915 resultados para Self-service


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The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data.^ Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities.^ The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service-learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition.^ The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course. ^

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This study explored the strategies that community-based, consumer-focused advocacy, alternative service organizations (ASOs), implemented to adapt to the changes in the nonprofit funding environment (Oliver & McShane, 1979; Perlmutter, 1988a, 1994). It is not clear as to the extent to which current funding trends have influenced ASOs as little empirical research has been conducted in this area (Magnus, 2001; Marquez, 2003; Powell, 1986). ^ This study used a qualitative research design to investigate strategies implemented by these organizations to adapt to changes such as decreasing government, foundation, and corporate funding and an increasing number of nonprofit organizations. More than 20 community informants helped to identify, locate, and provide information about ASOs. Semi-structured interviews were conducted with a sample of 30 ASO executive directors from diverse organizations in Miami-bade and Broward Counties, in South Florida. ^ Data analysis was facilitated by the use of ATLAS.ti, version 5, a qualitative data analysis computer software program designed for grounded theory research. This process generated five major themes: Funding Environment; Internal Structure; Strategies for Survival; Sustainability; and Committing to the Cause, Mission, and Vision. ^ The results indicate that ASOs are struggling to survive financially by cutting programs, decreasing staff, and limiting service to consumers. They are also exploring ways to develop fundraising strategies; for example, increasing the number of proposals written for grants, focusing on fund development, and establishing for-profit ventures. Even organizations that state that they are currently financially stable are concerned about their financial vulnerability. There is little flexibility or cushioning to adjust to "funding jolts." The fear of losing current funding levels and being placed in a tenuous financial situation is a constant concern for these ASOs. ^ Further data collected from the self-administered Funding Checklist and demographic forms were coded and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive information and frequencies generated findings regarding the revenue, staff compliment, use of volunteers and fundraising consultants, and fundraising practices. The study proposes a model of funding relationships and presents implications for social work practice, and policy, along with recommendations for future research. ^

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Adoption of special needs children is now seen as a life long event whereby the adoptive child and family have unique needs. The need for postplacement resources throughout the life cycle of the adoption process is evident. This exploratory-descriptive research employed a random stratified cross-sectional design. The purpose of the study was to describe, identify, examine, and assess the relative influence of identified empirically and conceptually relevant variables of self-report experiences of adoptive parents of special needs children. Primary areas of exploration included: (1) adoptive children and families' characteristics, (2) postplacement service needs, utilization and satisfaction, and (3) adoptive parents' perceptions of their adoption experiences. A proportionate stratified random mail survey was used to obtain 474 families who had adopted special needs children from the 15 geographic districts which make up the state adoption social service agency in Florida. A 144-item survey questionnaire was used to collect basic information on demographic data, service provision, and adoption experiences. Four research questions were analyzed to test the effect the predictor variables had on willingness to adopt another special needs child, successful adoption, satisfying experience, and realism about problems. All four research questions revealed that the full model and the child's antecedent and the adoptive parents' intervening variable blocks were significant in explaining the variance in the dependent variables. The child's intervening variables alone were only significant in explaining the variance for one of the dependent variables. The results of the statistical analysis on the fifth research question and the three hypotheses determined that (1) only one postplacement service, crisis intervention, had a statistically significant impact on the adoptive parents' perceived level of satisfaction with the adoption experience; (2) adoptive parents who rate their adoption as successful are more likely to express a desire to adopt another special needs child; (3) the more adequate information on the child the adoptive parents perceived that they had prior to placement, the more they perceived they were realistic about the problems they would encounter; and (4) six specific postplacement services were found to be significant in predicting successful adoptions--crisis intervention, outpatient drug/alcohol treatment, maintenance subsidy, physical therapy, special medical equipment, and family counseling. Implications for the social work field and future research are discussed. ^

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The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data. Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities. The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service- learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition. The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course.

