Academic literature on the topic 'Integrated health residence'
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Journal articles on the topic "Integrated health residence"
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Aveno, Arlene. "Community Involvement of Persons with Severe Retardation Living in Community Residences." Exceptional Children 55, no. 4 (January 1989): 309–14. http://dx.doi.org/10.1177/001440298905500404.
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A national survey was conducted with 294 community residential facilities (CRFs) serving adults with severe retardation. Respondents were asked to rate 38 community-based activities twice: one rating representing the activity involvement of the residents living in the CRFs, and one rating representing the perceived activity involvement of “average,” well-integrated community members. Nonhandicapped community members were perceived to have significantly more involvement in 30 activities than adults living in CRFs. Group home and foster home residents were perceived to be more involved in employment or day activities outside the residence, use of health care services, walking or wheelchair strolling for pleasure, and use of parks or zoos than nonhandicapped community members.
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Jacobs, Christine, Jay A. Brieler, Joanne Salas, Renée M. Betancourt, and Peter F. Cronholm. "Integrated Behavioral Health Care in Family Medicine Residencies." Family Medicine 50, no. 5 (May 2, 2018): 380–84. http://dx.doi.org/10.22454/fammed.2018.639260.
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Background and Objectives: Behavioral health integration (BHI) in primary care settings is critical to mental health care in the United States. Family medicine resident experience in BHI in family medicine residency (FMR) continuity clinics is essential preparation for practice. We surveyed FMR program directors to characterize the status of BHI in FMR training. Methods: Using the Council of Academic Family Medicine Educational Research Alliance (CERA) 2017 survey, FMR program directors (n=478, 261 respondents, 54.6% response rate) were queried regarding the stage of BHI within the residency family medicine center (FMC), integration activities at the FMC, and the professions of the BH faculty. BHI was characterized by Substance Abuse and Mental Health Services Agency (SAMHSA) designations within FMRs, and chi-square or ANOVA with Tukey honest significant difference (HSD) post hoc testing was used to assess differences in reported BHI attributes. Results: Program directors reported a high level of BHI in their FMCs (44.1% full integration, 33.7% colocated). Higher levels of BHI were associated with increased use of warm handoffs, same day consultation, shared health records, and the use of behavioral health (BH) professionals for both mental health and medical issues. Family physicians, psychiatrists, and psychologists were most likely to be training residents in BHI. Conclusions: Almost half of FMR programs have colocated BH care or fully integrated BH as defined by SAMHSA. Highly integrated FMRs use a diversity of behavioral professionals and activities. Residencies currently at the collaboration stage could increase BH provider types and BHI practices to better prepare residents for practice. Residencies with full BHI may consider focusing on supporting BHI-trained residents transitioning into practice, or disseminating the model in the general primary care community.
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Hiltunen, Anna-Maria, Iiris Hörhammer, Katariina Silander, Jaakko Kaikuluoma, and Miika Linna. "Integrating health service delivery for geriatric patients after hospital admission—A register study on the outcomes and costs." Health Services Management Research 33, no. 1 (November 26, 2019): 24–32. http://dx.doi.org/10.1177/0951484819887668.
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After a care episode in a hospital, elderly patients often face delays in transitions to permanent residence. Poor care coordination burdens both the patients and the healthcare system. Whereas different models for coordinating geriatric patients’ care and discharge planning have been developed, evidence on their cost-effectiveness remains scant. In this study, we evaluated the associations of an integrated care model on health and social care costs and service utilization among geriatric patients admitted to a hospital in a Finnish city with c. 68,000 citizens. Elderly patient cohorts admitted before (N = 709) and after (N = 364) the implementation of the integrated care model were compared restrospectively. The new model consisted of changes in regional care criteria, discharge planning, coordination between inpatient facilities, and the daily work of nursing staff. Patients treated in the new model spent, on average, 7.4 days less in institutionalized care during one year, and the total annual cost of care decreased by 967€ per patient. A regionally coordinated care pathway from hospital admission to permanent residence may improve the cost-effectiveness of elderly care. Coordination and monitoring of outcomes at regional level is essential to avoid fragmentation of care and suboptimization among different care providers serving the elderly.
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Shishebori, Davood, and Mohammad Saeed Jabalameli. "Improving the Efficiency of Medical Services Systems: A New Integrated Mathematical Modeling Approach." Mathematical Problems in Engineering 2013 (2013): 1–13. http://dx.doi.org/10.1155/2013/649397.
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Nowadays, the efficient design of medical service systems plays a critical role in improving the performance and efficiency of medical services provided by governments. Accordingly, health care planners in countries especially with a system based on a National Health Service (NHS) try to make decisions on where to locate and how to organize medical services regarding several conditions in different residence areas, so as to improve the geographic equity of comfortable access in the delivery of medical services while accounting for efficiency and cost issues especially in crucial situations. Therefore, optimally locating of such services and also suitable allocating demands them, can help to enhance the performance and responsiveness of medical services system. In this paper, a multiobjective mixed integer nonlinear programming model is proposed to decide locations of new medical system centers, link roads that should be constructed or improved, and also urban residence centers covered by these medical service centers and link roads under investment budget constraint in order to both minimize the total transportation cost of the overall system and minimize the total failure cost (i.e., maximize the system reliability) of medical service centers under unforeseen situations. Then, the proposed model is linearized by suitable techniques. Moreover, a practical case study is presented in detail to illustrate the application of the proposed mathematical model. Finally, a sensitivity analysis is done to provide an insight into the behavior of the proposed model in response to changes of key parameters of the problem.
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Bussu, Sonia. "Integrated care: learning from East London." British Journal of General Practice 68, suppl 1 (June 2018): bjgp18X697265. http://dx.doi.org/10.3399/bjgp18x697265.
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BackgroundDespite a growing body of literature on integrated, there remains a relatively small evidence base to suggest which elements of integrated care are most effective and how to implement them successfully. This might also be due to the fact that policy thinking around integrated care is struggling to translate into organisation change at the point of delivery. Better understanding of patterns of collaborations and integrated pathways is crucial to understand frontline staff’s OD needs and provide adequate support.AimThis paper focuses on the frontline level to assess progress towards integrated care in East London.MethodWe use admission avoidance (Rapid Response service) and discharge services (Discharge to Assess) as a lens to examine how frontline staff from secondary care, community health services and social service work together to deliver more integrated care. The study uses the Researcher in Residence (RiR), where the researcher is embedded in the in the organisations she is evaluating, as a key member of the delivery team.ResultsInitial findings suggest that while work on integrated care has enabled some level of collaborative working at strategic levels in partner organisations, on the frontline professionals are grappling with issues such as professional identity, professional boundaries, mutual trust and accountability, as new services and roles struggle to be fully embedded within the local health system.ConclusionThe paper sheds light on to the complexity on integrated care at the point of delivery. Better understanding of integrated care pathways is crucial to evidence patterns of collaboration across organisations; assess how these new roles and teams are embedding themselves within the local health economy; identify organisation development needs; and provide adequate support to frontline staff.
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Godinho, Myron Anthony, Md Mahfuz Ashraf, Padmanesan Narasimhan, and Siaw-Teng Liaw. "Community health alliances as social enterprises that digitally engage citizens and integrate services: A case study in Southwestern Sydney (protocol)." DIGITAL HEALTH 6 (January 2020): 205520762093011. http://dx.doi.org/10.1177/2055207620930118.
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South Western Sydney (SWS) is one of the fastest growing regions in the state of New South Wales (Australia). Much of the population live in local government areas (LGAs) with levels of disadvantage higher than the state average, with a predominance of non-communicable and chronic diseases that are typically associated with age-related and behavioural factors. This necessitates the management of social determinants of health through the integrated provision of primary and social care. The SWS Local Health District and Primary Health Network is exploring the potential of community health alliances (CHAs) as an innovative approach to support the provision of integrated health services. CHAs are a population health approach for addressing health challenges faced by people who share a common area of residence, sociocultural characteristic or health need, and are characterised by a shared mission, shared resource needs and acquiring/developing necessary organisational knowledge and skills. We explore how CHAs operate as social enterprises that utilise digital health and citizen engagement to deliver integrated people-centred health services (IPCHS) by conducting two case studies of CHAs operating in SWS: in Wollondilly and Fairfield LGAs. Using this approach, we aim to unpack the conceptual convergence that enables social enterprises to utilise digital health interventions and citizen engagement strategies to co-produce IPCHS with a view to developing theory and a framework for engaging digital citizens in integrated primary health care via social enterprise.
