Search results for: long term services and supports

Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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Authors: Liu Yi-Hui, Chiu Fan-Yun, Lin Yu Fang, Jhang Yu Cih, He You Jing

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The demand for care support has been rising with the aging of society and the advancement of medical science and technology. To meet rising demand, the Taiwanese government promoted the “Long Term Care Ten-Year Plan 2.0” in 2017. However, this policy and its related services failed to be fully implemented because of the ignorance of the public, and their lack of desire, fear, or discomfort in using them, which is a major obstacle to the promotion of long-term care services. Given the above context, this research objectives included the following: (1) to understand the current situation and predicament of family caregivers; (2) to reveal the actual use and assistance of government’s long-term care resources for family caregivers; and (3) to explore the support and impact of social capital on family caregivers. A semi-structured in-depth interview with five family caregivers to understand long-term care networks and social capital for family caregivers.

Keywords: family caregivers, long-term care, social capital

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Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: Peter Brink

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Much of the research examining sexuality in long-term care focus on individual experiences, specifically their past, present, and future lived experiences. We know little about long-term care home policies, how they relate to the LGBT community, or how accommodating long-term care homes are to the LGBT+ community. In many ways, residents who identify as LGBT+ have been invisible in long-term care homes. Up until the not-to-distant past, homosexuality was illegal, and discrimination was acceptable. Canada’s LGBT population has also suffered because of the HIV/AIDS epidemic. For these and other reasons, members of the LGBT community might resist entering long-term care or attempt to keep their sexuality secret. The goal of any long-term care home is to be a welcoming place, to display signs of inclusion, and to help residents and staff feel that they are embraced. From the perspective of the long-term care home, it is possible that many of these facilities do not necessarily see the need to mention gender identity or sexual orientation in their welcoming materials. However, from the perspective of the invisible minority, it may be important that these homes be more than just welcoming. This study examined the role of institutional policies in long-term care for residents who identify as LGBT.

Keywords: long-term care, LGBT, HIV/AIDS, policy

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Authors: Stephanie Giordano, Rosa Plasencia

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In the USA, in 2013, public service systems such as Medicaid, aging, and disability systems undertook an effort to measure the quality of service delivery by examining the experiences and outcomes of those receiving public services. The goal of this effort was to develop a survey to measure the experiences and outcomes of those receiving public services, with the goal of measuring system performance for quality improvement. The performance indicators were developed through with input from directors of state aging and disability service systems, along with experts and stakeholders in the field across the United States. This effort, National Core Indicators –Aging and Disabilities (NCI-AD), grew out of National Core Indicators –Intellectual and Developmental Disabilities, an effort to measure developmental disability (DD) systems across the States. The survey tool and administration protocol underwent multiple rounds of testing and revision between 2013 and 2015. The measures in the final tool – called the Adult Consumer Survey (ACS) – emphasize not just important indicators of healthcare access and personal safety but also includes indicators of system quality based on person-centered outcomes. These measures indicate whether service systems support older adults and people with disabilities to live where they want, maintain relationships and engage in their communities and have choice and control in their everyday lives. Launched in 2015, the NCI-AD Adult Consumer Survey is now used in 23 states in the US. Surveys are conducted by NCI-AD trained surveyors via direct conversation with a person receiving public long-term services and supports (LTSS). Until 2020, surveys were only conducted in person. However, after a pilot to test the reliability of videoconference and telephone survey modes, these modes were adopted as an acceptable practice. The nature of the survey is that of a “guided conversation” survey administration allows for surveyor to use wording and terminology that is best understand by the person surveyed. The survey includes a subset of questions that may be answered by a proxy respondent who knows the person well if the person is receiving services in unable to provide valid responses on their own. Surveyors undergo a standardized training on survey administration to ensure the fidelity of survey administration. In addition to the main survey section, a Background Information section collects data on personal and service-related characteristics of the person receiving services; these data are typically collected through state administrative record. This information is helps provide greater context around the characteristics of people receiving services. It has also been used in conjunction with outcomes measures to look at disparity (including by race and ethnicity, gender, disability, and living arrangements). These measures of quality are critical for public service delivery systems to understand the unique needs of the population of older adults and improving the lives of older adults as well as people with disabilities. Participating states may use these data to identify areas for quality improvement within their service delivery systems, to advocate for specific policy change, and to better understand the experiences of specific populations of people served.

