Search results for: residential care

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: Miriam Colleran, Barbara Sheehy-Skeffington

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Background: Patients with intellectual disabilities have specific palliative care needs, which can affect how resources and services are planned for this type of patient population. Aim: The purpose of this practice review is to assess the indications for, numbers of and outcomes of care for adults with intellectual disabilities referred to a specialist palliative care service over a two-year period. Service utilization aspects considered included the frequency of home visits by a specialist palliative care doctor or clinical nurse specialist and the number of hospice admissions that occurred for the patients. Method: A retrospective review was carried out of persons 18 years and older with intellectual disabilities referred to a specialist palliative care service. A manual review was carried out of the register using the place of residence and diagnosis in addition to the patients known to the clinicians who had intellectual disabilities. Results: 16 persons with intellectual disabilities were identified as being referred during that time. However, this may be an underestimate. 8 women and 8 men were referred with an age range of 50 to 81 years old. 4 patients referred did not have home visits from the specialist palliative care team. A range of 2 to 12 phone calls per person occurred by the specialist palliative care team regarding this cohort of patients. For some patients, the care is ongoing. Sadly, other patients died. Conclusion: Providing specialist palliative care for adults with intellectual disabilities is an important element of palliative care. Further research is necessary, and education to inform, support and empower specialist palliative care professionals in optimizing palliative and end-of-life care for persons with intellectual disabilities and to inform service development and provision.

Keywords: palliative care, intellectual disabilities, service planning, practice review

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Authors: Mohammad Rahim Rahnama

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The study employs Monte Carlo method for simulation of rented housing in Mashhad second largest city in Iran. A total number of 334 rental residential units in Mashhad, including both apartments and houses (villa), were randomly selected from advertisements placed in Khorasan Newspapers during the months of July and August of 2015. In order to simulate the monthly rent price, the rent index was calculated through combining the mortgage and the rent price. In the next step, the relation between the variables of the floor area and that of the number of bedrooms for each unit, in both apartments and houses(villa), was calculated through multivariate regression using SPSS and was coded in XML. The initial model was called using simulation button in SPSS and was simulated using triangular and binominal algorithms. The findings revealed that the average simulated rental index was 548.5$ per month. Calculating the sensitivity of rental index to a number of bedrooms we found that firstly, 97% of units have three bedrooms, and secondly as the number of bedrooms increases from one to three, for the rent price of less than 200$, the percentage of units having one bedroom decreases from 10% to 0. Contrariwise, for units with the rent price of more than 571.4$, the percentage of bedrooms increases from 37% to 48%. In the light of these findings, it becomes clear that planning to build rental residential units, overseeing the rent prices, and granting subsidies to rental residential units, for apartments with two bedrooms, present a felicitous policy for regulating residential units in Mashhad.

Keywords: Mashhad, Monte Carlo, simulation, rent price, residential unit

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Authors: Peng Yew Wong

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House prices in the Australian capital cities were at record levels subsequent to Global Financial Crisis (GFC) 2008 and many believed that foreign investors, especially the Chinese investors, were the main reason for the Australian capital cities’ house prices escalation. This research conducted an Australian cross border semi-structured interviews in Shanghai, China to uncover historical evidence and emerging trend supporting the existence of a significant relationship between overseas investors and residential housing markets performance in Australia subsequent to the GFC 2008. Some unique investment strategies of private investors from China which emphasised on non-capitalist factors such as early education were identified, alongside with some insights on the significant China government policies that have incentivised the cross border investments from China. It is believed that this understanding will assist policy makers to effectively manage the overheated Australian residential property market without compromising the steady flow of FREI.

