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Kinds of Residential Terms modified by Residential Selected AbstractsEvaluation of natural attenuation at a 1,4-dioxane-contaminated siteREMEDIATION, Issue 1 2008Dora Sheau-Yun Chiang 1,4-Dioxane entered the environment as a result of historic leaks and spills in the production area at an industrial facility in the southeastern coastal plain. The areal extent of the 1,4-dioxane plume is several hundred acres and is largely contained on the site. Land use adjacent to the plant property is primarily undeveloped (wetlands or woods) or industrial, with a small area of mixed land use (commercial/residential) to the southwest and north. The surficial aquifer is a relatively simple hydrogeologic system with well-defined boundaries and is comprised of a 50- to 70-foot-thick deposit of alluvial/fluvial sand and gravel that overlies an aquitard in excess of 100 feet thick. A groundwater flow model, developed and calibrated using field-measured data, was used for the fate-and-transport modeling of 1,4-dioxane. The flow-and-transport model, combined with the evaluation of other site geochemical data, was used to support the selection of monitored natural attenuation (MNA) as the proposed groundwater remedy for the site. Since the active sources of contamination have been removed and the modeling/field data demonstrated that the plume was stable and not expanding, the proposed MNA approach was accepted and approved by the regulatory agency for implementation in 2004. Subsequent accumulated data confirm that concentrations in the 1,4-dioxane plume are declining as predicted by the fate-and-transport modeling. © 2008 Wiley Periodicals, Inc. [source] DESTINATION EFFECTS: RESIDENTIAL MOBILITY AND TRAJECTORIES OF ADOLESCENT VIOLENCE IN A STRATIFIED METROPOLIS,CRIMINOLOGY, Issue 3 2010PATRICK SHARKEY Two landmark policy interventions to improve the lives of youth through neighborhood mobility,the Gautreaux program in Chicago and the Moving to Opportunity (MTO) experiments in five cities,have produced conflicting results and have created a puzzle with broad implications: Do residential moves between neighborhoods increase or decrease violence, or both? To address this question, we analyze data from a subsample of adolescents ages 9,12 years from the Project on Human Development in Chicago Neighborhoods, a longitudinal study of children and their families that began in Chicago,the site of the original Gautreaux program and one of the MTO experiments. We propose a dynamic modeling strategy to separate the effects of residential moving across three waves of the study from dimensions of neighborhood change and metropolitan location. The results reveal countervailing effects of mobility on trajectories of violence; whereas neighborhood moves within Chicago lead to an increased risk of violence, moves outside the city reduce violent offending and exposure to violence. The gap in violence between movers within and outside Chicago is explained not only by the racial and economic composition of the destination neighborhoods but also by the quality of school contexts, adolescents' perceived control over their new environment, and fear. These findings highlight the need to simultaneously consider residential mobility, mechanisms of neighborhood change, and the wider geography of structural opportunity. [source] Organophosphorus pesticides in storm-water runoff from southern California (USA)ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 8 2004Kenneth Schiff Abstract Large quantities of the organophosphorus (OP) pesticides diazinon and chlorpyrifos are applied to California (USA) watersheds every year, but few data are available on the sources of OP pesticides in urban watersheds. The goal of this study was to characterize diazinon and chlorpyrifos concentrations from different land uses indicative of source categories in urban southern California watersheds. This characterization included analysis of 128 runoff samples from eight different land uses over five storm events. Diazinon was consistently detected (93% of samples) during this study, whereas chlorpyrifos was not consistently detected (12% of samples). The mixed agricultural land use had the highest flow weighted mean (FWM) concentration of diazinon (4,076 ng/L), which exceeded the next-highest land-use categories (commercial and residential) by one to two orders of magnitude (324,99 ng/L, respectively). Open space had the lowest concentration of diazinon (<20 ng/L). Concentrations of diazinon at replicate land-use sites and during replicate storm events at the same site were highly variable. The difference in diazinon FWM concentrations among replicate sites ranged from 1.5-fold to 45-fold. The difference in diazinon FWM concentrations among storms at the same site ranged from 1.25-fold to 30-fold. Part of this variability is a response to the temporal patterns observed within a storm event. The majority of land-use site-events had peak concentrations before peak flow indicating a first-flush effect, but this was not always a predictable temporal trend. The first-flush effect was rarely evident in terms of mass loadings because flows can range orders of magnitude during a single event in highly impervious urban watersheds. Flow variability thus overwhelms the variability in diazinon concentrations attributable to the first-flush effect. [source] The National Treatment Outcome Research Study (NTORS): 4,5 year follow-up resultsADDICTION, Issue 3 2003Michael Gossop ABSTRACT Aims ,The National Treatment Outcome Research Study (NTORS) is the first prospective national study of treatment outcome among drug misusers in the United Kingdom. NTORS investigates outcomes for drug misusers treated in existing services in residential and community settings. Design, setting and participants,The study used a longitudinal, prospective cohort design. Data were collected by structured interviews at intake to treatment, 1 year, 2 years and at 4,5 years. The sample comprised 418 patients from 54 agencies and four treatment modalities. Measurements, Measures were taken of illicit drug use, injecting and sharing injecting equipment, alcohol use, psychological health and crime. Findings, Rates of abstinence from illicit drugs increased after treatment among patients from both residential and community (methadone) programmes. Reductions were found for frequency of use of heroin, non-prescribed methadone, benzodiazepines, injecting and sharing of injecting equipment. For most variables, reductions