scholarly journals Hospice at Home services in England: a national survey

2019 ◽  
pp. bmjspcare-2019-001818 ◽  
Author(s):  
Melanie Rees-Roberts ◽  
Peter Williams ◽  
Ferhana Hashem ◽  
Charlotte Brigden ◽  
Kay Greene ◽  
...  
Keyword(s):  
National Survey ◽  
Service Provision ◽  
Psychosocial Support ◽  
Symptom Assessment ◽  
Service Development ◽  
Hands On ◽  
Urban Rural ◽  
Hospice At Home ◽  
Service Managers ◽  
At Home

ObjectiveHospice at Home (HAH) services aim to enable patients to be cared for and die at home, if that is their choice and achieve a ‘good death’. A national survey, in 2017, aimed to describe and compare the features of HAH services and understand key enablers to service provision.MethodsService managers of adult HAH services in the ‘Hospice UK’ and National Association for Hospice at Home directories within England were invited to participate. Information on service configuration, referral, staffing, finance, care provision and enablers to service provision were collected by telephone interview.ResultsOf 128 services invited, 70 (54.7%) provided data. Great diversity was found. Most services operated in mixed urban/rural (74.3%) and mixed deprivation (77.1%) areas and provided hands-on care (97.1%), symptom assessment and management (91.4%), psychosocial support (94.3%) and respite care (74.3%). Rapid response (within 4 hours) was available in 65.7%; hands-on care 24 hours a day in 52.2%. Charity donations were the main source of funding for 71.2%. Key enablers for service provision included working with local services (eg, district nursing, general practitioner services), integrated health records, funding and anticipatory care planning. Access to timely medication and equipment was critical.ConclusionThere is considerable variation in HAH services in England. Due to this variation it was not possible to categorise services into delivery types. Services work to supplement local care using a flexible approach benefitting from integration and funding. Further work defining service features related to patient and/or carer outcomes would support future service development.

scholarly journals Young people in HIV care in Ukraine: a national survey on characteristics and service provision

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 323
Author(s):  
Galyna Kyselyova ◽  
Violeta Martsynovska ◽  
Alla Volokha ◽  
Nataliya Nizova ◽  
Ruslan Malyuta ◽  
...  
Keyword(s):  
Young People ◽  
National Survey ◽  
Service Provision ◽  
Hiv Infections ◽  
Hiv Care ◽  
Service Development ◽  
Structural Barriers ◽  
Adult Services ◽  
Hiv Acquisition ◽  
Hiv Aids

Background: Ukraine’s perinatally HIV-infected (PHIV) young people are ageing into adolescence/young adulthood and, alongside those with horizontally-acquired HIV infections, require transitional and other support services. We aimed to map this population and policies/service provision at specialist HIV centres, to inform future service development. Methods: A national survey was conducted of 28 HIV/AIDS centres on number, characteristics (age group, HIV acquisition mode) and care setting (paediatric/adult) of 10-24 year olds in HIV care in each of 24 regions in January 2016. Information was collected on policies/service provision at each centre. Results: Of 13,286 young people aged 10-24 years registered for HIV care nationally in Ukraine in January 2016, 1,675 were aged 10-18 years. Three-quarters of ≤19 year olds were PHIV, while 72% of 20-24-year-olds had sexually-acquired infection. Five regions accounted for two-thirds of 10-18 year olds in paediatric and 85% of 19-24 year olds in adult services. In 2015, 97 young people transitioned from paediatric to adult services nationally, typically at 18 years although with flexibility in timing at 17/28 centres. At 27/28 centres, horizontally HIV-infected young people aged <18 years began their HIV care in paediatric services sometimes (5) or always (22). Transition support most commonly consisted of a joint appointment with paediatrician and adult doctor, and support from a psychologist/social worker (both at 24/28 centres). Only 5/28 centres offered routine HIV care during the evening or weekend, and availability of integrated sexual/reproductive health and harm reduction services was uneven. Of 16/28 centres selectively following-up patients who did not attend for care, 15 targeted patients in paediatric services. Conclusions: Heterogeneity in the population and in service availability at the main regional/municipal HIV/AIDS centres has implications for potential structural barriers to HIV care, and development of services for this group.

