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1
Botz, Chas K., Susan Bestard, Mary Demaray und Gail Molloy. „Resource Utilization Groups (RUGs): Defining Chronic Care, Rehabilitation and Nursing Home Case Mix in Canada“. Healthcare Management Forum 6, Nr. 4 (Dezember 1993): 5–11. http://dx.doi.org/10.1016/s0840-4704(10)61129-5.
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The two major purposes of this study were: (1) to evaluate Resource Utilization Groups (RUGs III) as a unified method for classifying all residential, chronic care and rehabilitation patients at the St. Joseph's Health Centre, London, and (2) to compare the potential funding implications of RUGs and other patient/resident classification systems. RUGs were used to classify a total of 336 patients/residents in residential, extended care, chronic care and rehabilitation beds at the Health Centre. Patients were also concurrently classified according to the Alberta Long Term Care Classification System and the Medicus Long Term Care System. Results show that RUGs provide relatively more credit for higher acuity patients than do the Alberta or Medicus systems. If used as a basis for funding, chronic care and rehabilitation hospitals would be entitled to more funding (relative to residential/nursing homes) under RUGs than under the other two patient classification mechanisms.
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Janzen, Wonita, und Sharon Warren. „A Residential Care Centre (RCC) for Persons with Alzheimer Disease (AD)“. Journal of Social Work in Long-Term Care 3, Nr. 3-4 (23.03.2006): 37–43. http://dx.doi.org/10.1300/j181v03n03_04.
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Montserrat, Carme, Paulo Delgado, Marta Garcia-Molsosa, João M. S. Carvalho und Joan Llosada-Gistau. „Young Teenagers’ Views Regarding Residential Care in Portugal and Spain: A Qualitative Study“. Social Sciences 10, Nr. 2 (10.02.2021): 66. http://dx.doi.org/10.3390/socsci10020066.
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Research on residential care has been well established in the literature. Nonetheless, research drawing from the actual experiences of adolescents is relatively scarce. A qualitative study was designed highlighting the voices of children, analysing their fostering experience, interpersonal relationships, their participation in daily decisions, and future aspirations. The sample included 33 early adolescents in residential care aged 12–14 in Portugal (n = 17) and Spain (n = 16). Results showed that there was agreement in terms of the importance given to education, their satisfaction with the material conditions of residential centre, and their dissatisfaction concerning matters of individuality, autonomy, participation, and socialization.
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Rohani, Ropizah, Zakiyah Jamaluddin und Abd Razak Abd Manaf. „Psychosocial Adjustment Among Abused Children in Residential Care“. Journal of Business and Social Review in Emerging Economies 5, Nr. 1 (30.06.2019): 175–80. http://dx.doi.org/10.26710/jbsee.v5i1.521.
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Purpose – The purpose of this paper is to propose a conceptual framework on the key determinant of psychosocial adjustments in terms of behavior, social, emotion and mental health among abused children in residential care.
Methodology – This research is designed as a qualitative study approach. Case study method is used to explore primer data which emphasis on psychosocial adjustments and narrative data from the perspective of children living in residential care. Research participants consist of children living in welfare care in Perlis, Malaysia and the respective staffs.
Findings – Chronic abuse will leave harmful effects on various aspects of the children’s development. Abuse will also affect one’s emotional wellness and balance which will further impact the psychosocial stability of an individual in adulthood. Most victims will not be able to develop a sense of belonging and necessary social skills which eventually will lead to these individuals not being able to socialize in the real life situations. Therefore the placements of these children in a safe environment so as to ensure better care and protection must be given proper attention. The transition of caregivers from parents to the welfare centre will affect these chindren too. They need time to build trust and relationship so that they can feel comfortable to share their experiences and also emotions. Caregivers in the institutions are the main elements in ensuring the quality and effectiveness of educational programmes of the centres.
Practical Implications – Rehabilitation programme is needed to balance the children’s needs based on age and ability to give the residents chances to practice skills and also learn to adapt to the outside world.
Social Implications – The institutions should provide condusive life experiences as they have a large impact to the success of the rehabilitation process. In addition, good quality services in fulfilling the children’s need will assure healthy development of the children and their ability to adapt well to the outside world
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Weller, Ben G. A., und Malcolm P. I. Weller. „Health Care in a Destitute Population: Christmas 1985“. Bulletin of the Royal College of Psychiatrists 10, Nr. 9 (September 1986): 233–35. http://dx.doi.org/10.1192/s0140078900028315.
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The closure of the Camberwell Resettlement Centre, the largest in Europe, in September 1985, followed the closure of an estimated 2,000 common lodging houses and low cost accommodation in London between 1982 and 1984. Over a two year period only 14 out of the 25,000 who passed through the Centre had been rehoused. To aggravate the problem there had been a fall in local authority residential places in the six years up to 1982, accompanied by a decrease in the provision of home helps and meals on wheels, despite an increasing proportion of elderly in the community. of those who had utilised Camberwell Reception Centre 79% had slept rough and 19% had tuberculosis (personal communication of the staff).
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Cardoso, G., C. Coelho und J. Caldas de Almeida. „The DEMoBinc Study in Portugal: Development and First Results“. European Psychiatry 24, S1 (Januar 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70404-3.
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The DEMoBinc study's main objective is to develop an instrument for assessing the living conditions, the quality of care, and the human rights of long-term mentally ill patients in psychiatric and social residential care. It started on March 2007, with 11 centres and 10 countries participating.The Portuguese centre has carried out a national literature review of mental health legislation, standards of care related with residential care for mental patients, and mandatory procedures for physical restraint and seclusion.A three-round Delphi exercise with four groups of experts - advocates, mental health professionals, service users, and carers - was also developed. In the first round the participants were asked to state the ten more important components of care helping recovery in institutional care for the long-term mentally ill. The results were sent back to be rated for their importance on a 5-point scale. Finally, the participants were asked to confirm or change their own scores in comparison with the calculated group median. Between twelve and 18 participants by group were contacted, and the overall rate of participation was 73%.A pilot study using the first draft of the DEMoBinc instrument was done, and refinement of the instrument is being carried out in twenty institutions and will be completed during the next months.The results of the Portuguese centre on the national literature review, the Delphi exercise, and the first phase refinement of the DEMoBinc instrument will be presented and discussed.
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Waskiewich, Shelly, Laura M. Funk und Kelli I. Stajduhar. „End of Life in Residential Care from the Perspective of Care Aides“. Canadian Journal on Aging / La Revue canadienne du vieillissement 31, Nr. 4 (23.10.2012): 411–21. http://dx.doi.org/10.1017/s0714980812000360.
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RÉSUMÉNous avons examiné les caractéristiques contextuelles qui façonnent les soins de fin de vie (SFV) dans les établissements de soins pour bénéficiaires, en s’appuyant sur les perspectives de 11 aidants résidents (AR) dans un centre urbain canadien de l’Ouest. ARs décrivent les soins de fin de vie comme “offrant un confort,” y compris le bien-être physique et émotionnel. Les inquiétudes au sujet des défis posés par le temps et la charge de travail ont dominé les comptes et ont généré la culpabilité, la tristesse et de la frustration. ARs ont essayé de “trouver le temps” en le prenant d’eux-mêmes ou les autres résidents, et en s’appuyant sur l’engagement des collègues et sur les familles. Les résultats soulignent l’importance du rôle d’AR (en particulier en offrant un confort émotionnel), mais faire appel à l’attention à l’interprétation de ce qui est impliqué dans ce travail, et à la définition du portée de la pratique et de la formation. Les résultats également réitère l’importance, entre aidants résidents canadiens, des charges de travail adéquates pour faciliter les soins de fin de vie de qualité, et soulève des préoccupations au sujet des contraintes et comment elles forment la pratique de soins de fin de vie et les significations qui infusent une telle pratique.
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Gagnon, Éric, Michèle Clément und Lilianne Bordeleau. „Speaking Out and Being Heard Residents’ Committees in Quebec’s Residential Long-Term Care Centre“. Health Care Analysis 25, Nr. 4 (31.07.2015): 308–22. http://dx.doi.org/10.1007/s10728-015-0301-3.
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Erdei, Ildikó, und Karolina Eszter Kovács. „The Statistical Analysis of the Academic Achievement of Young People Living in the Child Protection System“. Central European Journal of Educational Research 2, Nr. 3 (30.11.2020): 29–38. http://dx.doi.org/10.37441/cejer/2020/2/3/8527.