were evident at 1 year with outcomes remaining at about the 1 year level or with further reductions. Crack cocaine and alcohol outcomes at 4,5 years were not significantly different from intake. Conclusions, Substantial reductions across a range of problem behaviours were found 4,5 years after patients were admitted to national treatment programmes delivered under day-to-day conditions. The less satisfactory outcomes for heavy drinking and use of crack cocaine suggest the need for services to be modified to tackle these problems more effectively. Despite differences between the United Kingdom and the United States in patient populations and in treatment programmes, there are many similarities between the two countries in outcomes from large-scale, multi-site studies. [source] Inpatient substance abuse care and the outcome of subsequent community residential and outpatient careADDICTION, Issue 6 2000Rudolf H. Moos Aim. To compare participation in treatment and 1-year substance use, symptom and functioning outcomes between patients with substance use disorders who did versus those who did not have an episode of inpatient care immediately prior to an episode of community residential and outpatient mental health care. Design. Two matched groups of 257 patients each with substance use disorders were assessed at entry to and discharge from a community residential facility (CRF) and at a 1-year follow-up. Findings. Patients in the two treatment groups received a comparable amount of CRF and outpatient mental health care. Nevertheless, patients who had prior inpatient care were more likely to be employed at 1-year follow-up. In addition, when they entered CRF care directly, patients with co-morbid psychiatric disorders were more likely to continue use of alcohol and drugs in the CRF and less likely to complete the program. These patients also experienced more distress and psychiatric symptoms, and were less likely to be employed at the 1-year follow-up. Conclusions. Among patients who seek treatment at Department of Veterans Affairs (VA) facilities, those who have both substance use and psychiatric disorders and enter CRF care directly have somewhat worse outcomes than those who have an immediately prior episode of inpatient care. [source] ,MOVING AROUND': THE SOCIAL AND SPATIAL MOBILITY OF YOUTH IN LUSAKAGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 3 2008Katherine V. Gough ABSTRACT Claims have recently been made for a ,mobilities paradigm' which is challenging the relative ,a-mobile' focus of much of the social sciences. The agenda drawn up for this mobilities paradigm is clearly based on Northern trends with little consideration of the South. African populations have always been mobile but little is known about the mobility of urban populations and in particular of the youth, who constitute a large proportion of the population. This paper explores the daily and residential mobility of young people in Lusaka building upon interviews held with low- and middle-income youth. The aim is to contribute to discussions of: how mobility varies by gender and class; the links between spatial mobility and social and economic mobility; the nature of the relationship between patterns of mobility and residential structure; and how examining mobility can illuminate many other aspects of young people's lives. Overall the picture emerging from Lusaka is rather bleak. In a context of spiralling economic decline and rising HIV/AIDS rates, the social mobility of youth is predominantly downwards which is reflected in the residential and daily mobility patterns of the young people. There is a strong link between young people's mobility and their livelihoods, an aspect of mobility that is widespread in the South but largely overlooked by the emerging mobilities paradigm. [source] Types and Patterns of Later-life MigrationGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 3 2000William H. Walters This paper refines previous typologies of later-life mobility by explicitly evaluating the spatial migration patterns and household characteristics of retired American migrants. Migrants' lifecourse attributes (economic status, disability, presence of spouse), large-scale migration patterns (internal migration) and household characteristics (living arrangements, economic independence, residential independence) are used to identify three types of post-retirement mobility. The first type, amenity migration, has a distinctive spatial pattern that suggests a search for attractive climate and leisure amenities. The second type of mobility, assistance migration, can be traced to low income and the absence of a spouse in the household. It often results in residential and economic dependence , specifically, in co-residence with adult children or other labor force members. The third type of mobility, migration in response to severe disability and spouse absence, tends to result in nursing home residence. While amenity migration has long been associated with good health and favorable economic status, this analysis reveals that many disabled and lower-income retirees share the inmigration pattern typical of amenity migrants. In fact, amenity migration is the predominant type of mobility among those migrants with fewer than two unfavorable lifecourse attributes (low income, severe disability and spouse absence). Unlike previous lifecourse typologies, this study shows no clear relationship between moderate disability and co-residence with adult children. The results suggest that co-residence is primarily a strategy for reducing living costs rather than a means of coping with moderate disability. [source] AFRICAN, RUSSIAN, AND UKRAINIAN REFUGEE RESETTLEMENT IN PORTLAND, OREGONGEOGRAPHICAL REVIEW, Issue 2 2005SUSAN E. HUME ABSTRACT. The residential patterns, adaptation experiences, and impacts of immigrants on North American cities have been well documented in the geographical literature. In this article, we build on prior work by testing the theories of Gaim Kibreab, who identified three factors that shape the experiences of recent refugees: attitudes of the receiving society; current policy environments; and employment opportunities in local communities. We analyze some of the ways in which these factors operate as interrelated systems for two comparative groups of foreign-born migrants in Portland, Oregon: sub-Saharan Africans; and Russians and Ukrainians. Using a mixed-methods approach, we triangulate data from a blend of in-depth interviews, participant observation in the community and at refugee