The Quality of Life of a Multidiagnosis Group of Special Needs Children: Associations and Costs

Purpose. To determine the quality of life, associations, and costs of a multidiagnosis group of special needs children. Methods. In this cross-sectional survey families were identified from the Children's Treatment Network, a Canadian multisector program for children with special needs. Families were eligible if the child was aged 2–19 years, resided in Simcoe/York, and if there were multiple child/family needs. Quality of life was measured using the PedsQL (n = 429). Results. Quality of life scores were lower in this group compared to published healthy and single disorder groups of children. Quality of life scores decreased with advancing age. Child psychosocial well-being was more strongly associated with child/family variables compared to physical well-being. Health Utilization costs were higher in children with greater physical challenges. Conclusions. Further research is needed in other complex needs child samples to confirm the decrease in quality of life found in these children into adolescence. Investigations into the interactions of child and family variables are needed

Jobs in Springfield, Massachusetts: understanding and remedying the causes of low resident employment rates

As part of the Federal Reserve Bank of Boston's commitment to supporting efforts to revitalize the economy of Springfield, Massachusetts, this paper explores the causes of and potential remedies for the city's low resident employment rates. When compared to the state as a whole and to other midsize New England cities, the share of employed city residents is low, particularly for residents of downtown Springfield and its nearby neighborhoods. By analyzing the availability of jobs across Springfield's various neighborhoods and in nearby towns and cities, this paper's goal is to learn why so few Springfield residents are employed, and thus to identify policy priorities to increase employment. This study finds that solving Springfield's low resident employment rates will require a combination of new job creation, improved informational and physical access to jobs, and strengthening the citizenry's job skills.Economic conditions - Massachusetts ; Job creation - Massachusetts ; Unemployment - Massachusetts

System Integration and Its Influence on the Quality of Life of Children with Complex Needs

Purpose. To explore the interactions between child and parents psychosocial factors and team integration variables that may explain improvements in physical dimensions of the PEDS QL quality of life of children with complex needs after 2 years. Methods. In this 2-year study, parents were identified by the Children's Treatment Network. Families were eligible if the child was aged 0–19 years, had physical limitations, resided in either Simcoe County or the Region of York, Ontario, and there were multiple other family needs. Regression analysis used to explore associations and interactions; n = 110. Results. A child's physical quality of life was affected by interacting factors including child's behavior, parenting, and integrated care. Statistically significant interactions between team integration, processes of care, and child/parent variables highlight the complexity of the rehabilitation approach in real-life situations. Conclusions. Rehabilitation providers working with children with complex needs and their families should also address child and parent problematic behaviors. When this was the case in high integrated teams, the child's physical quality of life improved after two years

Greater Springfield employment challenges: findings of employer survey and interviews

This paper presents the findings from in-depth interviews and a survey of employers in the Greater Springfield area regarding (a) employment opportunities for entry-level workers with limited skills and (b) barriers that residents of Springfield's low-income neighborhoods face in accessing these jobs. The survey and interviews indicate that entry-level jobs that do not require college are available in the Springfield area. However, even entry-level jobs require the ability to perform a variety of tasks, and many applicants lack the skills needed to perform these jobs or have work readiness problems. Lack of prior experience and the absence of referral networks limit access to these jobs for residents of Springfield's low-income neighborhoods.Cities and towns - Massachusetts ; Labor market - Massachusetts

Towards a more prosperous Springfield, MA: what jobs exist for people without a college education?

This paper analyzes projections of Massachusetts employment opportunities by occupation to address concerns about a shortage of jobs for those who lack a college education. While occupations requiring a college degree will grow more rapidly over the period 2006-2016 than occupations that do not require college, replacement needs will ensure large numbers of job openings that do not require college. Wage levels in jobs that do not require college are generally low, however. The exceptions usually require meaningful training of another sort, such as long-term on-the-job training or courses in postsecondary schools or community college. Additionally, some individuals who demonstrate the necessary qualities achieve higher wages through promotion. The distribution of occupations in the Springfield metropolitan area is sufficiently similar to that in Massachusetts that inferences from the Massachusetts projections should be relevant to Springfield.Cities and towns - Massachusetts ; Labor market - Massachusetts

Conceptualizing and validating the human services integration measure

PURPOSES: This paper proposes both a model and a measure of human service integration through strategic alliances with autonomous services as one way to achieve comprehensive health and social services for target populations. THEORY: Diverse theories of integrated service delivery and collaboration were combined reflecting integration along a continuum of care within a service sector, across service sectors and between public, not-for-profit and private sectors of financing services. METHODS: A measure of human service integration is proposed and tested. The measure identifies the scope and depth of integration for each sector and service that make up a total service network. It captures in quantitative terms both intra and inter sectoral service integration. RESULTS: Results are provided using the Human Service Measure in two networks of services involved in promoting Healthy Babies and Healthy Children known to have more and less integration. CONCLUSIONS: The instrument demonstrated discriminate validity with scores correctly distinguishing the two networks. The instrument does not correlate (r=0.13) with Weiss (2001) measure of partnership synergy confirming that it measures a distinct component of integration. DISCUSSION: We recommend the combined use of the proposed measure and the Weiss (2001) measure to more completely capture the scope and depth of integration efforts as well as the nature of the functioning of a service program or network

