Brown, William; Balán, Ivan C; Dolezal, Curtis; Ho, Titcha; Sheinfil, Alan; Ibitoye, Mobolaji; Lama, Javier R; McGowan, Ian; Cranston, Ross D; Carballo-Diéguez, Alex
During a Phase 2 rectal microbicide trial, men who have sex with men and transgender women (n = 187) in 4 countries (Peru, South Africa, Thailand, United States) reported product use daily via short message service (SMS). To prevent disclosure of study participation, the SMS system program included privacy and security features. We evaluated participants' perceptions of privacy while using the system and acceptability of privacy/security features. To protect privacy, the SMS system: (1) confirmed participant availability before sending the study questions, (2) required a password, and (3) did not reveal product name or study participation. To ensure security, the system reminded participants to lock phone/delete messages. A computer-assisted self-interview (CASI), administered at the final visit, measured burden of privacy and security features and SMS privacy concerns. A subsample of 33 participants underwent an in-depth interview (IDI). Based on CASI, 85% had no privacy concerns; only 5% were very concerned. Most were not bothered by the need for a password (73%) or instructions to delete messages (82%). Based on IDI, reasons for low privacy concerns included sending SMS in private or feeling that texting would not draw attention. A few IDI participants found the password unnecessary and more than half did not delete messages. Most participants were not concerned that the SMS system would compromise their confidentiality. SMS privacy and security features were effective and not burdensome. Short ID-related passwords, ambiguous language, and reminders to implement privacy and security-enhancing behaviors are recommended for SMS systems.
Perez, Freddy; Aung, Khin Devi; Ndoro, Theresa; Engelsmann, Barbara; Dabis, François
Background Prevention of Mother-to-Child Transmission of HIV (PMTCT) is among the key HIV prevention strategies in Zimbabwe. A decrease in use of antenatal care (ANC) services with an increase in home deliveries is affecting the coverage of PMTCT interventions in a context of accelerated economic crisis. The main objective was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs) in family and child health services through their participation in PMTCT programmes in Zimbabwe. Methods A community based cross-sectional survey was undertaken using multistage cluster sampling in two rural districts through interviews and focus group discussions among women who delivered at home with a TBA, those who had an institutional delivery and TBAs. Results 45% of TBAs interviewed knew the principles of PMTCT and 8% delivered a woman with known HIV-positive status in previous year. Of the complete package of PMTCT services, more than 75% of TBAs agreed to participate in most activities with the exception of performing a blood test (17%), accompanying new-borns to closest health centre to receive medication (15%) and assisting health centres in documentation of the link ANC-PMTCT services (18%). Women who delivered at home were less likely to have received more than one ANC service or have had contact with a health centre compared to women who delivered in a health centre (91.0% vs 72.6%; P attendance, PMTCT programmes will benefit from complementary approaches to prevent missed opportunities. TBAs are willing to expand their scope of work regarding activities related to PMTCT. There is a need to reinforce their knowledge on MTCT prevention measures and better integrate them into the health system. PMID:19061506
Long, Larry D.
Fraternities and sororities promote the ideals of scholarship, leadership, service, and friendship. Little or no research, however, has demonstrated that college students who join fraternal organizations actually grow in these areas as a result of their fraternal experience. The purpose of this descriptive study was to assess the extent to which…
Variations in the incidence and burden of illnesses and injuries among non-retiree service members in the earliest, middle, and last 6 months of their careers, active component, U.S. Armed Forces, 2000-2015.
Uptegraft, Colby C; Stahlman, Shauna
This report uses routinely collected data in the Defense Medical Surveillance System (DMSS) to characterize the incidence and burden of medical conditions throughout the careers of service members separating from the active component of the U.S. Armed Forces between 1 October 2014 and 30 September 2015. Three surveillance periods between 30 September 2000 and 30 September 2015 were defined by each individual's time in service: early (first 6 months), middle (middle 6 months), and late (last 6 months). Overall, separating service members were most often aged 25-34 years (59.4%), male (84.0%), non-Hispanic white (64.0%), junior enlisted (52.4%), in the Marine Corps (33.1%), serving in a repair/engineering occupation (33.0%), and had never deployed (52.5%). The top five burden of disease categories across surveillance periods by sex were remarkably similar, including mental health disorders, which exhibited similar upward trends across the three surveillance periods (males: 1.3%, 17.0%, and 35.6%; females: 1.8%, 15.1%, and 32.4%, respectively). The most common diagnoses exhibiting upward, downward, or bimodal trends by incidence rate differences were mental health disorders, respiratory infections/diseases, and musculoskeletal diseases, respectively.
Participants in the “Schweizer Jugendforscht’” projects at CERN under the supervision of Günther Dissertori, professor at the Swiss Federal Institute of Technology (ETH Zürich) and other members of ETH Zürich, Werner Lustermann and Michael Dittmar.
Participants in the “Schweizer Jugendforscht’” projects at CERN under the supervision of Günther Dissertori, professor at the Swiss Federal Institute of Technology (ETH Zürich) and other members of ETH Zürich, Werner Lustermann and Michael Dittmar.
Dufour, Sarah; Lessard, Danielle; Chamberland, Claire
As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.
Fietz, Jennifer; Stupp, Barbara
Traditional municipal services are not successful at reaching Turkish seniors. Compared to native Germans Turkish seniors have a lower social participation. Do native language groups hosted by a German organization promote the social participation of Turkish seniors? How does social participation take place in the ZWAR networks (between work and retirement; a project to strengthen social participation of seniors) and which factors promote or reduce social participation? Qualitative structuring content analysis of two group discussions, which were based on guided interviews. The social participation of Turkish-speaking seniors was strengthened on three levels: (1) through regular meetings of the Turkish ethnic group social relationships were promoted and German language skills and other skills were improved. Through mutual sharing and understanding of the stressors specific to migration, emotional support was provided. The sharing of mutual cultural and linguistic backgrounds created a sense of community and meetings were perceived as an antidote to migrants' exhausting lives in German society. (2) At the organizational level, participation was promoted through extensive group events. Regardless of their cultural background all participants identified as equal ZWAR members. The ZWAR project functioned as an umbrella organization for participation in the intercultural context. (3) Participation in community events created contacts with community stakeholders and fostered volunteer work. Hence, participants were able to use their skills, and therefore broaden their horizons. Turkish ZWAR networks promoted the social participation of members because integration with their ethnic group reduced access barriers, broadened members' scopes of action, and created new opportunities for participation.
America vuelve a la escuela: Participe y colabore! Informacion para familias y miembros de la comunidad (America Goes Back to School: Get Involved! Stay Involved! Information for Families and Community Members).
Partnership for Family Involvement in Education (ED), Washington, DC.
This Spanish-language brochure provides several tips for families and for community members to help them encourage student achievement and success. The tips are grouped into three categories: (1) "Help our children read well and independently by the end of third grade"; (2) "Help our children learn to meet high math and science standards and take…
Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae
Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend income level was 0.45 (0.31-0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on
Evaluation of family-centred practices in the early intervention programmes for infants and young children in Singapore with Measure of Processes of Care for Service Providers and Measure of Beliefs about Participation in Family-Centred Service.
Tang, H N; Chong, W H; Goh, W; Chan, W P; Choo, S
The primary purpose of this study was to report on an evaluation of the perceptions and beliefs of service providers towards family-centred practices in 11 early intervention programmes for infants and young children in Singapore. The Measure of Processes of Care for Service Providers (MPOC-SP) and Measure of Beliefs about Participation in Family-Centred Service (MBP-FCS) were administered to 213 service providers made up of teachers, therapists, psychologists and social workers providing centre-based therapy to children with special needs who were below the age of 6 years. Exploratory factor analyses were performed with both scales. Nineteen of the 27 MPOC-SP items were retained and supported the original four-factor structure model. The exploratory factor analyses on MBP-FCS provided a less satisfactory outcome. Fourteen of the 28 items were retained and these loaded onto four factors. The two factors relating to Beliefs about benefits of FCS and Beliefs about the absence of negative outcomes from FCS failed to emerge as separate factors. Further multiple regressions indicated that more direct work with families and positive self-efficacy in implementing FCS contributed significantly to explaining service providers' positive perception towards family-centred practice in service delivery. This is the first time MPOC-SP and MBP-FCS were administered to a population in an Asian context. While MBP-FCS would benefit from further development work on its construct, MPOC-SP offered important insights into service providers' perspectives about family-centred practices that would have useful implications for professional and service development. © 2011 Blackwell Publishing Ltd.
