scholarly journals Evaluating a Geriatric Educational Program: Exploring Opportunities for Increasing Impact and Scale

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 758-758
Author(s):  
Shera Hosseini ◽  
Michelle Howard ◽  
Allison Ward
Keyword(s):  
Large Scale ◽  
Healthcare Professionals ◽  
Program Effectiveness ◽  
Qualitative Interviews ◽  
A Priori ◽  
The United States ◽  
Dissemination And Implementation ◽  
Geriatric Population ◽  
Learning Competencies ◽  
The Impact

Abstract The geriatric population is rapidly growing, and this growth is beyond the pace of increase in the number of healthcare professionals who are qualified to care for and tend to the various needs of this significant subgroup of the population. The current university curricula have not been sufficient in terms of quantity as well as their ability to address the ageism inherent in the perspectives of students from across the educational spectrum. In recognition of the absence of standardized geriatric guidelines, medical associations across Canada and the United States have established geriatric learning competencies for medical programs. Nevertheless, there are exiting gaps regarding the development and evaluation of geriatric-focused didactic programs that adequately train and build competency among the students interested in pursuing careers with geriatric-specific elements. A university-wide program was developed to enhance aging education and build competency through sparking interest, providing better education related to aging, and building better relationships between future healthcare professionals and older adults. To evaluate the impact of this program, a logical framework was developed a-priori and revised through constant iterations and following discussion with the program’s multidisciplinary stakeholder group. Quantitative measures are being augmented with in-depth qualitative interviews to explore elements influencing students’ experiences with the program and the effect on their interests in and attitudes towards geriatrics. The results will inform our conclusions regarding program effectiveness in enhancing interest in geriatric-focused education among the students and trainees and assist with recommending future directions regarding impact and large-scale dissemination and implementation.

Situational Breakdowns

2019 ◽  
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
Large Scale ◽  
Contextual Factors ◽  
The United States ◽  
Social Outcomes ◽  
Dynamic Processes ◽  
Collective Decisions ◽  
Different Types ◽  
The Impact

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

scholarly journals Impact of the first COVID-19 shelter-in-place order in the United States on emergency department utilization, Marin County, California

2020 ◽  
Author(s):  
Brett R. Bayles ◽  
Michaela F George ◽  
Haylea Hannah ◽  
Patti Culross ◽  
Rochelle R. Ereman ◽  
...  
Keyword(s):  
United States ◽  
San Francisco ◽  
Large Scale ◽  
Temporal Dynamics ◽  
The United States ◽  
Emergency Department Utilization ◽  
Marin County ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Background: The first shelter-in-place (SIP) order in the United States was issued across six counties in the San Francisco Bay Area to reduce the impact of COVID-19 on critical care resources. We sought to assess the impact of this large-scale intervention on emergency departments (ED) in Marin County, California. Methods: We conducted a retrospective descriptive and trend analysis of all ED visits in Marin County, California from January 1, 2018 to May 4, 2020 to quantify the temporal dynamics of ED utilization before and after the March 17, 2020 SIP order. Results: The average number of ED visits per day decreased by 52.3% following the SIP order compared to corresponding time periods in 2018 and 2019. Both respiratory and non-respiratory visits declined, but this negative trend was most pronounced for non-respiratory admissions. Conclusions: The first SIP order to be issued in the United States in response to COVID-19 was associated with a significant reduction in ED utilization in Marin County.

scholarly journals Evaluation of COVID-19 vaccination strategies with a delayed second dose

PLoS Biology ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. e3001211
Author(s):  
Seyed M. Moghadas ◽  
Thomas N. Vilches ◽  
Kevin Zhang ◽  
Shokoofeh Nourbakhsh ◽  
Pratha Sah ◽  
...  
Keyword(s):  
Program Effectiveness ◽  
Credible Interval ◽  
The United States ◽  
Optimal Time ◽  
Time Interval ◽  
Policy Debate ◽  
Agent Based ◽  
Vaccination Strategies ◽  
Supply And Distribution ◽  
The Impact