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Aderibigbe, Oluwakemi, Anthony Renda, and Christopher M. Perlman. "Factors Associated With Opiate Use Among Psychiatric Inpatients: A Population-Based Study of Hospital Admissions in Ontario, Canada." Health Services Insights 12 (January 2019): 117863291988863. http://dx.doi.org/10.1177/1178632919888631.
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Background: Use of opiates, including synthetic opioids, is associated with a number of negative consequences, including increased risk of opioid use disorders and other mental health conditions. However, studies are limited in examining patterns of opiate use among persons in inpatient psychiatry, particularly those that consider the relationship between pain and opiate use. Objective: This study examined the prevalence in the prior 12 months to admission and patterns of opiate use and pain in a population-based study of persons admitted to inpatient psychiatry in Ontario, Canada. Methods: We conducted retrospective cross-sectional study of 165 434 persons admitted to inpatient psychiatry between January 1, 2006 and December 31, 2017. Using data from the Resident Assessment Instrument for Mental Health, we examined prevalence and factors associated with opiate use in the prior 12 months by a number of patient characteristics, including demographics, mental and physical health status, concurrent substance use, pain severity and frequency, and health region of residence. Results: The prevalence of opiate use within 12 months of admission was 7.5%, between 17% and 22% among those experiencing daily pain, and 27% among persons with a primary substance use disorder. Multivariable analyses revealed strong associations among demographic and clinical variables with opiate use ( c = 0.91), including being of younger age, use of other substances, greater frequency and severity of pain, and health region of residence. Conclusion: The strong relationship between pain and opiate use in this population, and the regional variation in this pattern, supports the need for integrated care for mental illness and substance use, and therapeutic approaches to pain management that reduce risks of problems associated with substance use for persons with mental health conditions.
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Galako, T. "Expanding the Role of Primary Health Care in the Provision of Mental Health Services to the Population of the Kyrgyz Republic." European Psychiatry 41, S1 (April 2017): S606. http://dx.doi.org/10.1016/j.eurpsy.2017.01.954.
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Providing comprehensive, integrated services in the field of mental health in primary health care (PHC) is a component of the state mental health program for the population of the Kyrgyz republic (KR) in the 2017–2030 biennium. In order to develop an action plan in this area a situational analysis of resources of psychiatric care at PHC level was carried out. There was revealed a significant deficit of specialists, such as family doctors, mental health care professionals. In spite of the need for 3,300 family doctors, only 1706 work, and 80% of them are of retirement age.The results of a research showed a low level of knowledge and skills of family physicians for the early detection of mental disorders and provision of appropriate medical care. There are also a limited number of psychiatrists, especially in rural regions (77% of the required quantity).During recent years, there have been implemented significant changes in the system of mental health services, aimed at improving its quality, the approach to the place of residence of the patient and the prevalence of psychosocial services.Since 2016 in 8 southern regions in the Kyrgyz Republic has been introduced a new model for the provision of comprehensive health care services. Piloting this model involves psychosocial rehabilitation of patients with mental disorders, the help of mobile teams at the place of patient residence, as well as psychoeducation, training, and support to family doctors. These and other measures will help to optimise mental health care at PHC level.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Mandell, Wallace, Victor Lidz, and James J. Dahl. "Experimental evaluation of a vocationally integrated therapeutic community." Therapeutic Communities: The International Journal of Therapeutic Communities 36, no. 3 (September 14, 2015): 173–85. http://dx.doi.org/10.1108/tc-06-2014-0021.
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Purpose – Retrospective studies of therapeutic community (TC) treatment for drug abuse found reductions in drug use, criminality, and increased work participation after treatment completion. These studies have also shown treatment benefits, even without completion, are correlated with days of stay in residential treatment. However, others have found that high rates of early leaving from TC treatment reduce the proportion of clients with positive outcomes, raise the total cost per treated client, and lower the treatment benefit-to-costs ratio. The purpose of this paper is to describe an experimental approach to raising the days in residential treatment using earlier vocational access for clients. Design/methodology/approach – The current study used a random assignment design to compare earlier integration of on-site vocational training in a vocationally integrated therapeutic community to off-site vocational training initiated after one year of residence in a traditional therapeutic community. Findings – The resulting data support the hypotheses that client expectations and early training in job skills increase rate of treatment affiliation, the proportion of clients having effective lengths of stay, and the rate of treatment completion. Research limitations/implications – Research limitations/implications include the difficulty of assuring unbiased selection and controlling treatment assignment and conditions. Practical implications – Practical implications of this research project are to support practitioners striving for longer, more effective lengths of stay, while at the same time attempting to reduce treatment time and increase effectiveness. Social implications – Social Implications of this project are to encourage social support for addiction treatment and emphasize the value of paired residential treatment and vocational education. Originality/value – The originality and value of this research project lies in the adoption of a working model at Phoenix House TC (in-house vocational preparation), which utilizes early in-house vocational education as a means to increase residential program participation, increase employment skills and prospects, and decrease overall length of treatment.
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Catalanotti, Jillian, David Popiel, Patrik Johansson, and Zohray Talib. "A Pilot Curriculum to Integrate Community Health Into Internal Medicine Residency Training." Journal of Graduate Medical Education 5, no. 4 (December 1, 2013): 674–77. http://dx.doi.org/10.4300/jgme-d-12-00354.1.
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Abstract Background Public health training has become an important aspect of residency education. The Institute of Medicine recommends public health training for all resident physicians, and internal medicine educational milestones include general public health skills. Objective We sought to integrate community health into internal medicine residency training by developing a community health elective (CHE) curriculum. Methods We developed a 2-week CHE curriculum for internal medicine residents, featuring facilitated discussion sessions, clinical experience at health centers targeting medically underserved populations, and a culminating presentation. We evaluated our pilot curriculum using pre-elective and postelective course surveys with Likert-type questions. Results Of 150 eligible residents, 32 (21%) enrolled in the elective. Nearly all participants (30 of 32, 94%) strongly agreed that learning about community health was an important part of their residency training. Residents' perceived competence at discharging hospital patients with follow-up at community health sites increased 13-fold after taking the elective (P < .001). There was no increase in reported likelihood to practice in an underserved community or in primary care. Conclusions The CHE addresses several Accreditation Council for Graduate Medical Education competencies and internal medicine Milestones and could be a replicable model for internal medicine residency programs that seek to provide community health training.
Dissertations / Theses on the topic "Integrated health residence"
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Rossoni, Eloá. "Formação multiprofissional em serviço na atenção básica à saúde : processos educativos em tempos líquidos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/27073.
