Fitness Facility Staff Can Be Trained to Deliver a Motivational Interviewing-Informed Diabetes Prevention Program

Background: Training programs must be evaluated to understand whether the training was successful at enabling staff to implement a program with fidelity. This is especially important when the training has been translated to a new context. The aim of this community case study was to evaluate the effectiveness of the in-person Small Steps for Big Changes training for fitness facility staff using the 4-level Kirkpatrick training evaluation model.Methods: Eight staff were trained to deliver the motivational interviewing-informed Small Steps for Big Changes program for individuals at risk of developing type 2 diabetes. Between August 2019 and March 2020, 32 clients enrolled in the program and were allocated to one of the eight staff. The Kirkpatrick 4-level training evaluation model was used to guide this research. Level one assessed staff satisfaction to the training on a 5-point scale. Level two assessed staff program knowledge and motivational interviewing knowledge/skills. Level three assessed staff behaviors by examining their use of motivational interviewing with each client. Level four assessed training outcomes using clients' perceived satisfaction with their staff and basic psychological needs support both on 7-point scales.Results: Staff were satisfied with the training (M = 4.43; SD = 0.45; range = 3.86–4.71). All learning measures demonstrated high post-training scores that were retained at implementation follow-up. Staff used motivational interviewing skills in practice and delivered the program at a client-centered level (≥6; M = 6.34; SD = 0.83; range = 3.75–7.80). Overall, clients perceived staff supported their basic psychological needs (M = 6.55; SD = 0.64; range = 6.17–6.72) and reported high staff satisfaction scores (M = 6.88; SD = 0.33; range = 6–7).Conclusion: The Small Steps for Big Changes training was successful and fitness facility staff delivered a motivational interviewing-informed program. While not all staff operated at a client-centered level, clients perceived their basic psychological needs to be supported. Findings support the training for future scale-up sites. Community fitness staff represent a feasible resource through which to run evidence-based counseling programs.

Long-term care placement: The transitional support needs and preferences of spousal dementia caregivers

Background and objectives Many spousal caregivers experience stress, depression, loneliness, guilt and grief when placing a partner with dementia into long-term care. However, there is little research about their transitional support experiences, needs and preferences. This study aimed to gain a deeper understanding of these issues from spousal caregiver and long-term care facility staff perspectives, to inform subsequent support and intervention development. Research design and methods Semi-structured interviews and small group discussions were held separately with spousal caregivers ( n = 9) and care facility staff ( n = 11). Criterion and variation sampling aimed to ensure a range of experiences and perspectives. The ‘Framework’ approach was utilised for data analysis. Interpretation was with respect to underpinning models of stress-grief process in dementia caregiving. Findings A range of informational, psychoeducational and psychosocial supports were identified to help spousal caregivers cope better with the stressors and losses experienced throughout the transition from home to long-term care. Improved education about disease progression, information relating to long-term care provision, peer support and dementia-specific grief counselling were deemed important. Opportunities for better support within care facilities were also identified. Support should be tailored to individual needs and preferences. Discussion and implications The findings suggest a supportive care framework be developed, encompassing the trajectory from assessment for and admission into long-term care to end-of-life and post-bereavement support. Spousal caregivers should have their support needs assessed by trained health or social care professionals and be offered a range of support options as appropriate.

Older assistant workers in intermediate care facilities, and their influence on the physical and mental burden of elderly care staff

Background As there is a shortage of care staff in elderly care homes, seniors are expected to work as assistants to help the care staff. This study examined the influence of older assistant workers in intermediate elderly care facilities on care staff, specifically focusing on emotional exhaustion which is a sign of burnout. These facilities provide long-term nursing and supportive care to older residents. Methods Data from a mail survey of intermediate elderly care facilities with older assistant workers were analyzed. Care staff were asked about the advantages and disadvantages of introducing older assistant workers in elderly care work, and their degree of emotional exhaustion. We also assessed work self-evaluations of older assistant workers, including the benefits of the work, and physical and mental burdens. Results A significantly large number of care staff reported improvements in workload with the employment of older assistant workers. Intermediate elderly care facilities enrolling more older assistant workers showed lower mean emotional exhaustion among care staff, independent of possible covariates. While older assistant workers felt that their work contributed to helping both care users and staff, they also reported a mental burden. Conclusions Our results suggest that older assistant workers can play a significant role in reducing the physical and mental burden of intermediate elderly care facility staff. Thus, employing older assistant workers can be an effective approach to addressing shortages of care staff in elderly care homes.