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In recent years, there has been an increasing emphasis on placing children in foster care. Our main research aims to explore the connections between the future orientation of disadvantaged young people living in residential care homes and foster families. In our pilot-study, we made it measurable by a comparative analysis of their study results. The sample consists of children raised in the child protection specialist and aftercare system of the Greek Catholic Child Protection Centre of Debrecen and Nyírség. The comparative analysis included 57 children and young people living in residential care homes and 57 children and young adults living in foster care. The members of both groups were born between 1993 and 2003, so are 15-25-year-olds. The comparative analysis was made on the basis of the available documents and study statistics between June 2019 and November 2019, to measure and compare the academic achievement of young people living in residential care homes and with foster parents. According to the statistical analysis, it was found that the academic achievement, based on year repetitions, show a more favourable picture of students living with foster parents. Depending on our results, a number of additional research questions arise.
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Hannan, Shirina, Ian J. Norman und Sally J. Redfern. „Care work and quality of care for older people: a review of the research literature“. Reviews in Clinical Gerontology 11, Nr. 2 (Mai 2001): 189–203. http://dx.doi.org/10.1017/s0959259801112104.
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There is considerable research on work satisfaction and stress of care staff on the one hand and on quality of care and well-being of older people on the other. However, very little research in continuing-care settings for older people (nursing homes, residential homes and long-stay wards) links perceptions of workers (work satisfaction and stress) with the process of care (quality of care) and outcomes for residents/patients (well-being). This is a notable omission, given the emphasis of government policy on improving quality of health and social care services for vulnerable elderly people in the UK. The White Papers, The New NHS and Modernising Social Services and the National Priority Guidance for Health and Social Services for 2000–2003, all emphasize the importance of services that are responsive to local needs and which maintain and promote independence. The Centre for Policy on Ageing has been commissioned by the Department of Health to develop national standards for nursing and residential home care services for older people. This work will build upon recommendations of the Burgner Report and Achieving a Better Home Life, which identified areas for benchmarking. The national standards proposed under the forthcoming National Service Framework for Older People will underpin new legislation to regulate care services.
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Martin, Colin, Denise Carroll und Tim Duffy. „Effectiveness of the Birleson Depression Self-Rating Scale (DSRS) in screening for depression in vulnerable young males with severe emotional and behaviour difficulties in a residential setting“. European Journal for Person Centered Healthcare 2, Nr. 3 (15.07.2014): 314. http://dx.doi.org/10.5750/ejpch.v2i3.728.
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Depression in Looked After and Accommodated Children (LAAC) has been observed as being higher than in adolescents in the general population. The Birleson assessment instrument is frequently used to assess depression in young people. The focus of this paper is the evaluation of the effectiveness of the Birleson depression self-rating scale as an effective screening instrument for depression in adolescent males with emotional, behavioural, educational and social difficulties. One hundred and eighty-one participants from a Scottish residential centre (The Centre) for young males with severe emotional and behavioural difficulties participated in the study. The young people at the Centre consisted of 3 distinct groups: day pupils, residential and secure care (looked after and accommodated young people). As part of the admission process they completed the Birleson Depression Self-Rating Scale (DSRS) and also the standard professional approved Scottish LAAC health assessment. The analysis in this study showed that young people in secure care had a significantly higher level of depression than those in day care, as measured by the Birleson DSRS. Within the LAAC population at the Centre, a comparison of the Birleson DSRS detection rates for depression was made with findings from the standard health assessment. Prior to admission, 3% of the young people (n=6) at the centre had a previous clinical diagnosis of depression. The Birleson DSRS failed to identify 4 out of these 6 young people. The standard LAAC health assessment identified that 15% of LAAC (n=26) had current suicidal ideation/behaviours. Of the young people at the Centre who had current suicidal behaviours, the Birleson DSRS did not identify 27% of them. This raises concerns about the sensitivity of the Birleson DSRS to identify depression in this vulnerable population.
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Ramakrishnan, Devraj, Leyanna Susan George, Arun Jacob, Harsha Lais, Midhun Rajeev, K. N. Panicker und Vishal Marwaha. „Outbreak investigation of acid fly attack among residential students in a tertiary care centre in South India“. International Journal Of Community Medicine And Public Health 6, Nr. 12 (27.11.2019): 5355. http://dx.doi.org/10.18203/2394-6040.ijcmph20195498.
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Paederus dermatitis is the skin irritation resulting from contact with the haemolymph of certain rove beetles, a group that is comprised by the genus Paederus. In May 2018, there was an increase in the number of residential students reporting with burning skin lesions. In this context, an outbreak investigation was conducted. A team of public health specialists visited these residential buildings and premises. The inmates who were affected were interviewed and examined. Suspected insects were collected and entomologically evaluated by the Zoological Survey of India. On examination of the affected individuals, it was observed that the rashes were very much suggestive of acid fly toxin induced lesions. Inspection of the premises, revealed small heaps of dried leaves with moisture at two sites which could have served as a suitable environment for acid fly multiplication. Our study concluded that Paederus fuscipes as the causative agent. Top storeys of buildings, illuminated at night, facing potentially wet areas were considered to be the potential risk factor. Fly proofing of the building, cleaning the institution premises and chemical treatment was suggested as appropriate control measures.
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Warren, Sharon, Wonita Janzen, Corinna Andiel-Hett, Lili Liu, H. Robert McKim und Corinne Schalm. „Innovative Dementia Care: Functional Status over Time of Persons with Alzheimer Disease in a Residential Care Centre Compared to Special Care Units“. Dementia and Geriatric Cognitive Disorders 12, Nr. 5 (2001): 340–47. http://dx.doi.org/10.1159/000051279.
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Dozeman, Els, Digna J. F. van Schaik, Harm W. J. van Marwijk, Max L. Stek, Aartjan T. F. Beekman und Henriëtte E. van der Horst. „Feasibility and effectiveness of activity-scheduling as a guided self-help intervention for the prevention of depression and anxiety in residents in homes for the elderly: a pragmatic randomized controlled trial“. International Psychogeriatrics 23, Nr. 6 (22.02.2011): 969–78. http://dx.doi.org/10.1017/s1041610211000202.
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ABSTRACTBackground: Elderly people living in residential homes are at high risk for developing major depressive and anxiety disorders, and therefore deserve attention in terms of preventive interventions. We evaluated the feasibility and effectiveness of a guided self-help intervention for the prevention of depression and anxiety in these residents.Methods: We conducted a pragmatic randomized controlled trial in two parallel groups comparing the intervention with usual care in 14 residential homes in and surrounding the city of Amsterdam in the Netherlands. A total of 129 residents with a score of 8 or more on the Centre for Epidemiologic Studies Depression Scale (CES-D) screening instrument, who did not meet the full diagnostic criteria for disorders, and were not suffering from cognitive impairment were recruited between April 2007 and December 2008. Participants were randomized to a guided self-help intervention (n = 67) or to usual care (n = 62). The main outcome measures were improvement in the level of symptoms of depression and anxiety. The secondary outcome was improvement in participation in organized activities in the residential homes. The study is registered in de Dutch Cochrane Centre, under number ISRCTN27540731.Results: Only 21% of the participants (mean age 84.0 years (SD 6.7), 72.1% suffering from two or more chronic illnesses) completed the intervention. Although we found some large positive effect sizes on the CES-D, none of these effects was statistically significant.Conclusion: Although guided self-help may be promising in the prevention of depression and anxiety, it proved to be difficult to apply in this very old and vulnerable group of people living in residential homes.
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Giacomin, M. „Does community care works? Evaluate the effectiveness of mental health services“. European Psychiatry 33, S1 (März 2016): S631. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2372.
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IntroductionImproving quality require the capability to evaluate clinical and operational processes and improve patients outcomes. Just in the view of evidence-based practise (EBP) it's used HONOS rating Scale, adopted since May 2012, by Mental Health Center of Villorba (Treviso-Italy) There are 3 package treatments: rehabilitative, territorial and clinical.ObjectivesTo identify which variables are positively correlated to HONOS improvement in patients group who frequented Mental Health Centre along 36 months. All patients present severe mental illness.AimsEvaluate the effectiveness of interventions and correlate to treatment package and individual feature. Analyze treatment process for quality improvement.MethodA psychiatric team (4 nurses, 1 psychiatrist) administered Honos Rating Scale along 3 years: on starting point and 6, 12 and 36 months later: T 0,1,2,3,4. Patients are also described by diagnosis, mental, social and autonomy skill, time, utilization of MHC and anagraphic information.ResultsAll 15 groups’ patients realize lower scoring, after 36 months’ treatment. Seven have got reliable improvement (i.e. = > 8-point lowering T3–T4) and positively correlate with: (1) 36 months’ treatment, at 12 months in rehabilitative Package; (2) days in residential/semi-residential community from 82 to 311 days. Related tables are included in paper.Discussion and conclusionHONOS score correlates directly with clinical and riabilitation improvement, i.e. mental, social capacity, and personal autonomy. It needs more investigation to clear which other factors are involved with improvement.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Oddy, Belinda, Heather Rowe und Jane Fisher. „Consumers' views on the use of diagnostic labels to describe psychological distress in the postpartum: implications for health care“. Australian Journal of Primary Health 15, Nr. 1 (2009): 9. http://dx.doi.org/10.1071/py08061.
