DESerting clients? A Study Investigating Evidence-based Measures Supporting the Long-term Employment of Neurodiverse Australians

2019 ◽  
Vol 44 (4) ◽  
pp. 455-466
Author(s):  
Damian Mellifont
Keyword(s):  
Thematic Analysis ◽  
Good Practice ◽  
Policy Issue ◽  
Google Scholar ◽  
Evidence Based ◽  
Chi Square ◽  
Employment Services ◽  
Disability Employment ◽  
Chi Square Analysis

Employment outcomes for Australians with disability are weak and worsening. Aiming to assist in better understanding and redressing this troubling policy issue, this investigative research aims to (a) determine as to whether or not a significant relationship exists between disability type (i.e., physical or psychiatric) and long-term employment; and (b) identify evidence-based measures that might assist to improve the long-term employment of neurodiverse disability employment services (DES) clients. Addressing the first of these aims, an IBM SPSS-based chi-square analysis was conducted utilizing disability employment data sourced from the Australian Government. Targeting the second aim, a literature search was conducted utilizing Google Scholar, and thematic analysis was, then, applied on the results of this enquiry. Results of the chi-square analysis reveal that a DES client’s disability type appears to be associated with whether or not they attain long-term employment. From the 79 possibly relevant articles obtained from the Google Scholar enquiry, 13 were deemed relevant after applying the inclusion criteria. Thematic analysis constructed themes of resourcing, personalized support and education. In addition to offering a good practice employment guide based upon these themes, the study concludes by challenging Australian policymakers to consider the kinds of DES provider results that might not warrant reward.

scholarly journals Self-neglect and safeguarding adult reviews: towards a model of understanding facilitators and barriers to best practice

2019 ◽  
Vol 21 (4) ◽  
pp. 219-234 ◽  
Author(s):  
Michael Preston-Shoot
Keyword(s):  
Thematic Analysis ◽  
Good Practice ◽  
National Database ◽  
Evidence Based ◽  
Effective Practice ◽  
Data Set ◽  
Content Type ◽  
Core Data ◽  
The Core ◽  
Evidence Based Model

Purpose The purpose of this paper is twofold: first, to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis; second, to draw together the learning available from this data set of reviews to propose a model of good practice that can be used as the basis for subsequent SARs. Design/methodology/approach Further published reviews are added to the core data set from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains employed previously. A sufficient number of reviews have been performed from which to construct an evidence-based model of good practice. A framework is presented with the proposition that this can be used as a proportional methodology for further SARs where self-neglect is in focus. Findings Familiar findings emerge from the thematic analysis. This level of analysis, constructed over time and across reviews, enables a framework to be developed that pulls together the findings into a model of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners involved in such cases. This framework can then be used as an evidence-based model with which to review new cases where SARs are commissioned. Research limitations/implications The national database of reviews commissioned by SABs is incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless enables conclusions to be proposed about the components of effective practice, and effective policy and organisational arrangements for practice. Future reviews can then explore what enables such effective to be achieved and what barriers obstruct the realisation of effective practice. Practical implications Answering the question “why” is a significant challenge for SARs. A framework is presented here, drawn from research on SARs featuring self-neglect, that enables those involved in reviews to explore the enablers and barriers with respect to an evidence-based model of effective practice. The framework introduces explicitly research and review evidence into the review process. Originality/value The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also proposes a new approach to SARs by using the findings and recommendations systematically within a framework designed to answer “why” questions – what promotes and what obstructs effective practice.

scholarly journals 2502 The need for an evidence-based CTS specific IDP for early career training and for a long-term and sustainable career in clinical translational sciences

2018 ◽  
Vol 2 (S1) ◽  
pp. 61-62
Author(s):  
Camille A. Martina ◽  
Janice L. Gabrilove ◽  
Naomi Luban ◽  
Cecilia M. P. Sutton
Keyword(s):  
Career Development ◽  
Scoping Review ◽  
Online Survey ◽  
Career Planning ◽  
Early Career ◽  
Google Scholar ◽  
Evidence Based ◽  
Research Career ◽  
E Learning