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The work motivation construct is central to the theory and practice of many social science disciplines. Yet, due to the novelty of validated measures appropriate for a deep cross-national comparison, studies that contrast different administrative regimes remain scarce. This study represents an initial empirical effort to validate the Public Service Motivation (PSM) instrument proposed by Kim and colleagues (2013) in a previously unstudied context. The two former communist countries analyzed in this dissertation—Belarus and Poland— followed diametrically opposite development strategies: a fully decentralized administrative regime in Poland and a highly centralized regime in Belarus. The employees (n = 677) of public and nonprofit organizations in the border regions of Podlaskie Wojewodstwo (Poland) and Hrodna Voblasc (Belarus) are the subjects of study. Confirmatory factor analysis revealed three dimensions of public service motivation in the two regions: compassion, self-sacrifice, and attraction to public service. The statistical models tested in this dissertation suggest that nonprofit sector employees exhibit higher levels of PSM than their public sector counterparts. Nonprofit sector employees also reveal a similar set of values and work attitudes across the countries. Thus, the study concludes that in terms of PSM, employees of nonprofit organizations constitute a homogenous group that exists atop the administrative regimes. However, the findings propose significant differences between public sector agencies across the two countries. Contrary to expectations, data suggest that organization centralization in Poland is equal to—or for some items even higher than—that of Belarus. We can conclude that the absence of administrative decentralization of service provision in a country does not necessarily undermine decentralized practices within organizations. Further analysis reveals strong correlations between organization centralization and PSM for the Polish sample. Meanwhile, in Belarus, correlations between organization centralization items and PSM are weak and mostly insignificant. The analysis indicates other factors beyond organization centralization that significantly impact PSM in both sectors. PSM of the employees in the studied region is highly correlated with their participation in religious practices, political parties, or labor unions as well as location of their organization in a capital and type of social service provided.

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Psychiatric nurses have been facilitating therapeutic groups in acute psychiatric inpatient units for many years; however, there is a lack of nursing research related to this important aspect of care. This paper reports the findings of a study which aimed to gain an understanding of service users' experiences in relation to therapeutic group activities in an acute inpatient unit. A qualitative descriptive study was undertaken with eight service users in one acute psychiatric inpatient unit in Ireland. Data were collected using in-depth semi-structured interviews and analysed using Burnard's method of thematic content analysis. Several themes emerged from the findings which are presented in this paper.

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Background: Research suggests that patients presenting to hospital with self-cutting differ from those with intentional overdose in demographic and clinical characteristics. However, large-scale national studies comparing self-cutting patients with those using other self-harm methods are lacking. We aimed to compare hospital-treated self-cutting and intentional overdose, to examine the role of gender in moderating these differences, and examine the characteristics and outcomes of those patients presenting with combined self-cutting and overdose. Methods: Between 2003 and 2010, the Irish National Registry of Deliberate Self-Harm recorded 42,585 self-harm presentations to Irish hospital emergency departments meeting the study inclusion criteria. Data were obtained on demographic and clinical characteristics by independent data registration officers. Results: Compared with overdose only, involvement of self-cutting (with or without overdose) was significantly more common in males than females, with an overrepresentation of males aged <35 years. Independent of gender, involvement of self-cutting (with or without overdose) was significantly associated with younger age, city residence, repetition within 30 days and repetition within a year (females only). Factors associated with self-cutting as the sole method were no fixed abode/living in an institution, presenting outside 9 a.m. to 5 p.m., not consuming alcohol and repetition between 31 days and 1 year (males only). Conclusion: The demographic and clinical differences between self-harm patients underline the presence of different subgroups with implications for service provision and prevention of repeated self-harm. Given the relationship between self-cutting and subsequent repetition, service providers need to ensure that adequate follow-up arrangements and supports are in place for the patient.

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Background: Chronic fatigue syndrome, also known as myalgic encephalomyelitis (CFS/ME), is characterized by chronic disabling fatigue and other symptoms, which are not explained by an alternative diagnosis. Previous trials have suggested that graded exercise therapy (GET) is an effective and safe treatment. GET itself is therapist-intensive with limited availability. Objective: While guided self-help based on cognitive behavior therapy appears helpful to patients, Guided graded Exercise Self-help (GES) is yet to be tested. Methods: This pragmatic randomized controlled trial is set within 2 specialist CFS/ME services in the South of England. Adults attending secondary care clinics with National Institute for Health and Clinical Excellence (NICE)-defined CFS/ME (N=218) will be randomly allocated to specialist medical care (SMC) or SMC plus GES while on a waiting list for therapist-delivered rehabilitation. GES will consist of a structured booklet describing a 6-step graded exercise program, supported by up to 4 face-to-face/telephone/Skype™ consultations with a GES-trained physiotherapist (no more than 90 minutes in total) over 8 weeks. The primary outcomes at 12-weeks after randomization will be physical function (SF-36 physical functioning subscale) and fatigue (Chalder Fatigue Questionnaire). Secondary outcomes will include healthcare costs, adverse outcomes, and self-rated global impression change scores. We will follow up all participants until 1 year after randomization. We will also undertake qualitative interviews of a sample of participants who received GES, looking at perceptions and experiences of those who improved and worsened. Results: The project was funded in 2011 and enrolment was completed in December 2014, with follow-up completed in March 2016. Data analysis is currently underway and the first results are expected to be submitted soon. Conclusions: This study will indicate whether adding GES to SMC will benefit patients who often spend many months waiting for rehabilitative therapy with little or no improvement being made during that time. The study will indicate whether this type of guided self-management is cost-effective and safe. If this trial shows GES to be acceptable, safe, and comparatively effective, the GES booklet could be made available on the Internet as a practitioner and therapist resource for clinics to recommend, with the caveat that patients also be supported with guidance from a trained physiotherapist. The pragmatic approach in this trial means that GES findings will be generalizable to usual National Health Service (NHS) practice.