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Postpartum psychological distress is common and its detection is important in primary health care. Australia’s residential early parenting centres admit mothers with their infants and treat both infant sleep and settling and maternal mental health. Many women have health problems but low uptake of professional assistance after discharge. Psychological distress may be conceptualised as either individual psychopathology or a normal reaction to caring for an unsettled infant, loss of identity and status, and limited emotional and practical assistance, but the potential benefits or harms of psychiatric labelling are uncertain. We examined the opinions of consumers of a residential early parenting centre. The method used was that, 12 months after discharge, a self-report survey was mailed. Results showed 50/94 (54%) women returned completed surveys. Participants identified perceived causes of postpartum psychological distress as: difficult infant temperament and behaviour (57%); fatigue (53%); and insufficient support (47%). Sixty-one per cent thought that diagnostic labels could improve access to health care, but 58% believed that it might cause others to question a woman’s mothering ability or limit access to employment (83%). Psychiatric labels may improve access to health care in the postpartum, but effective treatments will address causes of distress as understood by women.
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Morad, M., J. Merrick und Y. Nasri. „Prevalence of Helicobacter pylori in people with intellectual disability in a residential care centre in Israel“. Journal of Intellectual Disability Research 46, Nr. 2 (Februar 2002): 141–43. http://dx.doi.org/10.1046/j.1365-2788.2002.00382.x.
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Lisk, Radcliffe, Keefai Yeong, David Fluck, Christopher H. Fry und Thang S. Han. „The Ability of the Nottingham Hip Fracture Score to Predict Mobility, Length of Stay and Mortality in Hospital, and Discharge Destination in Patients Admitted with a Hip Fracture“. Calcified Tissue International 107, Nr. 4 (11.07.2020): 319–26. http://dx.doi.org/10.1007/s00223-020-00722-2.
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Abstract The Nottingham Hip Fracture Score (NHFS) has been developed for predicting 30-day and 1-year mortality after hip fracture. We hypothesise that NHFS may also predict other adverse events. Data from 666 patients (190 men, 476 women), aged 60.2–103.4 years, admitted with a hip fracture to a single centre from 1/10/2015 and 7/12/2017 were analysed. The ability of NHFS to predict mobility within 1 day after surgery, length of stay (LOS) find mortality, and discharge destination was evaluated by receiver operating characteristic curves and two-graph plots. The area under the curve (95% confidence interval [CI]) for predicting mortality was 67.4% (58.4–76.4%), prolonged LOS was 59.0% (54.0–64.0%), discharge to residential/nursing care was 62.3% (54.0–71.5%), and any two of failure to mobilise, prolonged LOS or discharge to residential/nursing care was 64.8% (59.0–70.6%). NHFS thresholds at 4 and 7 corresponding to the lower and upper limits of intermediate range where sensitivity and specificity equal 90% were identified for mortality and prolonged LOS, and 4 and 6 for discharge to residential/nursing care, which were used to create three risk categories. Compared with the low risk group (NHFS = 0–4), the high risk group (NHFS = 7–10 or 6–10) had increased risk of in-patient mortality: rates = 2.0% versus 7.1%, OR (95% CI) = 3.8 (1.5–9.9), failure to mobilise within 1 day of surgery: rates = 18.9% versus 28.3%, OR = 1.7 (1.0–2.8), prolonged LOS (> 17 days): rates = 20.3% versus 33.9%, OR = 2.2 (1.3–3.3), discharge to residential/nursing care: rates = 4.5% vs 12.3%, OR = 3.0 (1.4–6.4), and any two of failure to mobilise, prolonged LOS or discharge to residential/nursing care: rates = 10.5% versus 28.6%, 3.4 (95% CI 1.9–6.0), and stayed 4.1 days (1.5–6.7 days) longer in hospital. High NHFS associates with increased risk of mortality, prolonged LOS and discharge to residential/nursing care, lending further support for its use to identify adverse events.
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Tierney, Len, und Meryl McDowell. „Child Welfare: Reception Centres, Regionalization, and Deinstitutionalization“. Children Australia 15, Nr. 1 (1990): 3–9. http://dx.doi.org/10.1017/s1035077200002522.
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Between 1972 - 1980, eighteen regional offices were opened by state welfare authorities in Victoria, with the long term prospect that a comprehensive set of programmes would be developed in each region. This is part of an extensive policy change in which the reception of children into care will proceed by more diverse and local arrangements. Safe custody options already include small residential units and foster care and the very term “reception centre” is no longer part of official language. Substantial progress has been made along these lines and of the two central reception centres, Allambie (25-150 residents) is in the process of being closed and Baltara (45-70 residents) is to be redeveloped. In the most recently published planning documents redevelopment of these facilities had been anticipated by December 1990.1 However, not a great deal is known about the population of these two centres, about reception processes and why some children proceed quickly through the process and others do not. This paper examines the present status of reception centres in Victoria and reports upon a preliminary study of the reception centre population for the period 1986-1987. An argument is made that there is a case for revising reception policy and practice not only in existing centres but, in proposed new facilities and for giving more attention to services, for children and families who present with unusual difficulties.
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Awal, Guneet, Surinder Pal Singh, Saurabh Sharma und Jasleen Kaur. „Spectrum and pattern of pediatric dermatoses in under five population in a tertiary care centre“. International Journal of Research in Dermatology 2, Nr. 4 (18.11.2016): 69. http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20163508.
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<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Pediatric dermatoses vary vastly from adult dermatoses in terms of clinical presentation, treatment and prognosis, thereby generating special interest in this field. The present study was carried to find out the spectrum, pattern and incidence of various skin disorders in infants and preschool children (upto 5 years), to correlate their prevalence with age, sex and rural/urban residential status.</span></p><p class="abstract"><strong>Methods:</strong> 1000 children under five years age , were evaluated for the presence of skin disease to study the pattern and incidence of these disorders and establish their relationship with age, sex and residential status (rural/urban).Skin disorders were described in detail and classified into groups like bacterial, fungal, parasitic, viral, eczematous, allergic, papulosquamous, pigmentary, miscellaneous.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Maximum number of children belonged to age group of less than 1 year (31.6%). Male patients (56.6%) out-numbered female patients (43.4%). 56.8% children belonged to urban area while 43.2% children were from rural area. Maximum incidence was of infections (41.1%). Of these infections, bacterial infections (14.5%) were the predominant followed by parasitic infections (10.9%). Eczematous skin disorders were the next common entity after infections seen in 35.1 % children followed by that of allergic disorders seen in 5.9% children. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">There is preponderance of infectious dermatoses among the under five population followed by eczematous and hypersensitivity disorders. The role of poverty, overcrowding, poor personal hygiene and low level of health education, undernutrition and consequent poor immunity are emphasized by these preventable diseases.</span></p>
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Forsyth, Monica Ginn. „Psychogeriatric Care in a Forensic Setting“. Journal of Mental Health and Addiction Nursing 1, Nr. 2 (18.10.2017): e1-e5. http://dx.doi.org/10.22374/jmhan.v1i2.23.
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Background and Objective: With an aging population, it has become increasingly important that nurses are equipped to provide appropriate psychogeriatric care. Patients with dementia are more likely of committing legal violations related to their behavioural and psychosocial symptoms. Thus, it is imperative that we explore how nursing staff can effectively manage psychogeriatric care in a forensic setting, in order to minimize stress and burnout of staff.
Material and Methods: Three populations were explored with the context of dementia and the justice system: patients with dementia who enter the forensic system, aging inmates in corrections, and criminal offenders in long-term residential care. The literature suggests that there is a dilemma as to where this population is best managed as there are no appropriate designated psychiatric facilities for the elderly offenders. Four options for geriatric service enhancement will be explored: Provide Gentle Persuasive Approach (GPA) training to forensic staff; modification of existing policies and procedures to support appropriate geriatric care; implement the use of Psychiatric Care Aides in skill mix; and create a secure forensic unit for geriatric populations.
Results: The recommendation for action is to implement education specific to psychogeriatric care, while also adjusting policies and procedures for a forensic centre to support therapeutic care.