OBJECTIVES/SPECIFIC AIMS: To establish a conceptual framework to develop a CTS-IDP with data analytics, and an e-Learning Faculty Development Guide on best practices and use of the IDP over the CTS academic life-course. METHODS/STUDY POPULATION: To accomplish our goal, we propose the following methods: (1) an online survey, using a convenience sample of the 24 KL2 CTSA IDP Collaborative members (conducted in 2017), to assess perceived needs for a universal CTS-IDP, current IDP practices, barriers to IDP use, and to discern and align each CTSA Hub’s interests, expertise and commitment to specific areas of the study; (2) A scoping narrative literature review, utilizing the Arksey and O’Malley framework covering the time period corresponding to the initiation of funding (1999) of the original K30 Clinical Research Curriculum Awards through to the present CTSA funding period, incorporating Medical Subject Heading (MeSH) keywords (career development; career development plan; employee plan; mentoring plans; compacts; research contracts; career planning; mentor guide), initially delineated by USC reference librarian and to be expanded by reference librarian services from the Icahn School of Medicine at Mount Sinai and University of Rochester, and performed on NIH searchable databases including NCBI PubMed, Central and Medline & Worldwide Science; Web of Science, ProQuest, ProQuest Abi/Inform, Google Scholar, Cochrane, Ovid MEDLINE databases, as well as Google for published papers in English and Spanish. For this portion of the work, we will describe and characterize (1) research career development or progression constructs, domains, and milestones; (2) establish the presence or absence of defined and/or pre-specified timed milestone objectives and inclusion of SWOT analytics (strengths, weaknesses, opportunities, and threats) and/or Gantt chart approaches; (3) delineate IDPs structure, toolkits and their key features (competencies, skills acquisition and processes utilized); (4) and identify specific gaps to best address the need for personalized career development education. Based on this review, we will synthesize CTS milestones, develop a time frame for meeting RCD expectations, and establish RCD benchmarks for achieving these milestones, all in consensus with the IDP Collaborative Workgroup. RESULTS/ANTICIPATED RESULTS: Seventy-seven percent of the IDP CTSA’s responded to the online survey, led by University of Rochester, and the results can be summarized as follows: (1) 100% agreed that the IDP process is important and should be considerably improved to optimize effectiveness; (2) a range of diverse IDP formats are utilized, making comparisons across programs difficult; (3) 50% of CTSA hubs report only fair to good compliance with the IDP process; (4) a major barrier to the IDP process is lack of instruction regarding how best to utilize; (5) poor alignment of currently available IDPs designed for basic science PhDs with CTS investigators; (6) an absence of a CTS specific IDP to best foster RCD for this specific career trajectory. When asked: What are the barriers to writing a detailed and thoughtful IDP, responses in order of agreement from greatest to least were: No verification of acquired competencies, beyond self-report (56%), Static platform (38%), Not constructed for clinical and translational researcher (31%), No analytical or documentation on use (31%), No instruction given to scholars on how to use it effectively and efficiently (31%), The IDP we are using is more constructed for PhD students and postdoctoral fellows (25%), No instruction given to the scholars on why it is important as adult learners (19%), and Not constructed for early career physicians/scientist (13%). Additional progress has been made on our Scoping review: An initial ABI/Inform and PubMed USC research librarian conducted search using Author names yielded 72 articles, of which only 2 were relevant to the topic at hand. A ProQuest™ search yielded 19 potentially relevant articles, 11 of which were of relevance to the topic of IDPs; and a Google Scholar search yielded 18 and 25 on career development and self-management, respectively. This has enabled us to put forth an initial model of factors that impact the purpose and design of IDPs that includes? DISCUSSION/SIGNIFICANCE OF IMPACT: Discussion: Our initial data suggests that many CTSA institutions see the need to further enhance the mentoring process with a more informed and personalized IDP template and process. Furthermore, our initial scoping review suggests a framework upon which to build specific components of a more ideal and useful IDP to best guide mentored research career development of CTS trainees. Significance: Developing and evaluating collaborative evidence-based CTS IDP and corresponding e-Learning Guide could potentially prevent or reduce important delays in RCD, a common roadblock for the translation of clinical interventions. Ultimately, the CTS-IDP serves not only to support and frame a scholar’s RCD “habits of mind” during training and early career development but to also to achieve a sustainable long-term career at a CTS researcher equipped to meet the ever challenging and dynamic research landscape.