Two of the Coronavirus Disease 2019 (COVID-19) vaccines currently approved in the United States require 2 doses, administered 3 to 4 weeks apart. Constraints in vaccine supply and distribution capacity, together with a deadly wave of COVID-19 from November 2020 to January 2021 and the emergence of highly contagious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants, sparked a policy debate on whether to vaccinate more individuals with the first dose of available vaccines and delay the second dose or to continue with the recommended 2-dose series as tested in clinical trials. We developed an agent-based model of COVID-19 transmission to compare the impact of these 2 vaccination strategies, while varying the temporal waning of vaccine efficacy following the first dose and the level of preexisting immunity in the population. Our results show that for Moderna vaccines, a delay of at least 9 weeks could maximize vaccination program effectiveness and avert at least an additional 17.3 (95% credible interval [CrI]: 7.8–29.7) infections, 0.69 (95% CrI: 0.52–0.97) hospitalizations, and 0.34 (95% CrI: 0.25–0.44) deaths per 10,000 population compared to the recommended 4-week interval between the 2 doses. Pfizer-BioNTech vaccines also averted an additional 0.60 (95% CrI: 0.37–0.89) hospitalizations and 0.32 (95% CrI: 0.23–0.45) deaths per 10,000 population in a 9-week delayed second dose (DSD) strategy compared to the 3-week recommended schedule between doses. However, there was no clear advantage of delaying the second dose with Pfizer-BioNTech vaccines in reducing infections, unless the efficacy of the first dose did not wane over time. Our findings underscore the importance of quantifying the characteristics and durability of vaccine-induced protection after the first dose in order to determine the optimal time interval between the 2 doses.

scholarly journals Involving people with dementia and their carers in dementia education for undergraduate healthcare professionals: a qualitative study of motivation to participate and experience

2018 ◽  
Vol 31 (06) ◽  
pp. 869-876 ◽  
Author(s):  
Zoe Cashin ◽  
Stephanie Daley ◽  
Molly Hebditch ◽  
Leila Hughes ◽  
Sube Banerjee
Keyword(s):  
Qualitative Study ◽  
Family Involvement ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Therapeutic Benefits ◽  
People With Dementia ◽  
Motivation To Participate ◽  
Face Time ◽  
The Impact ◽  
Dementia Education

ABSTRACTBackground:There is a need to improve dementia education to prepare future generations of healthcare professionals to deal with the increasing challenges they will face. Time for Dementia is an innovative undergraduate education program for medical, nursing, and paramedic students in the south of England. Success of the program is dependent upon the participation of families (people with dementia and their carers). This qualitative study seeks to explore the motivation and experiences of the families taking part in the program.Methods:A topic guide was developed to understand factors influencing motivation and retention. A purposeful sample of participant families, who had at least 12 months of involvement in the program, were selected from a cohort of 282 families and were invited to take part in an in-depth qualitative interview. Interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. This was subsequently refined in an on-going process of analysis aided by the use of Nvivo 11. Interviewing stopped when thematic saturation was reached.Results:Eighteen families took part in an in-depth qualitative interviews. Four themes were identified from the analysis. These themes were motivators, value to family, value to the person with dementia, and student factors.Conclusions:This study identifies underpinning factors that motivate families to join dementia education programs and the impact of such programs upon them. We found that engagement in such programs can have therapeutic benefits to participants, and do not cause harm. These findings can be used to strengthen recruitment and enhance family involvement in similar programs.