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A residência multiprofissional em serviço na atenção básica à saúde, tema desta tese, faz parte de uma rede de formação na área da educação e saúde no Brasil. A formação dentro de serviços de saúde tem como objetivo preparar profissionais para atuação no Sistema Único de Saúde. O foco da pesquisa volta-se para os processos educativos vivenciados por residentes e preceptores/as no Programa de Residência Integrada em Saúde: Atenção Básica em Saúde Coletiva, desenvolvido predominantemente em unidades básicas de saúde pertencentes, até 2009, ao Centro de Saúde-Escola Murialdo e vinculado à Escola de Saúde Pública. O programa busca formar profissionais para o planejamento, a gestão e a clínica da atenção básica em equipe multiprofissional, orientados para a integralidade da atenção. Esta tese analisa como trabalhadores/as e residentes vivenciam os processos educativos em serviço, que relações de poder-saber constituem e atravessam essa formação e alguns dos desafios que são colocados às instituições formadoras. Trata-se de uma investigação qualitativa cujo percurso metodológico tem aporte nos estudos culturais em aproximação com a etnografia pós-moderna, pois estes concebem a cultura como campo de produção de significados, no qual os diferentes grupos sociais, situados em posições diferenciadas de poder, lutam pela imposição de seus significados à sociedade. O trabalho de campo foi desenvolvido no período de março de 2007 a abril de 2008 e o material empírico inclui documentos pedagógicos e administrativos institucionais, legislação pertinente à regulamentação dos programas de residência, relatórios de residentes, observação direta das equipes nos ambientes de trabalho e entrevistas com os/as trabalhadores/as que atuam nas unidades básicas de saúde. Para refletir sobre as limitações e as possibilidades desta formação, utilizei, especialmente, os escritos de Bauman acerca das características culturais da “modernidade líquida”. As unidades de análise estruturadas, a partir destes pressupostos, abordam: o enfrentamento cotidiano das incertezas por trabalhadores/as e residentes; os saberes e as práticas constitutivos da formação em situação de trabalho na atenção básica; os desafios da formação em serviço em tempos líquidos; as relações de saber-poder nas dinâmicas de ensino/serviço/gestão, sobretudo as implicações dos conflitos das corporações profissionais e da municipalização da assistência nos processos educativos da residência. Estas relações produzem potencialidades e vulnerabilidades no programa de residência, no contexto estudado, marcado pela provisoriedade e pela incerteza. A partir destas análises foi possível apreender que, em tempos líquidos, a criatividade e a solidariedade são ferramentas importantes dos e nos processos educativos que preparam para a vida (profissional).Multidisciplinary residency in primary health care, subject of this thesis, is part of a network of training in education and health in Brazil. Training in health care aims to prepare professionals for action in the National Health System. The research focus turns to the educational process experienced by residents and preceptors in Integrated Health Residency Program: Primary Care in Public Health, developed predominantly in basic health units belonging, in 2009, to the Murialdo Health School-Centre, and linked to the School of Public Health. The program seeks to train professionals for the planning, management and clinical practice of primary care in multiprofessional teamwork oriented by integral care. This thesis examines how workers and residents experience educational processes in service, which relations of power-knowledge are/go through such training and some of the challenges that are posed to the educational institution. This is a qualitative research whose methodological course has input into cultural studies in approach to post-modern ethnography. These studies conceive culture as a field of meaning production, in which different social groups located in different positions of power are fighting for impose their meanings on society. Fieldwork was conducted from March 2007 to April 2008 and empirical data included educational and administrative documents institutions, relevant legislation to the regulation of residency programs, reports of residents, direct observation of teams in the workplace and interviews with workers in training places. To discuss the limitations and possibilities of this training, I used especially the writings of Bauman about the cultural features of “liquid modernity”. The units of analysis structured to address these assumptions are: the daily confrontation of uncertainties by workers and residents, the knowledge and practices constituting the training on the work in primary care, the challenges of in-service training days net; the relations of knowledge-power in the teaching/service/management, especially the implications of conflicts of professional corporations and the decentralization of assistance in the educational processes of the residence. These relations yield potentials and vulnerabilities in residency programs in the studied context marked by provisional and uncertain. From this analysis it was possible to apprehend that in times of liquid modernity, creativity and solidarity are important tools of/on educational processes that prepare for (professional) life.
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Gouge, Natasha, Jodi Polaha, and Rebecca Powers. "Bringing a Behavioral Health Consultant to Residency: Implications for Practice and Training." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/ijhse/vol2/iss2/4.
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This study examined pediatric residents’ responsiveness and experiences in the context of a new pilot program, building an on-site Behavioral Health Consultant (BHC) into their primary care training site. Fifteen pediatric residents were divided so that 9 had access to an on-site BHC and 6 did not. Over the first year of the program, research assistants observed 322 patient visits to record concerns raised, residents’ responses, and visit length. Data regarding BHC activity and residents’ subjective impressions of the program were also collected. Results showed that at least one BH concern was raised in 24% of observed visits. Residents with access to the BHC initiated 89 on-the-spot referrals, resulting in 127 BHC-to-patient interactions. On average, residents spent 10 additional min/visit when BH concerns were raised but those with access to the BHC saved 8 min/visit when BH concerns were raised. Overall, residents utilized the service, particularly first and second year residents. Those with BHC access managed BH concerns in less time than those in the control group. Residents who utilized the BHC were very satisfied, perceived a better quality of care and patient outcomes, and desired future BHC collaboration. Implications for training residents in the area of pediatric behavioral health by using an on-site provider are discussed.
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Feitosa, Maria Zelfa de Souza. "Afetividade na residÃncia integrada em saÃde: o psicÃlogo no territÃrio de form"aÃÃo"." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=12249.
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FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgicoA afetividade pode ser compreendida como a passagem de um estado de potÃncia a outro, que conduz corpo e mente, entendidos como uma totalidade, à aÃÃo ou à passividade. Admite-se que o trabalho do psicÃlogo, no Ãmbito das polÃticas pÃblicas de saÃde, entre outras questÃes, està perpassado por afetos emergentes do encontro com o territÃrio, e que a formaÃÃo profissional contribui para a maneira como esta atuaÃÃo se efetiva. Assim sendo, nosso estudo objetivou analisar o impacto da afetividade (emoÃÃes e sentimentos) na atuaÃÃo de psicÃlogos-residentes em polÃticas pÃblicas de saÃde, de nÃvel primÃrio e secundÃrio, a partir de seu contato com o territÃrio dos serviÃos. Para tanto, elegemos como lÃcus da pesquisa a ResidÃncia Integrada em SaÃde (RIS), vinculada à Escola de SaÃde PÃblica do Cearà (ESP/CE), nas Ãnfases de SaÃde da FamÃlia e Comunidade e SaÃde Mental Coletiva, entrevistando 18 psicÃlogos-residentes aà inseridos. Neste intento, foram adotadas como principais bases teÃricas a Psicologia Social de base HistÃrico-Cultural, desenvolvida por Silvia Lane e colaboradores, e a Psicologia Ambiental. Caracterizando-se como uma pesquisa qualitativa, a coleta de dados foi realizada por meio da aplicaÃÃo da parte qualitativa do Instrumento Gerador dos Mapas Afetivos, cuja anÃlise se efetivou por meio da AnÃlise de ConteÃdo Categorial e da AnÃlise do subtexto, do sentido e do motivo; e Entrevista Semiestruturada, analisada por meio da AnÃlise de ConteÃdo TemÃtica, com o auxÃlio do software Atlas.ti. Os resultados obtidos na pesquisa revelaram uma Estima de lugar negativa em relaÃÃo ao serviÃo de saÃde onde os psicÃlogos-residentes atuam, denotando, entretanto, uma tendÃncia à implicaÃÃo positiva com o territÃrio, mais especificamente a comunidade e os usuÃrios, e com o ideal do que o serviÃo deveria ser, havendo o predomÃnio da imagem de contrastes nos mapas, a qual denota polarizaÃÃes de afetos em relaÃÃo ao espaÃo, como por exemplo, alegria/angÃstia e satisfaÃÃo/medo. As entrevistas tambÃm refletiram a predominÃncia de imagens de contrastes em relaÃÃo à formaÃÃo acadÃmica e contrastes e agradabilidade relacionadas à RIS, apontando para uma maior satisfaÃÃo com a formaÃÃo em serviÃo. As principais prÃticas desenvolvidas referiram-se a atividades de grupo, atendimentos individuais e visitas domiciliares. Esperamos que a pesquisa desenvolvida contribua para a discussÃo da prÃtica do psicÃlogo nos serviÃos pÃblicos de saÃde e da proposta da ResidÃncia Multiprofissional, como formaÃÃo em serviÃo.
Affection can be understood as the passage from one state to another power, which leads the body and mind, understood as a totality, the action or inaction. It is believed that the work of the psychologist in the area of public health policies, among other issues, is permeated by emerging affections of the encounter with the territory, and that the training contributes to how this action is effective. Therefore, our study aimed to analyze the impact of affectivity (emotions and feelings) in practicing psychologists-residents in public health policy, primary and secondary levels, from its contact with the area of services. For that, we choose as research locus Integrated Health Residency (RIS), linked to Escola de SaÃde PÃblica do Cearà (ESP /CE) (School of Public Health of CearÃ), in emphasis of the Family and Community Health and Mental Health Collective, interviewing 18 psychologists-residents inserted therein. In this attempt, were adopted as the main theoretical basis of social psychology Historic Cultural bases developed by Silvia Lane and colleagues, and Environmental Psychology. Characterized as a qualitative research, the data collection was performed by applying the qualitative part of the Instrument Generator Maps Affective, whose analysis was accomplished by analysis of Categorical Content and Analysis of subtext, of sense and reason; and semi-structured interviews, analyzed through qualitative analysis with the help of Atlas.ti software. The results obtained in the study showed an Esteem negative role in relation to the health service where psychologists work-residents, but shows a tendency to positive engagement with the territory - specifically the community and users - and the ideal of the service should be, giving a predominance of mixed picture on the maps, which denotes polarization of affect in relation to space, such as happiness / satisfaction and anxiety / fear. The interviews also reflected the predominance of images of contrasts in relation to academic background and contrasts and pleasantness related to RIS, pointing to a greater satisfaction with job training. The main activities carried out were related to the group, individual consultations and home visits activities. We hope that the research developed will contribute to the discussion of the practice of the psychologist in public health services and of the proposal of the Multidisciplinary Residency as in-service training.