Keywords: quality of life, long term services and supports, person-centered practices, aging and disability research, survey methodology

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Authors: Valeri Arghutashvili, Mari Gogochuri

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Tourism industry development is one of the key priorities in Georgia, as it has positive influence on economic activities. Its contribution is very important for the different regions, as well as for the national economy. Benefits of the tourism industry include new jobs, service development, and increasing tax revenues, etc. The main aim of this research is to review and analyze the potential of the Georgian tourism industry with its long-term strategy and current challenges. To plan activities in a long-term development, it is required to evaluate several factors on the regional and on the national level. Factors include activities, transportation, services, lodging facilities, infrastructure and institutions. The major research contributions are practical estimates about regional tourism development which plays an important role in the integration process with global markets.

Keywords: regional tourism, tourism industry, tourism in Georgia, tourism benefits

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Authors: Teguh Sugiarto, Ahmad Subagyo, Ludiro Madu, Amir Mohammadian Amiri

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Recently, the significant fluctuations accosiated with Indonesian economy justifies the need for paying more attention to this issue. In this regard, the main objective of this study is to investigate the relationship between two issues related to the macro Indonesia economy called consumption and GDP during the period of 1967 to 2014. This research method exploits short term and long term relationships using Granger and subsequently, models them by the causality method . However, using analysis of Granger with Johansen shows that there is not only a long term, but also a short-long relationship between GDP and consumption using lags the interval 5.

Keywords: cointegration, Granger causality, GDP, consumption

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Authors: Qingyu Zhang, Mei Cao

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As the environments become increasingly uncertain, firms have attempted to achieve greater supply chain collaboration. Supply chain collaboration can generate significant benefits to its members, e.g., reducing risks and decreasing transaction costs. However, a strong relationship is often related to firm’s culture (e.g., short-term vs. long-term interests). The objective of the study is to explore the effect of long-term oriented culture on product quality in a supply chain. Data was collected through a Web survey of U.S. manufacturing firms. Structural equation modeling (LISREL) was used to analyze the data. The results support the mediating roles of goal congruence and communication in the relationship between long-term orientation and product quality in the supply chain. Goal congruence partially mediates the relationship between long-term orientation and communication; communication completely mediates the relationship between goal congruence and product quality. Without high levels of communication, goal congruence cannot improve product quality in a positive way.

Keywords: communication, long-term orientation, product quality, supply chain

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Authors: Mehrnaz Alibeikloo, Hajar Share Isfahani, Hadi Khabbaz

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In recent years, by developing cities and increasing population, reconstructing on closed landfill sites in some regions is unavoidable. Long-term settlement is one of the major concerns associated with reconstruction on landfills after closure. The purpose of this research is evaluating the effect of preloading in various patterns of height and time on long-term settlements of closed landfills. In this regard, five scenarios of surcharge from 1 to 3 m high within 3, 4.5 and 6 months of preloading time have been modeled using PLAXIS 2D software. Moreover, the numerical results have been compared to those obtained from analytical methods, and a good agreement has been achieved. The findings indicate that there is a linear relationship between settlement and surcharge height. Although, long-term settlement decreased by applying a longer and higher preloading, the time of preloading was found to be a more effective factor compared to preloading height.