and immigrant social service agencies, census and other statistical records, and cartographic analyses to report on the findings of our work. Data suggest that the residential, economic, and social spaces of new refugees are constructed as a complex multiplicity of networks and relationships that link time and place [source] BELGIAN SETTLEMENT AND SOCIETY IN THE INDIANA RUST BELT,GEOGRAPHICAL REVIEW, Issue 1 2003SUSAN E. HUME ABSTRACT. At first glance the industrial city of Mishawaka, near the northern border of Indiana, appears to be ethnically homogeneous. Closer examination, however, reveals the rich ethnic heritage of Mishawaka, as it does in so many other Rust Belt cities from Pittsburgh to Chicago. One of the most fascinating of these immigrant stories is the rise of Belgian Town, on Mishawaka's southwest side. This study examines residential, commercial, and social patterns of this evolving ethnic community during the first three decades of the twentieth century. Although industrial jobs attracted immigrants to the city, creation of a Flemish Catholic church provided the foundation on which to build a tightly knit Belgian community. [source] Oral health and oral implant status in edentulous patients with implant-supported dental prostheses who are receiving long-term nursing careGERODONTOLOGY, Issue 4 2009Rita Isaksson Aim:, The aim of this study was to investigate oral health and oral implant status in a group of edentulous patients receiving long-term residential or nursing care (LTC), all of whom had implant-supported fixed or removable dental prostheses. Material and methods:, A dental examination was performed on a total of 3310 patients receiving LTC and from this population 35 edentulous patients in whom dental implants had been placed formed the cohort for this study. All examinations were performed by a specialist in hospital dentistry and took place in the patients' own home environment. Oral health was assessed by means of a protocol which evaluated oral hygiene status, possible oral mucosal inflammation and oral mucosal friction levels. Any problems with the implant-supported prosthesis, implant mobility or other complications were also assessed. In addition, patients were asked about any oral symptoms and their usual oral hygiene procedures. Results:, About half of the subjects (17/35) were registered as having no/mild inflammation with 18 of 35 having moderate/severe inflammation. Twelve of the 35 patients had good/acceptable oral hygiene and 23 of 35 had poor/bad oral hygiene. Twenty-one of the 35 patients depended on help from the nursing personnel for their daily oral hygiene procedures. Obvious problems with food impaction were noted in 11 patients. A total of 229 implants had been placed in 43 jaws supporting 40 full arch-fixed prostheses and three implant-borne overdentures. There was no evidence of mobility or fractures of either the implants or the prostheses. Fifteen implants showed some exposed screw threads. Pus was exuding from one implant site and general peri-implant gingival hyperplasia was noted in two patients. Twenty-four patients were completely satisfied with the function and appearance of their implant-supported prostheses. Two patients were totally dissatisfied. Conclusion:, This study indicates that oral implant therapy can be considered as a treatment of choice in elderly patients, even if oral hygiene is sub-optimal. [source] Social costs of robbery and the cost-effectiveness of substance abuse treatmentHEALTH ECONOMICS, Issue 8 2008Anirban Basu Abstract Reduced crime provides a key benefit associated with substance abuse treatment (SAT). Armed robbery is an especially costly and frequent crime committed by some drug-involved offenders. Many studies employ valuation methods that understate the true costs of robbery, and thus the true social benefits of SAT-related robbery reduction. At the same time, regression to the mean and self-report bias may lead pre,post comparisons to overstate crime reductions associated with SAT. Using 1992,1997 data from the National Treatment Improvement Evaluation Study (NTIES), we examined pre,post differences in self-reported robbery among clients in five residential and outpatient SAT modalities. Fixed-effect negative binomial regression was used to examine incidence rate reductions (IRR) in armed robbery. Published data on willingness to pay to avoid robbery were used to determine the social valuation of these effects. Differences in IRR across SAT modalities were explored to bound potential biases. All SAT modalities were associated with large and statistically significant reductions in robbery. The average number of self-reported robberies declined from 0.83/client/year pre-entry to 0.12/client/year following SAT (p<0.001). Under worst-case assumptions, monetized valuations of reductions in armed robbery associated with outpatient methadone and residential SAT exceeded economic costs of these interventions. Conventional wisdom posits the economic benefits of SAT. We find that SAT is even more beneficial than is commonly assumed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Congregate care for infants and toddlers: Shedding new light on an old questionINFANT MENTAL HEALTH JOURNAL, Issue 5 2002Brenda Jones Harden With the advent of the "crack" epidemic and the concurrent decrease in available foster homes for young children, the placement of infants and toddlers in residential congregate care settings has resurfaced in some of the larger urban areas of the United States. Despite the controversy surrounding this type of placement, current research on congregate care settings is almost nonexistent. The present study examines the congregate care facilities that were established in an urban area in the mid-Atlantic region of the United States, as a response to the placement crisis for young children in foster care. In addition, the study compares the development of a group of children placed in these settings with a group who were placed in foster home settings. Findings suggest that congregate care facilities differ in their appropriateness for young children based on the number of children in the home and the practice philosophy of the group home. The study documented that children reared in foster family homes fared better than their group-reared counterparts on a variety of variables, including mental development and adaptive skills. In contrast, children reared in congregate care facilities were similar to foster home-reared children regarding observed and reported behavior