scholarly journals Young people in HIV care in Ukraine: a national survey on characteristics and service provision

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 323 ◽  
Author(s):  
Galyna Kyselyova ◽  
Violeta Martsynovska ◽  
Alla Volokha ◽  
Nataliya Nizova ◽  
Ruslan Malyuta ◽  
...  
Keyword(s):  
Young People ◽  
National Survey ◽  
Service Provision ◽  
Hiv Care ◽  
Service Development ◽  
Structural Barriers ◽  
Adult Services ◽  
Hiv Acquisition ◽  
Joint Appointment ◽  
Hiv Aids

Background: Ukraine’s perinatally HIV-infected (PHIV) young people are ageing into adolescence/young adulthood and, alongside those with behaviourally-acquired infections (BHIV), require transitional and other support services. We aimed to map this population and policies/service provision at specialist HIV centres, to inform future service development. Methods: A national survey was conducted of 28 HIV/AIDS centres on number, characteristics (age group, HIV acquisition mode) and care setting (paediatric/adult) of 10-24 year olds in HIV care in each of 24 regions in January 2016. Information was collected on policies/service provision at each centre. Results: Of 13,286 young people aged 10-24 years registered for HIV care nationally in Ukraine in January 2016, 1,675 were aged 10-18 years. Three-quarters of ≤19 year olds were PHIV, while 72% of 20-24-year-olds had sexually-acquired infection. Five regions accounted for two-thirds of 10-18 year olds in paediatric and 85% of 19-24 year olds in adult services. In 2015, 97 young people transitioned from paediatric to adult services nationally, typically at 18 years although with flexibility in timing at 17/28 centres. At 27/28 centres, BHIV young people aged <18 years began their HIV care in paediatric services sometimes (5) or always (22). Transition support most commonly consisted of a joint appointment with paediatrician and adult doctor, and support from a psychologist/social worker (both at 24/28 centres). Only 5/28 centres offered routine HIV care during the evening or weekend, and availability of integrated sexual/reproductive health and harm reduction services was uneven. Of 16/28 centres selectively following-up patients who did not attend for care, 15 targeted patients in paediatric services. Conclusions: Heterogeneity in the population and in service availability at the main regional/municipal HIV/AIDS centres has implications for potential structural barriers to HIV care, and development of services for this group.

scholarly journals Work-Life Conflict During the COVID-19 Pandemic

2021 ◽  
Vol 7 ◽  
pp. 237802312098285 ◽  
Author(s):  
Scott Schieman ◽  
Philip J. Badawy ◽  
Melissa A. Milkie ◽  
Alex Bierman
Keyword(s):  
National Survey ◽  
Social Life ◽  
Work Life ◽  
Work Family ◽  
High Work ◽  
Work Life Conflict ◽  
At Home

The coronavirus disease 2019 pandemic upended work, family, and social life. These massive changes may have created shifts in exposure to work-life conflict. Using a national survey that followed Canadian workers from September 2019 into April and June 2020, the authors find that work-life conflict decreased among those with no children at home. In contrast, for those with children at home, the patterns depended on age of youngest child. Among individuals with children younger than 6 or between 6 and 12, no decreases in work-life conflict were observed. In contrast, those with teenagers did not differ from the child-free. Although these patterns did not significantly differ by gender, they were amplified among individuals with high work-home integration. These findings suggest an overall pattern of reduced work-life conflict during the pandemic—but also that these shifts were circumscribed by age of youngest child at home and the degree of work-home integration.

scholarly journals Family and healthcare professionals’ perceptions of a pilot hospice at home programme for children: a qualitative study