Keywords: preloading, long-term settlement, landfill, PLAXIS 2D

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Authors: Hong Fan, Lifang Gao, Feng Zhan

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This paper examines the influence of local gambling attitudes on a firm's long-term financial performance. Firms located in gambling-prone regions may be more willing to take risks, thus spending more on innovative projects. However, firms in such regions may also be likely to choose projects impulsively and allocate resources inefficiently. By studying Chinese publicly listed firms from 2010 to 2017, we find that firms in more gambling-prone regions invest more in R&D. Both local gambling attitudes and firms’ R&D spending are positively associated with firms’ long-term financial performance. More importantly, our study reveals that the positive impact of R&D spending on firms’ long-term financial performance is weakened by gambling-friendly attitudes, probably because firms in gambling-prone regions are more likely to overinvest in risky projects. This effect is stronger for larger firms, state-owned enterprises (SOEs), firms with more government subsidies, and firms with weaker internal control.

Keywords: regional gambling attitudes, long-term financial performance, R&D, risk, local bias

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Authors: Alexander Rych

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Piql Preservation Services (“Piql”) is a turnkey solution designed for secure, migration-free long- term preservation of digital data. Piql sets an open standard for long- term preservation for the future. It consists of equipment and processes needed for writing and retrieving digital data. Exponentially growing amounts of data demand for logistically effective and cost effective processes. Digital storage media (hard disks, magnetic tape) exhibit limited lifetime. Repetitive data migration to overcome rapid obsolescence of hardware and software bears accelerated risk of data loss, data corruption or even manipulation and adds significant repetitive costs for hardware and software investments. Piql stores any kind of data in its digital as well as analog form securely for 500 years. The medium that provides this is a film reel. Using photosensitive film polyester base, a very stable material that is known for its immutability over hundreds of years, secure and cost-effective long- term preservation can be provided. The film reel itself is stored in a packaging capable of protecting the optical storage medium. These components have undergone extensive testing to ensure longevity of up to 500 years. In addition to its durability, film is a true WORM (write once- read many) medium. It therefore is resistant to editing or manipulation. Being able to store any form of data onto the film makes Piql a superior solution for long-term preservation. Paper documents, images, video or audio sequences – all of those file formats and documents can be preserved in its native file structure. In order to restore the encoded digital data, only a film scanner, a digital camera or any appropriate optical reading device will be needed in the future. Every film reel includes an index section describing the data saved on the film. It also contains a content section carrying meta-data, enabling users in the future to rebuild software in order to read and decode the digital information.

Keywords: digital data, long-term preservation, migration-free, photosensitive film

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Authors: Palaniraj Rama Raj, Himeesh Kumar, Paul Adler

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Purpose: To investigate the effect of ultrasound energy, expressed as cumulative dissipated energy (CDE), on short and long-term outcomes after uncomplicated cataract surgery by phacoemulsification. Methods: In this single-surgeon, two-center retrospective study, non-glaucomatous participants who underwent uncomplicated cataract surgery were investigated. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured at 3 separate time points: pre-operative, Day 1 and ≥1 month. Anterior chamber (AC) inflammation and corneal odema (CO) were assessed at 2 separate time points: Pre-operative and Day 1. Short-term changes (Day 1) in BCVA, IOP, AC and CO and long-term changes (≥1 month) in BCVA and IOP were evaluated as a function of CDE using a multivariate multiple linear regression model, adjusting for age, gender, cataract type and grade, preoperative IOP, preoperative BCVA and duration of long-term follow-up. Results: 110 eyes from 97 non-glaucomatous participants were analysed. 60 (54.55%) were female and 50 (45.45%) were male. The mean (±SD) age was 73.40 (±10.96) years. Higher CDE counts were strongly associated with higher grades of sclerotic nuclear cataracts (p <0.001) and posterior subcapsular cataracts (p <0.036). There was no significant association between CDE counts and cortical cataracts. CDE counts also had a positive correlation with Day 1 CO (p <0.001). There was no correlation between CDE counts and Day 1 AC inflammation. Short-term and long-term changes in post-operative IOP did not demonstrate significant associations with CDE counts (all p >0.05). Though there was no significant correlation between CDE counts and short-term changes in BCVA, higher CDE counts were strongly associated with greater improvements in long-term BCVA (p = 0.011). Conclusion: Though higher CDE counts were strongly associated with higher grades of Day 1 postoperative CO, there appeared to be no detriment to long-term BCVA. Correspondingly, the strong positive correlation between CDE counts and long-term BCVA was likely reflective of the greater severity of underlying cataract type and grade. CDE counts were not associated with short-term or long-term postoperative changes in IOP.