Keywords: Australian housing market, residential property, foreign real estate investment, education, China investor

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Authors: Yi-Chuan Cheng, Li-Chi Huang, Yu-Shan Chang

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Introduction: The main purpose of this study was to explore the relationship between the learning number, care knowledge, care skills and maternal confidence in preterm infant care in Taiwan. Background: Preterm infants care has been stressful for mother caring at home. Many programs have been applied for improving the infant care maternal confident. But less to know the learning behavior in mothers of preterm infant. Methods: The sample consisted of 55 mothers with preterm infants were recruited in a neonatal intermediate unit at a medical center in central Taiwan. The self-reported questionnaires including knowledge and skills of preterm infant care scales and maternal confidence scale were used to evaluation, which were conducted during hospitalization, before hospital discharge, and one month after discharge. We performed by using Pearson correlation of the collected data using SPSS 18. Results: The study showed that the learning number and knowledge in preterm infant care was a significant positive correlation (r = .40), and the skills and confidence preterm infant care was positively correlated (r = .89). Conclusions: Study results showed the mother had more learning number in preterm infant care will be stronger knowledge, and the skills and confidence in preterm infant care were also positively correlated. Thus, we found the learning behavior change significant care knowledge. And the maternal confidence change significant with skill on preterm infant’s care. But bondage still needs further study and develop the participation in hospital-based instructional programs, which could lead to greater long-term retention of learning.

Keywords: learning behavior, care knowledge, care skills, maternal confidence

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Authors: Daniella Arieli

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As human population is ageing, globally, we are faced with the need to find solutions for the care of older people who have reached the stage of needing full-time nursing care. Basically, there are two basic alternatives: 1. moving the individual to an institutional setting, a care home, or other form of residency, and 2. Arranging care for them in their own home, what is known as “ageing in place”. As ageing in place is becoming popular in many parts of the world, there is a need to understand its’ everyday consequences for all the involved parties: the care recipient, her/his family members and the live-in care workers. This is crucial because choosing home care means that the role of the care recipient’s relatives becomes very demanding and requires a level of support and responsibility that is often beyond what families can offer. This is particularly challenging when the older person faces dementia. While most Western countries offer a range of social services, many citizens around the world find the care provided by governments and associated social support structures insufficient. Individuals and families find themselves in the position of having to take on the responsibility themselves and find a path for the care of frail members, while facing considerable personal burdens and challenging dilemmas. The aim of this work is to discuss those challenges. The study is based on an ethnographic study of home care for older people in Israel.

Keywords: aging in place, family caregivers, policy making, qualitative research

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Authors: Yao Meng, Mahroo Eftekhari, Dennis Loveday

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Currently, there are two types of heating systems in Chinese residential buildings, with respect to the controllability of the heating system, one is an old heating system without any possibility of controlling room temperature and another is a new heating system that provides temperature control of individual rooms. This paper is aiming to evaluate the impact of potential variables on the energy performance of old and new buildings respectively in China, and to explore how the use of individual room temperature control would change occupants’ heating behaviour and thermal comfort in Chinese residential buildings and its impact on the building energy performance. In the study, two types of residential buildings have been chosen, the new building install personal control on the heating system, together with ‘pay for what you use’ tariffs. The old building comprised uncontrolled heating with payment based on floor area. The studies were carried out in each building, with a longitudinal monitoring of indoor air temperature, outdoor air temperature, window position. The occupants’ behaviour and thermal sensation were evaluated by questionnaires. Finally, use the simulated analytic method to identify the impact of influence variables on energy use for both types of buildings.

Keywords: residential buildings, China, design parameters, energy efficiency, simulation analytics method

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Authors: Keith Dominic T. Li

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The soaring prices of residential properties in Hong Kong has become a social problem that even the middle class is having dif?iculties in purchasing homes. In making policies to curb the prices, it is important to determine the factors that contribute to the property in?lation. Many researches attribute this in?lation to macroeconomic factors especially the interest rate. However, it is important to remember that Hong Kong is under a Currency Board system which makes its interest rate exogenously determined. This research aims to show the signi?icance of the money supply on Hong Kong residential property prices in post-1997 Asian Financial Crisis period. Using money supply data, macroeconomic fundamentals, and demographic variables from 2000Q1 to 2013Q2, the factors contributed to residential property price in?lation are estimated to calculate the share of each explanatory variable in disparity. It is found that the Hong Kong property market is mainly driven by investment and that the in?lation on Hong Kong residential property prices can explained by the increase in the Hang Seng Index and in the money supply M2.

