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Possibly, the maladaptive trait model of the DSM-5 has a prognostic value when predicting symptom decrease in psychotherapy patients. Given these mixed results in previous published literature regarding PDs and maladaptive traits, a systematic investigation of this hypothesis is necessary. However, to the best of our knowledge, no study exists that examines the relationship between maladaptive traits assessed with the PID-5 and symptom decrease across different disorders and treatment settings. Investigating this association is one objective of this work. Further, we expect especially the PID-5 domains Negative Affectivity and Detachment to be prognostic variables that predict symptom decrease. This assumption is plausible, since these two domains represent the maladaptive ends of the Big Five domains emotional stability and extraversion that are connected to symptom decrease as outcome. Investigating this associations also one objective of this work.

The analytic component of our research is designed to answer the following two questions: 1. Compare families with NTH and traditional schedules. For families with young children, how do those with NTH schedules compare with families with traditional schedules? How does child care use for children in families working NTH hours compare with the use for children in families with traditional schedules? How do preferences of parents with NTH care needs compare with preferences of parents working traditional care needs? How does the care used compare? How does child care use during NTH hours vary by type of care (child care center, parental care, etc.), time period (such as immediately before and after traditional work hours versus overnight or weekend), amount of care (hours used per week), consistency of work schedules, proximity, community characteristics, and subsidy receipt? For children in families with NTH and traditional schedules, how does use and preference vary by these factors? 2. Regression model within families with NTH schedules. What factors predict the type of care preferred and used for children in families with NTH schedules? To what extent do family, community, and state characteristics explain differences in child care used during NTH? How influential in relative terms are the factors included in the model? The second concurrent component of research is designed to answer the following question: 3. State Fact Sheets or Snapshots. What is the potential demand for NTH care in states and DC, and what CCDF policies are in place that could address the potential demand?

Key goals of the Child Care and Development Block Grant (CCDBG) Act of 2014 are “to increase the number and percentage of low-income children in high-quality child care settings” and “to promote parental choice to empower working parents to make their own decisions regarding the child care services that best suits their family’s needs” (Sec. 658A.b.1). Despite this, an Urban Institute study released in 2018 showed that in the District of Columbia (DC) a large portion of families are in need of nontraditional hour (NTH) care but lack access to it. With the current crisis resulting from the novel coronavirus pandemic, the need for research on the potential demand from families such as health care workers with NTH work is even more urgent. Yet, currently limited research is available beyond the DC study on potential gaps between supply and demand for NTH care and little is known about the preferences and uses of families with NTH care needs. And no research is available from a national sample that describes the match between families’ preferences, the types of care they use, and how preferences and access are affected by family, child, and community characteristics. Our study will produce policy-relevant information for the Office of Child Care and state child care administrators that describes parents’ preferences and use of NTH care and the factors that affect preferences and use. The NTH Study will also produce fact sheets with information on potential demand for NTH care in all 50 states and the District of Columbia (DC). The policy-relevant findings will inform state child care administrators about the potential needs of families to inform policy decisions related to increasing access to NTH care. We propose a two-phase study. For the first phase, we will analyze the 2019 National Study of Early Care and Education (NSECE), which contains a large, nationally representative sample of households with children below age 13 to (1) document differences in parental preferences and uses of child care for families with nontraditional hour (NTH) schedules versus traditional hour schedules; (2) perform regression analyses to determine factors (such as parental employment characteristics, demographics, proximity, and time period of needed care, subsidy use, and community characteristics) associated with different types of preferred and used child care. We hypothesize that families’ stated preferences will not match the care they use and will vary by family and child characteristics and that specific characteristics will be associated with the types of care used. For the second component, we will produce policy-relevant information for state child care administrators in the form of state fact sheets describing the potential demand for NTH care by building from existing analyses of the American Community Survey (ACS), Survey of Income and Program Participation (SIPP), and Child Care and Development Fund (CCDF) databases. Our hypothesis is that there will be substantial variability in potential demand for and policies about NTH care across states. Information produced from this research is vital for federal policymakers, state administrators, and local service providers as they seek to expand access to child care subsidies and regulated, high-quality care for families with NTH care needs, while honoring parental choice. The project will result in a report of findings, a set of policy-relevant state fact sheets, and presentations at key policy research conferences.

BackgroundThe coronavirus disease 2019 (COVID-19) disrupted the education and clinical training of nursing students. Clinical sites shut out students over low equipment supplies, physical distancing requirements, and redeployment of staff.Purpose and methodsThe purpose of this paper is to highlight a progressive solution to engage nurse practitioner students as part of the COVID-19 response given the disruption of their traditional clinical training environments so that student could continue to matriculate and graduate in a timely manner.FindingsNurse practitioner students swiftly responded and were deemed an essential part of the nursing workforce.DiscussionPolicy implications for advanced nursing practice and education for telehealth and simulation research moving forward is also provided.