Conclusions: The author argues that further research is needed that will determine the design of a new Psychogeriatric Forensic Centre.
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Hindhede, Anette L., Ane Bonde, Jasper Schipperijn, Stine H. Scheuer, Susanne M. Sørensen und Jens Aagaard-Hansen. „How do socio-economic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?“ Primary Health Care Research & Development 17, Nr. 06 (12.08.2016): 578–85. http://dx.doi.org/10.1017/s1463423616000268.
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AimThe aim was to explore the extent to which a Danish prevention centre catered to marginalised groups within the catchment area. We determined whether the district’s socio-economic vulnerability status and distance from the citizens’ residential sector to the centre influenced referrals of citizens to the centre, their attendance at initial appointment, and completion of planned activities at the centre.BackgroundDisparities in access to health care services is one among many aspects of inequality in health. There are multiple determinants within populations (socio-economic status, ethnicity, and education) as well as the health care systems (resource availability and cultural acceptability).MethodsA total of 347 participants referred to the centre during a 10-month period were included. For each of 44 districts within the catchment area, the degree of socio-economic vulnerability was estimated based on the citizens’ educational level, ethnicity, income, and unemployment rate. A socio-economic vulnerability score (SE-score) was calculated. Logistic regression was used to calculate the probability that a person was referred to the centre, attended the initial appointment, and completed the planned activities, depending on sex, age, SE-score of district of residence, and distance to the centre.FindingsCitizens from locations with a high socio-economic vulnerability had increased probability of being referred by general practitioners, hospitals, and job centres. Citizens living further away from the prevention centre had a reduced probability of being referred by their general practitioners. After referral, there was no difference in probability of attendance or completion as a function of SE-score or distance between the citizens’ district and the centre. In conclusion, the centre is capable of attracting referrals from districts where the need is likely to be relatively high in terms of socio-economic vulnerability, whereas distance reduced the probability of referral. No differences were found in attendance or completion.
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Dozeman, Els, Harm W. J. van Marwijk, Digna J. F. van Schaik, Filip Smit, Max L. Stek, Henriëtte E. van der Horst, Ernst T. Bohlmeijer und Aartjan T. F. Beekman. „Contradictory effects for prevention of depression and anxiety in residents in homes for the elderly: a pragmatic randomized controlled trial“. International Psychogeriatrics 24, Nr. 8 (22.03.2012): 1242–51. http://dx.doi.org/10.1017/s1041610212000178.
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ABSTRACTBackground: The aim of this study was to evaluate the effectiveness of a stepped-care program to prevent the onset of depression and anxiety disorders in elderly people living in residential homes.Methods: A pragmatic randomized controlled trial was conducted to compare the intervention with usual care in 14 residential homes in the Netherlands. A total of 185 residents with a minimum score of 8 on the Centre for Epidemiologic Studies Depression Scale, who did not meet the diagnostic criteria for a depressive or anxiety disorder, and were not suffering from severe cognitive impairment, were recruited between April 2007 and December 2008. They were randomized to a stepped-care program (N = 93) or to usual care (N = 92). The stepped-care participants sequentially underwent watchful waiting, a self-help intervention, life review, and a consultation with the general practitioner. The primary outcome measure was the incidence of a major depressive disorder (MDD) or anxiety disorder during a period of one year according to the Mini International Neuropsychiatric Interview.Results: The intervention was not effective in reducing the incidence of the combined outcome of depression and anxiety (incidence rate ratio (IRR) = 0.50; 95% confidence interval (CI) = 0.23–1.12). However, the intervention was superior to usual care in reducing the risk of MDD incidence (IRR = 0.26; 95% CI = 0.12–0.80) contrary to anxiety incidence (IRR = 1.32; 95% CI = 0.48–3.62).Conclusions: These results suggest that the stepped-care program is effective in reducing the incidence of depression, but is not effective in preventing the onset of anxiety disorders in elderly people living in residential homes.
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Lopes, Manuel José, Lara Guedes de Pinho, César Fonseca, Margarida Goes, Henrique Oliveira, José Garcia-Alonso und Anabela Afonso. „Functioning and Cognition of Portuguese Older Adults Attending in Residential Homes and Day Centers: A Comparative Study“. International Journal of Environmental Research and Public Health 18, Nr. 13 (30.06.2021): 7030. http://dx.doi.org/10.3390/ijerph18137030.
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The functioning and cognition of older adults can be influenced by different care contexts. We aimed to compare the functioning profiles and cognition of institutionalized and noninstitutionalized older adults and to evaluate the effect of sociodemographic factors on the functioning and cognition. This is a cross-sectional study that included 593 older adults. The data were collected using the Elderly Nursing Core Set and Mini Mental State Examination. Women, older adults who did not attend school and those live in Residential Homes are more likely to have a higher degree of cognitive impairment than men, those who attended school and those frequent Day Centre. The chances of an older adult with moderate or severe cognitive impairment increases with age. Older women, older adults who did not attend school, and older adults who live in Residential Homes had a higher degree of functional problem than men, those who attended school and those who frequent a Day Centre, independently to age. It is necessary to promote the health literacy of older adults throughout life. The implementation of social and health responses should allow older adults to remain in their homes, given the influence of functioning and cognition on self-care and quality of life.
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Rodrigues, Lycia M., André P. Smith, Debra J. Sheets und Johanne Hémond. „The Meaning of a Visual Arts Program for Older Adults in Complex Residential Care“. Canadian Journal on Aging / La Revue canadienne du vieillissement 38, Nr. 02 (17.12.2018): 143–54. http://dx.doi.org/10.1017/s0714980818000508.
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RÉSUMÉCette étude qualitative explore les expériences vécues par des personnes âgées participant dans un programme d’arts visuels créatifs dans un établissement de soins de Victoria (Colombie-Britannique). Une approche par enquête narrative a été utilisée dans le cadre d’entretiens en personne menés avec dix résidents et trois membres du personnel du programme. Les activités du programme et l’exposition artistique qui y était associée ont aussi fait l’objet d’une observation systématique. Les résultats démontrent que le programme a stimulé le sentiment de communauté des participants et augmenté leur estime d’eux-mêmes, en tant qu’artistes. Une exposition artistique publique dans un centre communautaire a permis de souligner la valeur de leur production artistique et a conféré un sens et un but à leur implication dans le programme. Les résultats démontrent l’importance des programmes artistiques stimulant la créativité chez la population âgée. Ils illustrent aussi que les personnes vivant en institution peuvent prendre conscience des multiples dimensions de leur personnalité à travers l’expression artistique. Cette étude souligne la pertinence d’accroître l’accès à des programmes artistiques pour les individus vivant en établissements de soins.
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Morant, N., B. Lloyd-Evans, H. Gilburt, M. Slade, D. Osborn und S. Johnson. „Implementing successful residential alternatives to acute in-patient psychiatric services: lessons from a multi-centre study of alternatives in England“. Epidemiology and Psychiatric Sciences 21, Nr. 2 (15.12.2011): 175–85. http://dx.doi.org/10.1017/s204579601100076x.
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Background.Standard acute psychiatric care in the UK is costly but problematic. Alternatives to standard in-patient wards exist, but little is known about their effectiveness, implementation and sustainability. This paper explores successful features and limitations of five residential alternative services in England and factors that facilitate or impede their initial and sustained implementation and success.Methods.Semi-structured interviews about the functioning of six alternative services were conducted with 36 mental health professionals with good working knowledge of, and various connections with these services. A group interview with study researchers was also conducted. Data were analysed using thematic analysis.Results.One service did not show evidence of operating as an alternative and was excluded from further analysis. The remaining five alternatives are valued for providing a more holistic style of care than standard services that confers many perceived benefits. However, they are seen as less appropriate for compulsorily detained or highly disturbed patients, and as providing less comprehensive treatment packages than hospital settings. Factors identified as important to successful implementation and sustainability are: responding to known shortcomings in local acute care systems; balancing role clarity and adaptability; integration with other services; and awareness of the alternative among relevant local health-care providers.Conclusions.Residential alternatives can play an important role in managing mental health crises. Their successful implementation and endurance depend on establishing and maintaining a valued position within local service systems. Findings contribute to bridging the gap between research evidence on the problems of standard acute care and delivering improved crisis management services.
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Lindsay, Meg. „Moving mountains armed only with a teaspoon: the work of a ‘centre of excellence’ for residential child care“. Social Work Education 17, Nr. 3 (September 1998): 339–49. http://dx.doi.org/10.1080/02615479811220331.