Standardized Infection Surveillance in Long-Term Care Interfacility Comparisons From a Regional Cohort of Facilities

2005 ◽  
Vol 26 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Kurt B. Stevenson ◽  
James Moore ◽  
Holly Colwell ◽  
Barbara Sleeper
Keyword(s):  
Control Charts ◽  
Long Term Care ◽  
Surveillance Data ◽  
Chi Square ◽  
Statistical Process ◽  
Term Care ◽  
Data Set ◽  
Hospital Infection Control ◽  
Chi Square Analysis

AbstractObjectives:To measure infection rates in a regional cohort of long-term-care facilities (LTCFs) using standard surveillance methods and to analyze different methods for interfacility comparisons.Setting:Seventeen LTCFs in Idaho.Design:Prospective, active surveillance for LTCF-acquired infections using standard definitions and case-finding methods was conducted from July 2001 to June 2002. All surveillance data were combined and individual facility performance was compared with the aggregate employing a variety of statistical and graphic methods.Results:The surveillance data set consisted of 472,019 resident-days of care with 1,717 total infections for a pooled mean rate of 3.64 infections per 1,000 resident-days. Specific infections included respiratory (828; rate, 1.75), skin and soft tissue (520; rate, 1.10), urinary tract (282; rate, 0.60), gastrointestinal (77; rate, 0.16), unexplained febrile illnesses (6; rate, 0.01), and bloodstream (4; rate, 0.01). Initially, methods adopted from the National Nosocomial Infections Surveillance System were used comparing individual rates with pooled means and percentiles of distribution. A more sensitive method appeared to be detecting statistically significant deviations (based on chi-square analysis) of the individual facility rates from the aggregate of all other facilities. One promising method employed statistical process control charts (U charts) adjusted to compare individual rates with aggregate monthly rates, providing simultaneous visual and statistical comparisons. Small multiples graphs were useful in providing images valid for rapid concurrent comparison of all facilities.Conclusion:Interfacility comparisons have been demonstrated to be valuable for hospital infection control programs, but have not been studied extensively in LTCFs.

scholarly journals Nutrition from the kitchen: culinary medicine impacts students’ counseling confidence

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emily Magallanes ◽  
Ahana Sen ◽  
Milette Siler ◽  
Jaclyn Albin
Keyword(s):  
Medical Students ◽  
Early Death ◽  
The United States ◽  
Evidence Based ◽  
Lifestyle Modifications ◽  
Chi Square ◽  
Culinary Medicine ◽  
Chi Square Analysis ◽  
The Impact

Abstract Background Although a poor diet is the number one risk factor for early death in the United States and globally, physicians receive little to no training in dietary interventions and lack confidence counseling patients about lifestyle modifications. Innovative, interprofessional strategies to address these gaps include the emergence of culinary medicine, a hands-on approach to teaching the role of food in health outcomes. We sought to assess the impact of a culinary medicine elective on counseling confidence, awareness of an evidence-based approach to nutrition, and understanding of the role of interprofessional teamwork in dietary lifestyle change among medical students at one undergraduate medical school. Methods We administered pre- and post-course surveys to two cohorts of medical students (n = 64 at pre-test and n = 60 at post-test) participating in a culinary medicine enrichment elective. Chi-square analysis was used to assess the relationship between participation in the course and a positive response to each survey item. Results Compared with the baseline, students participating in culinary medicine were more likely to feel confident discussing nutrition with patients (29% vs 92%; p < 0.001), to feel familiar with the Mediterranean diet (54% vs. 97%; p < 0.001), and to understand the role of dietitians in patient care (37% vs. 93%; p < 0.001). Conclusions Culinary medicine shows promise as an impactful educational strategy among first-year medical students for increasing counseling confidence, promoting familiarity with evidence-based nutrition interventions, and augmenting understanding of the role of interprofessional engagement to address lifestyle-related disease.

scholarly journals Longitudinal Trends of Clostridium difficile Infection (CDI) within Department of Veterans Affairs (VA) Medical Centers—Acute Care and Long-term Care

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S390-S391
Author(s):  
Stephen Kralovic ◽  
Martin Evans ◽  
Loretta Simbartl ◽  
Gary Roselle
Keyword(s):  
Acute Care ◽  
Long Term Care ◽  
Healthcare Facility ◽  
Healthcare Associated Infection ◽  
Chi Square ◽  
Term Care ◽  
Medical Centers ◽  
Chi Square Analysis ◽  
Community Onset