problems. Implications of these finding for policies and practices related to congregate care placements are discussed. ©2002 Michigan Association for Infant Mental Health. [source] Optimizing Patching-based multicast for video-on-demand in wireless mesh networksINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 9-10 2010Fei Xie Abstract In this work, we study the application of video-on-demand (VoD) in wireless mesh networks (WMN), a next generation edge technology to provide broadband data access in residential, business and even city-wise networks. We adopt a Patching-based multicast technique to better utilize the bandwidth resources in the mesh network. We optimize the Patching-based multicast by addressing two critical problems, namely, the Minimum Cost Multicast Tree (MCMT) problem and the Maximum Benefit Multicast Group (MBMG) problem. The MCMT problem is to find a MCMT in the network. We show that finding such a tree in the WMN can be formulated as a graph theory problem, which is to find the tree with minimum number of non-leaf nodes, and which spans all the nodes in the multicast group. We further prove the problem is NP-hard and propose a fast greedy algorithm to accommodate the real-time feature of the VoD application. We solve the MBMG problem by minimizing the communication of a Patching group in the entire network. A Markov model is proposed to capture the growth of the multicast group in the WMN. Simulation study results validate the proposed solutions of the two problems. Copyright © 2009 John Wiley & Sons, Ltd. [source] Modeling an industrial energy system: Perspectives on regional heat cooperationINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 9 2008S. Klugman Abstract Through energy efficiency measures, it is possible to reduce heat surplus in the pulp and paper industry. Yet pulp and paper mills situated in countries with a heat demand for residential and commercial buildings for the major part of the year are potential heat suppliers. However, striving to utilize the heat within the mills for efficient energy use could conflict with the delivery of excess heat to a district heating system. As part of a project to optimize a regional energy system, a sulfate pulp mill situated in central Sweden is analyzed, focusing on providing heat and electricity to the mill and its surrounding energy systems. An energy system optimization method based on mixed integer linear programming is used for studying energy system measures on an aggregated level. An extended system, where the mill is integrated in a regional heat market (HM), is evaluated in parallel with the present system. The use of either hot sewage or a heat pump for heat deliveries is analyzed along with process integration measures. The benefits of adding a condensing unit to the back-pressure steam turbine are also investigated. The results show that the use of hot sewage or a heat pump for heat deliveries is beneficial only in combination with extended heat deliveries to an HM. Process integration measures are beneficial and even increase the benefit of selling more heat for district heating. Adding a condensing turbine unit is most beneficial in combination with extended heat deliveries and process integration. Copyright © 2007 John Wiley & Sons, Ltd. [source] Thermoeconomic modeling of micro-CHP (micro-cooling, heating, and power) for small commercial applicationsINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 9 2008Alan Moran Abstract The increasing demand for electrical power as well as energy for heating and cooling of residences and small commercial buildings is a growing worldwide concern. Micro-cooling, heating, and power (micro-CHP), typically designated as less than 30,kW electric, is decentralized electricity generation coupled with thermally activated components for residential and small commercial applications. The number of combinations of components and parameters in a micro-CHP system is too many to be designed through experimental work alone. Therefore, theoretical models for different micro-CHP components and complete micro-CHP systems are needed to facilitate the design of these systems and to study their performance. This paper presents a model for micro-CHP systems for residential and small commercial applications. Some of the results that can be obtained using the developed model include the cost per month of operation of using micro-CHP versus conventional technologies, the amount of fuel per month required to run micro-CHP systems, the overall efficiency of micro-CHP systems, etc. A case study is used to demonstrate differences in the system performances of micro-CHP systems driven by a natural gas internal combustion engine and a diesel engine. Some of the results show that both systems have similar performance and that system total efficiencies in cooler months of up to 80% could be obtained. Also, modeling results show that there is a limit in fuel price that economically prevents the use of CHP systems, which is $11 MBTU,1 for this specific case. Copyright © 2008 John Wiley & Sons, Ltd. [source] Public funding for residential and nursing home care: projection of the potential impact of proposals to change the residential allowance in services for older peopleINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2003Paul Clarkson Abstract Background This paper investigates the potential effects of a policy change in the funding of UK residential care. The White Paper Modernising Social Services (Cm 4169, 1998) outlined plans to change the distribution of the Residential Allowance (RA), payable in support of residents in independent residential or nursing home care, from a component of income support paid direct to establishments to a grant to local authorities. This change was intended to remove the perverse incentive in accessing independent residential care more favourably than local authority care. A further objective was to encourage local authorities to use the grant to support home-based alternatives to residential care. The policy rests on a model in which price signals dictate the choice of care for an older person. By, in effect, raising the price of independent residential and nursing home care, the policy provides an incentive for authorities to seek alternatives to institutional care. Methods Managers from 16 UK social services departments attended a focus group discussion, completed questionnaires and provided information to assist in calculating the potential diversionary effect of the policy. Results Managerial estimates