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Guilfoyle, Clare, Richard Wootton, Stacey Hassall, Jann Offer, Margo Warren, Debbie Smith und Michelle Eddie. „User satisfaction with allied health services delivered to residential facilities via videoconferencing“. Journal of Telemedicine and Telecare 9, Nr. 1_suppl (Juni 2003): 52–54. http://dx.doi.org/10.1258/135763303322196349.
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summary We have investigated the role of videoconferencing in allied health service provision to high-care clients in rural residential facilities. Videoconferencing equipment was set up at a rural aged-care facility and a metropolitan allied health centre; ISDN transmission at 384 kbit/s was used to link the equipment. Twelve residents were assessed by both videoconference and face to face across five allied health disciplines (a total of 120 assessments). User satisfaction was measured using questionnaires and focus groups. Face-to-face assessment took significantly longer than videoconferencing assessment. However, the mean satisfaction ratings for face-to-face assessments were higher than for videoconferencing and the majority of the staff preferred the face-to-face format. Videoconferencing was particularly useful for consultations and the initial stages of the assessment process. A number of issues relating to the videoconferencing equipment, to the environment in which assessments were performed and to the clients themselves need to be addressed in order for this form of service delivery to be effective.
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Christe, D. M., D. Tamilselvi, S. Surya, S. Shobha und C. Ponnuraja. „Vaginal deliveries in a tertiary centre: a current profile“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, Nr. 1 (26.12.2019): 134. http://dx.doi.org/10.18203/2320-1770.ijrcog20196009.
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Background: A normal delivery is what every woman wishes to have. The objective of this study was to find out the maternal and neonatal outcome and background characteristics of women delivering vaginally in a tertiary care center in Chennai, South India.Methods: For this one-year study, with power above 80%, Parturition records were selected by computerized random numbers, for a calculated sample size. Salient demographic features such as age, residential background and religion were noted. Details of obstetric history, past and current, delivery and baby details and admission to NICU were analyzed. Acceptance of postpartum contraception was noted.Results: A total of 338 women delivered vaginally. Majority of 63%, were from urban background. Late referrals were 19.2% of women,38.5% women had antenatal complications. Primigravida were 49.7%. Nearly 91.4% of women delivered naturally. Previous pregnancy loss was noted in 14.8%. Term deliveries were in 72% of women, and 2.7% of women delivered twins. Average birth weight among primi was 2.5kg and in multi it was 2.8 kg. There were no maternal deaths. Perinatal deaths of 2.96%, of which 90% were preterm births, and all among babies with birth weight below 1.5 kg.Conclusions: The larger majority of 91.4% of women had natural vaginal delivery. Primigravida were 49.7%, and 63% were from urban background. Antenatal complications, obstetric, medical or other complications were noted in 38.5 % of women. Most often observed complications were Gestational hypertension, Gestational diabetes, and Hypothyroidism. NICU care was required for 18% of babies. Preterm births were16.6%. Perinatal deaths were seen in 2.96% of babies. There were no maternal deaths.
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Wales, Lorna, Carolyn Dunford und Kathy Davis. „Following severe childhood stroke, specialised residential rehabilitation improves self-care independence but there are ongoing needs at discharge“. British Journal of Occupational Therapy 83, Nr. 8 (27.01.2020): 530–37. http://dx.doi.org/10.1177/0308022619894870.
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Introduction Stroke is a major cause of mortality and disability in childhood. There is a false belief that children will recover better than adults and recent research confirms that younger age at injury can have a negative impact on rehabilitation outcomes, resulting in lifelong disability. Self-care is a key rehabilitation outcome for children and young people. Methods This service evaluation reviews routinely collected clinical self-care data from one specialised residential rehabilitation centre in the United Kingdom. Admission and discharge scores from the United Kingdom Functional Independence Measure +Functional Assessment Measure, Rehabilitation Complexity Scale – E and Northwick Park Nursing Dependency Scale were analysed. Results Twenty-six children and young people age 8 years and over with severe stroke were included. Mean scores of independence increased and mean scores of complexity and dependency decreased. A proportion of the sample had ongoing self-care needs in relation to support needed in washing, dressing and bathing. A small number remained highly dependent, requiring assistance from two carers. Conclusion Children and young people make significant gains in self-care independence during specialised rehabilitation. However, a proportion return to the community with high self-care needs. Occupational therapists and the wider care team should address ongoing self-care needs in this population.
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Omland, Guro B., und Agnes Andenas. „Peer relationships at residential care institutions for unaccompanied refugee minors: An under-utilised resource?“ Qualitative Social Work 19, Nr. 5-6 (02.07.2019): 917–33. http://dx.doi.org/10.1177/1473325019860183.
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Without access to their own families, how do young, unaccompanied refugee minors re-establish their social lives in ways that facilitate a sense of togetherness in their everyday lives during resettlement? This question was approached by exploring the young persons’ creation of relational practices and the kinds of sociomaterial conditions that seemed to facilitate the evolvement of these practices, including the professional caregivers’ contributions. Interviews with 11 boys and 4 girls (aged 13–16) from Afghanistan, Somalia, Angola and Sri Lanka, as well as their professional caregivers in their country of residence, Norway, were analysed systematically by searching for, and categorizing, the variation of relational practices among the young persons. Three overarching practices are presented. First, the young persons worked to connect past, present and future contexts through collective meaning-making practices. Second, they regulated their peers’ emotions through emotional care practices. Third, they widened each other’s social networks through practices of social inclusion. Following the resettlement procedure the young persons moved from one kind of institution (care centre) to other parts of the country and to another kind of institution (group home) where the relational practices mentioned above appeared to be less prevalent. The article suggests that arranging everyday life as collective enterprises, as well as housing peers with similar cultural backgrounds, were central for the evolvement of the relational practices. As such, the article both elucidates a range of health-promoting relational practices that the young persons’ realised as a group as well as how these practices are embedded in sociomaterial conditions.
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Jack, CIA, und JN McGalliard. „Rehabilitation in elderly people with visual impairment“. Reviews in Clinical Gerontology 9, Nr. 1 (Februar 1999): 77–80. http://dx.doi.org/10.1017/s0959259899009181.
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In England there are over 100 000 elderly people registered blind and a further 80 000 registered partially sighted. Visual impairment is common in the elderly population, with approximately 10% of people of 65 years of age and over having poor vision. The prevalence of visual problems appears to be much greater among older people in institutionalized care. A study of 100 elderly people living in residential homes in London revealed that 51% had cataract and 34% had significant refractive errors. A further study of patients attending a geriatric day centre found that about one-third had unrecognized visual loss.
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Bhattarai, Madhur Dev. „Facilitation of free residential training inside the country – The fundamental health service responsibility of the Government and its regulatory body“. Journal of Nepal Medical Association 53, Nr. 197 (31.03.2015): 40–69. http://dx.doi.org/10.31729/jnma.2704.
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For optimum Peripheral Health Service and implementation of various Vertical Public Health Programme Services, network of public Rural and Urban Health Centers with trained Specialists in General Practice (GP) is essential. Later such Specialist GPs will thus fulfill both comprehensive training and experience required for Health Management and Planning Service in the centre. About 40%-50% of all Residential Trainings and Specialists are required in GP. There are further up to 100 to 150 possible specialties in which remaining doctors can be trained for Specialty Health Services. Though free Residential Training has numerous advantages, its shortage inside country is the bottleneck to provide above mentioned Health Services. Planning for health service delivery by at least trainee residents under supervision or appropriately trained specialists guides Residential Training’s regulations. Fulfillment of objective training criteria as its core focus is the concept now with the major role of Faculty as supervising residents to provide required service in the specialty and simultaneously updating themselves and their team for Evidence-Based Medicine practice. Similarly the need of Ambulatory Health Service and joint management of in-patients by specialists in hospitals has changed unit and bed divisions and requirements for Residential Training. Residents, already the licensed doctors, are thus providing required hospital service as indispensable part of its functional hierarchy for which they need to be paid. With such changing concepts and trends, there are some essential points in existing situation to facilitate free Residential Training inside country. For Government doctors, relevant amendment in their regulation is accordingly required.
Keywords: ambulatory care; general practice; health service; hospitalist; medical council; medical
education; public health; regulatory body; research; residential training.
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Varlakova, Valentina. „THE MARKET OF RESIDENTIAL PROPERTY OF THE NOVOSIBIRSK CITY“. Interexpo GEO-Siberia 7 (2019): 134–40. http://dx.doi.org/10.33764/2618-981x-2019-7-134-140.
