Using the social ecological model to identify drivers of nutrition risk in adult day settings serving East Asian older adults
education; support; united-states; care; impact; guidelines; programs; perspective; community; malnutrition
Adult day care (ADC) centers provide community-based care (including meals) to frail, ethnically diverse older adults, many of whom are at risk for malnutrition. To support the development of interventions to benefit ADC users, the authors aimed to identify barriers and facilitators of healthy nutrition among ADC users born in Vietnam and China. Semi-structured qualitative interviews were conducted among ADC stakeholders to identify barriers and facilitators. Data were analyzed using Braun and Clarke's six-step method and organized within the framework of the Social Ecological Model. Facilitators of good nutrition included adherence to traditional diet at the ADC center, peer networks, and access to ethnic grocers. Poor health, family dynamics, and loneliness all contributed to poor nutrition, as did the restrictive nature of nutrition programs serving ADC users in the United States. Individual, relationship, organizational, community, and policy level factors play a role in ADC users' nutritional status. Targeted nutrition interventions should leverage culturally congruent relationships between ADC users and staff and include advocacy for enhancement of federal programs to support this population.
Sadarangani TR; Johnson JJ; Chong SK; Brody A; Trinh-Shevrin C
Research in Gerontological Nursing
2020
2020-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.3928/19404921-20191210-02" target="_blank" rel="noreferrer noopener">10.3928/19404921-20191210-02</a>
RESIDENT TRAINING IN NURSING-HOME CARE - SURVEY OF SUCCESSFUL EDUCATIONAL-STRATEGIES
experience; physicians; Geriatrics & Gerontology; programs; internal-medicine; geriatric-medicine; older persons
OBJECTIVE: To identify educational strategies for resident training in nursing home care deemed successful by a large number of programs. DESIGN: A mail survey with three follow-up mailings. PARTICIPANTS: Directors of accredited internal medicine and family practice residency programs. MEASUREMENTS: Open- and closed-ended questionnaire eliciting curricular content, instructional strategies, and evaluation techniques from programs offering a nursing home experience. Identification of barriers to implementation of a nursing home curriculum and recommendations for success were requested. MAIN RESULTS: Of the 814 surveys mailed, 537 were returned for a response rate of 66%. Nursing home experiences were required in 86% of family practice residency programs but in only 25% of internal medicine programs. Most geriatric medicine curricular content areas were taught in the nursing home; however, relatively little emphasis was given to rehabilitation, organization, and financing of health care, and coordination of care between acute and chronic settings. Direct patient care, bedside rounds, and lectures were the most common instructional strategies reported. Evaluation approaches included faculty observations, resident attendance, and chart reviews with written and skill based examinations infrequent. Availability of faculty and conflict with other rotations were identified as the principal barriers to implementation of nursing home rotations. An organized nursing home curriculum supervised by enthusiastic faculty using a longitudinal rotation format with resident involvement in an interdisciplinary team was recommended. CONCLUSIONS: Educational strategies exist for successful implementation of a residency nursing home curriculum. Greater priority must be given to training residents in nursing home care and developing nursing home faculty to substantially increase the number and quality of physicians who practice in this setting.
Counsell S R; Katz P R; Karuza J; Sullivan G M
Journal of the American Geriatrics Society
1994
1994-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1532-5415.1994.tb06988.x" target="_blank" rel="noreferrer noopener">10.1111/j.1532-5415.1994.tb06988.x</a>
Emergency medicine resident research requirements and director characteristics
Emergency Medicine; programs; emergency medicine research; research directors; research requirement; scholarly activity
Objectives: To describe emergency medicine (EM) residency program research requirements, characterize research directors (RDs), and describe their research activities and productivity. Methods: A survey with questions addressing program research requirements, RDs' background, type of research productivity, time spent, and compensation was mailed to RDs at all Accreditation Council for Graduate Medical Education (ACGME)-approved programs. Results: One hundred of 111 (90%) RDs responded; 54 of the 100 respondents were from university programs. Research is a formal requirement in 80% of EM programs. Writing a manuscript (35%) and major involvement in a project (31%) are the most common minimum requirements. University and community programs had similar research requirements and were equally likely to have delayed withheld certificates. Eighty-six percent of the RDs were male; 70% held this position for <5 years and 70% plan on being in the position for less than or equal to 5 additional years. More than half were junior faculty and 21 had completed a fellowship. Most (88%) did not serve in an associate RD position, and currently only 20 programs reported having this position. Fifty-four percent had protected time. Median hour/week time allocations are: clinical-22, own research-10, other people's research-6, administration-5, and department administration-5. Factors associated with research productivity were senior rank (OR 6.87), having a research assistant (OR 4.78), protected time for their own research (OR 3.06), and reporting that extramural funding was considered in the RD's performance evaluation (OR 2.69). Conclusions: Most programs have established research requirements. Most RDs are junior faculty, have limited research training, expect a short tenure in the position, and have variable access to research resources. EM needs to foster an environment that will enable us to thrive in the academic community and create opportunity for residents to participate in meaningful research. This requires that all RDs have protected time, and that a greater proportion be at the associate or full professor level, have qualified research assistants, and receive periodic evaluation reviewing their ability to generate external funds. Appointment of associate RDs may improve research training and help ensure qualified RDs.