Fradgley, Elizabeth A; Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J
With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen's kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of
Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J
Background With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. Objective The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. Methods In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. Results A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen’s kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement
Louis Anthony Iaquinto
Full Text Available Despite forty years of research, community sector service providers still find operationalising participation in their practice confusing and difficult. This paper presents the results of a preliminary study that begins to question why this is so and what can be done about it? The study examines the meaning and importance of participation determined by a review of the academic literature, by soliciting feedback from a range of stakeholders in community sector organisations, including service users with complex barriers to participation, staff, and board members. The participants’ perspectives, views and experience of participation were obtained through the use of semi-structured interviews. The data generated a number of telling examples of the impact organisational culture has on service delivery and how the values of the leadership shape the organization, as well as illustrations of the principles that underpin participation expressed from the standpoints of the three participant groups. Study findings underscore the critical importance for service providers to consider their culture and its influences. Keywords: organisational culture, vulnerable clients, client participation
children’s psych health and development at pre- mid- and post-timepoints. Children participate through doll and puppet play interview. Teacher ratings...Regulation and Dysregulation: Development , Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of...Psychiatry, 127, 1653-1658. Shields, A.M., & Cicchetti, D. (1997). Emotion regulation among school-age children : The development and validation of a new
Full Text Available Background. Achievement motive is defined as the intention to achieve one’s goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154 answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model’s statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044–0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001, a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001 and a total effect on purpose in life (total effect = 0.615. Discussion. This result suggests that enhancing the intention to achieve one’s goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.
Sano, Nobuyuki; Kyougoku, Makoto
Background. Achievement motive is defined as the intention to achieve one's goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model's statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044-0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one's goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.
Woodruff, Susan I; Galarneau, Michael R; Luu, Bethi N; Sack, Daniel; Han, Peggy
There is a need for more work to understand the quality of life (QOL) outcomes of survivors of Operations Enduring Freedom and Iraqi Freedom combat injury to improve care and treatment, and prevent poor physical, psychological, and social outcomes. We describe the study design and methods of the Wounded Warrior Recovery Project, a study supported by the Department of Defense that will track close to 10,000 military personnel wounded in Operations Enduring Freedom and Iraqi Freedom. The overall objective of the 6-year longitudinal study is to track changes in QOL and describe variations in those changes as they relate to sociodemographic factors, injury characteristics, service-related factors, clinical/diagnostic measures including traumatic brain injury and posttraumatic stress disorder, and medical procedures and services. The Wounded Warrior Recovery Project study will be among the first longitudinal population-based investigations of QOL outcomes after combat injury and will provide a basis upon which large-scale epidemiological studies can be conducted. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Understanding Health-related Quality of Life in Caregivers of Civilians and Service Members/Veterans with Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Mental Health Measures.
Carlozzi, Noelle E; Hanks, Robin; Lange, Rael T; Brickell D Psych, Tracey A; Ianni, Phillip A; Miner, Jennifer A; French Psy D, Louis M; Kallen, Michael A; Sander, Angelle M
To provide important reliability and validity data to support the use of the PROMIS Mental Health measures in caregivers of civilians or service members/veterans with traumatic brain injury (TBI). Patient-reported outcomes surveys administered through an electronic data collection platform. Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. 560 caregivers of individuals with a documented TBI (344 civilians and 216 military) INTERVENTION: Not Applicable MAIN OUTCOME MEASURES: PROMIS Anxiety, Depression, and Anger Item Banks RESULTS: Internal consistency for all of the PROMIS Mental Health item banks was very good (all α > .86) and three-week test retest reliability was good to adequate (ranged from .65 to .85). Convergent validity and discriminant validity of the PROMIS measures was also supported. Caregivers of individuals that were low functioning had worse emotional HRQOL (as measured by the three PROMIS measures) than caregivers of high functioning individuals, supporting known groups validity. Finally, levels of distress, as measured by the PROMIS measures, were elevated for those caring for low-functioning individuals in both samples (rates ranged from 26.2% to 43.6% for caregivers of low-functioning individuals). Results support the reliability and validity of the PROMIS Anxiety, Depression, and Anger item banks in caregivers of civilians and service members/veterans with TBI. Ultimately, these measures can be used to provide a standardized assessment of HRQOL as it relates to mental health in these caregivers. Copyright © 2018. Published by Elsevier Inc.
Newman, Lareen; Biedrzycki, Kate; Baum, Fran
To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.
Slovenia became an official member of IPPOG on 19 April 2018. The MOU was signed by the head of Particle Physics Department at Jozef Stefan Institute representing Slovenia participation at IPPOG. Andrej Gorišek, country representative for Slovenia in IPPOG, brought the document to the meeting in Italy where IPPOG chairs signed it, confirming Slovenia membership to the collaboration.
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.63) is Palau which deposited its Instrument of Acceptance of the Statute on 2 March 2007. The Attachment hereto shows the dates on which the present 144 Member States became Members [fr
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.63) is Palau which deposited its Instrument of Acceptance of the Statute on 2 March 2007. The Attachment hereto shows the dates on which the present 144 Member States became Members [es
Romaní-Romaní, Franco; Curisinche-Rojas, Maricela; Arteaga, Norka Rojas; Lopez, Pedro Riega; Cabezas, César
There is a gap between human resources and technical-operational education that limits the Peruvian health system's ability to implement public health interventions. The Peruvian Ministry of Health, through the National Health Institute and the Ministry of Defense, implemented a Public Health Training Program addressed to young full-time military servicemen, on the basis of the competency profile of a public health technician. The program consists of seven thematic units given in 390 hours, 200 of which correspond to classroom and field practices. Between July 2014 and December 2015, the program has been carried out in 10 venues of the three armed forces, training and certifying 405 young servicemen. The intervention provides the military service with an additional educational benefit, making it more appealing as a chance for development and opens up a line of work in the public health sector for young people in more remote areas. This experience seeks to increase public health-trained human resources to a technical-operational level. In collaboration with regional governments, graduates are expected to be welcomed and included in the public health system.
The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described
Hackett, Katie L; Newton, Julia L; Deane, Katherine H O; Rapley, Tim; Deary, Vincent; Kolehmainen, Niina; Lendrem, Dennis; Ng, Wan-Fai
A significant proportion of patients with primary Sjögren's syndrome (PSS) is functionally impaired and experience difficulties participating in various aspects of everyday life. There is currently no evidence of efficacy for non-pharmacological interventions aimed specifically at supporting the patients with PSS to improve their participation and ability to perform daily activities. This paper describes a research protocol for a mixed-methods study to develop an intervention to improve these outcomes. The protocol follows the Medical Research Council framework for complex interventions. We will use group concept mapping with the patients, adults who live with them and healthcare professionals to identify factors which prevent people with PSS from participating in daily life and performing daily activities. The factors will be prioritised by participants for importance and feasibility and will inform an intervention to be delivered within a National Health Service (NHS) setting. Evidence-based intervention techniques will be identified for the prioritised factors and combined into a deliverable intervention package. Key stakeholders will comment on the intervention content and mode of delivery through focus groups, and the data will be used to refine the intervention. The acceptability and feasibility of the refined intervention will be evaluated in a future study. The study has been approved by an NHS Research Ethics Committee, REC Reference: 13/NI/0190. The findings of this study will be disseminated in peer-reviewed journals and through presentation at national and international conferences. UKCRN Study ID: 15939. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The proposed method of analysis for concrete members subjected to temperature changes is consistent with the requirements of ultimate strength design. This also facilitates the provision of the same safety margin as for other loads. Due to cracks and creep in concrete, thermal stresses are nonlinear; they are dependent on the effective member stiffness, which in turn vary with the magnitude of loading. Therefore it is inconsistent to have an ultimate strength design in conjunction with an analysis based on the linear elastic theory. It is proposed that when the requirements of serviceability are met, the neutral axis corresponding to the ultimate load capacity conditions be considered for temperature-induced loadings. This conforms with the fact that the thermal load, because of creep and formation of cracks in the member, can be self-relieving as the failure load condition or ultimate capacity is approached. The maximum thermal load that can develop in dependent on the effective cross section of the member. Recommendations are made for determining the average effective member stiffness, which lies between the stiffness corresponding to the cracked (at ultimate condition) and the uncracked sections. In the proposed method, thermal stresses are not considered completely self-relieving. The stresses are considered simultaneously with stresses resulting from other causes. A step-by-step approach is presented for analysis and design of concrete members subjected to temperature changes
Kagawa, Rose Calnin; Anglemyer, Andrew; Montagu, Dominic
The extent of faith-based organizations' participation within the overall health systems of developing countries is unclear. Recent reports state that faith-based organizations play a substantial role in providing healthcare in developing countries, cited in some publications as up to 70% of all healthcare services. The data behind these numbers are sometimes difficult to pinpoint and seem at odds to national and regional survey data. In an effort to quantify the contribution of faith-based organizations to healthcare delivery in low- and middle-income countries, we undertook a systematic review of the literature and conducted a new analysis of relevant Demographic and Health Survey data from 47 countries. Our findings demonstrate that the magnitude of healthcare provided by faith-based organizations may be lower than previously estimated. Understanding the scale of FBO-provided medical care is important for health sector planning, and more accurate and complete estimates are needed.