Keywords: real estate, Hong Kong, property market, monetary economics, monetary policy

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Authors: Bengi Demirci

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Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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Authors: Baloyi Gift Tlharihani

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This paper explores the relationship between pastoral care and counselling and psychology. It will critically review the variety of views and debates regarding this relationship while acknowledging the different sides of the debates on the sameness and difference of these notions, this paper argues for the inevitable interconnectedness of the two. There has always been a close relationship, between pastoral care and counselling and psychology, although these are two totally different notions. Even though pastoral care and counselling are thought of as more spiritually focused and psychology with emotional and mental challenges, the components that connect these two sciences are represented by the care of human being. Therefore, this paper is interested in the interconnectedness of these two science as they both makes a vital contribution to human caring. It indicates that whether we take the dualistic difference between the body and soul, the trichotomous difference between the body, soul and spirit, our essential nature is found in the unity of those constituent elements.

Keywords: anthropology, human care, pastoral care and counseling, psychology

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Authors: Parastou Kharazmi

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In this paper, rehabilitation methods for pipeline by advanced polymeric coating such as relining are reviewed. A number of diverse methods which are globally used are described and a brief summary of advances in technology, methods and materials is provided. The paper explains why it is claimed that sewerage rehabilitation with relining in residential buildings is environmentally friendly and economical, the importance of the quality control procedure is discussed and several quality tests are proposed.

Keywords: buildings, composite, material, renovation

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Authors: Zareen Shahid

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Rapid increase in population has resulted in uncontrolled and unplanned growth of metropolitan cities in Pakistan. Pakistan is facing unprecedented challenges of acute housing shortages, unhealthy living conditions and a non-existent or dilapidated infrastructure across the country. The government of Pakistan has also failed to devise a comprehensive and long-term strategy to cope with the problem of housing and better infrastructure development and management that has resulted in congestion, overcrowding and deterioration of environment in cities. On the other hand public has developed intense faith upon Defence Housing Authority (DHA) Lahore. This research paper is about to observe the difference in residential estate development and services provided by DHA Lahore. This paper attempts to identify the factors which are contributing towards the success of DHA and recommend measures for improvement in public sector for betterment.

Keywords: residential estate, development and management, defence housing authority

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Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

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Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

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Authors: Eunkyo Kang, Jihye Lee, Jiyeon Choo

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Background: Pediatric palliative care has been increasing, and the number of studies has focused on the age at which pediatric patient can be notified their terminal illness, pediatric advanced care planning (ACP) and palliative care. However, there is a lack of research on health professionals’ perception. Aim: We aimed to investigate the perceptions of healthcare professionals about appropriate age disclosing terminal illness, awareness of ACP, and the relationship between ACP knowledge and the preference for palliative care for children. Methods: We administered nationwide questionnaires to 928 physicians from the 12 hospitals and the Korean Medical Association and 1,241 individuals of the general Korean population. We asked about the age at which the pediatric patients could be notified of their terminal illness, by 4 groups; 4 years old or older, 12 years old or older, 15 years old or older, or not. In addition, we surveyed the questionnaires about the knowledge of ACP of the medical staff, the preference of the pediatric hospice palliative care, aggressive treatment, and life-sustaining treatment preference. Results: In the appropriate age disclosing terminal illness, there were more respondents in the physicians than in the general population who thought that it was possible even at a younger age. Palliative care preference in pediatric patients who were expected to expire within months was higher when health care professionals had knowledge of ACPs compared to those without knowledge. The same results were obtained when deaths were expected within weeks or days. The age of the terminal status notification, the health care professionals who thought to be available at a lower age have a higher preference for palliative care and has less preference for aggressive treatment and life-sustaining treatment. Conclusion: Despite the importance of pediatric palliative care, our study confirmed that there is a difference in the preference of the health care professionals for pediatric palliative care according to the ACP knowledge of the medical staff or the appropriate age disclosing terminal illness. Future research should focus on strategies for inducing changes in perceptions of health care professionals and identifying other obstacles for the pediatric palliative care.