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Medeiros, Roberto Henrique Amorim de. "Residência integrada em saúde : a torção do discurso universitário na cena de formação do profissional em saúde." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/29961.
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A Residência Integrada em Saúde (RIS) é um dispositivo pedagógico-clínico-políticoburocrático que movimenta o debate acerca da atenção à saúde no país e, por conseguinte, o pensamento em torno dos impasses e enigmas da formação em serviço no contexto do SUS. Esta tese procurou lançar a escuta e o olhar crítico, bem como o pensamento reflexivo, sobre os espaços, tempos e dispositivos de formação em uma das ênfases do programa da RIS do Grupo Hospitalar Conceição, na cidade de Porto Alegre-RS. Para tanto, contou com elementos conceituais, dentre eles a teoria dos quatro discursos de Lacan, em especial o discurso da Universidade, aspectos do pensamento de Benjamin, elementos da formação do psicanalista, bem como as propostas dos principais autores nacionais que se dedicam ao tema da formação de profissionais em saúde e o SUS. A escolha pela forma ensaística como é apresentada a tese é sustentada pela teoria de Adorno e privilegiada como o modo mais adequado de dar tratamento expressivo e conceitual ao corpus, composto por cenas do cotidiano da Residência colecionadas pelo pesquisador. Partindo da diferenciação entre saber e conhecimento, associada às exigências quanto à formação do novo profissional em saúde, para cumprir as promessas do SUS à população, que parecem recair mais na construção de saberes do que de conhecimentos, a tese afirma e formaliza a possibilidade de transmissão de um saber a partir do que estipulou como cena de formação. Finalmente, analisa os papéis dos formadores - equipes e preceptores - para problematizar sua posição na cena de formação, constituindo, desse modo uma teoria sobre a ensinaprendizagem em residências integradas em saúde. Destaca-se, além da cena de formação, a supervisão como dispositivo com potencial de torção no discurso da universidade, ato essencial para que as propostas de formação do profissional em saúde em situação de Residência contemplem as expectativas contidas nos objetivos de seus projetos pedagógicos.The Integrated Health Residency (RIS) is a pedagogical, clinical, political and bureaucratic device that moves the debate on health care in the country and hence the thinking on the dilemmas and enigmas of in-service formation in the context of the SUS. This thesis purported to launch listening and critical look as well as reflective thinking about space, time and formation devices in one of the emphasis of the RIS program of the Hospital Group Conceição, in Porto Alegre-RS. This involved with conceptual elements, including the theory of Lacan's four discourses, in particular the discourse of the University, aspects of Benjamin's thought, elements of the formation of psychoanalysts, as well as the proposals of the major national authors who focus on this issue of training of health professionals and the public health system. The choice for the essay form as the thesis is presented is supported by Adorno’s theory, and privileged as the most appropriate way of giving expressive and conceptual treatment to the corpus, composed by scenes of Residence’s everyday life, which were collected by the researcher. Starting from the distinction between knowledge and learning, associated with the demands on the formation of the new health professional to carry out the SUS’ promises to the people, which appear to fall more on building of knowledge than learning, the thesis states and formalizes the possibility of transmission of knowledge from what it stipulated as formation scene. Finally, it analyzes the roles of educators - staff and tutors - to discuss their position on the scene of formation, constituting thus a theory on teachinlearnig in integrated residences in health. It stands out, besides the scene of formation, the supervision as a device with potential torsion in the university discourse, an essential act to that the proposals of formation of health professionals in situations of Residence contemplate the expectations contained in the objectives of their pedagogical projects.
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Chi-HsuanChou and 周祈炫. "An integrated approach for conducting long-term PM2.5 exposure and health risk assessment for residents." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/tpz9da.
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碩士國立成功大學
環境醫學研究所
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SUMMARY In this study, the relationship of PM2.5 data sets obtained from the mobile monitoring station (MMS), stationary monitoring station (SMS) and Air Quality monitoring station of the Environmental Protection Agency monitoring station (AQMS) were established in order to describe the spatial and temporal variations of PM2.5 of the Shalu area, and to build a long term databank for conducting exposure and health risk assessment for residents’ exposures to PM2.5. A stationary PM2.5 monitoring station was built next to EPA monitoring station. In addition, a mobile monitoring station was used to measure PM2.5 of the area simultaneously in 2013-2014. Samplings were performed during both the daytime and nighttime on both weekdays and weekends for one month per season. Results show that most of daytime air pollution levels were significant higher than that of the nighttime due to the higher traffic flow and traffic density of the former. Comparing the results between Mm and Sm indicating that using the data of AQMS might cause underestimation for assessing residents’ exposures. Exposure assessment results show that annual mean value of SMS, MMS and AQMS are 29.14, 27.15 and 20.05 μg/m3, respectively, which is exceed PM2.5 air quality annual standard (15μg/m3) regulated by the EPA. High coefficient of determinations (R2) were found between AQMS and SMS, and between SMS and MMS, and hence an exposure databank of residents characterized with both spatial and temporal variations was established. The obtained long term exposure profile of residents, and the estimated incremental risks (IR) of the lung cancer, cardiovascular disease, and asthma are found to be unacceptable, which urges the needs for identifying main PM2.5 pollution sources for initiating proper control strategies in the future. Key words: Stationary measurement, Mobile measurement, PM2.5, Health risk assessment INTRODUCTION To date, Environmental Protection Agency monitoring station measurements (AQMS) are widely used for characterizing air quality data, but simply using AQMS could be inadequate to characterize residents’ exposures of the specific area. Our study analyzes the correlation of PM2.5 data sets of the mobile measurements (MMS), stationary measurements (SMS) and AQMS in order to describe the spatial and temporal variations of PM2.5 in the area, and to build a long term databank for conducting exposure and health risk assessment for residents’ exposures to PM2.5. MATTERALS AND METHODS The Shalu area was chosen as the target area. A stationary PM2.5 monitoring station was built next to EPA monitoring station. In addition, a mobile monitoring station was used to measure PM2.5 of the area simultaneously in 2013-2014. Samplings were performed during daytime (7:00-10:00 AM) and nighttime (18:00-21:00 PM) on both weekdays and weekends for one month per season. After eliminated high leverage value and outliers, the correlations of MMS, SMS and AQMS were established, and spatial and temporal variations of PM2.5 in the area were assessed, and finally a long term PM2.5 databank was constructed. The Bayesian decision analysis (BDA) were used for conducting long term exposure and health risk assessment of residents by comparing with EPA PM2.5 air quality standards (STD24hr). RESULTS AND DISCUSSION Results show that most of daytime air pollution indicators were significant higher than that of the nighttime due to the higher traffic flow and traffic density for the former. Comparing the results between MMS and SMS, the former are higher than that of the latter mainly due to their monitoring site is closer to local emission sources. Therefore, using the data of AQMS might cause underestimation for assessing residents’ exposures. Moreover, high concentrations were found in winter which may be affected by its intrinsic unfavorable atmospheric dispersion. Exposure assessment results show that annual mean value of SMS, MMS and AQMS are 29.14, 27.15 and 20.05 μg/m3, respectively, which is exceed PM2.5 air quality annual standard (15 μg/m3) regulated by the EPA. The coefficient of determination (R2) between AQMS and SMS are found to be 62.0% in spring, 75.6% in summer, 61.8% in fall, and 85.6% in winter. The R2 between SMS and MMS are 50.2% in spring, 64.3% in summer, 65.2% in fall, and 73.0% in winter. The above results suggest the possibility for effectively building an exposure databank of residents characterized with both spatial and temporal variations by combining the data of AQMS, MMS and SMS. Long term exposure profile of residents at Shalu area obtained by the BDA shows that residents' exposure rating (ER) most probability (i.e., 74%) falls to ER2 (i.e., 2.5 to 5 STD24hr). Using the same data sets, the increment risk (IR) of lung cancer (46.2%) falls to ER4 (i.e., ≥5*10-4), cardiovascular disease most probability (63.1%) falls to ER2 (i.e., 5*10-4 to 1.25*10-3), and asthma most probability (64.3%) falling to ER4 (i.e., 1.25*10-3ꟷ 2.5*10-3). CONCLUSION Our results suggest that simply using the data of AQMS might cause underestimation for assessing residents’ exposures. Judging from the obtained R2 between AQMS and SMS, and that obtained between SMS and MMS, the present study suggests the possibility for effectively building an exposure databank of residents characterized with both spatial and temporal variations by combining the data of AQMS, MMS and SMS. The obtained long term exposure profile of residents, and the estimated IR of the lung cancer, cardiovascular disease, and asthma are found to be unacceptable, which urges the needs for identifying main PM2.5 pollution sources for initiating proper control strategies in the future.