Chapman, J F; Cook, R
The Blood Stocks Management Scheme (BSMS) has been established as a joint venture between the National Blood Service (NBS) in England and North Wales and participating hospitals to monitor the blood supply chain. Stock and wastage data are submitted to a web-based data-management system, facilitating continuous and complete red cell data collection and 'real time' data extraction. The data-management system enables peer review of performance in respect of stock holding levels and red cell wastage. The BSMS has developed an innovative web-based data-management system that enables data collection and benchmarking of practice, which should drive changes in stock management practice, therefore optimizing the use of donated blood.
Koren L. Fisher
Full Text Available Purpose. To examine relationships between leisure time physical activity (LTPA and health services utilization (H in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50–65-year-old individuals were 27% less likely to report any GP consultations ORadj=0.73; P<0.001 and had 8% fewer GP consultations annually (IRRadj=0.92; P<0.01 than their inactive peers. Active persons aged 65–79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj=0.82, P<0.05. Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.
Varga, Christine; Brookes, Heather
In this article, we examine barriers to HIV testing uptake and participation in prevention of mother-to-child HIV transmission (PMTCT) services among adolescent mothers aged 15 to 19 years in rural and urban Limpopo Province, South Africa. We used the narrative research method involving key informants constructing typical case studies of adolescent experiences with HIV testing and entry into PMTCT. Case studies formed the basis of a community-based questionnaire and focus group discussions with adolescent mothers. Client-counselor dynamics during pretest counseling were pivotal in determining uptake and participation, and counselor profile strongly influenced the nature of the interaction. Other factors found to influence adherence to PMTCT recommendations included HIV and early premarital pregnancy stigma, fear of a positive test result, and concerns over confidentiality and poor treatment by health care providers. Adolescents described elaborate strategies to avoid HIV disclosure to labor and delivery staff, despite knowing this would mean no antiretroviral therapy for their newborn infants. Theoretical, methodological, and programmatic implications of study findings are also discussed.
И В Андронова
Full Text Available In the future, the Eurasian Economic Union can become one of the most important actors of the global economy, a regional and even a global leader, if the Union ensures positive economic and social effects for every participating country. The main challenge of the economic development of the EAEU is the development and diversification of national industries: three of the EAEU countries out of five almost completely depend on the export of resources (Russia and Kazakhstan - energy resources, Kyrgyzstan - precious metals. The other challenges for all participating countries are as follows: low competitiveness of production; inadequate development of the transport infrastructure for the current needs of integration; the lack of trade and investment cooperation between different countries; the lack of budget for the program of projects’ co-financing. The international experience proves that the higher the level of national economic development, the greater the share of high-tech industries in its economy, the more diversified its exports, and the greater opportunities the country has to maintain stable cooperation ties and division of labor with countries at different levels of industrial development. The successful realization of cooperation within the EAEU largely depends on the support of the population of participating countries. Despite the fact that according to sociological surveys the attitude of the population to the Eurasian Economic Union is rather positive there is a negative trend. The authors suggest the ways for the innovative modernization of the eco-nomies, which in turn will stimulate scientific-technological cooperation, enhance the level and quality of life, and contribute to the positive public perception of the integration, stability and viability of the EAEU and development of the Eurasian values’ system.
Hashemi, Seyyed Mahmoud; Hedjazi, Yousef
This paper presents work to identify factors affecting effectiveness of agri-business ventures (A-BVs) on the side of providers as perceived by their members. A survey was conducted among 95 members of A-BVs in Zanjan province, Iran. To collect data, a questionnaire was designed. Two distinct groups of A-BVs with low (group 1) and high (group 2) perceived (evaluated) levels of effectiveness were revealed. The study showed that there were significant differences between the two groups on important characteristics of A-BVs and their members. The study also found that there were statistically significant relationships between A-BVs' governance structure and capacity, management and organization characteristics and the perceived effectiveness, whereas there were no statistically significant relationships between A-BVs' advisory methods characteristic applied by members and the perceived effectiveness. Logistic regression results also showed that level of application of rules encouraging members' active participation in important decision makings, clear terms of reference to guide contracting procedures, roles, and responsibilities of parties involved, type of people served and geographical area of program coverage, and members' ability to use Information and Communication Technologies (ICTs) were predictors of the perceived (evaluated) effectiveness of A-BVs. The study showed that evaluation of members of effectiveness of A-BVs would not be the same. It is suggested that Iranian public agricultural extension organization, as responsible organization for monitoring and evaluating services conducted by A-BVs, considered these differences between members with different levels of some important variables. 2010 Elsevier Ltd. All rights reserved.
Public participation in the social policies and services of the community of Madrid: the institutional system / El sistema institucional de participación ciudadana en las políticas y los servicios sociales de la comunidad de Madrid
Gema Pastor Albaladejo
Full Text Available This article analyzes the Community of Madrid’s institutional public participation system, to determine whether the different existing formal mechanisms (regulatory framework and permanent participation organisms have an appropriate institutional design to ensure that citizens have access to, and the ability to intervene in, those deliberative processes that may in some way influence the regional social policies and services.
Carl Andrew Castro
Full Text Available This paper reviews the psychological health research conducted in the United States in support of combat veterans from Iraq and Afghanistan, using the Military Psychological Health Research Continuum, which includes foundational science, epidemiology, etiology, prevention and screening, treatment, follow-up care, and services research. The review is limited to those studies involving combat veterans and military families. This review discusses perplexing issues regarding the impact of combat on the mental health of service members such as risk and resilience factors of mental health, biomarkers of posttraumatic stress syndrome (PTSD, mental health training, psychological screening, psychological debriefing, third location decompression, combat and suicide, the usefulness of psychotherapy and drug therapy for treating PTSD, role of advanced technology, telemedicine and virtual reality, methods to reduce stigma and barriers to care, and best approaches to the dissemination of evidence-based interventions. The mental health research of special populations such as women, National Guardsmen and reservists, and military families is also presented. The review concludes by identifying future areas of research.
Full Text Available This study investigates whether a community-based task force’s redistricting plan in Ventura County, California, positively affected fair representation, social equity issues, community interests, and the electoral process. Examination and evaluation of the organizational strategies and collaborations involved in the task force’s redistricting process find that the Board of Supervisors districts that members of the community drew were successful in improving and maintaining fair representation. This finding is based on comparing supervisorial votes and policies with community members’ votes on state propositions and local measures, in addition to conducting interviews with task force members, politicians, and community activists. This study finds that citizen participation in governmental processes improves overall community health and political participation.
Bowen, Deborah J; Albrecht, Terrance; Hay, Jennifer; Eggly, Susan; Harris-Wei, Julie; Meischke, Hendrika; Burke, Wylie
Interventions to improve communication among family members may facilitate information flow about familial risk and preventive health behaviors. This is a secondary analysis of the effects of an interactive website intervention aimed at increasing communication frequency and agreement about health risk among melanoma families. Participants were family units, consisting of one family member with melanoma identified from a previous research study (the case) and an additional first degree relative and a parent of a child 0–17. Family triads were randomized to receive access to the website intervention or to serve as control families. Family communication frequency and agreement about melanoma prevention behaviors and beliefs were measured at baseline and again at one year post randomization. Intervention participants of all three types significantly increased the frequency of communication to their first degree relatives (Parents, siblings, children; range =14–18 percentage points; all pcommunication about cancer risk. PMID:28248624
This article explores the overlapping and conflicting points of contact between ‘consumerism’, collectivism and participation in Britain's National Health Service during a period of relatively well-funded expansion during the economic ‘golden age’ of the 1960s and 1970s. Despite recent neo-liberal attempts to define ‘consumerism’ around the wishes and choices of the individual, and to conceptualise areas such as individual hospital referrals as particularly ‘consumerist’, this article demonstrates that collective provision, the protection of disadvantaged groups and the concept of ‘participatory’ citizen involvement were all alternative meanings of the concept during this period, co-existing uneasily with the competitive concepts that have become more familiar since the late 1980s. This insight is then utilised to show how health care debates today might become better informed, ignoring extreme claims for all three concepts and focusing instead on a theoretically informed but ultimately empirical grasp of constant flux in any health care system. PMID:24771976
... Include When Purchasing Goods or Services Under a TIA? E Appendix E to Part 37 National Defense Department... When Purchasing Goods or Services Under a TIA? A. As discussed in § 37.705, you must inform recipients...., supplies or equipment) under their TIAs. Note that purchases of goods or services differ from subawards...