Keywords: pediatric palliative care, disclosing terminal illness, palliative care, advanced care planning

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Authors: Khadija Bouzaachane, El Mahdi El Guarmah

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The classification of low-resolution satellite images has been a worthwhile and fertile field that attracts plenty of researchers due to its importance in monitoring geographical areas. It could be used for several purposes such as disaster management, military surveillance, agricultural monitoring. The main objective of this work is to classify efficiently and accurately low-resolution satellite images by using novel technics of deep learning and reinforcement learning. The images include roads, residential areas, industrial areas, rivers, sea lakes, and vegetation. To achieve that goal, we carried out experiments on the sentinel-2 images considering both high accuracy and efficiency classification. Our proposed model achieved a 91% accuracy on the testing dataset besides a good classification for land cover. Focus on the parameter precision; we have obtained 93% for the river, 92% for residential, 97% for residential, 96% for the forest, 87% for annual crop, 84% for herbaceous vegetation, 85% for pasture, 78% highway and 100% for Sea Lake.

Keywords: classification, deep learning, reinforcement learning, satellite imagery

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Authors: Nabil A. Ahmed, Nasser A. N. Mhaisen

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The paper presents a solution to enhance the power quality and to reduce the peak load demand in Kuwait electric grid as a solution to the shortage of electricity production. Technical, environmental and economic feasibility study of utilizing integrated grid-connected photovoltaic (PV) system in residential buildings for supplying 7.1% of electrical power consumption in Kuwait is carried out using RETScreen software. A 10 KWp on-grid PV power generation system spread on the rooftop of the residential buildings is adopted and investigated and the complete system performance is simulated using PSIM software. Taking into account the international prices of electricity and natural gas, the proposed solution is investigated and tested for four different types of installation systems in terms of power generation and costs which includes horizontal installation, 25º tilted angle, single axis tracking and dual axis tracking. Results shows that the 25º tilted angle fixed mounted system is the most efficient type. The payback period as a tool of benefit analysis of the proposed system is calculated and it found to be 2.55 years.

Keywords: photovoltaics, residential buildings, electrical grid, production capacity, on-grid, power generation

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Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Sara Rankohi, Lloyd Waugh

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Construction sites are information saturated. Digitalization is hitting construction sites to meet the incredible demand of knowledge sharing and information documentations. From flying drones, 3D Lasers scanners, pocket mobile applications, to augmented reality glasses and smart helmet, visualization technologies help real-time information imposed straight onto construction professional’s field of vision. Although these technologies are very applicable and can have the direct impact on project cost and productivity, experience shows that only a minority of construction professionals quickly adapt themselves to benefit from them in practice. The majority of construction managers still tend to apply traditional construction management methods. This paper investigates a) current applications of visualization technologies in construction projects management, b) the direct effect of these technologies on productivity improvement and cost saving of a multi-residential building project via a case study on Mac Taggart Senior Care project located in Edmonton, Alberta. The research shows the imaged based technologies have a direct impact on improving project productivity and cost savings.

Keywords: image-based technologies, project management, cost, productivity improvement

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Authors: Nuri Onat, Omer Tatari, Gokhan Egilmez

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The U.S. buildings consume significant amount of energy and natural resources and they are responsible for approximately 40 % of the greenhouse gases emitted in the United States. Awareness of these environmental impacts paved the way for the adoption of green building movement. The green building movement is a rapidly increasing trend. Green Construction market has generated $173 billion dollars in GDP, supported over 2.4 million jobs, and provided $123 billion dollars in labor earnings. The number of LEED certified buildings is projected to be almost half of the all new, nonresidential buildings by 2015. National Science and Technology Council (NSTC) aims to increase number of net-zero energy buildings (NZB). The ultimate goal is to have all commercial NZB by 2050 in the US (NSTC 2008). Green Building Initiative (GBI) became the first green building organization that is accredited by American National Standards Institute (ANSI), which will also boost number of green buildings certified by Green Globes. However, there is much less focus on greening the residential buildings, although the environmental impacts of existing residential buildings are more than that of commercial buildings. In this regard, current research aims to model the residential green building movement with a dynamic model approach and assess the possible strategies to stabilize the carbon footprint of the U.S. residential building stock. Three aspects of sustainable development are considered in policy making, namely: high performance green building (HPGB) construction, NZB construction and building retrofitting. 19 different policy options are proposed and analyzed. Results of this study explored that increasing the construction rate of HPGBs or NZBs is not a sufficient policy to stabilize the carbon footprint of the residential buildings. Energy efficient building retrofitting options are found to be more effective strategies then increasing HPGBs and NZBs construction. Also, significance of shifting to renewable energy sources for electricity generation is stressed.

