Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

Sexual and Family Violence: Overcoming Barriers to Service Access for Aboriginal and Torres Strait Islander Clients

ABSTRACT

Despite the fact that Aboriginal and Torres Strait Islander communities typically experience a high prevalence of sexual and family violence, service responses have mostly been culturally inappropriate and ineffective. This article reports on a collaborative, participatory research project aimed at exploring barriers to service access by Aboriginal and Torres Strait Islander clients when they have been affected by sexual and family violence. The findings reveal multiple barriers to service access, including justice system deterrents, social taboo, shame, and a lack of culturally appropriate services. The article highlights the importance of recognising and addressing the complex interplay of historic, social, and cultural factors influencing service access.     

Being involved in the country: Productive ageing in different types of rural communities

Productive ageing recognises the contribution of older people to economic, social and cultural growth and helps build a sustainable community. Being involved in community life is good for individuals and good for society. However, we know very little about the participation of and contribution by people aged 50 and over in rural communities. This research aimed to develop a better understanding of productive ageing in different types of communities in rural Victoria, Australia. An anonymous self-complete postal questionnaire was distributed to a sample of households in twenty rural communities using the Australia Post Unaddressed Select Service. Those householders 50 years of age and older were invited to complete the survey. Data collected allowed examination of social and civic engagement, familiarity with community, the value placed on social relations by people aged 50 years and over, and how community involvement was linked to community sustainability. In particular it attempts to address the question ‘Does social and civic engagement differ across declining, stable and growing rural communities?’ Despite differences among rural communities, this study showed that older people develop and maintain strong community connections and well-functioning social capital and that participation in social activities was associated with feelings of being connected with community. It also identified health issues and lack of options as the main constraints on participation. A key message for policy makers is that older people play an important role in the sustainability of rural communities. There is much to be gained from actively supporting their participation in activities that are connected to ageing well.     

A usability gap between older adults and younger adults on interface design of an Internet-based telemedicine system

Internet-based telemedicine is becoming an effective tool to deliver home-healthcare services and health information on demand, especially in rural areas, where there is often a large elderly population with greater rates of preventable chronic diseases. However, the designs of current interfaces for these internet-based telemedicine systems do not take elderly user characteristics into consideration. This study conducted usability testing on the interface of an internet-based telemedicine system using two different age groups, young adults and older adults. Differences in overall performance and satisfaction between the two groups were identified. Based on these results, a future direction is suggested for the interfaces of Internet-based telemedicine systems.     

Data mining in children and family services: the Contra Costa County experience

Despite access to a comprehensive administrative database that would allow for timely data retrieval and utilization, regular use of data to inform service provision remained infrequent at one children and family services agency. To address this issue, a research and evaluation manager was hired to facilitate regular data use and evidence-informed service provision. This led to a shift in agency culture that moved from viewing data collection as a burden and threat, to now valuing data as a powerful tool for improving programs and outcomes for children and families. This case study presents the experiences of this agency, describing the process by which the research and evaluation manager was hired, how data are now used by the agency, significant changes resulting from the agency's new data use practices, and perspectives of the evaluator and staff on data use and changes in agency culture.     

Using evidence-based accreditation standards to promote continuous quality improvement: the experiences of the San Mateo County Human Services Agency

Following a difficult period of service provision, an agency determined that drastic changes were needed to improve agency-wide capacity and functioning. The agency engaged in an organizational level self-assessment aimed at identifying areas for improvement and beginning work towards determining professional standards for service. Results of this organizational self-assessment paved the way for pursuing accreditation of its services, and the agency became the first public agency in its state to be accredited by the Council on Accreditation in all eligible services. This case study describes this agency's efforts in engaging in an organizational self-assessment, the analysis and codification of their practices, and their eventual development of a systematized process for capturing, evaluating and improving practice.     

Coffee intake,health-related quality of life,and associated factors of overactive bladder in older Korean women living in rural South Korea

ABSTRACT

Overactive bladder (OAB) is a common health problem in older women. The aim of the study was to investigate coffee consumption, health-related quality of life (HRQOL), and associated factors of OAB in older Korean women living in rural South Korea. A total of 248 women aged 65 years and older participated in this study. Chi-square tests, t-tests, and multivariable logistic regressions were performed. The means of coffee consumption between OAB and non-OAB groups were not significantly different. Women with OAB showed significantly lower HRQOL than women with stress urinary incontinence only. OAB was associated with high body mass index and poor health status.     

Catastrophe Risk Models for Evaluating Disaster Risk Reduction Investments in Developing Countries

Major natural disasters in recent years have had high human and economic costs, and triggered record high postdisaster relief from governments and international donors. Given the current economic situation worldwide, selecting the most effective disaster risk reduction (DRR) measures is critical. This is especially the case for low‐ and middle‐income countries, which have suffered disproportionally more economic and human losses from disasters. This article discusses a methodology that makes use of advanced probabilistic catastrophe models to estimate benefits of DRR measures. We apply such newly developed models to generate estimates for hurricane risk on residential structures on the island of St. Lucia, and earthquake risk on residential structures in Istanbul, Turkey, as two illustrative case studies. The costs and economic benefits for selected risk reduction measures are estimated taking account of hazard, exposure, and vulnerability. We conclude by emphasizing the advantages and challenges of catastrophe model‐based cost‐benefit analyses for DRR in developing countries.     

Improved deviance goodness of fit statistics for a gamma regression model

A gamma regression model with an exponential link function for the means Is considered. Moment properties of the deviance statistics based on maximum likelihood and weighted least squares fits are used to define modified deviance statistics which provide alternative global goodness of fit tests. The null distribution properties of the deviances and modified deviances are compared with those of the approximating chi-square distribution and It is shown that the use of the modified deviances gives much better control over the significance levels of the tests.     

The relationship between open innovation,entrepreneurship, and introduction of new business models in Korean and Indonesian information technology enterprises

This case study sought to identify the relationships that can exist between open innovation, entrepreneurship, and the introduction of new business models at the enterprise level. Eleven Korean enterprises and five Indonesian enterprises were chosen, to obtain minimum research generality. While the number of enterprises is not great, it provides enough samples to determine the concrete relationships among these factors. The article starts by pointing out the general relationship between entrepreneurship, open innovation, and the introduction of a new business model. It examines two different contexts: the difference between the Seoul and Daegu regional innovation systems, and the difference between the Indonesian and Korean national innovation systems.