COVID-19 Cases Among Facility-Staff by Neighbourhood of Residence and Social and Structural Determinants: An Observational Study (Preprint)

BACKGROUND Disproportionate risks of COVID-19 in congregate settings including long-term care homes, retirement homes, and shelters both affect and are affected by SARS-CoV-2 infections among facility-staff. In cities across Canada, there has been a consistent trend of geographic clustering of COVID-19 cases. However, there remain limited data on how COVID-19 among facility-staff reflect urban neighbourhood disparities, particularly stratified by the social and structural determinants of community-level transmission. OBJECTIVE To compare the concentration of cumulative cases by geography and social/structural determinants across three mutually exclusive subgroups in the Greater Toronto Area (population 7.1 million): community, facility-staff, and healthcare workers (HCW) in other settings. METHODS We conducted a retrospective, observational study using surveillance data on laboratory-confirmed COVID-19 cases (January 23 to December 13, 2020; prior to vaccination roll-out). We derived neighbourhood-level social/structural determinants from census data, and generated Lorenz curves and Gini coefficients to visualize and quantify inequalities in cases. RESULTS The hardest-hit neighbourhoods (comprising 20% of the population) accounted for 53.4% of community cases, 48.6% of facility-staff cases, and 42.3% of other HCW cases. Compared with other HCW, cases in facility-staff more closely reflected the distribution of community cases. Cases in facility-staff reflected greater social and structural inequalities (larger Gini coefficients) than other HCW across all determinants. Facility-staff cases were also more likely than community cases to be concentrated in lower income neighbourhoods (Gini 0.24[0.15-0.38] vs 0.14[0.08-0.21] with lower household density (Gini 0.23[0.17-0.29] vs 0.17[0.12-0.22]) and with a greater proportion working in other essential services (Gini 0.29 [0.21-0.40], 0.22[0.17-0.28]). CONCLUSIONS COVID-19 cases among facility-staff largely reflects neighbourhood-level heterogeneity and disparities; even more so than cases in other HCW. Findings signal the importance of interventions prioritized and tailored to home geographies of facility-staff in addition to workplace measures, including prioritization and reach of vaccination at home (neighbourhood-level) and at work.

Risk factors for childhood illness and death in rural Uttar Pradesh, India: perspectives from the community, community health workers and facility staff

Background Uttar Pradesh (UP), India continues to have a high burden of mortality among young children despite recent improvement. Therefore, it is vital to understand the risk factors associated with under-five (U5) deaths and episodes of severe illness in order to deliver programs targeted at decreasing mortality among U5 children in UP. However, in rural UP, almost every child has one or more commonly described risk factors, such as low socioeconomic status or undernutrition. Determining how risk factors for childhood illness and death are understood by community members, community health workers and facility staff in rural UP is important so that programs can identify the most vulnerable children. Methods This qualitative study was completed in three districts of UP that were part of a larger child health program. Twelve semi-structured interviews and 21 focus group discussions with 182 participants were conducted with community members (mothers and heads of households with U5 children), community health workers (CHWs; Accredited Social Health Activists and Auxiliary Nurse Midwives) and facility staff (medical officers and staff nurses). All interactions were recorded, transcribed and translated into English, coded and clustered by theme for analysis. The data presented are thematic areas that emerged around perceived risk factors for childhood illness and death. Results There were key differences among the three groups regarding the explanatory perspectives for identified risk factors. Some perspectives were completely divergent, such as why the location of the housing was a risk factor, whereas others were convergent, including the impact of seasonality and certain occupational factors. The classic explanatory risk factors for childhood illness and death identified in household surveys were often perceived as key risk factors by facility staff but not community members. However, overlapping views were frequently expressed by two of the groups with the CHWs bridging the perspectives of the community members and facility staff. Conclusion The bridging views of the CHWs can be leveraged to identify and focus their activities on the most vulnerable children in the communities they serve, link them to facilities when they become ill and drive innovations in program delivery throughout the community-facility continuum.

Dying by Suicide in Nursing Homes: A Preventable End of Life Outcome for Older Residents

Suicide research and suicide prevention have given comparatively little attention to the older adult residents of nursing homes. This population is characterized by advanced age, significant infirmity, limited autonomy and social connections, and other factors associated with high suicide risk such as self-neglect. However, little is known of the actual incidence and prevalence of suicide in older adults in such residential care settings, partly because of how such deaths are reported. Suicide risk screenings are nominal, facility staff lack training to identify signs of suicidality, and suicide prevention programs are not common in the nursing home industry. These deficits can be remedied by increasing awareness among family members, facility caregivers, contracted providers, community aging services, accrediting and regulatory agencies, and residents.