Keywords: green building movement, residential buildings, carbon footprint, system dynamics

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Authors: Nishtha Kumar

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In order to understand how people like their interiors and how they feel inside a space, it is important to know the effect that the Colour of the space has on these individuals. Understanding this effect with the help of variables like colour choices of walls, furnishings, lighting, and the lifestyle of people will give a more clear understanding of the individual’s preferences and choices and how they feel about various colours and spaces. This paper focuses on understanding the various moods of people and the psychological effect that the colour of space has on the person living in it. An extensive literature review was conducted to analyse the effect of these variables of colour on the moods of people living in residential interiors. Alongside, a questionnaire survey was conducted to note the responses of people living in residential buildings who have got their interiors done regarding how different colours in their houses makes them feel and if it affects their mood. The results of this survey have helped in providing a better understanding of the relationship between various colours and how different people associate different moods with the same colour. Thus, such results allow us to have a deeper understanding of the effect of colour in residential interiors on individuals and how the colour of a space can affect the state of mind and mood of an individual. This result helps interior designers to incorporate colours into space according to the moods of the individual and understand how every colour depicts a different emotion in different human beings.

Keywords: colour, residental interiors, psychological effect, people, different moods

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Authors: Tran Le Na, Didit Novianto, Yoshiaki Ushifusa, Weijun Gao

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This paper introduces the characteristics of Japanese residential lifestyle and Japanese Architectural housing design, meanwhile, summarizes the results from an analysis of energy use of 12 households in electric-only multi dwellings in Higashida Smart Community, Kitakyushu, Japan. Using hourly load and daily load data collected from smart meter, we explore correlations of energy use in households according to the incentive of different levels of architectural characteristics and lifestyle, following three factors: Space (Living room, Kitchen, Bedroom, Bathroom), Time (daytime and night time, weekdays and weekend) and User (Elderly, Parents, Kids). The energy consumption reports demonstrated that the essential demand of household’s response to variable factors. From that exploratory analysis, we can define the role of housing equipment layout and spatial layout in residential housing design. Likewise, determining preferred spaces and time use can help to optimize energy consumption in households. This paper contributes to the application of Smart Home Energy Management System in Smart Community in Japan and provides a good experience to other countries.

Keywords: smart community, energy efficiency, architectural housing design, residential lifestyle

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Authors: Ayşegül Bilge, Hacer Demirkol, Merve Uğuryol

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Therapeutic touch is one of the most important methods of complementary and alternative treatments. Therapeutic touch requires the sharing of universal energy. Therapeutic touch (TT) provides the interaction between the patient and the nurse. In addition, nurses can be aware of physical and mental symptoms of patients through therapeutic touch. Therapeutic touch (TT) is short-term provides the advantage for the nurse. For this reason, nurses have to be aware of the importance of therapeutic touch and they can use it from the primary care to tertiary care in nursing practices at in health field.

Keywords: health care services, complementary treatment, nursing, therapeutic touch

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Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail

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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.

Keywords: urgent care centres, primary care physicians, overcrowding, cost

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Authors: Malinda Sabrina, Khoerul Anwar

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Railway noise generated by pass-by train has been described as a form of environmental pollutants especially for the residential area near the railway. Many studies have shown, that environmental noise particularly transportation noise has negative effects on people which resulting in annoyance and specific health problems such as cardiovascular disease, cognitive impairment and sleep disturbance. Therefore, various attempts are made to reduce the noise. One method of reducing such noise to acceptable noise levels is to build acoustically barrier walls. The objective of this study was to review the method of reducing railway noise and obtain the preliminary design of the acoustics barrier on the edge of railway tracks close to the residential area. The design of this barrier is using the Maekawa's method. Measurements have been performed in residential areas around the railroads in the Karawang - Indonesia with the absence of an acoustical barrier. From the observation, it was found that the railway was passed by five trains within thirty minutes. With the limited distance between the railway tracks and the location of the residential area as well as the street of residents, then it was obtained that a reduction in sound pressure level is 25 dBA. Maximum sound pressure level obtained is 86.9 dBA then by setting the barrier as high as 4 m at a distance, 2.5 m from the railway, the noise level received by residents in the settlement around the railway line becomes 61.9 dBA.

