Children with disabilities and their families are at higher risk during emergencies and disasters, which is often attributed to the lack of disability inclusion in emergency response as well as ...disparities in preparedness. This disparity speaks to a need for emergency preparedness that centers children with disabilities and their families. The purpose of this study was to elicit the perspectives of health professionals (nurses, occupational therapists, social workers), disability advocates, and public safety personnel (e.g., fire fighters, police officers, emergency management administrators) on what would enable these types of professionals to support family-centered emergency preparedness for families who care for children with disabilities. One goal of this research is to provide recommendations for practice and policy to improve safety outcomes for children with disabilities and their families in emergency situations.
This study consisted of 46 qualitative interviews with nurses, occupational therapists, social workers, public safety personnel, and advocacy organization representatives about their role in emergency preparedness for families of children with disabilities. Qualitative content analysis was used to identify themes from participants' responses.
Participants expressed interest in family-centered emergency preparedness, and stated that greater awareness, more education and training, increased networking between professions, and institutional support would enable their involvement.
These findings have implications for the importance of interprofessional collaboration in supporting family-centered emergency preparedness for families of children with disabilities. Stronger interprofessional networks would help overcome many of the barriers identified by participants, and advocacy groups appear to be well-positioned to bridge the gap between these professionals and their areas of expertise.
Hemodialysis patients use a variety of oral medications on a daily basis to control their kidney disease and comorbid illnesses. Under the new paradigm of kidney disease care for dialysis units ...outlined in the 2008 US Centers for Medicare & Medicaid Services Conditions for Coverage, there has been a formal shift in the role of the hemodialysis patient from a passive participant in care planning to a fully collaborative member of the interdisciplinary team. In the chronic disease care field, the focus from patient compliance or patient adherence to patient self-management complements this paradigm shift in dialysis care. In this narrative review, we discuss key barriers to adult hemodialysis patient self-management of oral medications that include pill burden, demographic and socioeconomic variables, psychosocial factors, health literacy, patient satisfaction, and health beliefs. We further examine these barriers in the context of the 2008 Medicare Conditions for Coverage. To promote hemodialysis patients' self-management of oral medication regimens, additional research and behavioral interventions are needed to help hemodialysis patients overcome obstacles that impede their ability to effectively manage chronic illness and improve health outcomes.
Observations of distant supernovae indicate that the Universe is now in a phase of accelerated expansion the physical cause of which is a mystery. Formally, this requires the inclusion of a term ...acting as a negative pressure in the equations of cosmic expansion, accounting for about 75 per cent of the total energy density in the Universe. The simplest option for this 'dark energy' corresponds to a 'cosmological constant', perhaps related to the quantum vacuum energy. Physically viable alternatives invoke either the presence of a scalar field with an evolving equation of state, or extensions of general relativity involving higher-order curvature terms or extra dimensions. Although they produce similar expansion rates, different models predict measurable differences in the growth rate of large-scale structure with cosmic time. A fingerprint of this growth is provided by coherent galaxy motions, which introduce a radial anisotropy in the clustering pattern reconstructed by galaxy redshift surveys. Here we report a measurement of this effect at a redshift of 0.8. Using a new survey of more than 10,000 faint galaxies, we measure the anisotropy parameter = 0.70 ± 0.26, which corresponds to a growth rate of structure at that time of f = 0.91 ± 0.36. This is consistent with the standard cosmological-constant model with low matter density and flat geometry, although the error bars are still too large to distinguish among alternative origins for the accelerated expansion. The correct origin could be determined with a further factor-of-ten increase in the sampled volume at similar redshift.
To examine how information and communication technology (ICT) access and use are conceptually incorporated in the Successful Aging 2.0 framework.
Using data from the 2011 National Health and Aging ...Trends Study (N = 6,476), we examined how ICT access and use for different purposes are associated with social engagement (i.e., informal and formal social participation) by gender. Weighted logistic regression analyses were performed.
Findings revealed that men were more likely to access and use ICT than women. ICT access was positively associated with all types of women's social engagement, but only with men's informal social participation. Information technology (IT) use for health matters was positively associated with formal social participation for women and with informal social participation for men. IT use for personal tasks was negatively associated with formal social participation for older adults. Communication technology use was positively associated with formal and informal social participation for women and men.
This study supports the expansion of the successful aging model by incorporating ICT access and use. Further, it assists in the identification of specific technologies that promote active engagement in later life for women and men.
This study was designed to assess dialysis subjects’ perceived autonomy support association with phosphate binder medication adherence, race and gender. A multi-site cross-sectional study was ...conducted among 377 dialysis subjects. The Health Care Climate (HCC) Questionnaire assessed subjects’ perception of their providers’ autonomy support for phosphate binder use, and adherence was assessed by the self-reported Morisky Medication Adherence Scale. Serum phosphorus was obtained from the medical record. Regression models were used to examine independent factors of medication adherence, serum phosphorus, and differences by race and gender. Non-white HCC scores were consistently lower compared with white subjects’ scores. No differences were observed by gender. Reported phosphate binder adherence was associated with HCC score, and also with phosphorus control. No significant association was found between HCC score and serum phosphorus. Autonomy support, especially in non-white end stage renal disease subjects, may be an appropriate target for culturally informed strategies to optimize mineral bone health.
