Yes / Acute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community. The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed changes in care. Methods and analysis: Cluster randomised pilot trial to test study procedures and indicate whether a further definitive trial is warranted. Fourteen care homes with nursing (nursing homes) will be randomly allocated to intervention (delivered at nursing home level) or control groups. Two nurses from each home become Practice Development Champions trained to implement the intervention, supported by a practice development support group. Data will be collected for 3 months preintervention, monthly during the 12-month intervention and 1 month after. Individual-level data includes resident, care partner and staff demographics, resident functional status, service use and quality of life (for health economic analysis) and the extent to which staff perceive the organisation supports person centred care. System-level data includes primary and secondary health services contacts (ie, general practitioner and hospital admissions). Process evaluation assesses intervention acceptability, feasibility, fidelity, ease of implementation in practice and study procedures (ie, consent and recruitment rates). / UK NIHR grant number RP-PG-0612-20010.

Despite the relative successes of the post-apartheid South African Government, government’s failure to adequately deliver basic services has led to recent national public unrest over the problem of poor service delivery. The aim of this study was to investigate satisfaction level pertaining the service delivery in Matjhabeng Local Municipality. Municipalities are mandated by the Constitution to provide basic services to its community such as potable water supply, electricity, refuse collection roads and sanitation. The analysis is mainly on the basis of service delivery experienced in different areas such as formal and informal townships, study amongst municipal employees, as well as middle and high suburb areas within Matjhabeng LM. The realistic evidence has revealed that communities are unhappy because of, among other things, the cadre deployment to the municipality, the poor service delivery, corrupt councillors, uncommitted employees, communication between municipality and its residents and interference of politicians which have impacted negatively on service delivery. The results showed that although many respondents are unhappy with the basic services besides the municipality making an effort to provide basic services. Furthermore, it is evident from the results that while being unhappy with services more than residents who receive monthly bills are willing to pay for services rendered. / MBA, North-West University, Potchefstroom Campus, 2015

Despite the relative successes of the post-apartheid South African Government, government’s failure to adequately deliver basic services has led to recent national public unrest over the problem of poor service delivery. The aim of this study was to investigate satisfaction level pertaining the service delivery in Matjhabeng Local Municipality. Municipalities are mandated by the Constitution to provide basic services to its community such as potable water supply, electricity, refuse collection roads and sanitation. The analysis is mainly on the basis of service delivery experienced in different areas such as formal and informal townships, study amongst municipal employees, as well as middle and high suburb areas within Matjhabeng LM. The realistic evidence has revealed that communities are unhappy because of, among other things, the cadre deployment to the municipality, the poor service delivery, corrupt councillors, uncommitted employees, communication between municipality and its residents and interference of politicians which have impacted negatively on service delivery. The results showed that although many respondents are unhappy with the basic services besides the municipality making an effort to provide basic services. Furthermore, it is evident from the results that while being unhappy with services more than residents who receive monthly bills are willing to pay for services rendered. / MBA, North-West University, Potchefstroom Campus, 2015

No description available.

This exploratory study has two major aims. The first is to investigate heuristically the sources and nature of meaning experienced by residents and staff living and working in an Australian nursing home. The second is to interpret those experiences within the context of wellness.The study utilises heuristic inquiry as the research method from an occupational science perspective. Occupational science is concerned with the ways in which humans realise their sense of meaning through both their daily occupations and their unique way of being in the world.Heuristic inquiry is utilised for both the research design and the analysis of data. The primary source of data was my own experience of working in Australian nursing homes as a nurse, educator, and grief counsellor; and of having supported the six members of my family who have lived and died in Australian nursing homes. In addition multiple other sources of data were accessed: residents and staff from three suburban Australian nursing homes; personal and professional memoirs of life and work in Australian nursing homes; novels depicting characters faced with nursing home life; and research report on the needs of elderly Aboriginal people also faced with nursing home admission.Data were collected using a diverse range of techniques: self dialogue, participant-observation, informal, semi-structured, and group interviews, analysis of staff journal entries, and analysis of the textual material - memoirs, novels, and the research report.The findings indicate that nursing home residents experience a sense of meaning when they are able to maintain a sense of connection with an enduring sense of self. Nursing home staff, on the other hand, experience a sense of meaning in association with their work when they are able to access their personally constructed vision of a professional self identity. Living and working with a sense ++ / of wellness, whilst possible, tends not to be an everyday experience for either residents or staff.This study makes an important contribution to the understanding of the interior experiences of both nursing home residents and staff. It explores the notion of wellness within the nursing home context and puts forward suggestions for promoting wellness in the nursing home. The study also makes a significant contribution to the discipline of occupational science and the application of heuristic inquiry to social research.

