Data Sharing Between Home Care Professionals: A Feasibility Study Using the RAI Home Care Instrument

Background: Across Ontario, home care professionals collect standardized information on each client using the Resident Assessment for Home Care (RAI-HC). However, this information is not consistently shared with those professionals who provide services in the client’s home. In this pilot study, we examined the feasibility of sharing data, from the RAI-HC, between care coordinators and service providers. Methods: All participants were involved in a one-day training session on the RAI-HC. The care coordinators shared specific outputs from the RAI-HC, including the embedded health index scales, with their contracted physiotherapy and occupational therapy service providers. Two focus groups were held, one with care coordinators (n = 4) and one with contracted service providers (n = 6). They were asked for their opinions on the positive aspects of the project and areas for improvement. Results: The focus groups revealed a number of positive outcomes related to the project including the use of a falls prevention brochure and an increased level of communication between professionals. The participants also cited multiple areas for improvement related to data sharing (e.g., time constraints, data being sent in a timely fashion) and to their standard practices in the community (e.g., busy workloads, difficulties in data sharing, duplication of assessments between professionals). Conclusions: Home care professionals were able to share select pieces of information generated from the RAI-HC system and this project enhanced the level of communication between the two groups of professionals. However, a single information session was not adequate training for the rehabilitation professionals, who do not use the RAI-HC as part of normal practice. Better education, ongoing support and timely access to the RAI-HC data are some ways to improve the usefulness of this information for busy home care providers

Having a Heart for ALL Students

The student body in today’s general educational classrooms continues to increase in diversity, with many of the students being English language learners. This growth in the number of non-English speaking students brings challenges to educators. Students’ test scores are the measurement of success for educators, resulting in a decrease of caring about students as individuals. This article addresses the importance and responsibility for Christian educators to reach out to non-English speaking students

A profile of the Australian seafood consumer

Seafood is an important food industry globally and increasing seafood consumption is high on the agenda of many developed countries.Understanding consumers is fundamental to the development of any marketing strategy, and while considerable research has been undertaken with European seafood consumers little is known about the seafood consumer in other markets including Australia. This paper presents a profile of the Australian seafood consumer designed to inform the decisions of key stake holders in the seafood industry:producers, middlemen and retailers. The profile has been developed from a range of studies undertaken through the Australian Seafood Collaborative Research Centre, a government supported body with a mission to improve profitability in the seafood industry and increase Australian seafood consumption. Australians consume on average approximately 2.2 serves of seafood per week. Two thirds of all seafood is prepared and consumed at home with 61% of seafood for at - home consumption purchased at supermarkets and 18% at fish markets or fish mongers. Key drivers of seafood consumption are taste, convenience, health,and versatility and these vary across species. Key barriers are price, concerns about origin and freshness and a lack of knowledge/confidence. Overwhelmingly, Australian consumers prefer Australian seafood and 'Australian’ serves as a surrogate for quality, safe, fresh and sustainable

Affirmational and Transformational Values and Practices in the Tolkien Fanfiction Community

Fanfiction based on the legendarium of J.R.R. Tolkien has existed for at least six decades and has been, within the past two, one of the most consistently active online fanfiction communities. Despite this, the fandom has been relatively unstudied by fan studies scholars. This paper considers how Tolkien-based fanfiction corroborates and complicates current theories of fanfiction, focusing especially on a theory proposed by obsession_inc that proposes two types of fandoms: affirmational and transformational. Current thought places fanfiction at the transformational end of the continuum. Using quantitative survey data of authors and readers of Tolkien-based fanfiction, this paper offers evidence that Tolkien-based fanfiction contains significant affirmational components that are an intentional and valued part of many Tolkien fanfiction communities. Authors and readers regard authority, critical functions of fanfiction, and reparative purposes for fanfiction differently than the more commonly studied media fandoms. Yet one cannot say simply that authors of Tolkien-based fanfiction are more affirmational than other fanwriters; instead, evidence shows that authors and readers of Tolkien-based fanfiction navigate transformational and affirmational elements in complex ways, and community cultures often center upon members’ values and practices