Keywords: acoustics barrier, Maekawa's method, noise attenuation, railway noise

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Francis Sichimba

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Literature has increasingly acknowledged the important role that grandparents play in child care with evidence highlighting differences in grand-parental investment between countries and cultures. However, there are very few systematic cross cultural studies on grandparents’ participation in child care. Thus, we decided to conduct this study in Zambia and the Netherlands because the two countries differ rather drastically socially and culturally. The objective of this study was to investigate grand-parental involvement in child care in Zambia and the Netherlands. In line with the general objective, four hypotheses were formulated using nationality, family size, social economic status (SES), attachment security as independent variables. The study sample consisted of 411 undergraduate students from the University of Zambia and the University of Leiden. A questionnaire was used to measure grand-parental involvement in child care. Results indicated that grandparent involvement in child care was prevalent in both Zambia and Netherlands. However, as predicted it was found that Zambian grandparents (M = 9.69, SD=2.40) provided more care for their grandchildren compared to their Dutch counterparts (M = 7.80, SD=3.31) even after controlling for parents being alive. Using hierarchical logistic regression analysis the study revealed that nationality and attachment-related avoidance were significant predictors of grand-parental involvement in child care. It was concluded that grand-parental care is a great resource in offering complementary care in both countries.

Keywords: attachment, care, grand-parenting involvement, social economic status

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Comprehensive and compassionate palliative care and support requires an integrated system of care that draws on formal health and social service providers working together with community and informal networks to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the community supports, services, and informal networks that health care professionals and social service providers rely on to allow their patients to die in their homes and communities. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers that arise as health care and social service providers attempt to build networks of care for patients with life limiting illnesses and families. Three main findings emerged: First, the variability that arises due to systemic barriers in accessing and providing care; second, the exceptionally challenging workload that providers are facing as they work to address complex social care needs (housing, disability, food security), along with escalating palliative care needs; and, finally, the lack of structural support that providers and informal care networks receive. Conclusion: These findings will facilitate and build stronger person-centred/relationship-centred principles and practices between providers, patients, community, and informal care networks by highlighting the systemic barriers to accessing and providing person-centred care. Further, they will have important implications for future partnerships in integrated care delivery programs and initiatives, community policies, education programs, and provincial and national palliative care strategies.

Keywords: public health palliative care, palliative care nursing, care networks, informal care, integrated health care

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Authors: Garima Singh

Abstract:

Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Yuchen Sharon Sung, Yingjui Tseng

Abstract:

High-rise residential buildings have become the most mainstream housing pattern in the world’s metropolises under the current trend of urbanization. The facades of high-rise buildings are essential elements of the urban landscape. The skins of these facades are important media between the interior and exterior of high- rise buildings. It not only connects between users and environments, but also plays an important functional and aesthetic role. This research involves a study of skins of high-rise residential buildings using the methodology of shape grammar to find out the rules which determine the combinations of the facade patterns and analyze the patterns’ parameters using software Grasshopper. We chose a number of facades of high-rise residential buildings as source to discover the underlying rules and concepts of the generation of facade skins. This research also provides the rules that influence the composition of facade skins. The items of the facade skins, such as windows, balconies, walls, sun visors and metal grilles are treated as elements in the system of facade skins. The compositions of these elements will be categorized and described by logical rules; and the types of high-rise building facade skins will be modelled by Grasshopper. Then a variety of analyzed patterns can also be applied on other facade skins through this parametric mechanism. Using these patterns established in the models, researchers can analyze each single item to do more detail tests and architects can apply each of these items to construct their facades for other buildings through various combinations and permutations. The goal of these models is to develop a mechanism to generate prototypes in order to facilitate generation of various facade skins.

Keywords: facade skin, grasshopper, high-rise residential building, shape grammar

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Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

Abstract:

Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: robotics and automation, engineering management, engineering in medicine and biology, medical services, public health-care

Procedia PDF Downloads 124