Books on the topic "Integrated health residence"
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Dias, Amit, Dilip Motghare, Daisy Acosta, Jacob Roy, A. T. Jotheeswaran, and Ralph N. Martins. Trials of interventions for people with dementia. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199680467.003.0012.
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There is very little awareness in LAMIC of people with dementia and the treatment gap ranges from 70%–90%. This chapter highlights the tremendous scope for well-designed RCTs to test innovative interventions that would be affordable and effective for the people with dementia and their families in low-resource settings. The Dementia Home Care Project demonstrates the process of developing and evaluating an intervention, to test the effectiveness of a flexible, stepped-care, psychosocial intervention, designed using locally available resources to help families of people with dementia. Non-specialist health workers were trained to deliver an intervention at the residence of the person with dementia in Goa, India. The trial concluded that locally available resources could be utilized to decrease the burden and burnout associated with caring for a person with dementia and should be integrated with primary health care in LAMIC to bridge the treatment gap for dementia.
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Feinstein, Robert, Joseph Connelly, and Marilyn Feinstein, eds. Integrating Behavioral Health and Primary Care. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.001.0001.
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This book describes real-world examples and practical approaches for integrating behavioral and physical health services in primary care and some specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists who are working in ambulatory/office-based practices. We examine the integrated care literature and recommend applying collaborative care and other existing models of integrated care based on the existing evidence-based research. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems. We assume the use of a fully integrated team staffing model while also recognizing this an ideal that may need modification based on local resources and practice cultures. The full integrated team includes a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s). The book has four sections: Part 1: Models of Integrated Care provides an overview of the principles and the framework of integrated care focusing on five highly successful integrated practices. We also discuss team-based care, financing, tele-behavioral health, and use of mental health assessments and outcome measures. Part 2: Integrative Care for Psychiatry and Primary Care is a review of existing and proposed models of integrated care for common psychiatric disorders. Our continuity approach emphasizes problem identification, differential diagnosis, brief treatment, and yearlong critical pathways with tables and figures detailing “how to” effectively deliver mental health care and manage substance misuse in an integrated care environment. Part 3: Integrated Care for Medical Sub-Specialties & Behavioral Medicine Conditions in Primary Care focuses on two models of integrating behavioral health care: (1) integrating wellness with behavioral health and (2) integrating psychiatry and neurology. Other chapters are “Women’s Mental Health Across the Reproductive Lifespan,” “Assessing and Treating Sexual Problems in an Integrated Care Environment,” “Integrated Chronic Pain and Psychiatric Management,” and “Death and Dying: Integrated Teams.” Part 4: Psychosocial Treatments in Integrated Care describes brief office-based counseling and psychosocial treatment approaches including: health coaching, crisis intervention, family, and group interventions. All of these brief treatment approaches are patient–centered, tailored to be used effectively integrated care settings and as an important contribution to population management.
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Feilchenfeld, Zac, Ayelet Kuper, Farah Friesen, Amanda Chen, and Cynthia Whitehead. Teaching the Social Sciences in Residency. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190849900.003.0006.
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Social sciences are only rarely integrated into graduate medical curricula, though there have been several calls for increasing social sciences in medical education. The usual approaches to teaching the social sciences in graduate medical education in the current literature include basing curricula on the Behavioral and Social Sciences model or the Social Determinants of Health model. One further approach attempts to teach competencies that suggest intersections between the social sciences and competency frameworks. A foundation of social science knowledge, analogous to the foundational basic science and clinical science knowledge learned by trainees to support medical expertise, could support the broader competencies required for trainees to become competent physicians. This chapter describes a model of foundational social science knowledge, developed from research findings. The chapter provides curricular ideas, practical tips, discussion questions, and helpful links for program directors looking to incorporate social science teaching in their programs.
Book chapters on the topic "Integrated health residence"
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Haugan, Gørill. "Nurse-Patient Interaction: A Vital Salutogenic Resource in Nursing Home Care." In Health Promotion in Health Care – Vital Theories and Research, 117–36. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63135-2_10.
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AbstractWe are now witnessing a major change in the world’s population. Many people globally grow very old: 80, 90, and 100 years. Increased age is followed by an increased incidence of functional and chronic comorbidities and diverse disabilities, which for many leads to the need for long-term care in a nursing home. Quality of life and health promotive initiatives for older persons living in nursing homes will become ever more important in the years to come. Therefore, this chapter focuses on health promotion among older adults living in nursing homes. First, this chapter clarifies the concepts of health, salutogenesis, and pathogenesis, followed by knowledge about health promotion. Then insight and knowledge about the nursing home population is provided; what promotes health and well-being in nursing home residents?Health promotion in the health services should be based on integrated knowledge of salutogenesis and pathogenesis. The salutogenic understanding of health is holistic and considers man as a wholeness including physical, mental, social, and spiritual/existential dimensions. Research indicates that various health-promoting interventions, specifically the nurse–patient interaction, influence on older adults in nursing homes as a wholeness of body–soul–spirit, affecting the whole being. Hence, dimensions such as pain, fatigue, dyspnea, nausea, loneliness, anxiety, and depressive symptoms will be influenced through health-promoting approaches. Therefore, two separate studies on the health-promoting influences of nurse–patient interaction in nursing home residents were conducted. In total, nine hypotheses of directional influence of the nurse–patient interaction were tested, all of which finding support.Along with competence in pain and symptom management, health-promoting nurse–patient interaction based on awareness and attentional skills is essential in nursing home care. Thus, health care workers should be given the opportunity to further develop their knowledge and relational skills, in order to “refine” their way of being present together with residents in nursing homes. Health professionals’ competence involves the “being in the doing”; that is, both the doing and the way of being are essential in health and nursing care.
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Moksnes, Unni Karin. "Sense of Coherence." In Health Promotion in Health Care – Vital Theories and Research, 35–46. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63135-2_4.
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AbstractThis chapter introduces the concept of sense of coherence which is a core concept in the salutogenic model defined by Aron Antonovsky. The salutogenic model posits that sense of coherence is a global orientation, where life is understood as more or less comprehensible, meaningful, and manageable. A strong sense of coherence helps the individual to mobilize resources to cope with stressors and manage tension successfully with the help of identification and use of generalized and specific resistance resources. Through this mechanism, the sense of coherence helps determine one’s movement on the health ease/dis-ease continuum. Antonovsky developed an instrument named Orientation to Life Questionnaire to measure the sense of coherence which exists in two original versions: a 29-item and a 13-item version. This chapter presents the measurement of the sense of coherence and the validity and reliability of the 13-item scale. It gives a brief overview of empirical research of the role of sense of coherence in association with mental health and quality of life and also on sense of coherence in different patient groups including nursing home residents, patients with coronary heart disease, diabetes, cancer, and mental health problems. It also briefly discusses the implications of using salutogenesis in health care services and the importance of implementing this perspective in meeting with different patient groups. The salutogenic approach may promote a healthy orientation toward helping the patient to cope with everyday stressors and integrate the effort regarding how to help the patient manage to live with disease and illness and promote quality of life.
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Scott, Mary Alice, Ernesto A. Moralez, and John Andazola. "Using Anthropological Perspectives to Integrate Health Equity Across a Family Medicine Residency Program in New Mexico." In Anthropology in Medical Education, 335–51. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-62277-0_15.
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Karimi, Habibeh, and Farid Gholamrezafahimi. "Study of Integrated Coastal Zone Management and Its Environmental Effects." In Oceanography and Coastal Informatics, 108–31. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7308-1.ch005.