Resnick, Sheilagh M; Griffiths, Mark D
The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic. Data were gathered via interviews with two groups of participants using the SERVQUAL questionnaire. The first group comprised 32 patients and the second 15 clinic staff. The SERVQUAL instrument measures service quality expectations and perceptions across five service dimensions and identifies gaps between service expectations and perceptions of what was delivered. Patients' service quality expectations were exceeded on four of five dimensions. However, staff members felt services fell below expectations on four of five dimensions with the "reliability" service dimension emerging as the common service element falling below expectations for both participant groups. It was concluded that achieving consistent service delivery and increasing empathy between staff and patients improves overall service quality perceptions. The paper relies on self-report methods from a relatively small number of individuals. There have been limited research studies measuring alcohol treatment service quality in the private sector.
Participation in young peoples' sexual cultures in Maputo, Mozambique led to reflections about the field dynamics of power, participation, desire, and discomfort. Structural inequalities of race, gender, and educational status resulted in informants seeing me as a morally righteous person to whom......' continued participation. I show how negotiating the risks of participation may simultaneously satisfy the desire for knowledge and curb erotic desires....
A National Study on the Effects of Concussion in Collegiate Athletes and US Military Service Academy Members: The NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium Structure and Methods.
Broglio, Steven P; McCrea, Michael; McAllister, Thomas; Harezlak, Jaroslaw; Katz, Barry; Hack, Dallas; Hainline, Brian
The natural history of mild traumatic brain injury (TBI) or concussion remains poorly defined and no objective biomarker of physiological recovery exists for clinical use. The National Collegiate Athletic Association (NCAA) and the US Department of Defense (DoD) established the Concussion Assessment, Research and Education (CARE) Consortium to study the natural history of clinical and neurobiological recovery after concussion in the service of improved injury prevention, safety and medical care for student-athletes and military personnel. The objectives of this paper were to (i) describe the background and driving rationale for the CARE Consortium; (ii) outline the infrastructure of the Consortium policies, procedures, and governance; (iii) describe the longitudinal 6-month clinical and neurobiological study methodology; and (iv) characterize special considerations in the design and implementation of a multicenter trial. Beginning Fall 2014, CARE Consortium institutions have recruited and enrolled 23,533 student-athletes and military service academy students (approximately 90% of eligible student-athletes and cadets; 64.6% male, 35.4% female). A total of 1174 concussions have been diagnosed in participating subjects, with both concussion and baseline cases deposited in the Federal Interagency Traumatic Brain Injury Research (FITBIR) database. Challenges have included coordinating regulatory issues across civilian and military institutions, operationalizing study procedures, neuroimaging protocol harmonization across sites and platforms, construction and maintenance of a relational database, and data quality and integrity monitoring. The NCAA-DoD CARE Consortium represents a comprehensive investigation of concussion in student-athletes and military service academy students. The richly characterized study sample and multidimensional approach provide an opportunity to advance the field of concussion science, not only among student athletes but in all populations at
Brandsma-van Bijleveld, G.G.; Dedding, C.W.M.; Bunders-Aelen, J.G.F.
Objective: Child participation is internationally seen as a crucial aspect of child protection and child welfare. Scholars have differences of opinion about what participation entails, but even less is known about whether children and case managers have similar perspectives on participation and its
...) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF... alternate is selected shall serve in place of that member on the committee, and shall have and be able to... members of the committee shall serve for terms of two years: Provided, That four of the initially selected...
95 B.2. Percentage of members who experienced sexual quid pro quo in the past year...Volume 3 B.2. Percentage of members who experienced sexual quid pro quo in the past year Table B.2 Percentage of members who experienced sexual quid ... SEXUAL ASSAULT AND SEXUAL HARASSMENT IN THE U.S. MILITARY Annex to Volume 3. Tabular Results from the 2014 RAND Military Workplace Study for
OECD Publishing, 2018
While the benefits of early childhood education and care (ECEC) services to better learning are now widely acknowledged, a widespread and accessible provision for these services also helps support gender equality in the workforce. In particular, the availability, intensity, reliability and affordability of ECEC play an important role in engaging…
Dosimetry service participation of CIEMAT in intercomparisons 2008-2010 for personal dosimeters EURADOS; Participacion del servicio de dosimetria del CIEMAT en las intercomparaciones EURADOS 2008-2010 para dosimetros personales
Rodriguez Jimenez, R.; Romero Gutierrez, A. M.; Lopez Moyano, J. L.
Individual monitoring of workers exposed to ionizing radiation requires the use of personal dosimeters. EURADOS (European Radiation Dosimetry Group) recently organized three intercomparison exercises External Personal Dosimetry Services (EPDS): two for body dosimeters in 2008 and 2010 and one for extremity dosimeters in the year 2009.El paper shows and analyzes the results obtained by CIEMAT SDPE participation in all exercises.
Saad-Sulonen, Joanna; Halskov, Kim; Eriksson, Eva
The aim of the Unfolding Participation workshop is to outline an agenda for the next 10 years of participatory design (PD) and participatory human computer interaction (HCI) research. We will do that through a double strategy: 1) by critically interrogating the concept of participation (unfolding...... the concept itself), while at the same time, 2) reflecting on the way that participation unfolds across different participatory configurations. We invite researchers and practitioners from PD and HCI and fields in which information technology mediated participation is embedded (e.g. in political studies......, urban planning, participatory arts, business, science and technology studies) to bring a plurality of perspectives and expertise related to participation....
Leggat Sandra G
Full Text Available Abstract Background Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. Methods Members of a state branch of the professional association of Australian health service managers participated in a teamwork survey. Results The 37% response rate enabled identification of a management teamwork competency set comprising leadership, knowledge of organizational goals and strategies and organizational commitment, respect for others, commitment to working collaboratively and to achieving a quality outcome. Conclusion Although not part of the research question the data suggested that the competencies for effective teamwork are perceived to be different for management and clinical teams, and there are differences in the perceptions of effective teamwork competencies between male and female health service managers. This study adds to the growing evidence that the focus on individual skill development and individual accountability and achievement that results from existing models of health professional training, and which is continually reinforced by human resource management practices within healthcare systems, is not consistent with the competencies required for effective teamwork.
Yang, Jingzhen; Kingsbury, Diana; Nichols, Matthew; Grimm, Kristin; Ding, Kele; Hallam, Jeffrey
With health care shifting away from the traditional sick care model, many hospitals are integrating fitness facilities and programs into their clinical services in order to support health promotion and disease prevention at the community level. Through a series of focus groups, the present study assessed characteristics of hospital-affiliated integrated facilities located in Northeast Ohio, United States and members' experiences with respect to these facilities. Adult members were invited to participate in a focus group using a recruitment flyer. A total of 6 focus groups were conducted in 2013, each lasting one hour, ranging from 5 to 12 participants per group. The responses and discussions were recorded and transcribed verbatim, then analyzed independently by research team members. Major themes were identified after consensus was reached. The participants' average age was 57, with 56.8% currently under a doctor's care. Four major themes associated with integrated facilities and members' experiences emerged across the six focus groups: 1) facility/program, 2) social atmosphere, 3) provider, and 4) member. Within each theme, several sub-themes were also identified. A key feature of integrated facilities is the availability of clinical and fitness services "under one roof". Many participants remarked that they initially attended physical therapy, becoming members of the fitness facility afterwards, or vice versa. The participants had favorable views of and experiences with the superior physical environment and atmosphere, personal attention, tailored programs, and knowledgeable, friendly, and attentive staff. In particular, participants favored the emphasis on preventive care and the promotion of holistic health and wellness. These results support the integration of wellness promotion and programming with traditional medical care and call for the further evaluation of such a model with regard to participants' health outcomes.
CALIDAD DEL SERVICIO DE COMIDA RÁPIDA A PARTIR DE LA PARTICIPACIÓN DEL EMPLEADO DE VANGUARDIA, MUNICIPIO LIBERTADOR, ESTADO MÉRIDA, VENEZUELA | QUALITY OF FAST FOOD SERVICE FROM VANGUARD EMPLOYEE PARTICIPATION, LIBERTADOR MUNICIPALITY, MERIDA STATE, VENEZUELA
Marysela Coromoto Morillo Moreno
Full Text Available Currently, the service quality is the biggest distinguishing factor and the most powerful competitive advantage of service companies, where the performance of the human factor is fundamental. For the study of service quality two fundamental props exist: the internal and the external clients. The present investigation analyzes the service quality of fast food businesses from the participation of the avant-garde employee, in the specific case of businesses located in Libertador Municipality of Merida State, Venezuela. For this purpose, the integral model of quality breaches of the service and the scale of Dineserv were applied during the second semester of 2014. In this regards, a representative sample of the population of managers, employees and external customers of fast food businesses was selected, and a survey was applied to each of them. Compliance with the standards of the service employees was verified, as well as the positive correspondence between this performance and the levels of quality of service perceived by the user. To confront the low perception of the performance of the employee, rewards, recognition and multiple and varied stimulus should be implemented in order to motivate for a continuous improvement of the quality of service.