In the last thirty years, a large number of studies have researched the destination image that visitors, travel industry representatives, students, and general consumers have of tourist destinations. However, few studies have analyzed the perceptions that local residents have of their own countries as tourist destinations. Local residents can provide valuable information about their countries as tourism destinations and can help tourism marketers determine how to represent local culture in more authentic and sustainable ways. Local residents can also provide valuable information about how to improve tourism development based on their experiences living in the area. Residents can further provide information and services to visitors and are themselves an integral part of tourism at a destination. This study focused on understanding how destination marketing portrays the people and places of a destination and how residents perceive the visuals used in destination marketing and promotion. Using a visual qualitative approach, the study analyzed the images of recent promotional campaigns employed by the Puerto Rico Tourism Company. The study then interviewed Puerto Rican residents regarding their attitudes toward tourism development in general and toward the specific imagery used in the campaigns. Overall, residents had rather positive opinions of tourism in Puerto Rico. They also had largely positive attitudes toward the visual imagery used to market the destination. However, they felt the portrayal was incomplete and did not reflect the modern way of Puerto Rican daily life.

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Project Thesis (D. Min.)--Denver Seminary, 1988. / Includes bibliographical references (leaves 313-329).

Abstract Background: There is insufficient research about the health information seeking, access, and usage among immigrants to the United States, who, face health disparities associated with their immigrant status. Health-information seeking behaviors and attitudes, unique to immigrants, need to be considered as one set of factors contributing to health disparities. Objective: This thesis focused on identifying differences in information seeking behaviors and attitudes between natal and immigrant US residents and the subset who had either themselves had been diagnosed with cancer or who had a family member diagnosed with cancer. Methods/Analyses: Nationally representative Health Information National Trends Survey (HINTS) data (HINTS4Cycle 3), collected from a sample of respondents (N=3185) by mail between September and December 2013, was used for these analyses. Sample weights were applied during SAS data analysis to account for the complex survey design. Analyses assessed the frequencies of health information seeking behaviors and attitudes of natal versus immigrant US residents. Results: Both natal and immigrant US residents indicated that the Internet was the most popular choice for seeking health or medical information (69.9% and 69.8%, respectively), with the next highest being doctor, healthcare provider, or cancer organization combined (14.3% and 17.1%, respectively). These differences in use of information sources were not significant. Both natal and immigrant US residents “strongly agreed” or “agreed” that they were frustrated (68.1% and 65.8%, respectively) and were concerned about the quality of the information (52.9% and 54.8%, respectively) during the last time they searched for health information. Again, these differences in attitudes toward information were not significant. On the other hand, compared to natal US residents, immigrant US residents were more likely to state that their most recent search took a lot of effort (35.2% and 46.1%, respectively, p=.01). There were also moderate and significant differences between natal and immigrant respondents’ trust toward information from government health agencies (69.3% and 81.3%, respectively, p About one-third (30.2%) of immigrant US residents reported that they spoke English “not well” or “not well at all.” Among the immigrant US residents, the Internet was the source most commonly chosen by both groups (Speak English “very well,” or “well” and speak English “not well” or “not at all”) as the source they went to first during their most recent search for health or medical information (78.1% and 45.8%, respectively, p Conclusions: There are important differences between Internet-related health information seeking behaviors and attitudes of natal US residents and immigrant US residents.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / End‐of‐life (EOL) care and decision‐making in pediatrics is a challenging and complex aspect of patient care experienced by residents and physician attendings. Previous studies have evaluated determinants that contribute to physicians’ attitudes towards EOL care as well as preparedness of students and residents in EOL decision‐making. However, the determinants contributing to a physician’s ability to make such decisions and feel confident in addressing EOL issues are dynamic. Recognizing that decision‐making changes over time, identifying when these changes occur may demonstrate the need for educational interventions for medical students and residents early in their career to help prepare them for EOL decision‐making. A longitudinal assessment of changes in attitudes and knowledge of EOL discussions and how they impact EOL decision‐making was not previously evaluated. This preliminary study establishes a baseline for medical student, resident, and attendings for EOL decision‐making and those factors that contribute to their decisions. This preliminary data has demonstrated a difference amongst attendings compared to residents and students. Despite low probability of survival, residents and students are more likely to select more aggressive management options when compared to attendings. Data obtained after completion of future surveys will show when decision‐making changes, which factors contribute to these changes and their significance in making decisions, and when participants are comfortable addressing EOL care.