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The property market in Novosibirsk is quite diverse. The city, as one of the largest cities of the country and the capital of Siberia, rapidly develops residential building market, the annual volume of which reaches up to 1 mln sq.metres. Basically it concerns high-rise apartment houses, most of which are located in outer-lying residential districts. There is hardly any free space for building in the central districts, although the high-density building development process is still going on. And property buyers face the problem of choice: where to buy and how much to spend for a new flat – whether it will be a new one in the suburb or an old one in the centre. It is important to note that in choosing the residence the buyer considers the material of his future house. The most part of residences is acquired by the co-investment agreement as such a deal is 20–30 % cheaper than the total cost of property. However, there are some risks to take care of. During the last years mortgage lending became really popular, as it helps most families acquire their own flats. In 2017 the mortgage rate lowering caused a growth in demand for property, which, in its turn, produced a growth in supply on the market, increased the number of constructional projects and stabilized flat prices.
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Nanayakkara, Wathsala Sripali, Paula Skidmore, Leigh O'Brien, Tim Wilkinson, Chris Frampton und Richard Gearry. „From menu to mouth: the decay pathway of nutrient intake from planned menu to consumed and characteristics of residents in an aged care facility with greater nutrient decay rates: a cross-sectional study“. BMJ Open 9, Nr. 10 (Oktober 2019): e024044. http://dx.doi.org/10.1136/bmjopen-2018-024044.
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ObjectivesTo observe the cascade of nutrient loss from meals planned to those provided and subsequently consumed by older people in residential care. A secondary aim was to determine the characteristics of residents with higher nutrient loss resulting in lower intake of key nutrients.DesignA single-centre cross-sectional study.SettingAn aged residential care facility in Christchurch, New Zealand.ParticipantsAll low and high level of care residents except those who are end of life, enterally fed or on short-term stay were invited to participate in the study. 54 of 60 selected residents who consumed all three main meals (breakfast, lunch and dinner) for three non-consecutive days were included in the analyses.Main outcome measuresNutrient contents of planned menu; nutrient contents of meals served and consumed using modified 3-day diet records; and percentage of planned nutrients served and consumed.ResultsVitamins C, B12 and folate had the greatest total decay rates of 50% or more from that planned to be consumed to what was actually consumed, while unsaturated fats, beta carotene, iodine and zinc had the lowest decay rates of 25% or less. Male participants and lower care level residents consumed significantly more nutrients, compared with female participants and those receiving higher level care. Increased age, female gender, higher level of care, smaller meal size, pureed diet and lower body mass index were associated with larger decay rates and lower nutrient intakes.ConclusionsNot all planned and served food and beverages are consumed, contributing to potential multiple nutrient deficiencies including energy and protein in the majority of aged-care residents. As a consequence, some nutrients may need to be oversupplied if consumption is to match planned intakes.
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Archibald, Mandy, Michael Lawless, Rachel C. Ambagtsheer und Alison Kitson. „Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description“. BMJ Open 10, Nr. 3 (März 2020): e035339. http://dx.doi.org/10.1136/bmjopen-2019-035339.
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ObjectivesDespite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive–descriptive qualitative study.SettingAged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia.Participants39 non-frail, prefrail, frail and very frail South Australian older adults.MethodsSeven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators.ResultsFrailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail.ConclusionsAside from a disability model, views of frailty as unmodifiable permeated older persons’ diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective.
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Rinehart, Natalie E., Samantha Smorgon und Jessica Holman. „GP clinic and community health centre approach to after hours and the role of Medicare Locals in educating and raising awareness“. Australian Journal of Primary Health 20, Nr. 2 (2014): 197. http://dx.doi.org/10.1071/py12131.
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This article reviews a Quality Improvement Project concerning how GP clinics approach after hours (AH) primary care information for themselves and their patients. Medicare Locals have been given the responsibility of coordinating AH services in their catchments and supporting health systems and patients in accessing care appropriate to their needs. The AH project conducted by Inner North West Melbourne Medicare Local (INWMML) sought to explore how a range of GP clinics approached AH information before an educational forum, evaluation of its developed resources for increasing awareness of AH options and how clinics would choose to change their approach to AH following this process. The findings suggested that 46 participating clinic staff had a strong focus on hospitals and locum services as the main AH options despite telephone advice line options being available. Additionally, there was a lack of awareness for some clinic staff concerning services for mental health, dental health and residential aged care. The educational forum and the AH resources developed (i.e. brochures, posters and service directory) by INWMML were rated as valuable and would be used and shared with other health care providers and patients. Confidence that patients would be able to find appropriate care in the AH period after clinics had finished implementing planned changes, rose significantly in key areas after participating in the AH project.
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Reilly, Claire, Dan R. Johnson und Kirstin Ferguson. „Validation of the Massachusetts Youth Screening Instrument with a looked after population“. Clinical Child Psychology and Psychiatry 24, Nr. 3 (29.09.2018): 593–607. http://dx.doi.org/10.1177/1359104518799119.
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The Massachusetts Youth Screening Instrument–version 2 (MAYSI-2) was developed to help identify mental health needs of young people admitted to youth detention centres. Only one study has applied the tool to a UK population and none have looked at young people who live in residential and secure care in Scotland. This study aimed to assess the validity of the MAYSI-2 in Scotland with a looked after and accommodated population. Boys and girls in a large education and care centre were asked to complete the MAYSI-2 within 72 hours of being accommodated. A total of 168 males and 69 females with a mean age of 15 completed the tool. Substantial levels of mental health need were identified. Girls appeared to have higher needs on all areas, bar alcohol and substance misuse. The MAYSI-2 had good internal consistency and exploratory factor analysis showed good overlap with the tool’s original factor model. As a result, there can be more confidence in the validity and consistency of the tool with this population. This is also further evidence of the high need of this population, particularly girls.
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Baker, Kenneth, Aidan Hanrath, Ina Schim van der Loeff, Su Tee, Richard Capstick, Gabriella Marchitelli, Ang Li et al. „COVID-19 Management in a UK NHS Foundation Trust with a High Consequence Infectious Diseases Centre: A Retrospective Analysis“. Medical Sciences 9, Nr. 1 (04.02.2021): 6. http://dx.doi.org/10.3390/medsci9010006.
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Recent large national and international cohorts describe the baseline characteristics and outcome of hospitalised patients with COVID-19, however there is limited granularity to these reports. We aimed to provide a detailed description of a UK COVID-19 cohort, focusing on management and outcome. We performed a retrospective single-centre analysis of clinical management and 28-day outcomes of consecutive adult inpatients with SARS-CoV-2 PCR-confirmed COVID-19 from 31 January to 16 April 2020 inclusive. In total, 316 cases were identified. Most patients were elderly (median age 75) with multiple comorbidities. One quarter were admitted from residential or nursing care. Mortality was 84 out of 316 (26.6%). Most deaths occurred in patients in whom a ceiling of inpatient treatment had been determined and for whom end of life care and specialist palliative care input was provided where appropriate. No deaths occurred in patients aged under 56 years. Decisions to initiate respiratory support were individualised after consideration of patient wishes, premorbid frailty and comorbidities. In total, 59 (18%) patients were admitted to intensive care, of which 31 (10% overall cohort) required intubation. Multiple logistic regression identified associations between death and age, frailty, and disease severity, with age as the most significant factor (odds ratio 1.07 [95% CI 1.03–1.10] per year increase, p < 0.001). These findings provide important clinical context to outcome data. Mortality was associated with increasing age. Most deaths were anticipated and occurred in patients with advance decisions on ceilings of treatment.
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Day, Anne-Marie. „Hearing the voice of looked after children: challenging current assumptions and knowledge about pathways into offending“. Safer Communities 16, Nr. 3 (10.07.2017): 122–33. http://dx.doi.org/10.1108/sc-01-2017-0003.
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Purpose The purpose of this paper is to assess the early findings of research which aims to hear the voice of looked after children about their pathways into offending and subsequent entry into the youth justice system, and the implications that this may have for policy and practice. Design/methodology/approach One-to-one semi-structured interviews have taken place with 19 looked after children, who are also subject to youth justice supervision. The interviews have been analysed to identify emerging themes, using broadly grounded approaches. Findings Three important findings arise from the interviews with the participants. First, children in care are being labelled and removed from the mainstream due to problematic behaviours, rather than searching for the underlying cause of the behaviour. Second, significant anger and frustration is expressed towards residential care staff and the child’s social worker, due to several reasons relating to the institutional environment within residential care, and a lack of trust for those professionals with whom control over the child’s life rests. Finally, the children describe feeling powerless whilst in care, and within this context, the peer group plays a crucial role within the lives of the children interviewed. Research limitations/implications The findings are based on the subjective views of 19 interviewees. The sample is not representative, and has not been compared with other forms of data. Rather, it provides the reader with the perspectives of some of the most challenging and vulnerable children in the youth justice system, and places their voice at centre stage. Practical implications This paper points to several challenges within current youth justice and social work practice which led to the interviewees feeling disempowered and ambivalent about their future. A number of recommendations for policy and practice are made in the concluding sections of the paper which may assist those in policy and practice. Originality/value The voice of the looked after child who is also subject to youth justice has not been given centre stage within research to date. The findings are based on this voice and offer a different perspective about a looked after child’s pathways into offending. A number of potential implications for policy and practice, which could be considered and implemented to deal with this problem, are then discussed.