indicated a small diversionary effect of the policy; A potential effect of 0.26 and 0.19 per 1000 older people diverted from residential and nursing care respectively. Conclusions The study indicated that wider organisational factors other than price are likely to play a greater role in deciding whether an older person is admitted to care. Changes in public funding alone do not reflect the complexities involved in decision-making concerning the residential placement of older people. Copyright © 2003 John Wiley & Sons, Ltd. [source] NANDA and NIC: Mediators to Describe Irish Intellectual Disability NursingINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Fintan Sheerin PURPOSE To identify the foci of interest specific to nursing interventions within residential, intellectual disability nursing through the use of the terms and meanings presented in NANDA and NIC. METHODS Data were collected using a Delphi approach involving a purposive sample of 8 individuals with relevant expertise, followed up by the conduct of three focus groups held with a total sample of 17 intellectual disability nurses working in three Irish service settings: traditional residential, community residential, and nurse education. Data were examined for contextual meaning as well as consensus of perceptions. FINDINGS Many potential interventions and diagnoses were identified for the field of residential learning disability nursing. Interventions that elicited a >50% consensus among participants across groups were examined for contextual meaning, based on the taped and noted responses, and potentially related NIC interventional labels were then applied. These led, through a reverse NIC-NANDA linkage exercise, to the identification of 8 potentially related interventions. The contextual aspect directed the analysis process to identify the nursing diagnoses associated with the interventions to be used, and 21 resultant diagnoses were identified. DISCUSSION Further analysis and study are needed to verify the relevance of these diagnoses and interventions to residential learning disability. A quick comparison of the results with those of studies carried out in other countries demonstrates that certain diagnoses have been identified by one or more authors in their studies. CONCLUSIONS This study identified a number of foci that have achieved various levels of consensus among the study participants. The ongoing study plan will further examine nurses' and managers' perceptions while also looking at these within the context of current service philosophy. [source] Paleopathology and health of native and introduced animals on Southern Peruvian and Bolivian Spanish Colonial sitesINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2010S. D. Defrance Abstract Spanish colonial sites in southern Peru and Bolivia contain remains of native camelids and introduced bovids with examples of degenerative paleopathologies that are interpreted as reflecting changes in herd management, animal use and animal health following the Spanish conquest. The archaeological contexts include three Spanish colonial wineries from Moquegua in southern Peru and the nearby colonial village of Torata Alta where indigenous people were forced to resettle under Spanish control. Also from Peru is faunal material from the 14th to 16th century rural agropastoral village of Pillistay located near Camana. Animal remains with bone abnormalities are also present in residential, commercial and industrial sites associated with Spanish silver mining near Potosí, Bolivia at Tarapaya and Cruz Pampa. Eighteen pathological specimens are described including examples of degenerative changes to phalanges, vertebrae, tarsals, limb elements and ribs. Paleopathologies present include exostoses, osteophytes, porosity, grooving and eburnation. Examples of phalangeal exostoses on bovid phalanges indicate the use of these introduced animals as draught cattle. Exostoses on camelid first phalanges suggests their use as cargo animals as do thoracic vertebrae with severe cases of degenerative pathology. Introduced caprines contain few pathologies indicating their primary use as food animals. The bone abnormalities from colonial sites are more severe than those reported for prehispanic faunal assemblages. These data provide insights into the health and work behaviour of indigenous Andean camelids and introduced Eurasian animals following the Spanish conquest. Copyright © 2009 John Wiley & Sons, Ltd. [source] Clinical medication review by a pharmacist of elderly people living in care homes: pharmacist interventionsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2007David P Alldred research clinical pharmacist Objectives To describe the rate and nature of pharmacist interventions following clinical medication review of elderly people living in care homes. Setting Care home residents aged 65+ years, prescribed at least one repeat medication, living in nursing, residential and mixed care homes for older people in Leeds, UK. Method Analysis of data from care home residents receiving clinical medication review in the intervention arm of a randomised controlled trial. Intervention outcomes for each medicine were evaluated for each resident. Key findings Three-hundred and thirty-one residents were randomised to receive a clinical medication review and 315 (95%) were reviewed by the study pharmacist; 256 (77%) residents had at least one recommendation made to the general practitioner. For the 2280 medicines prescribed, there were 672 medicine-related interventions: medicines for cardiovascular system (167 (25%)), nutrition and blood (121 (18%)), central nervous system (113 (17%)) and gastrointestinal conditions (86 (13%)) accounted for 487 (73%) of medicine-related interventions. There were 75 non-medicine-related interventions. The most common interventions were ,technical' (225 (30%)), ,test to monitor medicine' (161 (22%)), ,stop drug' (100 (13%)), ,test to monitor conditions' (75 (10%)), ,start drug' (76 (10%)), ,alter dose' (40 (5%)) and ,switch drug' (37 (5%)). Recommendations to stop a medicine were most common for CNS drugs (32 (32%)). The most common medicine to be recommended to be started was calcium and vitamin D (45 (59%)). Following a recommendation to test to monitor a medicine, 23 (14%) medicines required a change. Conclusions This study has demonstrated that clinical medication review by a pharmacist can identify medicine problems in approximately 80% of care home residents, requiring intervention in 1 in 4 of their prescribed medications. [source] An