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Coasts were one of the main places of residence for human beings through the history. From the emergence of civilization to now, the human beings used coastal zone as a best place for residence. However, in early 21 century, almost two-third of people in the world (i.e. 3/7 billion people) lived in the 60 km of sea sideline. Therefore, some problems threaten human communities, includes soil erosion, changes in coastline, coastal habitat destruction, drying or polluting underground waters, and creating dangerous situation for hygiene and health in order to lack of insufficient repulsing waste and sewage. Thus, according to these problems, the integrated coastal zone management (ICZM) was considered as a main way for solving the environmental problems. This chapter follows the goal that is related to the ICZM, particularly in Iran, after investigating the problems in the coastal region.
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Karimi, Habibeh, and Farid Gholamrezafahimi. "Study of Integrated Coastal Zone Management and Its Environmental Effects." In Advances in Environmental Engineering and Green Technologies, 64–88. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-1683-5.ch004.
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Coasts were one of the main places of residence for human beings through the history. From the emergence of civilization to now, the human beings used coastal zone as a best place for residence. However, in early 21 century, almost two-third of people in the world (i.e. 3/7 billion people) lived in the 60 km of sea sideline. Therefore, some problems threaten human communities, includes soil erosion, changes in coastline, coastal habitat destruction, drying or polluting underground waters, and creating dangerous situation for hygiene and health in order to lack of insufficient repulsing waste and sewage. Thus, according to these problems, the integrated coastal zone management (ICZM) was considered as a main way for solving the environmental problems. This chapter follows the goal that is related to the ICZM, particularly in Iran, after investigating the problems in the coastal region.
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Wenzel, Andrea. "Developing an Intervention." In Community-Centered Journalism, 75–104. University of Illinois Press, 2020. http://dx.doi.org/10.5622/illinois/9780252043307.003.0004.
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Chapter Three integrates previous research on solutions journalism and engaged journalism into a communication infrastructure theory framework, which looks at the health of local “storytelling network” ties between local media, organizations, and residents. This framework is used to assess storytelling networks, then design and pilot interventions to strengthen them. It focuses on Western Kentucky, an economically marginalized, but more rural region with a different demographic and political context to previous urban cases. The chapter explores how place identity and political polarization affect ties between residents, community groups, and local journalists. It then looks at a series of pilot interventions that grew out of a participatory design process—including an online and offline town hall, a participatory journalism program, and a series of listening sessions focused on informal rural gathering spaces. It explores how these interventions address key trustworthiness factors, and account for the needs and assets of local places.
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"Climate Change Solutions." In Utilizing Innovative Technologies to Address the Public Health Impact of Climate Change, 236–68. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-3414-3.ch008.
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Carbon pricing initiatives, as well as carbon capture and geologic sequestration (CCS), are tools to offset and reduce the impact of CO2 emissions. The best solution is to not create the CO2 emissions in the first place by switching from fossil fuels to renewable clean energy sources. This can be incentivized through tax breaks, as Norway has done with EVs. DOI can be used to change the public mindset so that they will embrace EVs, as Germany is doing now. Sea level rise solutions include shoreline armoring and beach renourishment, elevation of roadways and sidewalks, managed retreat through purchase of vulnerable land for public use, and avoidance through limiting development in high-risk areas. This chapter gives case examples from U.S.'s 100 Resilient Cities, and UK's Bristol is Open, a programmable city where data on air quality, transportation, health, and needs of elderly residents are integrated into one high-speed centralized network.
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"Walkability in Metropolitan Area." In Big Data Analytics in Traffic and Transportation Engineering, 45–66. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7943-4.ch003.
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Promoting active trips has been considered as a key element towards achieving more sustainable transportation. Walking as a mode of transportation can contribute to more sustainable and healthy travel habits. This chapter presents a new approach for measuring walkability within Melbourne region, Australia. An integrated approach combining transport and land-use planning concepts was employed to construct the walking access index (WAI), which is a location-based measure for accessibility. The WAI along with a common existing walkability index were employed in regression models to examine how the new index performs in transport modelling. Key findings indicate that residents are more likely to have walking trips when living in a more walkable environment. Furthermore, it was found using statistical modelling that the WAI produces better results than one of the common approaches.
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Lutz, Wolfgang, and William P. Butz. "Introduction." In World Population & Human Capital in the Twenty-First Century. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198813422.003.0005.
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This book addresses systematically and quantitatively the role of educational attainment in global population trends and models. By adding education to the traditional demographic characteristics of age and sex, this distinguishing feature substantially alters the way we look at changes in populations and how we project them into the future. In most societies, particularly during the process of demographic transition, women with more education have fewer children, both because they want fewer and because they find better access to birth control. And better educated men and women in virtually all societies have lower mortality rates and their children have a better chance of survival. Migration flows also differ by level of education, and better educated migrants integrate more easily into receiving societies. These pervasive demographic differentials by level of education matter greatly for population dynamics. When we explicitly address this important source of population heterogeneity the projected future population trends are different from those based on the conventional stratifications that include only age and sex. In addition, the future educational attainment levels of the adult population are of great interest in their own right as a key determinant of outcomes ranging across economic growth, quality of governance, and adaptive capacity to environmental change. Traditionally in demography, the sex of a person is considered the most fundamental characteristic because it is essential for studying the process of reproduction. Mortality and migration also show significant variation by gender. Age is another key characteristic because it is the main driver of biological maturation at an early age and is directly related to school attendance, labour force entry, and retirement, all landmarks that are important for social institutions. Because there are distinct age-related patterns of fertility, mortality, and migration intensities, gender and age are considered the most fundamental demographic dimensions. In addition, demographers frequently take into account other biological, social, and economic characteristics, including place of residence (especially urban or rural), citizenship, marital status, race, migration status, employment status, health/disability status, and educational attainment. These additional characteristics are not systematically considered in every study, but tend to appear in corresponding topical studies.
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Decrop, Alain, and Antónia Correia. "Conclusion Preparing for the future of travel and tourism in vulnerable times." In Sustainable and Collaborative Tourism in a Digital World. Goodfellow Publishers, 2021. http://dx.doi.org/10.23912/9781911635765-4850.
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When gathering the best papers presented in 2019 during the 8th ATMC conference in Namur for editing this book, we were not expecting 2020 to become the nightmare year that we all experienced in the world. The Covid-19 crisis has significantly disrupted our consumption and travel habits. Heaps of business sectors were severely impacted by the two waves of lockdown of populations and countries, the closure of stores and restaurants and the overall context of anxiety and uncertainty. More than other sectors, the tourism and travel industry was severely affected. The trips and recreative activities of our fellow citizens are henceforth punctuated by ‘barrier gestures’ and by a large number of health measures taken in order to limit the spread of the pandemic. Of course, the objective of this book was not to account for the current crisis, nor to analyze the extent to which our tourism and leisure activities have changed, and whether these changes are likely to last. The aim of the book was first to discuss sustainability and collaborative practices in order to fill tourism development with ethics and responsibility. Following the collegial tradition of Advances in Tourism Marketing conferences, this book is the result of the collaboration of established international scholars with emergent researchers around the globe. The twelve chapters of this book have offered innovative and dovetailing perspectives around four major strategic questions that may support tourism development in these vulnerable times, i.e.: Can technology enhance value co-creation and the tourism experience? How sharing economy practices develop in tourism? To what extent sustainability issues affect culture and the well-being of residents? What is the connection between technology, millennials and overtourism? Of course, those issues were considered in the framework of the digital world that is ever expanding since two decades. Digital technology has been massively integrated into the strategies and operations of tourism operators. Historically dedicated to marketing and communication, digital technology is now revolutionizing the entire tourism value chain. The promotion of a destination can no longer be considered without the mix between official digital channels and levers such as influencers and rating platforms. Any tourist expects to find relevant and up-to-date information on the Internet in order to prepare for his stay, to choose among transportation, accommodation and recreational alternatives, and to book activities. The exchange of tips and advice has become an important element in choosing a destination. In many regions, competition between destinations and operators makes it essential to be attractive via a different offer and digital technology may act as a major differentiator (e.g., Histopad to visit Chambord’s Castle, Monument Tracker). To answer these questions, the book was organized in four parts where interdependence, collaboration, sustainability and responsible behavior are deeply discussed with the aim of contributing to marketing tourism in the digital world that we know today. The book started with a discussion about how to co-create value with or without technologies, detailed how web platforms reboot collaborative economic practices, presented sustainable tourism development under a human perspective and ended with the discussion of key issues in tourism marketing, including overtourism and residents’ propensity to boost tourism development. We now summarize the key takeaways of those four parts, closing each part with a reflection on the lessons learnt from current Covid-19 crisis in order to assess what will be left after the vulnerable times that we live now.