Keywords: cataract surgery, phacoemulsification, cumulative dissipated energy, CDE, surgical outcomes

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Authors: Oleg Oborin

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This paper is dedicated to the development of the model, which can be used to evaluate the effectiveness of long-term corporate strategies and identify the best strategies. The theoretical model of the relatively homogenous product market (such as iron and steel industry, mobile services or road transport) has been developed. In the model, the market consists of a large number of companies with different internal characteristics and objectives. The companies can perform mergers and acquisitions in order to increase their market share. The model allows the simulation of long-time dynamics of the market (for a period longer than 20 years). Therefore, a large number of simulations on random input data was conducted in the framework of the model. After that, the results of the model were compared with the dynamics of real markets, such as the US steel industry from the beginning of the XX century to the present day, and the market of mobile services in Germany for the period between 1990 and 2015.

Keywords: Economic Modelling, Long-Time Strategy, Mergers and Acquisitions, Simulation

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Authors: Reinhard Haas, Amela Ajanovic

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In recent years especially electricity generation from intermittent sources like wind and solar has increased remarkably. To balance electricity supply over time calls for storages has been launched. Because intermittency also exists over longer periods – months, years, especially the need for long-term electricity storages is discussed. The major conclusions of our analysis are: (i) Despite many calls for a prophylactic construction of new storage capacities with respect to all centralized long-term storage technologies the future perspectives will be much less promising than currently indicated in several papers and discussions; (ii) new long term hydro storages will not become economically attractive in general in the next decades; however, daily storages will remain the cheapest option and the most likely to be competitive; (iii) For PtG-technologies it will also become very hard to compete in the electricity markets despite a high technological learning potential. Yet, for hydrogen and methane there are prospects for use in the transport sector.

Keywords: storages, electricity markets, power-to-gas, hydro pump storages, economics

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Authors: Thang V. Kieu, Long P. Nguyen

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Kernelized Correlation Filter (KCF) based trackers have gained a lot of attention recently because of their accuracy and fast calculation speed. However, this algorithm is not robust in cases where the object is lost by a sudden change of direction, being obscured or going out of view. In order to improve KCF performance in long-term tracking, this paper proposes an anomaly detection method for target loss warning by analyzing the response map of each frame, and a classification algorithm for reliable target re-locating mechanism by using Random fern. Being tested with Visual Tracker Benchmark and Visual Object Tracking datasets, the experimental results indicated that the precision and success rate of the proposed algorithm were 2.92 and 2.61 times higher than that of the original KCF algorithm, respectively. Moreover, the proposed tracker handles occlusion better than many state-of-the-art long-term tracking methods while running at 60 frames per second.

Keywords: correlation filter, long-term tracking, random fern, real-time tracking

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Authors: Farheen Akram

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Research and Development (R&D) is the most crucial element of the firm’s survival in a competitive business environment. R&D is a long-term investment; therefore, executives having the power to make the investment decisions may be pessimistic when their compensation is closely linked with short-term firm performance. Thus, the current study investigates the impact of board composition and executives’ compensation (cash or short-term benefits and LTIs) on R&D spending using a sample of 85 S&P/100 firms listed on the Australian Stock Exchange (ASX) in 2017. SmartPLS (v.3.2.7) was used to evaluate the proposed model of current research. The empirical findings of this study indicate that board composition has a significant and positive effect on R&D spending. While, as expected, executive cash compensation has negative and Long-Term-Incentives (LTIs) has a positive impact on R&D spending. Based on current findings, the study suggested that myopic behavior of CEOs and top management towards long-term value creation investment like R&D can be controlled by using long-term compensation rewards.