assessment of pharmaceutical inspection reports from nursing and residential homes for the elderly in Northern IrelandINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2004Anna K. Schweizer Phd student Objectives To highlight issues currently being inspected in nursing, residential and dual-registered homes (care homes) for the elderly in Northern Ireland as part of a pharmaceutical inspection. Methods A cross-sectional survey and analysis of reports from pharmaceutical inspections in Northern Ireland care homes between January 1999 and December 2000 was undertaken, using reports provided by the four Registration and Inspection Units (R & I Units 1,4) within the region. Reports were reviewed and all recommendations made by inspectors were classified into 11 main categories. Binary logistic regression was used to examine possible relationships between the type of home (nursing, residential or dual-registered) or the R & I unit and the recommendations made by the inspectors, with corresponding odds ratios and 95% confidence intervals. Key findings Reports from 415 homes (one report per home) formed the final sample for analysis. Each R & I unit used different documentation to conduct a pharmaceutical inspection. Homes received the majority of recommendations from inspectors in the categories ,Records' (66.7% of all homes), ,Policies and protocols' (39.3%) and ,Medication' (31.8%). More recommendations in a number of categories emanated from R & I unit 4 compared with R & I unit 1 (referent). Dual-registered homes (those registered as a nursing and residential facility) were more likely to receive a recommendation in the categories ,Storage of medicine', ,Order and receipt of medication' and ,Equipment' than nursing or residential homes. Conclusion Inspections of care homes should be standardised in terms of documentation used and facilities should be given guidance on issues that are likely to result in recommendations from inspectors. In the longer-term, pharmaceutical inspections should move from a focus on structure/process measures to those that emphasise quality in prescribing. [source] Fade correlation and diversity effects in satellite broadcasting to mobile users in S-bandINTERNATIONAL JOURNAL OF SATELLITE COMMUNICATIONS AND NETWORKING, Issue 5 2008Albert Heuberger Abstract In this paper, we present measurement results for fade correlation in time and space of signals from two satellites in geostationary orbit with 30° separation. Fade data for urban, residential and rural environments are analyzed. In addition to fade cumulative distribution function, rice factor and coherence length of individual fade signals, also the joint probability density function and the cross-correlation for the fade from the two satellites are presented. The coherence length of single satellite fades extends to about 18,m in the urban area and is around 2,m in the rural area. The correlation coefficient of dual satellite fades is below 0.3 in the residential and rural area. In the urban area larger correlations around 0.7 occur. Based on the measured fade data the diversity gain for various network configurations are determined by simulation for a forward error correction scheme using concatenated codes in combination with random interleavers. Network configurations of interest are single-satellite space diversity, two-satellite space diversity, one-satellite time diversity and two-satellite space and time diversity. For short interleavers of 5,m the diversity gain is in the residential area of 2.3,dB for the two-satellite space diversity, 0.3,dB for one-satellite time diversity and 4.1,dB for two-satellite space and time diversity. Copyright © 2008 John Wiley & Sons, Ltd. [source] Immigrant Place Entrepreneurs in Los Angeles, 1970,99INTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 2 2002Ivan Light Proclamations of the death of Los Angeles' growth machine are premature. These proclamations overlook the growing role of immigrant Korean and Chinese entrepreneurs in regional property development. Since 1970, Korean and Chinese entrepreneurs have seriously restructured Los Angeles' morphology, creating hierarchically arranged residential and business clusters for co,ethnic immigrants. Koreatown and Monterey Park are the brand names most familiar to outsiders, but these prominent localities really coexist with a multiplicity of less well,known ethnic communities that owe their origins to immigrant property developers. The immigrant property developers use the classic methods of the growth machine: buy land cheaply, promote it in Chinese or Korean emigration basins, then sell it to co,ethnic immigrants at a profit. In the process, the immigrant property developers reduce the difficulty of immigration to Los Angeles at the same time that they enhance its perceived desirability. The success of the Chinese and Korean developers highlights the hazard of assuming, as is conventionally done, that ethnic residential clustering arises from leaderless social processes. In both these highlighted cases, entrepreneurial elites created residential clusters of co,ethnics from conscious, long,term plans that required political as well as economic savoir,faire. In so doing, the immigrant property developers joined the Los Angeles growth machine whose fortunes, admittedly, have been waning among the native born population of the region. La mort annoncée de la dynamique de croissance de Los Angeles est prématurée. Ce serait oublier le rôle grandissant des chefs d'entreprise immigrés coréens et chinois dans l'aménagement immobilier régional. Depuis 1970, ces entrepreneurs ont considérablement restructuré la morphologie de Los Angeles, créant des ,agglomérats' commerciaux et résidentiels hiérarchisés pour migrants de m?,me ethnie. Si Koreatown et Monterey Park sont des noms bien connus des étrangers, ces lieux dominants coexistent en réalité avec une multiplicité de communautés ethniques moins renommées qui doivent leurs origines à des promoteurs immigrés. Ces derniers appliquent les mécanismes classiques de la prospérité: acheter le terrain bon marché, le promouvoir dans des bassins d'émigration chinois ou coréens, puis le vendre à profità des immigrants co,ethniques. Ainsi, les promoteurs immigrés facilitent l'immigration vers Los Angeles tout en en accentuant l'aspect attractif. La réussite des aménageurs chinois et coréens souligne le risque qu'il y a à supposer, comme bien souvent, que tout regroupement résidentiel ethnique naît de processus sociaux non dirigés. Dans les deux cas