Conference papers on the topic "Integrated health residence"
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French, Jesse J., Caitlin T. Clancy, Allison L. Johnston, Maria A. Holland, and John M. Henshaw. "Design and Fabrication of the Energy Generating Components for the Sustainable Shepherd’s Residence in Northeastern China." In ASME 2009 3rd International Conference on Energy Sustainability collocated with the Heat Transfer and InterPACK09 Conferences. ASMEDC, 2009. http://dx.doi.org/10.1115/es2009-90074.
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The Sustainable Shepherd’s Residence (SSR) is a novel, multi-year service learning project executed by students at the University of Tulsa in the Jilin Province of Northeastern China. The SSR is an effort to design and fabricate a dwelling that is manufacturable with local materials on a budget commensurate with local earnings. It utilizes modern sustainable energy methods to bring power to some of the 20 million rural Chinese who live without electricity in one of the world’s harshest climates. Wind power, passive solar heating, photovoltaic battery charging, and biogas technology are all incorporated into a structure that houses a single family and their associated livestock. After completing an assessment trip to the region to inventory health conditions, energy needs, and available materials, students designed a residence that provided greatly improved living conditions for the rural shepherd whilst accommodating the special security issues that remain a challenge in the region. On subsequent return trips, the students worked alongside local craftsmen to build the structure and the sustainable energy components and assemble them into a ‘green model home’. The SSR is currently occupied and visited frequently by farmers from neighboring villages who seek to improve their standard of living using the sustainable techniques on display. This paper focuses on the challenges associated with the fabrication of fairly well understood modern sustainable energy technologies in the face of cultural and materiel difficulties present in an international and rural setting. The competing forces at play include the lack of basic maintenance habits due to long-term absence of privatized machinery ownership and the desire for high-wattage electrical conveniences found in the larger cities. The practical engineering aspects of the design and testing of the SSR energy generating components are considered. Specific topics include the fabrication and modification of two different wind turbines, manufacture and operational testing of a biogas digester, and the design of an integrated residential greenhouse with an aquaponics system capable of year round production.
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Sakurai, Fumi, and Akira Mita. "Biofied room integrated with sensor agent robots to interact with residents and acquire environmental information." In SPIE Smart Structures and Materials + Nondestructive Evaluation and Health Monitoring, edited by Masayoshi Tomizuka. SPIE, 2011. http://dx.doi.org/10.1117/12.880204.
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Aliabadi, Ardavan, and Klaus A. Hoffmann. "Three-Dimensional Fluid-Structure-Interaction Simulation of Tilting Disk Mechanical Heart Valve." In ASME 2013 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/imece2013-65335.
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The current computational effort will focus on the numerical analysis of current tiling disk MHVs. In this work an implicit fluid-structure-interaction (FSI) simulation of the Bjork-Shiley design was carried out using in-house codes implemented in the commercial code software FLUENT™. In-house codes in the form of journal files, schemes, and user-defined functions (UDFs) were integrated to automate the inner iterations and enable communication between the fluid and the moving disk at the interfaces. Based on the investigations of the current simulations, a new design aiming at improving the hemodynamic performance is suggested. Hemodynamics of the flow in current tilting-disk valves is compared with the suggested design and it is concluded that the suggested design has a better hemodynamic performance in terms of shear stress values and residence times.
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Figueiredo, Daniel Martins, Roel Vermeulen, and Jan Duyzer. "P I – 2–6 An integrated modelling framework to estimate residents exposure to pesticides from boom sprayer applications." In ISEE Young 2018, Early Career Researchers Conference on Environmental Epidemiology – Together for a Healthy Environment, 19–20 March 2018, Freising, Germany. BMJ Publishing Group Ltd, 2018. http://dx.doi.org/10.1136/oemed-2018-iseeabstracts.84.
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Weiland, Nathan T., and Peter A. Strakey. "NOx Reduction by Air-Side vs. Fuel-Side Dilution in Hydrogen Diffusion Flame Combustors." In ASME Turbo Expo 2009: Power for Land, Sea, and Air. ASMEDC, 2009. http://dx.doi.org/10.1115/gt2009-60128.
Full textAbstract:
Lean-Direct-Injection (LDI) combustion is being considered at NETL as a means to attain low NOx emissions in a high-hydrogen gas turbine combustor. Integrated Gasification Combined Cycle (IGCC) plant designs can create a high-hydrogen fuel using a water-gas shift reactor and subsequent CO2 separation. The IGCC’s air separation unit produces a volume of N2 roughly equivalent to the volume of H2 in the gasifier product stream, which can be used to help reduce peak flame temperatures and NOx in the diffusion flame combustor. Placement of this diluent in either the air or fuel streams is a matter of practical importance, and has not been studied to date for LDI combustion. The current work discusses how diluent placement affects diffusion flame temperatures, residence times, and stability limits, and their resulting effects on NOx emissions. From a peak flame temperature perspective, greater NOx reduction should be attainable with fuel dilution rather than air or independent dilution in any diffusion flame combustor with excess combustion air, due to the complete utilization of the diluent as a heat sink at the flame front, although the importance of this mechanism is shown to diminish as flow conditions approach stoichiometric proportions. For simple LDI combustor designs, residence time scaling relationships yield a lower NOx production potential for fuel-side dilution due to its smaller flame size, whereas air-dilution yields a larger air entrainment requirement and a subsequently larger flame, with longer residence times and higher thermal NOx generation. For more complex staged-air LDI combustor designs, dilution of the primary combustion air at fuel-rich conditions can result in full utilization of the diluent for reducing the peak flame temperature, while also controlling flame volume and residence time for NOx reduction purposes. However, differential diffusion of hydrogen out of a diluted hydrogen/nitrogen fuel jet can create regions of higher hydrogen content in the immediate vicinity of the fuel injection point than can be attained with dilution of the air stream, leading to increased flame stability. By this mechanism, fuel-side dilution extends the operating envelope to areas with higher velocities in the experimental configurations tested, where faster mixing rates further reduce flame residence times and NOx emissions. Strategies for accurate CFD modeling of LDI combustors’ stability characteristics are also discussed.
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Kusumawati, Yeny, and Fresty Africia. "Implementation of No Smoking Area Policy in High School 2, Nganjuk, East Java, Indonesia." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.01.
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ABSTRACT Background: In school environments, the No Smoking Area Policy is based on protecting young people who are currently studying at school from exposure to harmful cigarette smoke. It is expected to indirectly reduce student smoking rates. This study aimed to describe the implementation of the No Smoking Area policy at High School 2 Nganjuk, East Java and to identify the factors influencing the policy implementation. Subjects and Methods: This was a qualitative study carried out at High School 2 Nganjuk, East Java. The study subjects were included the principal, student deputy principals, counseling guidance teachers, homeroom teachers, employees, and students of High School 2 Nganjuk. Data were collected using observation, interviews, and documentation. The source triangulation technique used the technique of checking the validity of the data. This study used an interactive model of data analysis technique, which is based on the theory of George C. Edward III, consisted of communication, resources, dispositions, and bureaucratic structures. Results: In High School 2 Nganjuk, the No Smoking Area Policy has not been implemented optimally, particularly on the resource factor. For example, some teachers and staff still smoking in schools. This was not in accordance with the provisions in the No Smoking Area Policy. As the budget for funds from School Operational Assistance (BOS) was integrated with the School Environment Introduction Period (MPLS/MOS as well as the Adiwiyata program, there was no special budget for the implementation of the No Smoking Area policy. There was still not enough amount of billboards about no smoking area. The communication factor was the supporting factor. The policy for the No Smoking Area is always communicated to school residents. The disposition factors was the policy implementers’ engagement. The bureaucratic factor were structure and the presence of SOP in policy implementation. Conclusion: The enforcement of the policy of the No Smoking Area in High School 2 Nganjuk has not been maximized, so all factors, both contact factors, resource factors, disposal factors, and bureaucratic factors, need to be assisted. Keywords: smoking area, high school, policy Correspondence: Yeny Kusumawati. School of Health Sciences, Satria Bhakti Nganjuk, East Java, Indonesia. Email: yenykusumawati.sbn.ngk@gmail.com. Mobile: 082244297997 DOI: https://doi.org/10.26911/the7thicph.04.01
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Cross, Andrew, Kimberly Hammer, Rick Hurt, and Robert F. Boehm. "An Autonomous Controller for Ductless Mini-Split Heat Pumps, Residential Solar Thermal Collection, and Hydronic Floor Heating." In ASME 2014 8th International Conference on Energy Sustainability collocated with the ASME 2014 12th International Conference on Fuel Cell Science, Engineering and Technology. American Society of Mechanical Engineers, 2014. http://dx.doi.org/10.1115/es2014-6316.