... 29 Labor 4 2010-07-01 2010-07-01 false Influencing Members of Congress. 1400.735-19 Section 1400... Responsibilities § 1400.735-19 Influencing Members of Congress. No money appropriated to the Service shall be used... devices intended to influence any Member of Congress regarding any legislation or appropriation before the...
Townsend, Anne; Cox, Susan M
Background Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emer...
To thrive, a successful school library program needs active participation from all members of its community. As an instructional leader, the school librarian must be the one to raise the bar, not just informing other educators about resources and services, but empowering all adults to become engaged in the school library program. For example,…
participation so central to the Renewable Energy Island project can be better understood as instances of material participation motivated first and foremost by a concern for the future of the island as a 'liveable' community; a community in which jobs and institutions are not constantly threatening to disappear...
Full Text Available Background and purpose: In recent years although the number of students registering for medicines has decreased in Kermanshah University of Medical sciences parallel to other universities of medical sciences the quality of educational services has not improved the informal reports suggests that the competency of medical graduates is not satisfactory Since any intervention needs situation analysis this study was conducted to obtain viewpoints of three main groups of stockholders including faculty members, students and graduates on medical school problems and insufficiencies.Methods: In this qualitative study faculty members of medical schools, medical graduated of 2005-6, and medical students of different phases participated. With participation of these subjects Focus Group Discussion (FGD sessions were carried out. The goals of the projects were first explained for participants. In the end of each discussion session the discussions were careful transcribed. The sessions continued till the sessions get saturated. The transcript of discussion was thoroughly reviewed by researchers and codified. The problems were classified in 7 areas of management, planning, education goals, evaluation, ethics, teaching, and students.Results: The subjects believed that the most important problems in Kermanshah medical school include neglecting the student evaluation, no educational objectives or being inattentive to them, unwanted effects of pay for service plan, too much duties for interns (students, overload of medical duties and insufficiency in the number of faculty members, no rewarding system for teachers, inattention to needed outcomes, shortage of facilities for student in hospital and being negligent about mutual respect between students and teachers.Conclusion: some of the problems such as the effects of pay for service plan and insufficiency in the number of faculty members have solutions stemming beyond the university at Ministry of Health level
Lateefa O. Al-Dakhil
Full Text Available Objectives: Clinical trials are experimental projects that include patients as subjects. A number of benefits are directly associated with clinical trials. Healthcare processes and outcomes can be improved with the help of clinical trials. This study aimed to assess the attitudes and beliefs of patients about their contribution to and enrolment in clinical trials. Methods: A cross-sectional study design was used for data collection and analysis. A questionnaire was developed with six categories to derive effective outcomes. Results: Of the 2000 participants approached to take part in the study, 1081 agreed. The majority of the study population was female, well educated, and unaware of clinical trials. Only 324 subjects (30.0% had previously agreed to participate in a clinical trial. The majority (87.1% were motivated to participate in clinical trials due to religious aspects. However, fear of any risk was the principal reason (79.8% that reduced their motivation to participate. Conclusions: The results of this study revealed that patients in Saudi Arabia have a low awareness and are less willing to participate in clinical trials. Different motivational factors and awareness programs can be used to increase patient participation in the future.
Russell C. Moody; Jen Y. Liu
Glued structural members are manufactured in a variety of configurations. Structural composite lumber (SCL) products consist of small pieces of wood glued together into sizes common for solid-sawn lumber. Glued-laminated timber (glulam) is an engineered stress-rated product that consists of two or more layers of lumber in which the grain of all layers is oriented...
Lithuania is on course to become an associate member of CERN, pending final approval by the Lithuanian parliament. Associate membership will allow representatives of the Baltic nation to take part in meetings of the CERN Council, which oversees the Geneva-based physics lab.
The political upheaval in what was the Soviet Union was reflected in an Extraordinary Plenipotentiaries Committee of Joint Institute for Nuclear Research (JINR) Member States, held in Dubna, near Moscow, on 10-13 December, with representatives of eleven sovereign republics of the former Soviet State taking part
Radin, Jennifer M; Hawksworth, Anthony W; Ortiguerra, Ryan G; Brice, Gary T
In 2011, a new variant of influenza A(H3N2) emerged that contained a recombination of genes from swine H3N2 viruses and the matrix (M) gene of influenza A(H1N1)pdm09 virus. New combinations and variants of pre-existing influenza viruses are worrisome if there is low or nonexistent immunity in a population, which increases chances for an outbreak or pandemic. Sera collected in 2011 were obtained from US Department of Defense service members in three age groups: 19-21 years, 32-33 years, and 47-48 years. Pre- and post-vaccination samples were available for the youngest age group, and postvaccination samples for the two older groups. Specimens were tested using microneutralization assays for antibody titers against H3N2v (A/Indiana/10/2011) and seasonal H3N2 virus (A/Perth/16/2009). The youngest age group had significantly (p<0.05) higher geometric mean titers for H3N2v with 165 (95% confidence interval [CI]: 105-225) compared with the two older groups, aged 32-33 and 47-48 years, who had geometric mean titers of 68 (95% CI: 55-82) and 46 (95% CI: 24-65), respectively. Similarly, the youngest age group also had the highest geometric mean titers for seasonal H3N2. In the youngest age group, the proportion of patients who seroconverted after vaccination was 12% for H3N2v and 27% for seasonal H3N2. Our results were similar to previous studies that found highest seroprotection among young adults and decreasing titers among older adults. The proportion of 19- to 21-year-olds who seroconverted after seasonal vaccination was low and similar to previous findings. Improving our understanding of H3N2v immunity among different age groups in the United States can help inform vaccination plans if H3N2v becomes more transmissible in the future.
Nathalia Correia Pompeu
Full Text Available Based on subdivisions that LC No. 116 of 2003 established the computer services, many companies are fined, particularly in cities such as S.o Paulo, which have different rates for the services of one item Attaches list of this Law, for not differentiate correctly the services provided. This is because, as the Law brings vague and imprecise concepts, they differ widely among the computing market, technical professionals and municipal tax area, causing quite a stir in the taxation of ISS. The importance of defining, understanding and define the various application of this tax concepts will bring legal certainty to those involved in the process as well, enable the technological development in the correct tax assessment of international contracts.
Ma, Ning; Xin, Shuang; Du, Jia-Yuan
Personalized learning based on learning analytics has become increasingly important for teachers' development via providing adaptive contents and strategies for teachers by identifying their questions and needs. Currently, most studies on teachers' professional development focus on pre-service teachers, and studies on teachers' personalized…
Thank you! Over the past year, AGU has received 12,104 gifts, both large and small, from members and friends. The Union has also received corporate contributions, National Science Foundation grants, and support from the National Oceanographic Partnership Program and National Association of Geoscience Teachers. Together their generosity has benefited AGU non revenue producing programs that are critical to our science and the future health of the Union. The following list gratefully acknowledges annual gifts of $100 or more and cumulative giving of $5,000 or more. The 1919 Society ($100,000 or more) and Benefactors ($5,000-$99,999) recognize single major gifts and cumulative contributions. Three circles acknowledge annual giving: President's Circle ($1,000 or more), Leadership Circle ($200-$999), and Supporters Circle ($100-$199). Supporting Life Members, who contribute a one-time gift of $1,200 in addition to lifetime dues, are among our most loyal Supporters.
Summer is coming, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 25 € instead of 31 €. Access to Aqualibi: 5 € instead of 8 € on presentation of your Staff Association member ticket. Free for children under 100 cm. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 24 € instead of 30 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children under 100 cm. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is coming, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 24 € instead of 30 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children under 100 cm. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Development and pilot evaluation of a clinic-based mHealth app referral service to support adult cancer survivors increase their participation in physical activity using publicly available mobile apps.
