Boise City-Nampa MSA Employment and Industry Analysis

This report is the first component of a four-part study on skills alignment of Boise State University graduates and Boise City-Nampa Metropolitan Statistical Area (MSA) employers. This report frames the local economic and social environment through a demographic and socio-economic comparative analysis of the Boise City -Nampa MSA and 20 peer MSAs across the western United States. An employment analysis of the Boise City-Nampa MSA at the industry sector and industry sub-sector is also provided, identifying how the industry composition has changed following the Great Recession, which industries show area competitiveness through resilience to employment loss, if not growth, as well as which industries are heavily embedded within the Treasure Valley when compared to the nation. The employment analysis \u27es directly into an industry sector analysis of the Treasure Valley. Interviews and focus groups with local business owners, economic developers and chambers of commerce representatives were conducted in early 2013 to provide insight into the local economy and its industry sectors. The report has potential to provide useful information for state and local representatives and institution a3emp\u27ng to foster a competitive region through policies and meeting employment and employer needs for successful outcomes. These three analyses comprise the first part of the larger four-part study

The student experience of PACE at Macquarie University : Understanding motivations for learning

Professional and Community Engagement (PACE) at Macquarie University offers undergraduate students experiential learning opportunities with local, regional and international partners. Through PACE, students work on mutually beneficial projects that both meet the partner's organizational goals and enable students to strengthen graduate capabilities while gaining credit towards their degree and contributing to positive social change. This paper will outline findings from the Student Experience of PACE Project, which investigates the perceived impact of PACE on students' graduate capabilities and career aspirations, specifically addressing the following research question: Does PACE offer any distinct motives for learning? The findings bearing on distinctive motivators, such as personal and professional development, practical experience and constructive social action align with the literature in affirming the importance of these factors for achieving not only educational, but also lifelong learning objectives

metaboprep: an R package for pre-analysis data description and processing

MOTIVATION: Metabolomics is an increasingly common part of health research and there is need for preanalytical data processing. Researchers typically need to characterize the data and to exclude errors within the context of the intended analysis. Whilst some preprocessing steps are common, there is currently a lack of standardization and reporting transparency for these procedures. RESULTS: Here, we introduce metaboprep, a standardized data processing workflow to extract and characterize high quality metabolomics datasets. The package extracts data from preformed worksheets, provides summary statistics and enables the user to select samples and metabolites for their analysis based on a set of quality metrics. A report summarizing quality metrics and the influence of available batch variables on the data are generated for the purpose of open disclosure. Where possible, we provide users flexibility in defining their own selection thresholds. AVAILABILITY AND IMPLEMENTATION: metaboprep is an open-source R package available at https://github.com/MRCIEU/metaboprep. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online

Understanding and Reducing the Psychosocial Impact of Coronavirus Social Distancing and Behavioural Changes on Families of Care Home Residents in Scotland

Project Report Aims This project examined the impact of social distancing on care home communities as a result of lockdown to minimise threats of COVID-19 with a particular focus on the health and well-being of family carers and investigated measures taken by care home staff to help families to stay in touch with their relatives in care homes. Key findings The Importance of visits: The experience of being unable to visit their loved ones during the pandemic had a negative impact upon the emotional well-being of the study participants. In our interviews, the inability to touch and see their loved ones caused multiple negative emotions. This was supported by the survey data in which 76% of participants gave responses indicating mental distress. Significance of prior trust: The pandemic has heightened the significance of prior trust in care home staff and management, and the importance of frequent effective communication building trust and confidence when relatives are no longer in the building and able to see good practice in action. COVID-19 led to creative changes in care home practices: Care home staff instituted greater pro-active communication with relatives, and staff reported enhanced confidence in their communication with families. Staff also made great use of digital technology to facilitate communication between residents, family carers and themselves. There was a widely expressed belief that many of these changes could be built on to improve care home practices in the future. Maintaining communication is crucial. Analysis from the survey suggests that respondents who felt they were kept well-informed by the care home on average experienced less mental distress than those who did not. Lack of insight into the impact of lockdown on family carers. Most policy makers and leading figures in the sector had a superficial understanding of the impact of lockdown on family carers. In particular, there was little acknowledgement of family carers as partners in providing care and the importance of that relationship to both care-giver and care-receiver. Human rights. There was a widely expressed concern that the human right to a family life had not been adequately balanced against the risks of infection. Impact on marginalised communities. There was a recognition the pandemic has revealed how little we value older people with dementia within our society and the needs of black and minority ethnic communities. National Guidance. The mixed economy of care home providers meant that it was extremely difficult to implement national guidance in a manner which was consistent, equitable and appropriate across the whole sector

COVID, communication and care homes:A staffs’ perspective of supporting the emotional needs of families

An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth café-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship

[Study Protocol] Palliative long-term abdominal drains versus repeated drainage in individuals with untreatable ascites due to advanced cirrhosis: study protocol for a feasibility randomised controlled trial