Teamwork is an aspiration in the delivery of interprofessional care to older adults, but how does it play out in residential settings that combine independent living, assisted living, and skilled ...nursing care? This study investigated teamwork as an organic part of a retirement and assisted living community immersed in mission-driven care. Drawing on 44 in-depth interviews, 62 meeting observations, and five years of immersion in the setting by the first author, we explored the complex dynamics of teamwork. Our overarching findings showed that co-location aided by physical design and a mission-driven investment in care may not be sufficient to effect teamwork in a complex care environment, and that the organizational context was potentially damaging to teamwork. Our study highlights opportunities to improve teamwork and interprofessional collaboration in organizational settings that combine the provision of health and social care. Increasing expectations for teamwork outcomes may prove essential as retirement and assisted living care settings offer supportive and therapeutic environments for older adults who move between different levels of care.
Fatalism is reported as a salient cultural belief that influences cancer screening disparities in racial and ethnic minority groups. Previous studies provide a range of measures and descriptions of ...cancer fatalism, but no studies to our knowledge have analyzed how fatalistic views cluster together within subgroups to form distinct profiles, and how these profiles can be predicted. This study identified subgroups of Korean American immigrants with similar fatalistic beliefs toward cancer and examined the influence of fatalism, health belief variables, and health literacy on mammography use. A cross-sectional survey design was used to obtain a convenience sample of 240 Korean American immigrant women in Los Angeles, California. Latent class analysis was used to identify unobserved subgroups of fatalism. Hierarchical logistic regression models were used to identify predisposing, enabling, and need factors associated with recent mammography use. The latent class analysis model identified three cancer fatalism subgroups: high fatalism (17.8%), moderate fatalism (36.7%), and low fatalism (45.5%). Women in the high fatalism subgroup were more likely to have had a mammogram within the past 2 years than women in the low fatalism subgroup. Regression analysis revealed three facilitators of recent mammogram use: level of fatalism, perceived barriers to mammogram, and family history of cancer. Although cultural beliefs can have a powerful influence on health-seeking behavior, it is important to weigh individual and contextual factors that may weaken or mediate the relationship between fatalism and engaging in preventive care such as having a mammogram.
This study explored the extent to which college men and women of various racial and ethnic groups differ in their health beliefs and behaviors. Exploratory factor analyses of survey responses from a ...diverse sample of 1816 undergraduate students identified 21 items in six cohesive domains: Diet; Anger and Stress; Preventive Care; Medical Compliance; Substance Use; and Beliefs about Masculinity. Analyses of variance explored group differences across these domains. Findings revealed consistent gender differences, with men engaging in riskier behaviors and holding riskier beliefs than women. Main effects for ethnicity were also observed, but only for the diet domain was a gender by ethnicity interaction found. Implications for establishing gender- and ethnicity-based health promotion and disease prevention interventions are discussed.
The Vimos VLT deep survey Garilli, B.; Le Fèvre, O.; Guzzo, L. ...
Astronomy and astrophysics (Berlin),
08/2008, Letnik:
486, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Context. The VVDS-Wide survey has been designed to trace the large-scale distribution of galaxies at z similar to 1 on comoving scales reaching similar to 100 h super(-1) Mpc, while providing a good ...control of cosmic variance over areas as large as a few square degrees. This is achieved by measuring redshifts with VIMOS at the ESO VLT to a limiting magnitude I AB = 22.5, targeting four independent fields with sizes of up to 4 deg super(2) each. Aims. We discuss the survey strategy which covers 8.6 deg super(2) and present the general properties of the current redshift sample. This includes 32 734 spectra in the four regions, covering a total area of 6.1 deg super(2) with a sampling rate of 22 to 24%. This paper accompanies the public release of the first 18 143 redshifts of the VVDS-Wide survey from the 4 deg super(2) contiguous area of the F22 field at RA = 22\rm phi . Methods. We have devised and tested an objective method to assess the quality of each spectrum, providing a compact figure-of-merit. This is particularly effective in the case of long-lasting spectroscopic surveys with varying observing conditions. Our figure of merit is a measure of the robustness of the redshift measurement and, most importantly, can be used to select galaxies with uniform high-quality spectra to carry out reliable measurements of spectral features. We also use the data available over the four independent regions to directly measure the variance in galaxy counts. We compare it with general predictions from the observed galaxy two-point correlation function at different redshifts and with that measured in mock galaxy surveys built from the Millennium simulation. Results. The purely magnitude-limited VVDS Wide sample includes 19 977 galaxies, 304 type I AGNs, and 9913 stars. The redshift success rate is above 90% independent of magnitude. A cone diagram of the galaxy spatial distribution provides us with the current largest overview of large-scale structure up to z similar to 1, showing a rich texture of over- and under-dense regions. We give the mean N (z) distribution averaged over 6.1 deg super(2) for a sample limited in magnitude to I AB = 22.5. Comparing galaxy densities from the four fields shows that in a redshift bin Delta z = 0.1 at z similar to 1 one still has factor-of-two variations over areas as large as similar to 0.25 deg super(2). This level of cosmic variance agrees with that obtained by integrating the galaxy two-point correlation function estimated from the F22 field alone. It is also in fairly good statistical agreement with that predicted by the Millennium simulations. Conclusions. The VVDS WIDE survey currently provides the largest area coverage among redshift surveys reaching z similar to 1. The variance estimated over the survey fields shows explicitly how clustering results from deep surveys of even 1 deg super(2) size should be interpreted with caution. The survey data represent a rich data base to select complete sub-samples of high-quality spectra and to study galaxy ensemble properties and galaxy clustering over unprecedented scales at these redshifts. The redshift catalog of the 4 deg super(2) F22 field is publicly available at http://cencosw.oamp.fr.
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