scholarly journals A Logic Model for Evaluation and Planning in an Adult Day Care for Disabled Japanese Old People

Author(s):  
Takashi Naruse ◽  
Ayaka Kitano ◽  
Hiroshige Matsumoto ◽  
Satoko Nagata

Adult day care (ADC) provides various services for meeting clients’ needs. Based on the mini-Delphi method with 46 ADC staff and the discussions with eight ADC administrators, this study developed and finalized a comprehensive logic model to represent the elements of ADC. For the three basic structures of a logic model—inputs/activities, outputs, and outcomes—the model contained seven core categories and 23 sub-categories. The ADC inputs/activities consisted of two core categories: “Place to stay” and “Intervention from staff”. These inputs/activities caused two kinds of outputs: “Clients’ experiences” and “Families’ experiences”. “Accumulating experiences” with repeated ADC visits was established as the link between the ADC outputs and outcomes, which were “Clients’ change” and “Families’ change”. ADC centers provide various experiences for their clients and their caregivers, ranging from the fulfillment of needs for fundamental care to psychiatric care and self-actualization. Improving various model-related inputs/interventions can produce better experiences and outcomes. The model can guide ADC administrators, policymakers, and researchers in the evaluation of a heterogeneous ADC service program that is community-based, thereby ensuring optimal care for clients with an efficient use of resources.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mirko Di Martino ◽  
Michela Alagna ◽  
Adele Lallo ◽  
Kendall Jamieson Gilmore ◽  
Paolo Francesconi ◽  
...  

Abstract Background The benefits of chronic polytherapy in reducing readmissions and death after myocardial infarction (MI) have been clearly shown. However, real-world evidence shows poor medication adherence and large geographic variation, suggesting critical issues in access to optimal care. Our objectives were to measure adherence to polytherapy, to compare the amount of variation attributable to hospitals of discharge and to community-based providers, and to identify determinants of adherence to medications. Methods This is a population-based study. Data were obtained from the information systems of the Lazio and Tuscany Regions, Italy (9.5 million inhabitants). Patients hospitalized with incident MI in 2010–2014 were analyzed. The outcome measure was medication adherence, defined as a Medication Possession Ratio (MPR) ≥ 0.75 for at least 3 of the following drugs: antiplatelets, β-blockers, ACEI/ARBs, statins. A 2-year cohort-study was performed. Cross-classified multilevel models were applied to analyze geographic variation. The variance components attributable to hospitals of discharge and community-based providers were expressed as Median Odds Ratio (MOR). Results A total of 32,962 patients were enrolled. About 63% of patients in the Lazio cohort and 59% of the Tuscan cohort were adherent to chronic polytherapy. Women and patients aged 85 years and over were most at risk of non-adherence. In both regions, adherence was higher for patients discharged from cardiology wards (Lazio: OR = 1.58, p < 0.001, Tuscany: OR = 1.59, p < 0.001) and for patients with a percutaneous coronary intervention during the index admission. Relevant variation between community-based providers was observed, though when the hospital of discharge was included as a cross-classified level, in both Lazio and Tuscany regions the variation attributable to hospitals of discharge was the only significant component (Lazio: MOR = 1.30, p = 0.001; Tuscany: MOR = 1.31, p = 0.001). Conclusion Adherence to best practice treatments after MI is not consistent with clinical guidelines, and varies between patient groups as well as within and between regions. The variation attributable to providers is affected by the hospital of discharge, up to two years from the acute episode. This variation is likely to be attributable to hospital discharge processes, and could be reduced through appropriate policy levers.


1988 ◽  
Vol 9 (1) ◽  
pp. 85-102 ◽  
Author(s):  
Joyce Hedenstrom ◽  
Sharon K. Ostwald
Keyword(s):  
Day Care ◽  

2014 ◽  
Vol 8 (2) ◽  
pp. 162-168
Author(s):  
Maria Vânia Silva Nunes ◽  
Ana Almeida Pinho ◽  
Helena Mauricio Campos ◽  
Paula Abreu ◽  
Isabel Pinto Gonçalves ◽  
...  

ABSTRACT Objective: In the present paper we present an observational study of the implementation of a Neuropsychological Stimulation Program at an Elderly Day Care Center in low-educated participants with very similar backgrounds concerning social economic status. Methods: The implemented program tackled several dimensions, including daily orientation sessions, cognitive stimulation sessions twice a week, followed by movement sessions, and structured sessions conducted every two weeks. Cognitive Evaluation was performed before and after implementation of the program. Results: Results are discussed taking into consideration cognitive outputs as well as non-cognitive outputs and the specificities of community-based intervention. Conclusion: It was concluded that community-based intervention is set to become vital in promoting dementia prevention.


1992 ◽  
Vol 16 (6) ◽  
pp. 336-337
Author(s):  
R. S. Augustine ◽  
P. N. Kurian ◽  
A. Michael

This audit examined 65 consecutive admissions to a psychiatric hospital in the Irish Midlands over six months. The admissions came from a defined sector with a total population of 39,000. In the year prior to the study major changes in the delivery of psychiatric care in the sector were instituted. These changes included the introduction of admission guidelines and extra resources in the community. The general practitioners who see mental illness at first contact were informed of these changes. Attempts were made by the sector psychiatrist team to screen for appropriateness of admission with regard to the special groups such as alcoholics, the aged and the mentally handicapped.