Abstract Background CDI remains a significant and serious healthcare-associated infection within hospital and long-term care (LTC) settings. In 2012 VA began a CDI Prevention Initiative in its acute care (AC) facilities, which expanded to include LTC. Data were collected with regard to CDI cases and healthcare-facility associated (HCFA) status. Methods VA used CDC National Healthcare Safety Network (NHSN) Lab-ID Event definitions from CDI/MDRO Module with the exception that HCFA-status was called with a more stringent timeframe at 48 hours after admission. Monthly, VA Medical Centers and LTC Facilities report data to a central repository which includes number of cases meeting NHSN definitions for recurrence, hospital onset HCFA (HO-HCFA), community-onset HCFA (CO-HCFA) and community-onset non HCFA (CO-notHCFA) cases (equivalent of NSHN community-acquired [CA] cases). Data collection began from 2011 forward in AC, and from part of 2012 forward in LTC. Results In AC, the number of all cases reported ranged from 6313 to 6595 with no trend for increase/decrease noted from 2011 to 2016. However, when evaluating proportions of each type of CDI contributing to the overall occurrence, there is significant change over the years (P &lt; 0.0001, Chi-Square analysis of proportions) with HO-HCFA and CO-HCFA contributing to less (24.4% and 25.2%, decreases, respectively) and CO cases (particularly CO-notHCFA) contributing to more (38.1% increase) of the cases, (Fig 1). In LTC, there were overall lesser cases ranging from 980 to 789 from 2013 through 2016 (P = 0.05, linear regression), with no significant changes over the years (P = 0.06, Chi-Square of proportions) (Fig 2). Conclusion Over time, HO-HCFA and CO-HCFA cases have declined within VA AC facilities. However, an increase of CO-notHCFA cases (similar to NHSN CA cases) has occurred, increasing admission prevalence of CDI at VA facilities. As CDI prevalence on admission is a contributor to risk for HCFA disease, this increased pressure indicates the success of the VA CDI Prevention Initiative in decreases of HO-HCFA is even more substantive than raw rates would indicate. However, it also highlights a group of CDI cases which need a different, focused targeting of prevention strategies. Disclosures All authors: No reported disclosures.

scholarly journals Knowledge, attitude and practices of residences toward antimicrobial usage and resistance in Gondar, Northwest Ethiopia

2022 ◽  
Author(s):  
Haileyesus Dejene ◽  
Rediet Birhanu ◽  
Zewdu Seyoum Tarekegn
Keyword(s):  
Antimicrobial Agent ◽  
Marital Status ◽  
Educational Level ◽  
Animal Health ◽  
Good Practice ◽  
Antimicrobial Use ◽  
Chi Square ◽  
Attitudes And Practices ◽  
Risk Increase ◽  
Chi Square Analysis

Abstract Background Antimicrobials are essential for human and animal health. Drug resistance to an antimicrobial agent follows the introduction of a new antimicrobial agent. Evidence suggests that the public plays an important role in the risk, increase, and spread of antimicrobial resistance. The purpose of this study was to assess the knowledge, attitudes, and practices of the Gondar city residences regarding antimicrobial use and resistance. Methods A cross-sectional study was conducted from April to July 2021 on 400 randomly selected Gondar city residents using a pretested semi-structured questionnaire. The descriptive and Chi-square tests were used to analyse the data. Results The response rate was one hundred percent. Approximately 75% of respondents were men, with 32% having completed secondary school. Nearly 74% and 35% of participants were married and worked in various government jobs, respectively. Furthermore, 48%, 54%, and 50% of respondents, respectively, had moderate knowledge, a positive attitude, and good practice concerning antimicrobial use and resistance. The chi-square analysis revealed a significant (p < 0.05) disparity between knowledge and educational level, marital status, and position in the house. The respondents' attitude level was also significantly associated (p < 0.05) with their educational level, marital status, occupation, and position in the house. Respondents' practice level was also significantly associated (p 0.05) with their educational level and occupation. The study also found a significant relationship between respondents' knowledge and attitude (χ2 = 215.23, p ≤ 0.001), knowledge and practice (χ2 = 147.2, p ≤ 0.001), and attitude and practice (χ2 = 116.03, p ≤ 0.001). Conclusion This study found that study participants had some misconceptions about antimicrobial use and resistance. As a result, enforcing antimicrobial regulation and educating people about antimicrobial use are both recommended.

scholarly journals The Association Between Mother’s Care Practices With Stunting Incident In Children Age 12-35 Months In Air Dingin Primary Health Center Padang 2018

2018 ◽  
Vol 3 (2) ◽  
pp. 176
Author(s):  
Wahyu Zikria ◽  
Masrul Masrul ◽  
Lusiana El Sinta Bustami
Keyword(s):  
Health Center ◽  
Care Practice ◽  
Primary Health Center ◽  
Chi Square ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Primary Health ◽  
Psychosocial Stimulation ◽  
Chi Square Analysis