Keywords: cash compensation, LTIs, board composition, R&D spending

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Authors: Shu-Yu Chung, Ying-Fang Wang, Shih-Min Wang

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To conduct long-term exposure assessments are important for workers exposed to chemicals with chronic effects. However, it usually encounters with several constrains, including cost, workers' willingness, and interference to work practice, etc., leading to inadequate long-term exposure data in the real world. In this study, an integrated approach was developed for conducting long-term exposure assessment for welding workers in a shipbuilding factory. A laboratory study was conducted to yield the fume generation rates under various operating conditions. The results and the measured environmental conditions were applied to the near field/far field (NF/FF) model for predicting long term fume exposures via the Monte Carlo simulation. Then, the predicted long-term concentrations were used to determine the prior distribution in Bayesian decision analysis (BDA). Finally, the resultant posterior distributions were used to assess the long-term exposure and serve as basis for initiating control strategies for shipbuilding workers. Results show that the NF/FF model was a suitable for predicting the exposures of metal contents containing in welding fume. The resultant posterior distributions could effectively assess the long-term exposures of shipbuilding welders. Welders' long-term Fe, Mn and Pb exposures were found with high possibilities to exceed the action level indicating preventive measures should be taken for reducing welders' exposures immediately. Though the resultant posterior distribution can only be regarded as the best solution based on the currently available predicting and monitoring data, the proposed integrated approach can be regarded as a possible solution for conducting long term exposure assessment in the field.

Keywords: Bayesian decision analysis, exposure assessment, near field and far field model, shipbuilding industry, welding fume

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Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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Authors: İrem Bulut, Mustafa Z. Söyük, Ertuğrul Yalçın, Simge Şişman-Bal

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Eyewitness testimony is one of the most frequently used methods in criminal cases for the determination of crime and perpetrator. In the literature, the number of studies about the reliability of eyewitness testimony is increasing. The study aims to reveal the factors that affect the short-term and long-term visual memory performance of the participants in the event of an accident. In this context, the effect of the emotional content of the accident and the sounds during the accident on visual memory performance was investigated with eye-tracking. According to the results, the presence of visual and auditory stimuli with emotional content during the accident decreases the participants' both short-term and long-term recall performance. Moreover, the data obtained from the eye monitoring device showed that the participants had difficulty in answering even the questions they focused on at the time of the accident.

Keywords: eye tracking, eyewitness testimony, long-term recall, short-term recall, visual memory

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Authors: Hanneke J. A. Smaling, Mandy Visser

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One way to reduce the risk of COVID-19 infection is by preventing close interpersonal contact with distancing measures. These social distancing measures presented challenges to the health and wellbeing of people with dementia and their informal and professional caregivers. This study describes the concerns and recommendations of informal and professional caregivers for COVID-19 policy for home care and long-term care for people with dementia during the first and second COVID-19 wave in the Netherlands. In this qualitative interview study, 20 informal caregivers and 20 professional caregivers from home care services and long-term care participated. Interviews were analyzed using an inductive thematic analysis approach. Both informal and professional caregivers worried about getting infected or infecting others with COVID-19, the consequences of the distancing measures, and quality of care. There was a general agreement that policy in the second wave was better informed compared to the first wave. At an organizational level, the policy was remarkably flexible. Recommendations were given for dementia care (need to offer meaningful activities, improve the organization of care, more support for informal caregivers), policy (national vs. locally organization, social isolation measures, visitor policy), and communication. Our study contributes to the foundation of future care decisions by (inter)national policymakers, politicians, and healthcare organizations during the course of the COVID-19 pandemic, underlining the need for balance between safety and autonomy for people with dementia.