The emergence of personal growth amongst healthcare professionals who care for dying children

2017 ◽  
Vol 16 (3) ◽  
pp. 298-307 ◽  
Author(s):  
Laura Beaune ◽  
Barbara Muskat ◽  
Samantha J. Anthony
Keyword(s):  
Compassion Fatigue ◽  
Personal Growth ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Secondary Analysis ◽  
Well Being ◽  
Three Dimensions ◽  
Positive Effects ◽  
Dying Children ◽  
The Impact

ABSTRACTObjective:Compassion fatigue, burnout, and vicarious traumatization are prominent topics in the current literature on the impact of the rewarding but challenging work of healthcare professionals who care for patients with life-limiting illnesses. The positive effects of caregiving constitute a newly emerging outcome that has been relatively unexplored in the pediatric literature, and yet they may play an important role in contributing to the satisfaction and well-being of the healthcare professionals who care for children who have a life-limiting illness.Method:This paper reports the results of a secondary analysis of qualitative interview transcripts that explored the experiences of hospital-based pediatric healthcare providers caring for children with varied life-limiting illnesses. In-depth qualitative interviews were conducted with 25 healthcare professionals (9 social workers, 8 nurses, and 8 physicians). The majority of participants were women (80%), with an age range between 20 and 60 years, and most (84%) had the experience of caring for more than 15 dying children. Thematic analysis was conducted using interpretive description and constant comparison.Results:Every healthcare professional interviewed experienced personal growth as a result of their providing care for dying children. Three dimensions of personal growth were most consistently reported: (1) new or altered life perspectives, (2) enhanced personal resources, and (3) benevolence.Significance of results:A deeper understanding of the phenomenon of personal growth could help healthcare organizations to implement innovative approaches that would counterbalance compassion fatigue, and thereby enhance both healthcare provider well-being and child and family outcomes.

scholarly journals Role of Soil Moisture Feedback in the Development of Extreme Summer Drought and Flood in the United States

2016 ◽  
Vol 17 (8) ◽  
pp. 2191-2207 ◽  
Author(s):  
Roop Saini ◽  
Guiling Wang ◽  
Jeremy S. Pal
Keyword(s):  
United States ◽  
Soil Moisture ◽  
Large Scale ◽  
Climate Model ◽  
The United States ◽  
Summer Drought ◽  
Large Set ◽  
Drought And Flood ◽  
The Impact ◽  
Soil Moisture Feedback

Abstract This study tackles the contribution of soil moisture feedback to the development of extreme summer precipitation anomalies over the conterminous United States using a regional climate model. The model performs well in reproducing both the mean climate and extremes associated with drought and flood. A large set of experiments using the model are conducted that involve swapped initial soil moisture between flood and drought years using the 1988 and 2012 droughts and 1993 flood as examples. The starting time of these experiments includes 1 May (late spring) and 1 June (early summer). For all three years, the impact of 1 May soil moisture swapping is much weaker than the 1 June soil moisture swapping. In 1988 and 2012, replacing the 1 June soil moisture with that from 1993 reduces both the spatial extent and the severity of the simulated summer drought and heat. The impact is especially strong in 2012. In 1993, however, replacing the 1 June soil moisture with that from 1988 has little impact on precipitation. The contribution of soil moisture feedback to summer extremes is larger in 2012 than in 1988 and 1993. This may be because of the presence of strong anomalies in large-scale forcing in 1988 and 1993 that prohibit or favor precipitation, and the lack of such in 2012. This study demonstrates how the contribution of land–atmosphere feedback to the development of seasonal climate anomalies may vary from year to year and highlights its importance in the 2012 drought.

scholarly journals INTERNATIONAL TOURISM AS A NEOLIBERAL PRACTICE OF CHINESE INFLUENCE IN THE WESTERN BALKANS

2021 ◽  
pp. 14-28
Author(s):  
A. Parfinenko
Keyword(s):  
Large Scale ◽  
The United States ◽  
Silk Road ◽  
Western Balkans ◽  
Investment Activity ◽  
Logistics Network ◽  
The Balkans ◽  
Tourist Destinations ◽  
Complex Interdependence ◽  
The Impact