Reinvigorating Springfield's economy: lessons from resurgent cities

As part of the Federal Reserve Bank of Boston's commitment to supporting efforts to revitalize the economy of Springfield, Massachusetts, this paper analyzes the economic development approaches of other mid-sized manufacturing-oriented cities during the past half century. From among a comparison group of 25 municipalities that were similar to Springfield in 1960, the study identifies 10 "resurgent cities" that have made substantial progress in improving living standards for their residents, and that are recognized as vital communities in a broader sense by experts on urban economic development and policy. These case studies suggest that industry mix, demographic composition, and geographic position are not the key factors distinguishing the resurgent cities from Springfield. Instead, the most important lessons from the resurgent cities concern leadership and collaboration. Initial leadership in these cities came from a variety of key institutions and individuals. In some cases, the turnaround started with efforts on the part of the public sector, while in other cases nongovernmental institutions or private developers were at the forefront. Regardless of who initiated the turnaround, economic redevelopment efforts spanned decades and involved collaborations among numerous organizations and sectors.Cities and towns ; Cities and towns - Massachusetts ; Economic policy - Massachusetts

Palliative wound care: optimising the use of classification systems

Systemy klasyfikacyjne stanowią użyteczne narzędzie pozwalające na sprowadzenie złożonego stanu/choroby do możliwych do określenia elementów oraz ułatwiające komunikację pomiędzy profesjonalistami. Systemy te mogą służyć do definiowania, zazwyczaj w aspekcie nasilenia, poszczególnych objawów chorób i stanów. Mogą również być stosowane przy klasyfikowaniu predyspozycji do pewnych stanów, np. ryzyka powstania odleżyny. Uzyskane informacje wykorzystuje się przy planowaniu leczenia i opieki oraz do prognozowania przebiegu. Systemy klasyfikacyjne mogą być obszerne i złożone, jeśli dotyczą złożonych procesów lub stanów chorobowych, lub mogą być uproszczone. Oba te ograniczenia są szczególnie istotne w medycynie paliatywnej, w której poważny stan pacjentów wiąże się z współwystępowaniem licznych schorzeń i wymaga stosowania wielu metod leczenia oraz uwzględnienia indywidualnych cech chorego. Skuteczne stosowanie systemów klasyfikacyjnych przy podejmowaniu decyzji klinicznych wymaga, oprócz rozległej wiedzy klinicznej, stosowania obowiązujących i praktycznych systemów. System kliniczny TELER®, oparty na sporządzaniu notatek, jest nowoczesnym sposobem oceny, łączącym w sobie klasyfikację, planowanie opieki oraz ocenę wyników leczenia. System ten uwzględnia cele pacjenta, wiedzę teoretyczną i kliniczną oraz w unikalny sposób ocenia, jak zmieniają się dolegliwości pacjenta pod wpływem leczenia i pielęgnacji. Do tego systemu można włączyć uznane systemy klasyfikacyjne, np. drabinę analgetyczną Światowej Organizacji Zdrowia, stosowaną przy łagodzeniu bólu nowotworowego. Niniejsza praca przedstawia system TELER® jako narzędzie wykorzystywane przy podejmowaniu decyzji i szczegółowej ocenie leczenia paliatywnego ran, w kontekście całościowej opieki nad chorym.Classification systems can be useful tools for reducing a complex disease/condition into identifiable elements, and a means to communicate these between professionals. These systems may be used to define, usually in terms of severity, specific aspects of diseases and conditions. They may also be used to classify predisposition to specific conditions, for example the risk of pressure ulceration. Information generated is used to guide treatment and care planning, and to predict outcomes. Classification systems can become lengthy and complicated in the process of trying to represent the complex disease process/condition, or they are a simplification. Both these limitations may be particularly important in the specialty of palliative care where the advanced nature of patients’ conditions often results in multiple overlapping disease, treatment and individual variables. The successful use of classification systems in clinical decision-making requires valid and practical systems to be used alongside sound clinical knowledge. A novel approach that combines classification, care planning and treatment evaluation is a clinical note-making system, TELER®. This system includes patients’ goals, theoretical and clinical knowledge, and uniquely measures how patients’ problems change with treatment and care. The system can incorporate validated classification systems, for example the World Health Organisation analgesic ladder for cancer pain relief. In this paper the system is presented as a tool that has been applied to decision-making and evaluation in relation to the discrete elements of palliating wounds, in the context of total patient care

Interactions among Ecological Factors That Explain the Psychosocial Quality of Life of Children with Complex Needs

Purpose. To explore the associations and interactions among ecological factors and explain the psychosocial quality of life of children with complex needs. Methods. In this cross-sectional survey consenting parents were identified by the Children's Treatment Network. Families were eligible if the child from 0 to 19 years, resided in Simcoe/York, and there were multiple family needs. Regression analysis was used to explore associations and interactions. n = 429. Results. Younger children, without conduct disorder, without hostile and punitive parenting and with low adverse family impact demonstrated the highest levels of psychosocial quality of life. Statistically significant interactions between processes of care and parent variables highlight the complexity of real life situations. Conclusions. It is not possible to fully understand the child's psychosocial quality of life in complex needs families by considering only simple associations between ecological factors. A multitude of factors and interactions between these factors are simultaneously present and the care of these families requires a holistic approach

English Broadside Ballad Archive (EBBA): "Ballad Illustration Archive"

Focusing on the expansive English Broadside Ballad Archive (EBBA), http://ebba.english.ucsb.edu, containing over 2,000 distinct 17th-century woodcut illustrations, our proposed Ballad Illustration Archive (BIA) will allow unprecedented access to these hard-to-access images that are important cultural and artistic productions. Our project will make significant technological inroads through innovative integration of computer vision software and human cataloguing, delivering to the end-user a product which is technically cutting-edge and marked by careful scholarship. It will thus enable enhanced research in multiple humanities disciplines and also make these compelling images available to the interested non-specialist public. Ultimately, we see this project expanding to include a wider variety of early modern illustrations; we also expect it to expand the possibilities for future digital scholarship