Short, Camille E; Finlay, Amy; Sanders, Ilea; Maher, Carol
Participation in regular physical activity holds key benefits for cancer survivors, yet few cancer survivors meet physical activity recommendations. This study aimed to develop and pilot test a mHealth app referral service aimed at assisting cancer survivors to increase their physical activity. In particular, the study sought to examine feasibility and acceptability of the service and determine preliminary efficacy for physical activity behaviour change. A systematic search identified potentially appropriate Apple (iOS) and Android mHealth apps. The apps were audited regarding the type of physical activity encouraged, evidence-based behavioural strategies and other characteristics, to help match apps to users' preferences and characteristics. A structured service was devised to deliver the apps and counselling, comprising two face-to-face appointments with a mid-week phone or email check-up. The mHealth app referral service was piloted using a pre-post design among 12 cancer survivors. Participants' feedback regarding the service's feasibility and acceptability was sought via purpose-designed questionnaire, and analysed using inductive thematic analysis and descriptive statistics. Change in physical activity was assessed using a valid and reliable self-report tool and analysed using paired t-tests. In line with recommendations for pilot studies, confidence intervals and effect sizes were reported to aid interpretation of clinical significance, with an alpha of 0.2 used to denote statistical significance. Of 374 mHealth apps identified during the systematic search, 54 progressed to the audit (iOS = 27, Android = 27). The apps consistently scored well for aesthetics, engagement and functionality, and inconsistently for gamification, social and behaviour change features. Ten participants completed the pilot evaluation and provided positive feedback regarding the service's acceptability and feasibility. On average, participants increased their moderate
S. 1030: A bill to authorize private sector participation in providing products and services to support Department of Energy defense waste cleanup and modernization missions, introduced in the US Senate, One Hundred Second Congress, First Session, May 9, 1991
This bill was introduced into the US Senate on May 9, 1991 to authorize private sector participation in providing products and services to support Department of Energy defense waste cleanup and modernization. Congress finds that the management and cleanup of nuclear and hazardous waste and the modernization of Department of Energy facilities must be pursued expeditiously in order to protect the health and safety of the public and workers
Richman, Barbara T.
The new Board on Ocean Science and Policy (BOSP) (Eos, June 7, 1983, p. 402) met for the first time on May 4. John B. Slaughter, former director of the National Science Foundation and now chancellor of the University of Maryland in College Park, is the board's chairman. Other board members are D. James Baker, Jr. (University of Washington, Seattle); Kirk Bryan (Geophysical Fluid Dynamics Laboratory, Princeton University); John P. Craven (University of Hawaii); Charles L. Drake (Dartmouth College); Paul M. Fye (Woods Hole Oceanographic Institution); Edward D. Goldberg (Scripps Institution of Oceanography); G. Ross Heath (Oregon State University); Judith T. Kildow (Massachusetts Institute of Technology); John A. Knauss (University of Rhode Island); James J. McCarthy (Museum of Comparative Zoology, Harvard University); H. William Menard (Scripps Institution of Oceanography); C. Barry Raleigh (Lamont-Doherty Geological Observatory); Roger Revelle (University of California, San Diego); David A. Ross (Woods Hole Oceanographic Institution); Brian J. Rothschild (University of Maryland); William M. Sackett (University of South Florida); John H. Steele (Woods Hole Oceanographic Institution); and Carl Wunsch (MIT). Wallace Broecker (Lamont-Doherty Geological Observatory), an original board member, resigned after the first meeting. Broecker told Eos that combining the science and policy boards resulted in a new board whose mission is too broad. A new board member will be appointed in Broecker's place
A randomised controlled trial to improve general practitioners' services in cancer rehabilitation: Effects on general practitioners' proactivity and on patients' participation in rehabilitation activities
Bergholdt, SH; Søndergaard, J; Larsen, PV
by their GP reported by the patients and GPs, respectively, and patients' participation in rehabilitation activities. Methods. Cluster randomised controlled trial. All general practices in Denmark were randomised to an intervention group or to a control group (usual procedures). Patients were subsequently...
Andy-Wali, Hope Adanne; Wali, Andy Fred
This study investigates the impact of lecturers' leadership practices on students' experiences of participation within a case university in the UK's HE sector. The qualitative phenomenological research strategy, specifically the focus group interview approach, was used for data collection. Two key focus group interviews were conducted with a total…
Lal, Shalini; Daniel, Winnie; Rivard, Lysanne
Information and communication technologies (ICTs) are increasingly recognized as having an important role in the delivery of mental health services for youth. Recent studies have evaluated young people's access and use of technology, as well as their perspectives on using technology to receive mental health information, services, and support; however, limited attention has been given to the perspectives of family members in this regard. The aim of this study was to explore the perspectives of family members on the use of ICTs to deliver mental health services to youth within the context of specialized early intervention for a first-episode psychosis (FEP). Six focus groups were conducted with family members recruited from an early intervention program for psychosis. Twelve family members participated in the study (target sample was 12-18, and recruitment efforts took place over the duration of 1 year). A 12-item semistructured focus group guide was developed to explore past experiences of technology and recommendations for the use of technology in youth mental health service delivery. A qualitative thematic analysis guided the identification and organization of common themes and patterns identified across the dataset. Findings were organized by the following themes: access and use of technology, potential negative impacts of technology on youth in recovery, potential benefits of using technology to deliver mental health services to youth, and recommendations to use technology for (1) providing quality information in a manner that is accessible to individuals of diverse socioeconomic backgrounds, (2) facilitating communication with health care professionals and services, and (3) increasing access to peer support. To our knowledge, this is among the first (or the first) to explore the perspectives of family members of youth being treated for FEP on the use of technology for mental health care. Our results highlight the importance of considering diverse experiences
McCann, Terence V; Lubman, Dan I
To explore the coping strategies used by affected family members of a relative with substance misuse. Families play an important role in supporting a relative with substance misuse. However, the experience often has an adverse effect on their general well-being, the extent of which depends largely on their coping strategies. An interpretative phenomenological analysis study. Data were collected between January - December 2015. Semistructured, audio-recorded qualitative interviews were conducted with 31 affected family members. Three main themes and related subthemes were abstracted from the data illustrating how participants coped with their relative's substance misuse: (1) Seeking timely access to evidence-based information; (2) Enhancing personal coping strategies and (3) Accessing informal and formal support. Greater investment is needed in support services for affected family members, particularly in regional and rural areas. A wide range of accessible evidence-based information and informal and formal support, including telephone and online support, is needed to assist them to cope in this crucial support-giving role. Affected family members need to adopt a flexible set of coping strategies while supporting a relative with substance misuse. Family and friends, alcohol and other drug services, mental health nurses and other clinicians have a critical role providing emotional, instrumental and educational support to affected family members to enhance their adaptive coping strategies. © 2017 John Wiley & Sons Ltd.
Boyce, W F
A structural perspective was used in studying community participation of disadvantaged groups (poor women, street youth, and disabled persons) in health promotion projects. Five community projects in the Canadian Health Promotion Contribution Program were examined in a comparative case study utilizing in-depth interviews, documents, and secondary sources. Analysis revealed relatively low numbers and restricted range of participants, difficulties in recruiting and maintaining participants, declining rates of active participation over time, and limited target group influence and power. This paper reports on the relationship between various dimensions of structure (social-cultural, organizational, political-legal-economic) and the community participation process. Participation was influenced by structural factors such as bureaucratic rules and regulators, perceived minority group rights and relations, agency reputations and responsibilities, available resources, and organizational roles. Control of projects by target group members, rather than by service agencies, was an important overall organizational structural factor which allowed community members to achieve influence in projects. The study concludes that a conceptual model based on structural factors is useful in explaining how key factors from federal and local levels can restrict or facilitate the community participation process.
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.63) is Palau which deposited its Instrument of Acceptance of the Statute on 2 March 2007. The Attachment hereto shows the dates on which the present 144 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.64) is Nepal which deposited its Instrument of Acceptance of the Statute on 8 July 2008. The Attachment hereto shows the dates on which the present 145 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.61) are Belize, Mozambique and Malawi, which deposited their Instruments of Acceptance of the Statute on 31 March 2006, 18 September 2006 and 2 October 2006 respectively. The Attachment hereto shows the dates on which the present 142 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.62) is Montenegro which deposited its Instrument of Acceptance of the Statute on 30 October 2006. The Attachment hereto shows the dates on which the present 143 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members [ru
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members [fr
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.61) are Belize, Mozambique and Malawi, which deposited their Instruments of Acceptance of the Statute on 31 March 2006, 18 September 2006 and 2 October 2006 respectively. The Attachment hereto shows the dates on which the present 142 Member States became Members [fr
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members [fr
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.65) is the Sultanate of Oman which deposited its Instrument of Acceptance of the Statute on 5 February 2009. The Attachment hereto shows the dates on which the present 146 Member States became Members [fr
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.59) is the Islamic Republic of Mauritania, which deposited the instrument of acceptance of the Statute on 23 November 2004. The Attachment hereto shows the dates on which the present 138 Member States became Members
The new Members since the last list of Member States was issued (INFCIRC/2/Rev.66) are Bahrain, Burundi, Congo and Lesotho which deposited their Instruments of Acceptance of the Statute on 23 June 2009, 24 June 2009, 15 July 2009 and 13 July 2009, respectively. The Attachment hereto shows the dates on which the present 150 Member States became Members [es
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members [es
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.60) is Chad, which deposited the instrument of acceptance of the Statute on 2 November 2005. The Attachment hereto shows the dates on which the present 139 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.65) is the Sultanate of Oman which deposited its Instrument of Acceptance of the Statute on 5 February 2009. The Attachment hereto shows the dates on which the present 146 Member States became Members [es
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.58) is Kyrgyzstan, which deposited the instrument of acceptance of the Statute on 10 September 2003. The list shows the dates on which the present 137 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.65) is the Sultanate of Oman which deposited its Instrument of Acceptance of the Statute on 5 February 2009. The Attachment hereto shows the dates on which the present 146 Member States became Members
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.67) is Cambodia which deposited its Instrument of Acceptance of the Statute on 23 November 2009. The Attachment hereto shows the dates on which the present 151 Member States became Members [ru
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 21 € instead of 26 €. Access to Aqualibi: 5 € instead of 8 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 30 CHF instead of 39 CHF – Adults : 36 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 21,50 € instead of 27 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12:00 p.m. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 23 € instead of 29 €. Access to Aqualibi: 5 € instead of 6 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12:00 p.m. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 33 CHF instead of 39 CHF – Adults : 33 CHF instead of 49 CHF Bonus! Free for children under 5.