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Yong, Phooi Ling, Faizah Mas'ud und How Kee Ling. „Reflexivity: Doing Research with Women in a Mental health Care Facility“. Asian Social Work Journal 4, Nr. 4 (07.10.2019): 19–29. http://dx.doi.org/10.47405/aswj.v4i4.106.
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Reflexivity has been recognised as a crucial strategy in the knowledge generating process and applied in qualitative research to legitimate, validate and question research practices and representation, as well as evaluating the quality of qualitative research. Reflexivity in the social work literature have impacted in research and practice. However, the effect of researcher’s perspectives on the data collection and interpretation process by using reflexivity has not been examined in the mental health research in Malaysia. Thus, this paper aims to explore the role of methodological reflexivity in a qualitative research with Chinese women with mental health problems in a residential care setting in Malaysia. The researcher’s and participants’ interaction and experiences, as well as emotional context during interviews that affect the data interpretation and data collection process are discussed. Greater understanding on their experiences in the care centre has been generated by focusing on these women as an “abled-body” rather than people with disabilities. Recognition of the researcher’s feelings and experiences have enriched the research method and analysis, as well as informing the practice for social workers, health practitioners, and students who work with women with mental health problems.
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Praythiesh Bruce, M. S., und M. C. Vasantha Mallika. „Prevalence of complications of diabetes among patients with diabetes mellitus attending a tertiary care centre in Tamil Nadu“. International Journal Of Community Medicine And Public Health 6, Nr. 4 (27.03.2019): 1452. http://dx.doi.org/10.18203/2394-6040.ijcmph20191049.
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Background: Diabetes will be the 7th leading cause of death by the year 2030 as per the World Health Organization. In adults the prevalence of diabetes globally has risen from 4.7% in 1980 to 8.5% in 2014. Level of awareness depends on socioeconomic class, literacy of the patients, training received by them, source of information on diabetes. Knowledge, attitude, and practices about diabetes mellitus and its complications are important to reduce the prevalence and morbidity associated with diabetes mellitus and its complications.Methods: The cross sectional study was conducted among 201 patients with diabetes visiting. Outpatient department of Sree Mookambika Institute of Medical Sciences, Kulasekharam, Tamil Nadu during a period from January 2017 to June 2018 using a pre-tested, semi structured questionnaire.Results: Among 201 patients with diabetes included in the study, 69.0% had one or more of the complications of diabetes. Factors significantly associated with high rate of complications were the female gender (p<0.001), obesity, rural residential area, high blood pressure (p<0.001), familial history of diabetes (p<0.001), duration of the disease above 5 years (p< 0.001) and high HbA1c level (p<0.001).Conclusions: This study revealed that type 2 diabetic patients followed up in the OPD of SMIMS showed a high rate of chronic complications which often occurred in age more than 50 years. Socio-demographic and biological factors were significantly associated with the high rate of complications of diabetes.
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Kulmala, Meri, Michael Rasell und Zhanna Chernova. „Overhauling Russia’s Child Welfare system: Institutional and Ideational Factors behind the Paradigm Shift“. Journal of Social Policy Studies 15, Nr. 3 (25.09.2017): 353–66. http://dx.doi.org/10.17323/727-0634-2017-15-3-353-366.
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Meri Kulmala – Dr., Finnish Centre for Russian and East European Studies/Finnish Centre of Excellence in Russian Studies, Aleksanteri Institute, University of Helsinki, Finland. Email: meri.kulmala@helsinki.fi
Michael Rasell – Dr., School of Health & Social Care, University of Lincoln, UK. Email: mrasell@lincoln.ac.uk
Zhanna Chernova – Dr. Sciences, Department of Sociology, National Research University 'Higher School of Economics', Saint Petersburg. Email: zhchernova@hse.ru
This article studies the causal factors behind the major overhaul of Russia’s system for children in substitute care that has been taking place since the late 2000’s. A series of reforms have promoted fostering and family-like care in contrast to the large residential homes used in the Soviet period and 1990’s. We highlight the fundamental change in the 'ideal of care' represented by the move to 'deinstitutionalise' the care system by promoting domestic adoptions, increasing the number of foster families, creating early support services for families as well as restructuring remaining residential institutions into smaller, home-like environments. These are all key elements of the global deinstitutionalisation trend that is taking place around the globe. We look at the evolution of the related policies and ask why this policy shift happened during the 2010’s even though the issue of reform had partially been on the Russian policy agenda for some time. Building on an explanatory approach to family policy changes by Magritta Mäztke and Ilona Ostner, which incorporates material and ideational driving forces, we explain that the 'political will from above' behind these major reforms was shaped by a range of other societal and political factors. Multiple factors drove Russian political actors to adopt new ideas about care for children left without parental care. For instance, the increasing conservative turn in policies towards children and families, which are driven by the severe demographic decline in the country, work alongside the influence of international norms around children’s rights and changing socio-economic circumstances. In the 1990’s Russian NGOs had considerable input into the reforms as 'epistemic communities' in policy formation thanks to the high level of expertise that they developed in international networks and the increasing number of cross-sector consultative platforms at governmental bodies in contemporary Russia. We conclude that ideational factors were necessary preconditions for the reforms, but that political forces were ultimately the key driving force. The recentralisation of power and prioritisation of social policy under President Putin allowed new ideas to gain concrete policy realisation.
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Patil, Shrinivas K., und Shivaswamy M. S. „Assessment of sub-centres of Belagavi district according to Indian public health standards 2012 guidelines: a cross sectional study“. International Journal Of Community Medicine And Public Health 4, Nr. 6 (22.05.2017): 1938. http://dx.doi.org/10.18203/2394-6040.ijcmph20172153.
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Background: In the public sector, a sub-health centre (sub-centre) is the most peripheral and first point of contact between the primary health care system and the community. The current level of functioning of the Sub-centres is much below the expectations. Objective: To assess sub-centres of Belagavi District according to Indian public health standards 2012 guidelines.Methods: A facility based cross-sectional study was conducted in Belagavi district of Karnataka. forty SCs, four SC from each of the 10 Talukas of Belagavi district were selected by simple random sampling. Study period: 1st January to 31st December 2014. Data collected - using a predesigned and structured questionnaire for IPHS facility survey.Results: The study showed 35% of SCs were catering the services for population as per the norms. Services like ante-natal clinics, post-natal clinics and immunization sessions were conducted regularly in all the SCs. About 33% of SCs had no buildings. A deficiency worth highlighting in the present study was the absence of residential facilities for the staff in half of the SCs. Proper supervision and monitoring of the service delivery activities of the SC staff was done only in 70% of SCs.Conclusions: IPHS guidelines are not being followed at SC level in the district. Recruitment of SC staff especially the Health Worker Male post should be filled at all the SCs for efficient functioning of the SCs. The SC should be periodically surveyed to identify the deficiency and necessary action could be taken to correct it.
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Le, Brian H., Celia Marston, Christopher Kerley und Peter Eastman. „Facilitating the choice of dying at home or in residential care with the implementation of a palliative care rapid response team in a cancer centre and general hospital“. Palliative Medicine 33, Nr. 4 (28.01.2019): 475–76. http://dx.doi.org/10.1177/0269216318824273.
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Youde, J., J. Rawlings und J. Knight. „41 Using Patient Centred Care to Redesign Integrated Discharge Services in Derby“. Age and Ageing 49, Supplement_1 (Februar 2020): i11—i13. http://dx.doi.org/10.1093/ageing/afz185.04.