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Maria Brenner ◽  
Michael Connolly ◽  
Des Cawley ◽  
Frances Howlin ◽  
Jay Berry ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Professionals ◽  
Hospice At Home ◽  
At Home

Private Trade and Elite Privilege. The Trial of Nicolaas Schaghen, Director of Bengal

Itinerario ◽  
1996 ◽  
Vol 20 (3) ◽  
pp. 69-86 ◽  
Author(s):  
Pamela McVay
Keyword(s):  
The Netherlands ◽  
Board Of Directors ◽  
East India Company ◽  
Dutch East India Company ◽  
High Court ◽  
East Indies ◽  
Hands On ◽  
Dutch East Indies ◽  
At Home

It is common wisdom among the historians of the Dutch East Indies that everyone in the Dutch East India Company engaged in private trade. That is, ‘everyone’ traded in goods supposedly monopolized by the Company and ‘everyone’ abused his or her position to squeeze graft from the Company's trade. It was, supposedly, to get their hands on the private trade and graft that people joined the Dutch East India Company (VOC: Vereenigde Oost-Indische Compagnie) in the first place. But back in the Netherlands the VOC's Board of Directors (the Heeren XVII) objected vociferously to private trade, which drained Company profits and shareholder revenue. To appease the Heeren XVII back at home, the various Governors-General and Councillors of the Indies (Raad van Indië), who represented the Heeren XVII in Asia, issued annual placards forbidding private trade while the High Court (Raad van Justitie) carried out infrequent desultory trials for private trade. But these prosecutions were inevitably doomed to failure, so the story goes, because everyone engaged in private trade would ‘cover’ for everyone else.

Long-term noninvasive mechanical ventilation for children at home: A national survey

2003 ◽  
Vol 35 (2) ◽  
pp. 119-125 ◽  
Author(s):  
B. Fauroux ◽  
C. Boffa ◽  
I. Desguerre ◽  
B. Estournet ◽  
H. Trang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
National Survey ◽  
Noninvasive Mechanical Ventilation ◽  
At Home

scholarly journals Uptake and Scalability of a Peritoneal Dialysis Virtual Care Solution: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Lianne Jeffs ◽  
Trevor Jamieson ◽  
Marianne Saragosa ◽  
Geetha Mukerji ◽  
Arsh K Jain ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Health Care Providers ◽  
Decision Makers ◽  
Care Providers ◽  
Factors Influencing ◽  
Virtual Care ◽  
Key Stakeholders ◽  
Hands On ◽  
Semistructured Interviews ◽  
At Home

BACKGROUND Early research in the area of virtual care solutions with peritoneal dialysis (PD) patients has focused on evaluating the outcomes and impact of these solutions. There has been less attention focused on understanding the factors influencing the uptake, usability, and scalability of virtual care for chronic kidney disease (CKD) patients receiving PD at home. OBJECTIVE In this context, a study was undertaken to (1) assess and understand the factors influencing the uptake of a virtual care solution and (2) provide recommendations for the scalability of a virtual care solution aimed at enhancing CKD patients’ outcomes and experiences. METHODS This study used a qualitative design with semistructured interviews and a thematic analysis approach. A total of 25 stakeholders—6 patients and 3 caregivers, 6 health care providers, 2 vendors, and 8 health system decision makers—participated in this study. RESULTS The following three primary mechanisms emerged to influence the usability of the virtual care solution: (1) receiving hands-on training and ongoing communication from a supportive team, (2) adapting to meet user needs and embedding them into workflow, and (3) being influenced by patient and caregiver characteristics. Further, two overarching recommendations were developed for considerations around scalability: (1) co-design locally, embed into the daily workflow, and deploy over time and (2) share the benefits and build the case. CONCLUSIONS Study findings can be used by key stakeholders in their future efforts to enhance the implementation, uptake, and scalability of virtual care solutions for CKD and managing PD at home.

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