Niemann, R.C.; Gonczy, J.D.; Nicol, T.H.
A cryogenic support member is described for restraining a cryogenic system comprising; a rod having a depression at a first end. The rod is made of non-metallic material. The non-metallic material has an effectively low thermal conductivity; a metallic plug; and a metallic sleeve. The plug and the sleeve are shrink-fitted to the depression in the rod and assembled thereto such that the plug is disposed inside the depression of the rod. The sleeve is disposed over the depression in the rod and the rod is clamped therebetween. The shrink-fit clamping the rod is generated between the metallic plug and the metallic sleeve
When subjected to temperature changes and restrained from free movement, a member develops stresses. Restrained members are sometimes assumed to act independently of other members. A method of analysis and design for thermal stresses in such members is provided. The method of analysis, based on the ultimate strength concept, greatly reduces the computational efforts for determining thermal effects in concrete members. Available charts and tables and the recommendations given herein simplify the design. (Auth.)
Alsen, S. (Grontmij - Carl Bro, Glostrup (Denmark)); Theel, C. (Baltic Sea Solutions, Holeby (Denmark))
Within the NICe-funded project 'Nordic Environmental Technology Solutions (NETS)' a new type of networking at the Nordic level was organized in order to jointly exploit the rapidly growing market potential in the environmental technology sector. The project aimed at increased and professionalized commercialization of Nordic Cleantech in energy and water business segments through 1) closer cooperation and joint marketing activities, 2) a website, 3) cleantech product information via brochures and publications 4) and participating in relevant trade fairs and other industry events. Facilitating business-to-business activities was another core task for the NETS project partners from Norway, Sweden, Finland and Denmark with the aim to encourage total solutions for combined Cleantech system offers. The project has achieved to establish a Cleantech register of 600 Nordic Cleantech companies, a network of 86 member enterprises, produced several publications and brochures for direct technology promotion and a website for direct access to company profiles and contact data. The project partners have attended 14 relevant international Cleantech trade fairs and conferences and facilitated business-to-business contacts added by capacity building offers through two company workshops. The future challenge for the project partners and Nordic Cleantech will be to coordinate the numerous efforts within the Nordic countries in order to reach concerted action and binding of member companies for reliable services, an improved visibility and knowledge exchange. With Cleantech's growing market influence and public awareness, the need to develop total solutions is increasing likewise. Marketing efforts should be encouraged cross-sectional and cross-border among the various levels of involved actors from both the public and the private sector. (au)
Alsen, S [Grontmij - Carl Bro, Glostrup (Denmark); Theel, C [Baltic Sea Solutions, Holeby (Denmark)
Within the NICe-funded project 'Nordic Environmental Technology Solutions (NETS)' a new type of networking at the Nordic level was organized in order to jointly exploit the rapidly growing market potential in the environmental technology sector. The project aimed at increased and professionalized commercialization of Nordic Cleantech in energy and water business segments through 1) closer cooperation and joint marketing activities, 2) a website, 3) cleantech product information via brochures and publications 4) and participating in relevant trade fairs and other industry events. Facilitating business-to-business activities was another core task for the NETS project partners from Norway, Sweden, Finland and Denmark with the aim to encourage total solutions for combined Cleantech system offers. The project has achieved to establish a Cleantech register of 600 Nordic Cleantech companies, a network of 86 member enterprises, produced several publications and brochures for direct technology promotion and a website for direct access to company profiles and contact data. The project partners have attended 14 relevant international Cleantech trade fairs and conferences and facilitated business-to-business contacts added by capacity building offers through two company workshops. The future challenge for the project partners and Nordic Cleantech will be to coordinate the numerous efforts within the Nordic countries in order to reach concerted action and binding of member companies for reliable services, an improved visibility and knowledge exchange. With Cleantech's growing market influence and public awareness, the need to develop total solutions is increasing likewise. Marketing efforts should be encouraged cross-sectional and cross-border among the various levels of involved actors from both the public and the private sector. (au)
Mylona, Elza; Brubaker, Linda; Williams, Valerie N; Novielli, Karen D; Lyness, Jeffrey M; Pollart, Susan M; Dandar, Valerie; Bunton, Sarah A
Mentoring relationships, for all medical school faculty members, are an important component of lifelong development and education, yet an understanding of mentoring among medical school clinical faculty members is incomplete. This study examined associations between formal mentoring relationships and aspects of faculty members' engagement and satisfaction. It then explored the variability of these associations across subgroups of clinical faculty members to understand the status of mentoring and outcomes of mentoring relationships. The authors hypothesised that academic clinical faculty members currently in formal mentoring relationships experience enhanced employee engagement and satisfaction with their department and institution. Medical school faculty members at 26 self-selected USA institutions participated in the 2011-2014 Faculty Forward Engagement Survey. Responses from clinical faculty members were analysed for relationships between mentoring status and perceptions of engagement by faculty members. Of the 11 953 clinical faculty respondents, almost one-third reported having a formal mentoring relationship (30%; 3529). Most mentored faculty indicated the relationship was important (86%; n = 3027), and over three-fourths were satisfied with their mentoring experience (77%; n = 2722). Mentored faculty members across ranks reported significantly higher levels of satisfaction and more positive perceptions of their roles in the organisation. Faculty members who were not receiving mentoring reported significantly less satisfaction with their workplace environment and lower overall satisfaction. Mentored clinical faculty members have significantly greater satisfaction with their department and institution. This multi-institutional study provides evidence that fostering mentoring opportunities may facilitate faculty members' satisfaction and engagement, which, in turn, may help medical schools retain high-quality faculty staff committed to the multidimensional
Hamad, Rita; Fernald, Lia C H
Microcredit services--the awarding of small loans to individuals who are too poor to take advantage of traditional financial services--are an increasingly popular scheme for poverty alleviation. Several studies have examined the ability of microcredit programmes to influence the financial standing of borrowers, but only a few studies have examined whether the added household income improves health and nutritional outcomes among household members. This study examined the hypothesis that longer participation in microcredit services would be associated with better nutritional status in women. Cross-sectional data were obtained in February 2007 from 1593 female clients of a microcredit organisation in Peru. The primary predictor variable was length of time as a microcredit client measured in number of completed loan cycles (range 0 to 5.5 years, average loan size US$350). The outcome variables were age-adjusted body mass index (BMI), haemoglobin levels (g/dl) and food insecurity measured using the US household food security survey module. Extensive data on demographic and socioeconomic status were also collected. Longer microcredit participation was associated with higher BMI (β=0.05, p=0.06), higher haemoglobin levels (β=0.07, pmicrocredit participation has positive effects on the nutritional status of female clients. Further research should explore more definitive causal pathways through which these effects may occur and should examine the effects on other household members.
The involvement of local communities in public space planning and design processes is widely promoted as an essential element of landscape architecture and urban design practice. Despite this, there has been little theorisation of this topic within these fields. Furthermore, the implementation of ideals and principles commonly found in theory are far from becoming mainstream practice, indicating a significant gap between the theory and practice of participation. This thesis aims to contri...