exposés, les élites commerciales ont créé des regroupements résidentiels de m?,me ethnie selon des plans délibérés à long terme, impliquant un savoir,faire à la fois politique et économique. Ce faisant, les promoteurs immigrés ont rejoint la dynamique de croissance de Los Angeles qui, il est vrai, a vu décliner les succès au sein de sa population de souche. [source] The Social Networks of People with Intellectual Disability Living in the Community 12 Years after Resettlement from Long-Stay HospitalsJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2006Rachel Forrester-Jones Background, The social inclusion of people with intellectual disabilities presents a major challenge to services. As part of a 12-year follow up of people resettled from long-stay hospitals, the size of 213 individuals' social networks and the types of social support they received were investigated, as viewed by people with intellectual disabilities themselves. The types of support received in four different kinds of community accommodation were compared. Method, Individuals were interviewed and their social support networks mapped using a Social Network Guide developed for the study. Descriptive statistics were generated and comparisons made using generalized linear modelling. Results, The sample comprised 117 men (average age 51 years) and 96 women (average age 56 years). All but seven were White British, 92% were single and they had in general, mild to moderate intellectual disabilities. The average network size was 22 members (range 3,51). The mean density was 0.5. A quarter of all network members were other service users with intellectual disabilities and a further 43% were staff. Only a third of the members were unrelated to learning disability services. In general, the main providers of both emotional and practical support were staff, although these relationships were less likely to be described as reciprocal. Other people with intellectual disabilities were the second most frequent providers of all types of support. People in small group homes, hostels and supported accommodation were significantly more likely to report close and companiable relationships than those in residential and nursing homes, but they also reported a greater proportion of critical behaviour. Conclusions, The social networks revealed in this study are considerably larger than those of previous studies which have relied on staff reports, but findings about the generally limited social integration of people with intellectual disabilities are similar. A clearer policy and practice focus on the desirability of a range of different social contexts from which to derive potentially supportive network members is required so that people do not remain segregated in one area of life. [source] Service Use and Costs of Support 12 Years after Leaving HospitalJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2006Angela Hallam Background, There have been major changes in the provision and organization of services for people with intellectual disabilities in England over the last 30 years, particularly deinstitutionalization and the development of the mixed economy of care. The experiences of the people who participated in the Care in the Community Demonstration Programme in the mid-1980s provide evidence of the immediate and longer-term effects of the reprovision policy. Methods, Cross-sectional and longitudinal evidence was gathered on service use and costs for over 250 people 12 years after they left long-stay hospitals for community living arrangements. Comparisons were made with the situation in hospital, and 1 and 5 years after leaving. Relationships between costs after 12 years and individual characteristics assessed before people left hospital were explored. Results, Community care at the 12-year follow-up remained more expensive than hospital-based support, although the average cost was lower than at either of the 1- or 5-year community follow-up points. Service users were living in a wide variety of accommodation settings. Management responsibility fell on National Health Service (NHS) trusts, local authorities, voluntary agencies, or to private organizations or individuals. After standardizing for users' skills and abilities, costs in minimum support accommodation were significantly lower than those in residential and nursing homes, costs in staffed group homes significantly higher, and costs in hostels slightly lower. When looking at differences between individuals, no relationship was found between costs and outcomes although, overall, people were better off in the community than they had been when in hospital. Conclusions, Reprovision planning for hospital and other institutional modes of care requires major and long-term commitment of resources. Quality of life improvements can be achieved at a cost little different in the long-run from that for hospital care. The link between needs and costs (reflecting the services intended to meet those needs) would be made stronger through the individualization of care. [source] Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital TerritoryJOURNAL OF CLINICAL NURSING, Issue 2 2009Paul Arbon Aim., This paper reports a project investigating the potential role of the nurse practitioner in aged care across residential, community and acute care venues in the Australian Capital Territory. Background., Australia, like many other countries, faces unprecedented challenges in the provision of health care. Escalating health care costs, an ageing population, increasing prevalence of comorbidities and chronic illnesses, inefficient health care delivery, changing models of health care and shifting professional role boundaries are factors that have contributed to the development of advanced practice roles for nursing. Design., This was a mixed methods study using multiple data sources. Methods., Student aged care nurse practitioners were examined across the continuum of care in the acute, community and residential aged care settings. The potential role of the nurse practitioner in these areas was evaluated qualitatively and quantitatively to identify a model of care to enhance the delivery of efficient and effective health care. Results., The project findings have demonstrated that there is potential for significant improvement in client outcomes arising from a transboundary aged care nurse practitioner model. The improved outcomes are associated with a decrease in acute hospital admissions for residential care clients, timely intervention for a range of common conditions and