Author(s):  
Teresa Cristina de Miranda Mendonça ◽  
Renato de Oliveira dos Santos ◽  
Paloma Cristina Barbosa Lopes ◽  
Sandro dos Reis Andrade ◽  
Ana Paula Veríssimo de Moraes

Descrevendo o turismo no estado do Rio de Janeiro, destaca-se o seu litoral. Parte desta área integra a região turística denominada Costa do Sol (litoral norte) e a Costa Verde (litoral sul). Pode-se assim,remeter à ideia de apropriação do espaço litorâneo pela prática turística e aos conflitos existentes entre as populações locais e às novas lógicas do capital que se inserem na região. Este trabalho tem como foco de pesquisa a região da Costa Verde, que sofreu influencia do turismo a partir da década de 1970 com a inauguração do trecho Rio-Santos da BR101. Com a estrada chegaram à especulação imobiliária e consequente expulsão dos nativos, e também a instituição das leis ambientais como a criação de unidades de conservação da natureza de proteção integral. No entanto, nesta região estão presentes diversos grupos tradicionais: indígenas, caiçaras e quilombolas que lutam pelo reconhecimento de seu território, contra a expulsão do local herdado e os limites de utilização dos recursos impostos pelas unidades de proteção. Além disto, reivindicam serem incluídos no mapa do turismo da região. Como grande protagonista local foi criado, em 2007, o Fórum de comunidades Tradicionais Angra dos Reis, Paraty e Ubatuba - FCT que traz à tona questões diversas que permeiam a vida de todos que vivem neste local. Na reivindicação pela visibilidade ligada ao turismo foi elaborado o mapa de turismo de base comunitária - TBC do Fórum em 2015. Assim, tendo como metodologia de pesquisa exploratória e descritiva utilizando o método qualitativo (pesquisa documental, bibliográfica e de campo), este trabalho tem como objetivo investigar, do ponto de vista sociocultural e político-organizacional, como se constitui o TBC no território abrangido pelo FCT, porém tendo como foco de análise três iniciativas: a comunidade caiçara de São Gonçalo (Paraty), Quilombo Bracuí e Aldeia Sapukai, ambas localizadas em Angra dos Reis. O resultado traz reflexões sobre o TBC e suas correlações com alguns temas: populações tradicionais; resistência cultural, territorial e econômica; permanência no território tradicional; valorização da identidade e história local; o direito pela prática das atividades econômicas tradicionais e do turismo.Ou seja, ser uma população tradicional significa uma forma de resistência, que transforma experiências locais em turismo. Um turismo denominado localmente de TBC que significa também incluir no mapa do estado os grupos sociais “invisíveis”. Assim constata-se que estas iniciativas estão ligadas a um movimento político e social que tem o turismo como ferramenta de poder. Community-based tourism in Costa Verde (RJ): caiçaras, quilombolas and indigenous peoples ABSTRACT The coastline stands out in the description of tourism in the state of Rio de Janeiro (Brazil). Part of this area comprises the tourist regions of Costa do Sol (northern coast) and Costa Verde (southern coast). They are related to the ideas of appropriation of the coastal space by tourist practice and the conflicts among local populations and the new logics of the capital inserted in the region. This study discusses the Costa Verde region which was influenced by tourism from the 70s with the opening of the Rio-Santos stretch of the BR101 highway. It was followed by real estate speculation and consequentently expulsion of indigenous peoples and also the emergence of environmental laws with the creation of nature conservation units of integral protection. In this region, there are several tradition groups – such as indigenous peoples, caiçaras and quilombolas – who claim: a) the recognition of their territories against the expulsion of the inherited place and the limits of the use of resources imposed by the protected units, and b) their inclusion in the tourist map of the region. Playing the role of the great local protagonist, the Forum of the Traditional Comunities (FCT) of Angra dos Reis, Paraty e Ubatuba was created in 2007 to discuss several issues concerning the life of their residents. As to the demand to the visibility linked to tourism, a community-based tourism (TBC) map was made in the 2015 Forum. This work aims at investigating the TBC in the territories comprising the FCT under a sociocultural and political-organizational approach and an exploratory and descriptive methodological framework with focus on three initiatives: the caiçara community of São Gonçalo (Paraty), Bracuí Quilombo and Sapukai Village, located in Angra dos Reis. The findings of the research raise insights on the TBC and its correlation with the following themes: traditional populations, cultural, territorial and economic resistence, permanence in traditional territory, promotion of local identity and history and the right to the practice of traditional and economic activities and tourism. In other words, being a traditional population means a form of resistence which transforms local experiences in tourism and a locally named TBC also means including the ' invisible' social groups in the state map. Our claim is that these initiatives are linked to a political and social movement which uses tourism as a power tool. KEYWORDS: Community-Based Tourism; Traditional Populations; Costa Verde (RJ, Brazil); Forum of Traditional Communities.


2001 ◽  
Vol 36 (10) ◽  
pp. 500-507 ◽  
Author(s):  
F. Amaddeo ◽  
F. Zambello ◽  
M. Tansella ◽  
G. Thornicroft

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