Broer, Tineke; Nieboer, Anna P.; Bal, Roland
Abstract Background Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation process. Many articles have concluded that client participation is limited; professionals often still control the participation process and outcomes. Objective The objective of this study is to gain insight into (i) the practice of client participation within a quality improvement collaborative in mental health care and (ii) the consequences of a Foucauldian conceptualization of power in analysing practices of client participation. Design We used an ethnographic design consisting of observations of national events and improvement team meetings and interviews with the collaborative’s team members and programme managers. Results Contrary to many studies on client participation, we found both clients and service providers frequently felt powerless in its practice. Professionals and clients alike struggled with the contributions clients could make to the improvement processes and what functions they should fulfil. Moreover, professionals did not want to exert power upon clients, but ironically just for that reason sometimes struggled with shaping practices of client participation. This mutual powerlessness (partly) disappeared when clients helped to determine and execute specific improvement actions instead of participating in improvement teams. Conclusion Recognizing that power is inescapable might allow for a more substantive discussion concerning the consequences that power arrangements produce, rather than looking at who is exerting how much power. PMID:22390793
Derechos, ciudadanía y participación en salud: su relación con la accesibilidad simbólica a los servicios Rights, Citizenship And Participation In Health: Its Relationship With Simbolic Accessibility To Service
Full Text Available Este trabajo analiza la accesibilidad a la atención en salud de usuarios de un centro de salud de la Ciudad de Buenos Aires. Se define a la accesibilidad como un vínculo que se construye entre los sujetos y los servicios, que surge de una combinatoria entre las condiciones y discursos de los servicios y las condiciones y representaciones de los sujetos. Se considera que existe una íntima relación entre la accesibilidad simbólica y la participación social de los usuarios. Se entrevistaron usuarios con y sin participación con el fin de analizar los vínculos que cada grupo construye con el servicio. Los usuarios sin participación muestran sentimientos de agradecimiento hacia los trabajadores, y los responsabilizan de modo personal cuando hay una falla en la atención, mientras que es posible encontrar concepciones de Derecho a la Atención en Salud en los usuarios con participación, aunque ligadas a un derecho "selectivo", no universal.This work analyzes the accessibility to the attention in health of the users of a health unit located in Buenos Aires City. The accessibility is defined as a relationship that is built between the subjects and the services, that arises of a combination between the conditions and speeches of the services and the conditions and representations of the subjects. It is considered that there is an intimate relation between the symbolic accessibility and the social participation of the services users. We interviewed users with participation in health, and users without active participation in this area, in order to investigate the relationship that each group builds with the service. Users without participation in health, show feelings of gratitude toward the workers of the center, as well as they blame them in a personal way when there was a failure in the attention. On the contrary, it is possible to find conceptions of Right to the Attention in Health in users with participation in health, although these
The Courir shops propose the following offer: 15% discount on all articles (not on sales) in the Courir shops (Val Thoiry, Annemasse and Neydens) and 5% discount on sales upon presentation of your Staff Association membership card and an identity card before payment. Summer is here, enjoy our offers for the aquatic parcs! Walibi : Tickets "Zone terrestre": 21 € instead of 26 €. Access to Aqualibi: 5 € instead of 8 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Day ticket: – Children: 30 CHF instead of 39 CHF – Adults : 36 CHF instead of 49 CHF Bonus! Free for children under 5.
Association du personnel
La banque LCL propose aux membres de l’Association du personnel les avantages suivants : – Un barème Privilège sur le Prêt immobilier – Des avantages tarifaires sur l’épargne, notamment l’assurance-vie. – Un taux préférentiel de prêt à la consommation. En outre, jusqu’au 30 septembre 2013, elle offre 50€ à tous les nouveaux clients, membres de l'Association du personnel. Summer is here, enjoy our offers for the aquatic parcs! Tickets "Zone terrestre" : 21 € instead of de 26 €. Access to Aqualibi : 5 euros instead of 8 euros on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Free car park. * * * * * * * Full day ticket: – Children : 30 CHF instead of 39 CHF &...
The warm weather arrives, it's time to take advantage of our offers Walibi and Aquapark! Walibi : Tickets "Zone terrestre": 21 € instead of 26 € Access to Aqualibi: 5 € instead of 8 € on presentation of your SA member ticket. Free for children (3-11 years old) before 12 h 00. Free for children under 3, with limited access to the attractions. Car park free. * * * * * Aquaparc : Half-day ticket (5 hours): – Children: 26 CHF instead of 35 CHF – Adults : 32 CHF instead of 43 CHF Day ticket: – Children: 30 CHF instead of 39 CHF – Adults : 36 CHF instead of 49 CHF Free for children under 5.
Moukam Claudiane Yanick
Full Text Available The main approaches to forest conservation are often combined without the fact that stakeholders' perceptions and expectations are understood clearly and systematically. The main objective of this study is to analyze rural households’ behavior face to new approaches of PES in the management of community forestry. The contingent valuation method has been used. Econometric and statistical analyses show that the socio-economic characteristics such as age of the household head (+, marital status (-, household size (+, income (-, ethnicity (-, significantly influence the participation of households through their willingness to accept (WTA. Furthermore, the only logic of compensation at opportunity cost of practices competing with forest in the use of land, doesn’t lead unlikely to sustainable results. It is necessary for this purpose, to move from logic of compensation to an investment perspective, at the national level as at the local level. This will make PES scheme more efficient and equity in the distribution of resources.
José Antonio Peña Barreto
Full Text Available This research is proposed in order to propose an action plan for environmental sanitation citizen participation in the "Manuela Sáenz" Concentrating National Basic School Parish Municipality City Bolivia Pedraza Barinas state. It is part of the qualitative approach in the form of participatory action research and supported by a narrative descriptive design. The selected scenario for performance of work was the Concentrating National School "Manuela Sáenz" key informants consist of 1 member of the community, 1 member of the community council and one teacher of the institution. The techniques used are observation and depth interview, using as instruments a field notebook and an interview script. For the presentation and analysis of results he was categorized, triangulated and theorized the information obtained, performing a thorough and detailed report on the integrated management of solid waste diagnosis. Subsequently, the proposal called Action Plan for environmental sanitation was developed with citizen participation in concentrated Manuela Saenz National Basic School. Then the proposal where participants expressed the view that activities allowed to obtain very important basic knowledge on environmental sanitation was run.
Fabian, Louise; Samson, Kristine
The article discuss the conflicts, potentials and possible alliances of do-it-yourself (DIY) urbanism when it takes the form of spontaneous place appropriations, when it is performed as participatory urban design and when it is integrated strategically in planning. DIY urbanism and experimentation...... with participation are currently strong influential factors in Danish planning. The article explores the use of participatory DIY urban design in two cases: the relocation of beer drinkers in Enghave Square and the Carlsberg City development in Copenhagen, Denmark. Carlsberg City is the most thorough Danish example...
Full Text Available Abstract Background Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a to identify differences in psychosocial adjustment and health-related quality of life (HRQoL among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c to explore significant mediator and predictor variables. Methods Cross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45, 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis. Results Adolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390 and HRQoL (R2adj =.239 best. Conclusion The study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning.
Rasmussen, Annette Beedholm; Fisker, Jakob; Hagsten, Lars German
The system of cracks developing in reinforced concrete is in many aspects essential when modelling structures in both serviceability- and ultimate limit state. This paper discusses the behavior concerning crack development in flexural members observed from tests and associates it with two different...... existing models. From the investigations an approach is proposed on how to predict the crack pattern in flexural members involving two different crack systems; primary flexural cracks and local secondary cracks. The results of the approach is in overall good agreement with the observed tests and captures...... the pronounced size effect associated with flexural cracking in which the crack spacing and crack widths are approximately proportional to the depth of the member....
The document lists the 135 Member States of the Agency as of 19 March 2003. The new Member since the last issue of the list (INFCIRC/2/56) is the Republic of Honduras. The dates on which the present 135 Member States became Members are given in an Attachment. It also shows the States whose application for membership of the Agency has been approved by the General Conference but which has not yet deposited an instrument of acceptance of the Statute
The document lists the 130 Member States of the Agency as of 1 December 1999. The new Member since the last issue of the list (INFCIRC/2/52) is Angola. The dates on which the present 130 Member States became Members, and the state Honduras) whose application for membership of the Agency has been approved by the General Conference but which has not yet deposited an instrument of acceptance of the Statute are given in an Attachment
The new Member since the last list of Member States was issued (INFCIRC/2/Rev.55) is the Republic of Botswana, which deposited the instrument of acceptance of the Statute on 20 March 2002. The Attachment hereto shows the dates on which the present 134 Member States became Members. It also shows the State whose application for membership of the Agency has been approved by the General Conference, but which has not yet deposited an instrument of acceptance of the Statute
The document lists the 132 Member States of the Agency as of 1 June 2001. The new Members since the last issue of the list (INFCIRC/2/53) are Central African Republic and Azerbaijan. The dates on which the present 132 Member States became Members are given in an Attachment. It also shows the States whose application for membership of the Agency has been approved by the General Conference but which has not yet deposited an instrument of acceptance of the Statute