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Abstract Background Discharge to Assess as outlined by the Department of Health was adopted in Derby in 2016. Previously the discharge pathways to community settings from the acute trust were complex. Challenges included: Operating from a traditional residential care home.No integration of community health staff and social care teams leading to delays in treatment and decision making as well as multiple referrals and hand-overs and no joint communication which was confusing for patients.Stakeholder anticipation of 6 weeks length of stay.Limited responsiveness to capacity demand within planned and unplanned community physiotherapy.Changing the culture and mind-set of staff.Different health and social care processes and procedures, IT systems, working patterns, contracts and pay scales. Methods A new service model, joint processes and standard operating procedures was developed with the patient at the centre of the design. Trusted assessment and information sharing reduce multiple assessments and hand overs, ensuring a smoother and improved patient experience. Outcomes Triage of patients from the Integrated Discharge Hub to the appropriate pathway, early discharge planning, board rounds and MDT's and timely assessments combined with an enablement ethos have increased the flow of patients through the service, decreased care package hours and increased capacity through reducing both length of stay and delayed transfers of care. The health and social care teams are now delivering fully integrated care and undertaking joint training. This has led to a reduction in treatment times from 20 days to 12 days, reductions in DTOC to average of 8 days per month and improved access to community based routine therapy from 85% of referrals being seen by 6 weeks 2017-18 to 99% in 2018-19. Conclusions The integrated service delivers more for less resulting in significant savings in the healthcare and social care system while maintaining quality standards and outcomes.
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Giggie, Marisa A. „Catatonia in a 10-year-old boy with early childhood neglect and disruptive behaviours in psychiatric residential treatment“. BMJ Case Reports 14, Nr. 2 (Februar 2021): e239596. http://dx.doi.org/10.1136/bcr-2020-239596.
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Catatonia is a rare medical condition that can be fatal in paediatric patients if left untreated. It is often misdiagnosed or underdiagnosed. There are no published cases of catatonia in traumatised children living in long-term psychiatric care. However, there is some evidence that childhood maltreatment in its variant forms may be a risk for the development of catatonia in children and adolescents. In this case, a 10-year-old boy with intrauterine exposure to alcohol and multiple drugs and early childhood deprivation, developed neuroleptic-induced catatonia in an intensive psychiatric residential treatment centre approximately 24 hours after receiving a first-time intramuscular injection of haloperidol 5 mg for acute agitation. He had no known predisposing factors for catatonia such as psychosis, autism, neurological or general medical problems. This 10-year-old child’s early childhood trauma should be considered as a predisposing factor for catatonia.
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Patil, Shrinivas K., und Shivaswamy M. S. „Assessment of primary health centres of a district in North Karnataka according to Indian Public Health Standards 2012 guidelines: a cross sectional study“. International Journal Of Community Medicine And Public Health 6, Nr. 11 (24.10.2019): 4731. http://dx.doi.org/10.18203/2394-6040.ijcmph20195046.
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Background: Primary health centre (PHC) is a basic health unit to provide an integrated curative and preventive health care to the rural population as close to the people as possible, with emphasis on preventive and promotive aspects of health care.Methods: A facility based cross-sectional study was conducted in Belagavi district of Karnataka in India. Twenty PHCs, two PHCs from each of the 10 talukas of Belagavi district were selected by simple random sampling. The study period was from 1st January 2014 to 31st December 2014. Data was collected using a predesigned and structured questionnaire for IPHS facility survey.Results: In this study, only 60% of primary health centres covered the population as per the IPHS norms. All the PHCs were providing the regular outpatient department (OPD) services, referral services, antenatal care, family planning and in-patient services. Bed occupancy rate was less than 40% in 55% of PHCs. Building area in 75% of PHCs were inadequate according to IPHS norms. Residential facility for staff was available only in half of the studied PHCs.Conclusions: IPHS guidelines were not fully being followed at PHC level in the district. Though the requirement of medical officers and pharmacists was fulfilled in almost all the PHCs, deficiency was seen in the appointing of Ayush doctors and staff nurses at PHCs. There is an urgent need of recruiting the deficient staff for efficient functioning of the PHCs.
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Thayer, N., S. White, J. Islam, W. Jones, S. Kenzie und R. Kullu. „Evaluation of a collaborative pharmacy service initiative for people with intellectual disabilities in residential care homes“. International Journal of Pharmacy Practice 29, Supplement_1 (26.03.2021): i44—i45. http://dx.doi.org/10.1093/ijpp/riab015.054.
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Abstract Introduction People with Intellectual Disabilities (ID) often have complex care needs and increased likelihood of premature death.1 The NHS has committed to improving the use of psychotropic medicines in people with ID with the Stopping the Over-Medication of People with Learning Disabilities (STOMP) programme.2 In the Wirral a cross-sector, collaborative service initiative involving community pharmacists and a specialist mental health pharmacist was developed to provide pharmaceutical care reviews for ID care home residents, which included an evaluation of the initiative. Aim This study aimed to determine the number and type of pharmacists’ interventions and GP recommendations in this service initiative. Methods Pharmacists provided pharmaceutical care reviews for ID care home residents using a framework and where applicable made interventions or recommendations to residents’ GPs or consultant psychiatrist. The framework was devised by the lead Consultant, Mental Health Trust lead pharmacist and Local Pharmaceutical Committee representatives to align with national ID priorities.1 Pharmacists were recruited via expressions of interest and direct recruitment by the mental health trust. Using anonymised, aggregated, Clinical Commissioning Group data, an Oversight Group divided all ID care homes in the locality into two groups: homes with residents with low psychotropic medicines use were primarily assigned to community pharmacists, whilst those with higher psychotropic use were assigned to the specialist mental health pharmacist. Pharmacists contacted care home managers and arranged reviews with all residents, sharing learnings in weekly reviews. Community pharmacists identified residents who would benefit from specialist mental health pharmacist review and referred them. Data collected included patient demographic details, medication history, results of assessments completed and interventions/recommendations. Following institutional ethical approval, this data was downloaded from PharmOutcomes into Microsoft Excel and personally identifiable data removed. The data underwent descriptive statistical analysis in SPSS, including frequency counting interventions by type. Results The pharmacists conducted reviews with 160 residents (76 by community pharmacists and 84 by the specialist mental health pharmacist) from November 2019 – May 2020, reflecting all residents in visited care homes. These residents were prescribed 1207 medicines, 74% were prescribed 5 or more medicines (i.e. polypharmacy) and 507 interventions or recommendations were made, averaging 3.3 per resident. Table 1 shows that the highest proportion (30.4%) of these were public health related, whilst changing and stopping medicines accounted for 17.9% and 12.8% respectively. The majority (63%) of interventions made by community pharmacists were public health related, whilst those made by the mental health specialist pharmacist most frequently concerned changing medicines (25%), stopping medicines (18%), and blood monitoring (13%). Conclusion The study findings indicate a high level of polypharmacy among the ID residents and a high number of interventions / recommendations were needed to improve care, in line with national priorities.1,2 The small scale of the study is acknowledged, and further research is warranted. However, the findings suggest that this service model may be an effective use of the respective skill sets of the pharmacists involved and suitable for wider adoption, with community pharmacists focusing on holistic care and specialist mental health making specialist medicines interventions. References 1. University of Bristol Norah Fry Centre for Learning Disability Studies. The Learning Disability Mortality Review (LeDeR) Programme Annual Report 2018. Available at: https://www.hqip.org.uk/wp-content/uploads/2019/05/LeDeR-Annual-Report-Final-21-May-2019.pdf (last accessed 12/10/20). 2. NHS England. Stopping over medication of people with a learning disability, autism or both (STOMP). https://www.england.nhs.uk/learning-disabilities/improving-health/stomp/ (last accessed 12/10/20).
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Dube, Nkosiyazi, und Linda Harms Smith. „THE THORNY ISSUE OF STATUS DISCLOSURE TO CHILDREN LIVING WITH HIV: THE CASE OF HIV POSITIVE CHILDREN LIVING IN A CHILD AND YOUTH CARE FACILITY IN JOHANNESBURG, SOUTH AFRICA“. Southern African Journal of Social Work and Social Development 28, Nr. 1 (22.07.2016): 53–68. http://dx.doi.org/10.25159/2415-5829/1350.
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There is a dilemma regarding HIV/AIDS disclosure to children born and living with HIV/AIDS in residential settings. Since the advent and accessibility of Anti-Retroviral Therapy, most children born HIV positive live longer and have healthier lives. Some of these children find themselves in Need of Care due to abandonment, orphanhood and neglect or abuse, and are placed in alternative care such as a Child and Youth Care Centre (CYCC). Social Service Workers are then faced with this dilemma around disclosure of their HIV status, due to the complexities around the consequences of such a disclosure, and the absence of clear policies in this regard. The study explored the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living in a CYCC in Ekurhuleni, South Africa. The findings indicate that HIV status disclosure is a complex but essential process as it reinforces children’s ability to adhere to medication and dispels anxiety and suspicion within themselves around their status. Recommendations relate to community education and awareness programmes, policy and practice changes and makes suggestions for future research.