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A unique autonomous control system was developed to manage the HVAC components of a residence built specifically for an ultra-efficient home competition. Some of the home’s HVAC components that contribute to its ultra-efficiency (and necessitate such an autonomous controller) include multiple ductless mini-split heat pumps, multiple hydronic heated floor loops, multiple circulating ceiling fans, and a closed-loop solar thermal collection and storage system that not only provides hot water to the hydronic heated floors, but also supplies the home with domestic hot water. The autonomous controller integrates all this equipment with a mixture of technology that includes power-line communications, both wired and wireless TCP/IP network signals, low-voltage wiring, and infrared signals. By utilizing these many different methods to communicate with equipment around the home, the controller is able to simultaneously regulate components and systems that are often considered “stand alone” or impractical to implement in residential buildings due to their need for constant manual operation. The result is an HVAC system that consumes very little energy while still providing an expected level of comfort.
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Liu, Chengcheng. "Strategies on healthy urban planning and construction for challenges of rapid urbanization in China." In 55th ISOCARP World Planning Congress, Beyond Metropolis, Jakarta-Bogor, Indonesia. ISOCARP, 2019. http://dx.doi.org/10.47472/subf4944.
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In the past 40 years, China has experienced the largest and fastest urbanization development in the world. The infrastructure, urban environment and medical services of cities have been improved significantly. The health impacts are manifested in the decrease of the incidence of infectious diseases and the significant increase of the life span of residents. However, the development of urbanization in China has also created many problems, including the increasing pollution of urban environment such as air, water and soil, the disorderly spread of urban construction land, the fragmentation of natural ecological environment, dense population, traffic congestion and so on. With the process of urbanization and motorization, the lifestyle of urban population has changed, and the disease spectrum and the sequence of death causes have changed. Chronic noncommunicable diseases have replaced acute infectious diseases and become the primary threat to urban public health. According to the data published by the famous medical journal The LANCET on China's health care, the economic losses caused by five major non-communicable diseases (ischemic heart disease, cerebrovascular disease, diabetes mellitus, breast cancer and chronic obstructive pulmonary disease) will reach US$23 trillion between 2012 and 2030, more than twice the total GDP of China in 2015 (US$11.7 trillion). Therefore, China proposes to implement the strategy of "Healthy China" and develop the policy of "integrating health into ten thousand strategies". Integrate health into the whole process of urban and rural planning, construction and governance to form a healthy, equitable and accessible production and living environment. China is building healthy cities through the above four strategies. The main strategies from national system design to local planning are as follows. First of all, the top-level design of the country. There are two main points: one point, the formulation of the Healthy China 2030 Plan determines the first batch of 38 pilot healthy cities and practices the strategy of healthy city planning; the other point, formulate and implement the national health city policy and issue the National Healthy City. The evaluation index system evaluates the development of local work from five aspects: environment, society, service, crowd and culture, finds out the weak links in the work in time, and constantly improves the quality of healthy city construction. Secondly, the reform of territorial spatial planning. In order to adapt to the rapid development of urbanization, China urban plan promote the reform of spatial planning system, change the layout of spatial planning into the fine management of space, and promote the sustainable development of cities. To delimit the boundary line of urban development and the red line of urban ecological protection and limit the disorderly spread of urban development as the requirements of space control. The bottom line of urban environmental quality and resource utilization are studied as capacity control and environmental access requirements. The grid management of urban built environment and natural environment is carried out, and the hierarchical and classified management unit is determined. Thirdly, the practice of special planning for local health and medical distribution facilities. In order to embody the equity of health services, including health equity, equity of health services utilization and equity of health resources distribution. For the elderly population, vulnerable groups and patients with chronic diseases, the layout of community health care facilities and intelligent medical treatment are combined to facilitate the "last kilometer" service of health care. Finally, urban repair and ecological restoration design are carried out. From the perspective of people-oriented, on the basis of studying the comfortable construction of urban physical environment, human behavior and the characteristics of human needs, to tackle "urban diseases" and make up for "urban shortboard". China is building healthy cities through the above four strategies. Committed to the realization of a constantly developing natural and social environment, and can continue to expand social resources, so that people can enjoy life and give full play to their potential to support each other in the city.
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Deal, Benjamin, and Timothy L. Marbach. "Optimization of a Mesoscale Combustor Using Heat Recirculation and Porous Inert Media." In ASME 2007 Energy Sustainability Conference. ASMEDC, 2007. http://dx.doi.org/10.1115/es2007-36268.
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Continuous improvement of integrated circuitry has allowed for the development of small, sophisticated portable electronics and microelectromechanical systems (MEMS) for a wide range of applications. Compared to the electronics and other system components, the batteries powering small electronics and MEMS are large and heavy. Thus, smaller and lighter power systems are required to advance future products. Electricity for small systems may be supplied by miniature heat engines, which transform chemical energy of fuel into thermal energy, kinetic energy and electricity with the use of combustors, turbines and generators. Combustion at small scales is challenging because system heat losses to the surroundings are large and flow residence times are short. Heat recirculation can be used to improve combustion performance by reducing these heat losses and preheating reactants prior to ignition. Practical heat recirculation systems must be small to keep the overall system volume and mass small. The objectives of this study were: (a) to investigate heat transfer in miniature combustors, and (b) to identify effective means of reducing heat loss from small combustors. The analyses indicated that axial conduction through the combustor wall and radiation across the preheating annulus were the most significant pathways for heat loss from the system. Several design improvements, including extended surfaces and porous inert media (PIM) were analyzed. A design featuring PIM in the annulus with a gap between the PIM and outer wall was the most effective method of reducing system heat loss.
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Hormaza-Mejia, Alejandra, Li Zhao, and Jack Brouwer. "SOFC Micro-CHP System With Thermal Energy Storage in Residential Applications." In ASME 2017 15th International Conference on Fuel Cell Science, Engineering and Technology collocated with the ASME 2017 Power Conference Joint With ICOPE-17, the ASME 2017 11th International Conference on Energy Sustainability, and the ASME 2017 Nuclear Forum. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/fuelcell2017-3142.
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To improve the energy efficiency and achieve zero-net energy goals, as well as to reduce environmental impacts, we demonstrated and evaluated the use of a 1.5 kW Solid Oxide Fuel Cell (SOFC) with Micro-combined heat and power (Micro-CHP) for powering residential homes. In this study, we designed, tested and demonstrated an SOFC Micro-CHP system as a Distributed Generation (DG) prime mover that has high reliability and availability, high efficiency and ultra-low emissions for steady state operation. Energy balances and dynamic analyses of integrating a thermal storage system with the SOFC Micro-CHP system were carried out using a summer load profile of a residence in Southern California. The thermal storage system was found to mitigate the dynamics introduced from the electric water heater and smooth out the residential load profile. Additionally, the integrated thermal storage system and the SOFC Micro-CHP system was found to reduce the overall electricity import and thus the carbon emissions.
Reports on the topic "Integrated health residence"
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Choi, Yoojin, Nathan M. Stall, Antonina Maltsev, Chaim M. Bell, Isaac I. Bogoch, Tal Brosh, Gerald A. Evans, et al. Lessons Learned from Israel’s Vaccine Rollout. Ontario COVID-19 Science Advisory Table, February 2021. http://dx.doi.org/10.47326/ocsat.2021.02.09.1.0.
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As Ontario expands access to the COVID-19 vaccine beyond the Phase 1 priority populations, strategic planning and execution of mass vaccine rollout will have a significant impact on the health and safety of Ontario’s 14.5 million residents. There are six key elements of Israel’s successful COVID-19 vaccine campaign that can be readily applied to Ontario to expedite and expand the province’s vaccine rollout strategy: a simple vaccine prioritization process; modification to the transport, storage, and distribution of the vaccines; effective communication to promote vaccine confidence; decentralization of vaccination sites; centralized organization through Health Maintenance Organizations (HMOs) using a fully integrated information technology (IT) system in a universal health care system; and the engagement of community-based personnel, infrastructure, and resources.