Stunting is the long-term outcome of nutritionaldeficiency with height by age less than -2SD below themedian length who affects to decreased cognitive andphysical abilities in children. The aims of this study is todetermine the association between mother’s care practiceswith stunting incidennt in the children age 12-35 months inAir Dingin Primary Health Center Padang 2018. This study was a quantitative study with crosssectional design conducted at Air Dingin health center fromApril 2018 to May 2018. There were 77 mothers with 12-35month childrens became sample of this study. The motheras the respondent was interviewed directly with aquestionnaire. While the stunting incident was measured bybody height/age and interpreted by WHO-antro software.Data will analyzed in univariate and bivariate by using chisquareanalysis(p<0,05).The result of the study showed that 46,8% childrenssuffered stunting. The result of chi-square analysis revealedp-value between care practice for feeding (p=0,000), carepractice for hygiene (p=0,000), care practice for health(p=0,000) and care practice for psychosocial stimulation(p=0,000). There is an association between care practice forfeeding, care practice for hygiene, care practice for healthand care practice for psychosocial stimulation with stuntingincident. It is expected that mothers to pay more attention tocare practices provided to children so as to prevent theoccurrence of stunting in children.

Long-term follow up of 57 patients undergoing automated percutaneous discectomy

1995 ◽  
Vol 83 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Scott Shapiro
Keyword(s):  
Resonance Imaging ◽  
Chi Square ◽  
Content Type ◽  
Percutaneous Discectomy ◽  
Long Term Follow Up ◽  
The Mean ◽  
Chi Square Analysis ◽  
Lost To Follow Up

✓ Automated percutaneous discectomy has been performed in 57 patients at the author's institution since 1989, representing 4% of all lumbar spine surgeries. All 57 patients had unilateral sciatica. There were 33 women and 24 men ranging from 24 to 49 years of age, with a mean age of 45 years. All patients underwent computerized tomography (CT) in the prone position and CT and magnetic resonance imaging in the supine position. Diffuse versus eccentric disc bulging was determined for each patient. Four patients underwent surgery at the L3–4 level, four at L5–S1, and 49 at L4–5. One L5–S1 case could not be cannulated and surgery was aborted. There have been no complications related to surgery. Fifty patients (88%) stated they had reduced sciatica in the first 2 postoperative weeks. Forty (70%) had reduced sciatica 2 months postoperatively. The mean follow-up period was 27 months (range 6 to 45 months), with no patient lost to follow up. At their last follow-up examination, 33 patients (58%) showed improvement in their sciatica but only three (5%) were completely pain free. Of the 17 recurrences of sciatica, 11 patients have undergone microdiscectomy, with eight showing improvement. Chi-square analysis demonstrated a significantly better chance of improvement in patients with discs bulging eccentrically to the side of sciatica (p < 0.05) compared to patients with diffusely bulging discs. Automated percutaneous discectomy is safe and in selected patients can reduce sciatica, but only completely eliminated sciatica in 5% of patients with a follow-up period of 2.5 years.

scholarly journals ANALYSIS CORRELATION DURATION OF USE WITH RISK OF INCREASED BLOOD PRESURE ON THE ACCEPTORS INJECTABLE CONTRACEPTIVE DEPO MEDROXYPROGESTERON ACETATE (DMPA) : A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 6 (2) ◽  
pp. 108-113
Author(s):  
Sekar Muktiyani ◽  
Nurmainah Nurmainah
Keyword(s):  
Public Health ◽  
Health Care ◽  
Retrospective Cohort ◽  
Public Health Care ◽  
P Value ◽  
Chi Square ◽  
Cohort Design ◽  
One Year ◽  
Chi Square Analysis

Depo Medroxyprogesterone Acetate (DMPA) is a method of family planning program. DMPA is preferred because of its economical, practical, and effective in preventing pregnancy. Long-term use DMPA is suspected to be a risk of an increase in blood pressure. The purpose of this study was to analyze the correlation between duration of use with risk of hypertension in the DMPA acceptor at Perumnas II Pontianak Public Health Care. The research method was observational analytic with a retrospective cohort design. The population of the study is the new DMPA acceptor January-June 2018. This period is the index date for the use of DMPA or the date of the first use of DMPA by acceptors. The acceptor is followed by using DMPA for one year or more until the end of the 30 June 2019 study through its medical record data. Samples that met the inclusion and exclusion criteria were 81 acceptors. The results showed that acceptors with a duration of use of DMPA for more than 12 months had more risk of hypertension (66.7%) than acceptors with a duration of use for less than 12 months (38.5%). Chi-square analysis showed a significant correlation between the duration of use of DMPA and the risk of hypertension (p-value = 0.011, RR = 1.733 CI 95% = 1.104 - 2.72 in DMPA acceptor at Perumnas II Pontianak Public Health Care. The study concludes that there is a correlation between duration of use and risk of hypertension.

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