Blanda M; Gerson L W; Dunn K
Academic Emergency Medicine
1999
1999-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1553-2712.1999.tb00390.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.1999.tb00390.x</a>
Parental involvement in mathematics: giving parents a voice
childrens education; Education & Educational Research; elementary education; elementary-school; families; home; homework assistance; mathematics; metaanalysis; outcomes; parental involvement; parental role; perceptions; performance; programs; student academic-achievement
Understanding why parents become involved in their children's education is crucial in strengthening the relationship between parental involvement and academic achievement. The present study focuses on the parental role construction and parental self-efficacy. The resulting trends suggest that parents, regardless of their self-efficacy, may assume the 'equal partnership-focused' parental role regarding their children's mathematics education. The results also demonstrate that there may be a conflict in the way parents and teachers construct this parental role. While parents assumed the 'equally shared' role, teachers maintained the belief that the responsibility, although shared to a certain degree, should be primarily on teachers.
Wilder S
Education 3-13
2017
2017
Journal Article
<a href="http://doi.org/10.1080/03004279.2015.1058407" target="_blank" rel="noreferrer noopener">10.1080/03004279.2015.1058407</a>
The MATRICS consensus cognitive battery, part 1: Test selection, reliability, and validity
improve cognition; memory; performance; programs; Psychiatry; Rehabilitation; scale; schizophrenia; severe mental-illness; support
Objective: The lack of an accepted standard for measuring cognitive change in schizophrenia has been a major obstacle to regulatory approval of cognition-enhancing treatments. A primary mandate of the National institute of Mental Health's Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was to develop a consensus cognitive battery for clinical trials of cognition-enhancing treatments for schizophrenia through a broadly based scientific evaluation of measures. Method: The MATRICS Neurocognition Committee evaluated more than 90 tests in seven cognitive domains to identify the 36 most promising measures. A separate expert panel evaluated the degree to which each test met specific selection criteria. Twenty tests were selected as a beta battery. The beta battery was administered to 176 individuals with schizophrenia and readministered to 167 of them 4 weeks later so that the 20 tests could be compared directly. Results: The expert panel ratings are presented for the initially selected 36 tests. For the beta battery tests, data on test-retest reliability, practice effects, relationships to functional status, practicality, and tolerability are presented. Based on these data, 10 tests were selected to represent seven cognitive domains in the MATRICS Consensus Cognitive Battery. Conclusions: The structured consensus method was a feasible and fair mechanism for choosing candidate tests, and direct comparison of beta battery tests in a common sample allowed selection of a final consensus battery. The MATRICS Consensus Cognitive Battery is expected to be the standard tool for assessing cognitive change in clinical trials of cognition-enhancing drugs for schizophrenia. it may also aid evaluation of cognitive remediation strategies.
Nuechterlein K H; Green M F; Kern R S; Baade L E; Barch D M; Cohen J D; Essock S; Fenton W S; Frese F J; Gold J M; Goldberg T; Heaton R K; Keefe R S E; Kraemer H; Mesholam-Gately R; Seidman L J; Stover E; Weinberger D R; Young A S; Zalcman S; Marder S R
American Journal of Psychiatry
2008
2008-02
Journal Article
<a href="http://doi.org/10.1176/appi.ajp.2007.07010042" target="_blank" rel="noreferrer noopener">10.1176/appi.ajp.2007.07010042</a>