A Comparison of Home Care Quality Indicator Rates in Two Canadian Provinces

Background. Home care is becoming an increasingly vital sector in the health care system yet very little is known about the characteristics of home care clients and the quality of care provided in Canada. We describe these clients and evaluate home care quality indicator rates in two regions. Methods. A cross-sectional analysis of assessments completed for older (age 65+) home care clients in both Ontario (n=102,504) and the Winnipeg Regional Health Authority (n=9,250) of Manitoba, using the Resident Assessment Instrument for Home Care (RAI-HC). This assessment has been mandated for use in these two regions and the indicators are generated directly from items within the assessment. The indicators are expressed as rates of negative outcomes (e.g., falls, dehydration). Client-level risk adjustment of the indicator rates was used to enable fair comparisons between the regions. Results. Clients had a mean age of 83.2 years, the majority were female (68.6%) and the regions were very similar on these demographic characteristics. Nearly all clients (92.4%) required full assistance with instrumental activities of daily living (IADLs), approximately 35% had activities of daily living (ADL) impairments, and nearly 50% had some degree of cognitive impairment, which was higher among clients in Ontario (48.8% vs. 37.0%). The highest quality indicator rates were related to clients who had ADL/rehabilitation potential but were not receiving therapy (range: 66.8%-91.6%) and the rate of cognitive decline (65.4%-76.3%). Ontario clients had higher unadjusted rates across 18 of the 22 indicators and the unadjusted differences between the two provinces ranged from 0.6% to 28.4%. For 13 of the 19 indicators that have risk adjustment, after applying the risk adjustment methodology, the difference between the adjusted rates in the two regions was reduced. Conclusions. Home care clients in these two regions are experiencing a significant level of functional and cognitive impairment, health instability and daily pain. The quality indicators provide some important insight into variations between the two regions and can serve as an important decision-support tool for flagging potential quality issues and isolating areas for improvement. Background. Home care is becoming an increasingly vital sector in the health care system yet very little is known about the characteristics of home care clients and the quality of care provided in Canada. We describe these clients and evaluate home care quality indicator rates in two regions. Methods. A cross-sectional analysis of assessments completed for older (age 65+) home care clients in both Ontario (n=102,504) and the Winnipeg Regional Health Authority (n=9,250) of Manitoba, using the Resident Assessment Instrument for Home Care (RAI-HC). This assessment has been mandated for use in these two regions and the indicators are generated directly from items within the assessment. The indicators are expressed as rates of negative outcomes (e.g., falls, dehydration). Client-level risk adjustment of the indicator rates was used to enable fair comparisons between the regions. Results. Clients had a mean age of 83.2 years, the majority were female (68.6%) and the regions were very similar on these demographic characteristics. Nearly all clients (92.4%) required full assistance with instrumental activities of daily living (IADLs), approximately 35% had activities of daily living (ADL) impairments, and nearly 50% had some degree of cognitive impairment, which was higher among clients in Ontario (48.8% vs. 37.0%). The highest quality indicator rates were related to clients who had ADL/rehabilitation potential but were not receiving therapy (range: 66.8%-91.6%) and the rate of cognitive decline (65.4%-76.3%). Ontario clients had higher unadjusted rates across 18 of the 22 indicators and the unadjusted differences between the two provinces ranged from 0.6% to 28.4%. For 13 of the 19 indicators that have risk adjustment, after applying the risk adjustment methodology, the difference between the adjusted rates in the two regions was reduced. Conclusions. Home care clients in these two regions are experiencing a significant level of functional and cognitive impairment, health instability and daily pain. The quality indicators provide some important insight into variations between the two regions and can serve as an important decision-support tool for flagging potential quality issues and isolating areas for improvement

Development of a Case-Mix Funding System for Adults with Combined Vision and Hearing Loss

Background: Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity. Methods: A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, multidimensional assessment, the interRAI Community Health Assessment and the Deafblind Supplement. The main outcome was a summary of formal and informal service costs which included intervenor and interpreter support, in-home nursing, personal support and rehabilitation services. Informal costs were estimated based on a wage rate of half that for a professional service provider ($10/hour). Decision-tree analysis was used to create groups with homogeneous resource utilization. Results: The resulting CM model had 9 terminal nodes. The CM index (CMI) showed a 35-fold range for total costs. In both the derivation and replication sample, 4 groups (out of a total of 18 or 22.2%) had a coefficient of variation value that exceeded the overall level of variation. Explained variance in the derivation sample was 67.7% for total costs versus 28.2% in the replication sample. A strong correlation was observed between the CMI values in the two samples (r = 0.82; p = 0.006). Conclusions: The derived CM funding model for adults with DSL differentiates resource intensity across 9 main groups and in both datasets there is evidence that these CM groups appropriately identify clients based on need for formal and informal support

Professional Development\u27s Complex Ecology: Examining a Whole-School Balanced Literacy Professional Development

This descriptive study reports on the structure and implementation of a school wide professional development model in a southwest public elementary school. The professional development effort was designed to support educators’ understanding and teaching of balanced literacy. The paper reports on the components of this professional development and discusses the strengths of this model in relation to educational research and findings on professional development. We conclude by discussing this model from the perspective of involved administration, facilitators, and teachers, as they consider the process of crossing the borders from professional development into their classrooms. The study is strengthened by teachers’ opinions about the model in their school

The Relationship Between Agency Characteristics and Quality of Home Care

ABSTRACT. Background. This project assessed the relationship between home care quality indicators HCQIs) and agency characteristics. Methods. Twelve agencies completed a mailed survey on a variety of characteristics, including size of their caseload and for-profit (FP) status of contracted service providers. The HCQIs were derived from standardized assessments completed voluntarily for home care clients in Ontario and in Manitoba, Canada. Results. The average caseload was 121.3 clients per case manager, and over 40% of nursing, personal support and therapy providers were considered FP. For individual HCQIs, few correlations were statistically significant. An overall summary measure of quality was correlated with the size of the population served (r = _0.80; p \u3c 0.05) and the number of clients per case manager (r = _0.56; p \u3c 0.1). Conclusion. These data represent unique information on home care quality and organizational characteristics in Canada. The question remains as to how best to use HCQI data to inform practice in an era of limited resources and increasing caseloads

On the Inclination Dependence of Exoplanet Phase Signatures

Improved photometric sensitivity from space-based telescopes has enabled the detection of phase variations for a small sample of hot Jupiters. However, exoplanets in highly eccentric orbits present unique opportunities to study the effects of drastically changing incident flux on the upper atmospheres of giant planets. Here we expand upon previous studies of phase functions for these planets at optical wavelengths by investigating the effects of orbital inclination on the flux ratio as it interacts with the other effects induced by orbital eccentricity.We determine optimal orbital inclinations for maximum flux ratios and combine these calculations with those of projected separation for application to coronagraphic observations. These are applied to several of the known exoplanets which may serve as potential targets in current and future coronagraph experiments