Pengembangan Aplikasi Monitoring Inventaris Barang Pada Universitas Ibnu Sina Batam Berbasis Web

A The inventory system at Ibnu Sina University in the facilities and infrastructure section of the old system still has several shortcomings, therefore the authors are interested in developing from the old system so as to produce an updated and user friendly system which has more advantages including barcode features, control features goods, then the chairman has direct access that previously did not have the old system. The development of this inventory system, the author uses a prototype method with a development model using the Unified Model Language (UML). The purpose of this research will be to facilitate facility staff in finding information on goods by means of barcode scanners on QR labels that have been affixed to goods, making it easier to find out the condition of goods that are carried out regularly with the goods control feature, having three actors in using the inventory system which the main actor has full access and the other two actors have limited access in using the system. With the hope that the facilities section will make it easier to control all assets or inventory of goods at Ibn Sina University. So that it can be a solution to existing problems. Keywords: Goods Inventory, Prototype, QR Code. Abstrak: Sistem inventarisasi pada Universitas Ibnu Sina pada bagian sarana dan prasarana pada sistem yang lama masih memiliki beberapa kekurangan oleh karena itu penulis tertarik mengembangkan dari sistem yang lama sehingga menghasilkan sistem yang ter-update dan user friendly yang mana lebih memiliki kelebihan diantaranya fitur barcode, fitur kontrol barang, kemudian ketua memiliki akses secara langsung yang sebelumnya tidak dimiliki sistem lama. Pengembangan pada sistem inventaris barang ini penulis menggunakan metode prototype dengan model pengembangan menggunakan Unified Model Language (UML). Adapun tujuan dari penelitian ini nantinya dapat mempermudah staff sarana dalam pencarian informasi barang dengan cara scanner barcode pada label QR yang sudah ditempel pada barang, mempermudah mengetahui kondisi barang yang dilakukan secara berkala dengan adanya fitur kontrol barang, mempunyai tiga aktor dalam penggunaan sistem inventaris yang mana aktor utama memiliki akses secara penuh dan dua aktor lainnya memiliki akses terbatas dalam penggunaan sistem. Dengan harapan agar bagian sarana lebih mudah dalam pengkontrolan semua asset ataupun inventaris barang yang ada pada Universitas Ibnu Sina. Sehingga dapat menjadi solusi dalam permasalahan yang ada. Kata kunci: Inventaris Barang, Prototype, QR Code.

Working with laboratory rodents in Spain: a survey on welfare and wellbeing

Background Replacement, reduction and refinement, the 3R principles, provide a framework to minimize the use and suffering of animals in science. In this context, we aimed to determine the actual perception that individuals working with laboratory rodents in biomedical research have on animal welfare and on their interaction with the animals, as well as how they perceive its impact on their social relations. To this end, we designed an anonymous on-line survey for people working with rodents, at three responsibility levels, in Spain. Results Of the 356 participants, 239 were women (67 %); 263 were researchers (74 %), and 93 animal facility staff (26 %), of which 55 were caretakers/technicians (15 %), and 38 welfare officer/veterinarians (11 %). Animal facility staff indicated environmental enrichment to be a universal practice. About half of the participants reported that, in their opinion, animals suffer “little to none” or “minor” stress and pain. Animal caretakers/technicians and researchers perceived higher levels of stress and pain than welfare officers/veterinarians. Participants judged decapitation the most unpleasant method to kill rodents, whereas anaesthetic overdose was the least one. A sizable proportion − 21 % of animal caretakers/technicians and 11.4 % of researchers - stated that they were never given the choice not to euthanize the rodents they work with. Overall, women reported higher interactions with animals than men. Nevertheless, we could detect a significant correlation between time spent with the animals and interaction scores. Notably, 80 % of animal facility staff and 92 % of researchers rarely talked about their work with laboratory rodents with people outside their inner social circle. Conclusions Overall, the participants showed high awareness and sensitivity to rodent wellbeing; animal facility staff reported a similar perception on welfare questions, independently of their category, while researchers, who spent less time with the animals, showed less awareness and manifested lower human-animal interaction and less social support. Regarding the perception on social acceptance of laboratory animal work, all groups were cautious and rarely talked about their job, suggesting that it is considered a sensitive issue in Spain.