strengthened multidisciplinary approaches to care provision for older people. Conclusions., Overall the project findings strongly support the potential of a transboundary aged care nurse practitioner role. This role would focus on skilled assessment, timely assessment and intervention, brokering around access to care and clinical leadership and education for nurses. Relevance to clinical practice., This paper offers further evidence of support for the role of nurse practitioners in complementing existing health services and improving delivery of care. [source] ,You've got to grow up when you've got a kid': Marginalized young women's accounts of motherhoodJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 4 2008Alison Rolfe Abstract Teenage motherhood has been a source of considerable debate in policy and media circles in recent years. This paper explores the meanings of teenage motherhood for young women who were mothers before the age of 21, who were living in economically deprived areas of England and most of whom had been in residential or foster care. Qualitative interviews were carried out at several sites across England, with a total of 33 young women taking part in group interviews and one-to-one interviews. The accounts of the young women suggest that they talk about motherhood in three main ways: as ,hardship and reward', ,growing up and responsibility' and ,doing things differently'. It is argued that these ways of talking about motherhood present a different picture of teenage motherhood from that of dominant discourses. Furthermore, the young women are active in negotiating and constructing their own identities as mothers, carers and women. Copyright © 2008 John Wiley & Sons, Ltd. [source] The role of support staff in promoting the social inclusion of persons with an intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2010R. McConkey Abstract Background Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention. Methods In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job. Results Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks. Conclusions Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities. [source] Obstacles in large-scale epidemiological assessment of sensory impairments in a Dutch population with intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2004H. Evenhuis Abstract Background A population-based epidemiological study on visual and hearing impairment was planned in a random sample of 2100 clients, drawn from a base population of 9012 users of Dutch residential and day-care intellectual disability (ID) services with the whole range of IDs. Stratification was applied for age 50 years and over and Down syndrome. Visual and hearing functions were assessed according to a standardized protocol, in cooperation with regular ophthalmologists and regional audiological centres. Anticipated obstacles in sample collection, random inclusion, informed consent, expertise of investigators, time and costs were eliminated by a careful preparation. However, inclusion and participation were incomplete. Method In a descriptive retrospective design, we collected data from our study files on inclusion and participation as well as reasons for non-participation, to identify unanticipated obstacles for this kind of research. Results Consent was obtained for 1660 clients, and 1598 clients participated in the data collection (76% of intended sample of 2100). Inclusion and participation rates were especially lower in community-based care organizations, resulting in unintentional skewing of the sample towards more severe levels of ID. Complete and reliable data to diagnose visual impairment were obtained for 1358/1598 (85%) and to diagnose hearing impairment for 1237/1598 participants (77%). Unanticipated obstacles had to do with the quality of coordination within care organizations, with characteristics of screening methods, and with collaboration with the regular health care system. Assessments of visual function were more easy to organize than were those of hearing. Based on our current experience, practical recommendations are given for future multicentre research, especially in community-based settings. [source] Leadership and management skills of first-line managers of elderly care and their work environmentJOURNAL OF NURSING MANAGEMENT, Issue 6 2010FATHYA ABDELRAZEK PhD abdelrazek f., skytt b., aly m., el-sabour m.a., ibrahim n.& engström m.(2010) Journal of Nursing Management 18, 736,745 Leadership and management skills of first-line managers of elderly care and their work environment Aim, To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background, FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods, A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results, In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications, The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries. [source] Oral Health Status of San Francisco Public School Kindergarteners 2000,2005JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2006Lisa H. Chung DDS Abstract Objectives:To determine the prevalence of dental caries and oral health disparities in San Francisco kindergarten public school children from 2000,2005. Methods:The San Francisco Department of Public Health in partnership with the San Francisco Dental Society and assistance from the National Dental Association, has been conducting annual dental screenings of kindergarten children enrolled in the San Francisco Unified School District since 2000. Outcomes assessed from this series of cross-sectional screenings included prevalence of caries experience, untreated caries, treatment needs, and caries severity by child's sex, race/ethnicity, residential zip code, and a proxy for socioeconomic status. Results:Of 76 eligible schools, 62,72 participated, and 86,92% of enrolled children (n=3,354-3,527) were screened yearly. Although there was a small, significant decrease over the time period, in 2005, 50.1% of children had caries experience; 28.8% had untreated caries and 7.6% had urgent treatment needs. Each year caries prevalence was greatest for Asian children, those attending schools with > 50% children eligible for the free or reduced-price meal program, and children living in zip codes in and around Chinatown and San Francisco's southern border. Conclusions:Despite signs of improvement, caries remains a public health problem especially in Asian and Hispanic children, and children living in certain sections of San Francisco. [source] | ||||||||||||||||||||||||||||||||||||||||||||||