Keywords: covid-19, dementia, home care, long-term care, policy

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Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

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Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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Authors: Xiuying Wang, Changliang Li, Bo Xu

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A fixed-length feature vector is required for many machine learning algorithms in NLP field. Word embeddings have been very successful at learning lexical information. However, they cannot capture the compositional meaning of sentences, which prevents them from a deeper understanding of language. In this paper, we introduce a novel hierarchical tree long short-term memory (HTLSTM) model that learns vector representations for sentences of arbitrary syntactic type and length. We propose to split one sentence into three hierarchies: short phrase, long phrase and full sentence level. The HTLSTM model gives our algorithm the potential to fully consider the hierarchical information and long-term dependencies of language. We design the experiments on both English and Chinese corpus to evaluate our model on sentiment analysis task. And the results show that our model outperforms several existing state of the art approaches significantly.

Keywords: deep learning, hierarchical tree long short-term memory, sentence representation, sentiment analysis

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Authors: Lemi Tolu

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Background: Postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. Objective: This study assesses the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methodology: An institution-based cross-sectional study was conducted from January 1 to June 30, 2017. The six months of study were used as strata, and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariable logistic regressions were fitted to identify determinants of post-partum family planning uptake. An OR with 95% CIs was calculated, and p values set at 005 were used to determine the statistical significance of associations. Results: Four hundred and twenty-two post-partum women were interviewed. Two hundred sixty-eight (63%) women received counselling on family planning, and 241 (66.8 %) got information about contraception. One hundred and fifty-two (45%) of the women accepted long-term and permanent contraception on their immediate postpartum period before discharge. Contraceptive counselling (OR = 2.13, 95% CI 1.004-3.331), getting information from the health facility (OR = 15.15, 95% CI 1.848-19.242), and partner support (OR = 1.367, 95% CI 1.175-2.771) were significantly associated with long-term and permanent contraception uptake. Conclusion: Postpartum counselling on family planning and provision of contraception information improve immediate postpartum FP acceptance, and, hence postpartum programs need to strengthen such services.

Keywords: contraception, immediate postpartum, long-term family planning, post-partum family planning

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Authors: Yu-Ching Liu

Abstract:

Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.

Keywords: family caregiver, Long-term care, work-life balance, decision-making

Procedia PDF Downloads 180

Authors: Olga C. Rodrigue

Abstract:

Long-term care and skilled nursing facilities experience ebbs and flows of nursing staffing, a problem compounded by the perception of the facilities as undesirable workplaces and competition for staff from other healthcare entities. Travel nurses are contracted to fill staffing needs due to increased admissions, increased and unexpected attrition of nurses, or facility expansion of services. Prior to beginning the contracted assignment, the travel nurse must meet industry, company, and regulatory requirements (The Joint Commission and CMS) for skills and knowledge. Travel nurses, however, inconsistently receive the pre-assignment orientation needed to work at the contracted facility, if any information is given at all. When performance expectations are not met, travel nurses may subsequently choose to leave the position without completing the terms of the contract, and some facilities may choose to terminate the contract prior to the expected end date. The overarching goal of the Doctor of Nursing Practice evidence-based practice improvement project is to provide travel nurses with the basic and necessary information to prepare them to begin a long-term and skilled nursing assignment. The project involves the identification of travel nurse learning needs through a survey and the development and provision of web-based learning modules to address those needs prior to arrival for a long-term and skilled nursing assignment.

Keywords: nurse staffing, travel nurse, travel staff, contract staff, contracted assignment, long-term care, skilled nursing, onboarding, orientation, staff development, supplemental staff

Procedia PDF Downloads 168

Authors: Wei Gao

Abstract:

The current study investigates the change of listener responses in social conversations of the second language (L2) speakers who are staying abroad with Chinese L1 speakers in Australian universities and how their long-term stay abroad impacted their design for L2 recipient actions. There is a limited amount of empirical work on L2 English listener response acquisition, particularly regarding the influence of long-term stay abroad in English-speaking countries. Little is known whether the development of L2 listener responses and the improvement of interactional competence is affected by the prolonged residency in the target L2 country. Forty-eight participants were recruited, and they participated in the designed speaking task through Computer-Mediated Communication. Results showed that long-term stay abroad Chinese L1 speakers demonstrated an English-like pattern of listener responses in communication. Long-term stay abroad experience had a significant impact on L2 English listener responses production and organization in social conversation. Long-term stay abroad L1 Chinese speakers had an active and productive response in listenership than their non-stay abroad counterparts in terms of frequency and placement in producing listener responses. However, the L2 English listener response production only occurred to be partial in response tokens, such as backchannels and reactive expressions, also in resumptive openers' employment. This study shows that L2 English listener responses could be acquired during a long-term stay abroad in English-speaking countries but showed partial acquisition in collaborative finishes production. In addition, the most prominent finding was that Chinese L1 speakers changed their overall listener responses pattern from L1 Chinese to L2 English. The study reveals specific interactional changes in English L2 listener responses acquisition. It generates pedagogical implications for cross-cultural communication and L2 pragmatics acquisition during a long-term stay abroad.

Keywords: listener responses, stay abroad, interactional competence, L2 pragmatics acquisition

Procedia PDF Downloads 84

Authors: A. B. Benshak, M. G. Yilkangnha, V. Y. Nanle

Abstract:

Social crises and violent conflict can inflict direct (short-term) impact on the environment like poisoning water bodies, climate change, deforestation, destroying the chemical component of the soil due to the chemical and biological weapons used. It can also impact the environment indirectly (long-term), e.g., the destruction of political and economic infrastructure to manage the environmental resources and breaking down traditional conservation practices, population displacement and refugee flows which puts pressure on the already inadequate resources, infrastructure, facilities, amenities, services etc. This study therefore examines the impact of social crises on the environment in Jos Plateau State with emphasis on the long-term impact, analyze the relationship between crises and the environment and assess the perception of people on social crises because much work have concentrated on other repercussions such as the economy, health etc that are more politically expedient. The data for this research were collected mostly through interviews, questionnaire, dailies and reports on the subject matter. The data and findings were presented in tables and results showed that the environment is directly and indirectly impacted by crises and that these impacts can in turn result to a continuous cycle of violent activities if not addressed because of the inadequacies in the supply of infrastructural facilities, resources and so on caused by the inflow of displaced population. Recommendations were made on providing security to minimize conflict occurrences in Jos and its environs, minimizing the impact of social crises on the environment, provision of adequate infrastructural facilities to carter for population rise, renewal and regeneration schemes, etc. which will go a long way in mitigating the impact of crises on the environment.

Keywords: environment, impact, long-term, social crises

Procedia PDF Downloads 342

Authors: Saeed Yazdani, Sima Mohamadi Amidabadi, Amir Mohamadi Nejad, Farahnaz Nekoofar

Abstract:

As a result of uncertainty and doubts about the quantity of agricultural products, greater significance has been attached to risk management in the agricultural sector. Normally, farmers seek to minimize risks, and crop diversity has always been a means to reduce risk. The study at hand seeks to explore the long-term impact of crop diversity on income risk reduction. The timeframe of the study is 1998 to 2018. Initially, the Herfindahl index was used to estimate crop diversity in different periods, and next, the Hodrick-Prescott filter was applied to estimate income risk both in nominal and real terms. Finally, using the Vector Error Correction Model (VECM), the long-term impact of crop diversity on two modes of risk for the farmer's income has been estimated. Given the long-term pattern’s results, it is evident that in the long-run, crop diversity can reduce income fluctuations in two nominal and real terms. Moreover, results showed that in case the fluctuation shock affects the agricultural income in the short run, to balance out the shock in nominal and real terms, 4 and 3 cycles are needed respectively. In other words, in each cycle, 25% and 33% of the shock impact can be removed, respectively. Thus, as the results of the error correction coefficient showed, policies need to be put in place to prevent income shocks. In case of a shock, they need to be balanced out in a four-year period, taking inflation into account, and in a three-year period irrespective of the inflation and reparative policies such as insurance services should be developed.

Keywords: risk, long-term model, Herfindahl index, time series model, vector error correction model

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