Registered nurses (RNs) are a key component of the long-term care (LTC) workforce and prior research demonstrates their importance to ensuring patient safety in LTC settings. RNs who work in LTC settings earn less than those who work in hospitals and also are more likely to be from racial and ethnic minority groups. This study seeks to measure wage differences between Registered Nurses (RNs) working in LTC and other settings (e.g., hospitals) and whether differences are associated with the characteristics of the RN workforce between and within settings. We used the 2018 National Sample Survey of Registered Nurses (NSSRN) public-use file to examine RN employment and earnings. Our study population included a sample of 15,373 employed RNs who provided patient care. Characteristics such as race/ethnicity, type of RN degree completed, census region, and union status were included in bivariate analyses and multiple regression analyses to examine the effect of these characteristics on wages. Logistic regression was used to predict RN employment in LTC settings. We found that RNs in LTC experienced lower wages compared to those in non-LTC settings, yet this difference was not associated with racial/ethnic or international educational differences. LTC nurses were also significantly less likely to be represented by a labor union, and there was not a statistically significant wage difference for LTC RNs who were unionized. Because RNs in LTC earn lower wages than RNs in other settings, policies to minimize pay inequities are needed to support the RN workforce caring for frail older adults.

Additional file 1.

The Support at Home pilot program provided financial support for home care services by middle-income adults with disabilities in San Francisco to support aging in place. This presentation reports the results of the mixed-methods evaluation of the program, which incorporated administrative records, surveys of clients and comparison group members, surveys of informal caregivers of clients, surveys of the care providers hired by clients, and focus groups with clients and with informal caregivers. Outcome measures included the Older People’s Quality of Life Questionnaire, Patient Health Questionnaire-2, an adapted Burden Scale for Family Caregivers, and self-reported falls, emergency department visits, and hospitalizations. Analyses included pre-post chi-squared and t-test comparisons and comparisons of changes between the client and comparison groups. Multivariate regression analyses were conducted to control for demographic differences between the groups. An economic analysis was conducted to learn whether changes in costs associated with medical appointments, emergency department visits, and hospitalizations were greater than the costs of the program, including both voucher and administrative costs. Results indicated statistically significant positive changes in personal stress and financial stress, but not in the composite quality of life score. There also were statistically significant reductions in attendance at medical appointments, falls, emergency department visits, and hospitalizations. The focus group data supported the findings regarding personal and financial stress, and also indicated that clients and their caregivers perceived positive quality of life benefits. The economic analysis indicated substantial cost savings from the program due to reduced use of medical services.

El conjunto de datos “Iris de Fisher” ha sido extensamente utilizado en la literatura estadística y en numerosos artículos sobre testeo y comparación de técnicas de discriminación y clasificación multivariadas. Sin embargo, los modelos creados a partir de estas técnicas, requieren el cumplimiento de ciertos supuestos que no son satisfechos por este conjunto de datos. El objetivo de este trabajo es presentar una propuesta para introducir los procedimientos del Análisis Lineal Discriminante y el Análisis de Agrupamientos (Clusters) utilizando estos datos clásicos, en un curso de análisis estadístico multivariado exploratorio, mediante el empleo del software R, con especial atención en el análisis de los supuestos necesarios, la estimación e interpretación de los modelos obtenidos, y la validación de resultados.

Supplemental material, INQ-17-0300.Supplemental_Material.Revision for Nursing Home Implementation of Health Information Technology: Review of the Literature Finds Inadequate Investment in Preparation, Infrastructure, and Training by Michelle Ko, Laura Wagner and Joanne Spetz in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

ObjectivesTo develop an internationally accepted research definition of physical restraint.DesignComprehensive literature search followed by a web-based, three-round, modified Delphi technique comprising reviews and feedback.SettingClinical care settings.ParticipantsAn international group of 48 experts consisting of researchers and clinicians from 14 countries who have made sustained contribution to research and clinical application in the field of physical restraint in clinical care.MeasurementsData were collected using an online survey program and one in-person meeting. Results of the online survey and the in-person meeting were used for distribution in subsequent rounds until consensus on a definition was reached. Consensus was defined as 90% of the participating experts agreeing with the proposed definition of physical restraint.ResultsThirty-four different definitions were identified during the literature search and served as a starting point for the modified Delphi technique. After three rounds, 45 (95.7%) of 47 remaining experts agreed with the newly proposed definition: "Physical restraint is defined as any action or procedure that prevents a person's free body movement to a position of choice and/or normal access to his/her body by the use of any method, attached or adjacent to a person's body that he/she cannot control or remove easily."ConclusionA multidisciplinary, internationally representative panel of experts reached consensus on a research definition for physical restraints in older persons. This is a necessary step toward improved comparisons of the prevalence of physical restraint use across studies and countries. This definition can further guide research interventions aimed at reducing use of physical restraints.

Arbeit an der Bibliothek noch nicht eingelangt - Daten nicht geprüft Abweichender Titel laut Übersetzung des Verfassers/der Verfasserin Karl-Franzens-Universität Graz, Univ., Masterarbeit, 2016

Ineffective nurse-physician communication in the nursing home setting adversely affects resident care as well as the work environment for both nurses and physicians. Using a repeated measures design, this quality improvement project evaluated the influence of SBAR (Situation; Background of the change; Assessment or appearance; and Request for action) protocol and training on nurse communication with medical providers, as perceived by nurses and physicians, using a pre-post questionnaire. The majority (87.5%) of nurses respondents found the tool useful to organize information and provide cues on what to communicate to medical providers. Limitations expressed by some nurses included the time to complete the tool, and communication barriers not corrected by the SBAR tool. Project findings, including reported physician satisfaction, support the use of SBAR to address both issues of complete documentation and time constraints.