Background: UK deaths due to chronic liver diseases such as cirrhosis have quadrupled over the last 40 years, making this condition now the third most common cause of premature death. Most patients with advanced cirrhosis (end–stage liver disease, [ESLD]) develop ascites. This is often managed with diuretics, but if refractory then the fluid is drained from the peritoneal cavity every 10-14 days by large volume paracentesis (LVP), a procedure requiring hospital admissions. As the life expectancy of patients with ESLD and refractory ascites (if ineligible for liver transplantation) is on average ≤ 6 months, frequent hospital visits are inappropriate from a palliative perspective. One alternative is long-term abdominal drains (LTAD), used successfully in patients whose ascites is due to malignancy. Although inserted in hospital, these drains allow ascites management outside of a hospital setting. LTAD have not been formally evaluated in patients with refractory ascites due to ESLD. Methods: Due to uncertainty about appropriate outcome measures and whether patients with ESLD would wish or be able to participate in a study, a feasibility randomised controlled trial (RCT) was designed. Patients were consulted on trial design. We plan to recruit 48 patients with refractory ascites and randomise them (1:1) to either a) LTAD or b) current standard of care (LVP) for 12 weeks. Outcomes of interest include acceptability of LTAD to patients, carers and healthcare professionals as well as recruitment and retention rates. Palliative care Outcome Scale (IPOS), the Short Form Liver Disease Quality of Life (SF-LDQOL), the EuroQol (EQ-5D) and carer (Zarit Burden Interview [ZBI-12]) reported outcomes will also be assessed. Preliminary data on cost effectiveness will be collected and patients and healthcare professionals will be interviewed about their experience of the trial with a view to identifying barriers to recruitment. Discussion: LTAD could potentially improve end-of-life care in patients with refractory ascites due to ESLD by improving symptom control, reducing hospital visits and enabling some self-management. Our trial is designed to see if such patients can be recruited, as well as informing the design of a subsequent definitive trial. Trial registration: ISRCTN30697116, date assigned: 07/10/201

Ambulance attendance for Substance and/or Alcohol use in a Pandemic (ASAP): Interrupted time series analysis of incidents

Introduction: The Ambulance attendance for Substance and/or Alcohol use in a Pandemic (ASAP) study explores incidents during the COVID-19 lockdown in the East Midlands region of the United Kingdom (23/03/2020-04/07/2020). Method: Retrospective cross-sectional count per day of ambulance attendances from the East Midlands Ambulance Service Trust. Ambulance attendances relating to alcohol or other drug use in the year prior, during lockdown, and weeks following, were examined using interrupted time series analysis by patient demographics and geographical location. Results: 36,104 records were identified (53.7% male, 84.5% ethnicity classified as white, mean age 38.4 years). A significant drop in the number of attendances per day at the start of lockdown (-25.24, CI -38.16, -12.32) was observed, followed by gradual increase during the ongoing lockdown period (0.36, CI 0.23, 0.46). Similar patterns were found across genders, age groups 16-64, and urban/rural locations. Discussion: The pattern of ambulance attendances for alcohol or other drug use changed during the COVID-19 lockdown period. Conclusion: Lockdown significantly affected the use of ambulances for incidents involving alcohol or other drug use, impacting on healthcare services. Further research into hazardous use of alcohol or other drugs during the lockdown periods is needed to inform policy, planning and public health initiatives

Electronic health records in ambulances: the ERA multiple-methods study

Background: Ambulance services have a vital role in the shift towards the delivery of health care outside hospitals, when this is better for patients, by offering alternatives to transfer to the emergency department. The introduction of information technology in ambulance services to electronically capture, interpret, store and transfer patient data can support out-of-hospital care. Objective: We aimed to understand how electronic health records can be most effectively implemented in a pre-hospital context in order to support a safe and effective shift from acute to community-based care, and how their potential benefits can be maximised. Design and setting: We carried out a study using multiple methods and with four work packages: (1) a rapid literature review; (2) a telephone survey of all 13 freestanding UK ambulance services; (3) detailed case studies examining electronic health record use through qualitative methods and analysis of routine data in four selected sites consisting of UK ambulance services and their associated health economies; and (4) a knowledge-sharing workshop. Results: We found limited literature on electronic health records. Only half of the UK ambulance services had electronic health records in use at the time of data collection, with considerable variation in hardware and software and some reversion to use of paper records as services transitioned between systems. The case studies found that the ambulance services’ electronic health records were in a state of change. Not all patient contacts resulted in the generation of electronic health records. Ambulance clinicians were dealing with partial or unclear information, which may not fit comfortably with the electronic health records. Ambulance clinicians continued to use indirect data input approaches (such as first writing on a glove) even when using electronic health records. The primary function of electronic health records in all services seemed to be as a store for patient data. There was, as yet, limited evidence of electronic health records’ full potential being realised to transfer information, support decision-making or change patient care. Limitations: Limitations included the difficulty of obtaining sets of matching routine data for analysis, difficulties of attributing any change in practice to electronic health records within a complex system and the rapidly changing environment, which means that some of our observations may no longer reflect reality. Conclusions: Realising all the benefits of electronic health records requires engagement with other parts of the local health economy and dealing with variations between providers and the challenges of interoperability. Clinicians and data managers, and those working in different parts of the health economy, are likely to want very different things from a data set and need to be presented with only the information that they need