The article reveals China's geostrategic interests in the Western Balkans. The paper highlights the main directions of Beijing's political and economic cooperation with the countries of the region, the impact of these processes on the foreign policy orientations of the Balkan countries. The focus is on assessing the international political potential of Chinese outbound tourism as a tool for neoliberal influence on the host destinations of the Western Balkans. The work consists of three interrelated parts. The first part, within the neoliberal paradigm, reveals the understanding of tourism as a factor of international political interaction and the establishment of "complex interdependence". For China, which generates the largest outbound tourist flow, these human communications provide the possibility of indirect influence on host destinations through the created economic dependence and the approval of "official tourist destinations." The second part of the study highlights the Chinese approach to the Western Balkans. It is motivated by the implementation of a large-scale project of the New Silk Road "Belt and Road Initiative", designed to create a cross-border transport and logistics network to accelerate the delivery of Chinese goods to European markets. In the context of this project, the countries of the Western Balkans have become a geographical "entry point" for both land and sea corridors of the new Silk Road, which connect the markets of Europe and Asia. The third part of the publication shows that China's international political and investment activity in the Western Balkans is based on a network of transnational social ties created under the auspices of the state. An appropriate place among them is given to tourist flows from China, whose communication strategies influence emotional and commercial involvement, as well as a positive perception of China in the region. It has been concluded that the intensification of tourist contacts and the related liberalization of mobility regimes serve as an important factor in strengthening the complex asymmetric interdependence of the Balkans with China. In the long term, this will strengthen Beijing's position in Europe, especially in the context of global competition with the United States.

scholarly journals Music industry in crisis: The impact of a novel coronavirus on touring metal bands, promoters, and venues

2020 ◽  
Author(s):  
Kyle J. Messick
Keyword(s):  
Qualitative Interviews ◽  
Music Industry ◽  
The United States ◽  
Metal Music ◽  
Preventative Measures ◽  
Live Music ◽  
Travel Restrictions ◽  
Novel Coronavirus ◽  
The Impact ◽  
Financial Losses

In March of 2020 the world began to take widespread preventative measures against the spread of a novel coronavirus through travel restrictions, quarantines, and limitations on group gatherings. These restrictions resulted in the immediate closing of many businesses, including concerts venues, and also put an abrupt end to live music performances across Europe and the United States. This had immediate implications for touring bands, as bands earn most of their income touring, and many found themselves in a situation where they experienced substantial financial losses alongside negative affective ramifications. This article utilized evidence from qualitative interviews and public statements to draw inferences about the impact of COVID-19 on the music industry, with a particular focus on touring musicians and their respective managers, promoters, booking agencies, and record labels. Musicians reported negative affective and financial ramifications as a result of COVID-19, but they also reported overwhelming support from metal music fans that made the fallout from the pandemic less severe.

scholarly journals Cultures of light: Electric light in the United States, 1890s-1950s

2021 ◽  
Author(s):  
◽  
Margaret Maile Petty
Keyword(s):  
United States ◽  
Twentieth Century ◽  
Large Scale ◽  
Cultural Beliefs ◽  
The United States ◽  
Light Industry ◽  
Electric Light ◽  
American Society ◽  
The Individual ◽  
The Impact

<p>Cultures of Light is set within a period that stretches from the late nineteenth to the mid-twentieth century in the United States, an era in which nearly every aspect of American life was impacted to a lesser or greater degree by the introduction, distribution and integration of electric power and light. By no means attempting to comprehensively examine the impact and effects of this expansive transformation, this thesis has a narrow but meaningful target, defined by key intersections of electric lighting and American culture. Primarily concerned with the investigation of culturally bound ideas and practices as mediated through electric light and its applications, my thesis is focused on particular instances of this interplay. These include its role in supporting nationalizing narratives and agendas through large-scale demonstrations at world’s fairs and exhibitions, in the search for and expression of modernism and its variations in the United States. Similarly electricity and electric light throughout the better part of the twentieth century was scaled to the level of the individual through a number of mechanisms and narratives. Most prominently the electric light industry employed gendered discourses, practices and beliefs in their efforts to grow the market, calling upon the assistance of a host of cultural influencers, from movie stars to architects to interior designers, instigating a renegotiation of established approaches to the design of architecture and the visual environment. Connecting common themes and persistent concerns across these seemingly disparate subject areas through the examination of cultural beliefs, practices, rituals and traditions, Cultures of Light seeks to illustrate the deep and lasting significance of electric light within American society in the twentieth century.</p>

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