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Suicide is a serious international health problem and is more likely to occur in vulnerable populations such as offenders. There is an abundance of research into suicides of prisoners, but few studies have been carried out on suicides of offenders serving community sentences. This article identifies and evaluates the limited research that is available. Recommendations for future research are made, including how in-depth interviews can provide important information about near lethal incidents from the service users’ perspective, and how international comparisons could be helpful in understanding this problem further.

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The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

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Service users and carers (SUAC) have made significant contributions to professional training in social work courses in Higher Education (HE) over the past decade in the UK. Such participation has been championed by government, academics and SUAC groups from a range of theoretical and political perspectives. Most research into the effectiveness of SUAC involvement at HE has come from the perspectives of academics and very little SUAC-led research exists. This qualitative peer research was led by two members of the University of Worcester’s SUAC group. Findings were that SUAC perceived their involvement brought benefits to students, staff, the University and the local community. Significant personal benefits such as finding a new support network, increased self-development and greater confidence to manage their own care were identified in ways that suggested that the benefits that can flow from SUAC involvement at HE are perhaps more far-reaching than previously recognised. Barriers to inclusion were less than previously reported in the literature and the humanising effects of SUAC involvement are presented as a partial antidote to an increasingly marketised HE culture.

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The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its’component parts contribute to the assignment of risk estimates and how those estimates fare in prediction of non-violent adverse outcomes compared with the structured components. START assessment and outcomes data from a secure mental health service (N=84) was collected. Binomial and multinomial regression analyses determined the contribution of selected elements of the START structured domain and recent adverse risk events to risk estimates and outcomes prediction for violence, self-harm/suicidality, victimisation, and self-neglect. START vulnerabilities and lifetime history of violence, predicted the violence risk estimate; self-harm and victimisation estimates were predicted only by corresponding recent adverse events. Recent adverse events uniquely predicted all corresponding outcomes, with the exception of self-neglect which was predicted by the strength scale. Only for victimisation did the risk estimate outperform prediction based on the START components and recent adverse events. In the absence of recent corresponding risk behaviour, restrictions imposed on the basis of START-informed risk estimates could be unwarranted and may be unethical.

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This project was developed in collaboration with the South Carolina Department of Health and Environmental Control Primary Care Office in order to identify primary care market areas and resources within South Carolina. Primary Care Service Areas are designed to identify small geographic areas that are relatively self-contained markets for primary care. Included is a map and listing for Primary Care Service Areas in the state.

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The focus of this study is an in-service training program rooted in routines-based early intervention and designed to improve the quality of goals and objectives on individualized plans. Participants were local intervention team members and other professionals who worked closely with each team. This training program involved a small number of trainees per group, providing multiple learning experiences across time and various opportunities for self-assessment and monitoring. We investigated (a) the perceptions of the participants about the strengths and weaknesses of the training program, (b) medium-term outcomes of the training with a comparison group, (c) and variables associated with the quality of goals and objectives. This study involved training more than 200 professionals, and results support the effectiveness of the program in improving the quality of goals and objectives, showing the importance of the routines-based interview in producing that improvement.

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The purpose of this presentation is to highlight issues that exist for student nurses who embark on a career in children's nursing at a very young age and subsequently find themselves in a situation where they are expected to deliver high quality care to young people and their families. An introductory sentence indicating the purpose of the presentation: Currently in the UK under the Making a Différence Curriculum (DOH 1999) students can enrol on a single registration programme for Children's Nursing as young as 17.5 years. Children are admitted to hospital onto the children's wards between the ages of 0-16 years (occasionally older). Using Viner's (2003) définition of adolescence as being that period between the ages of ten and twenty-five years when biopsychosocial maturation leads to functional independence in adult iife demonstrates the possibility that both the patients and the nursing students could be undergoing very similar transitional experiences. Historically, in the 1940-50's children were admitted to childrens wards between the ages of 2-12 years. Nurse education at that time tended to be undertaken for first or second level registration in the first instance, followed by post-registration training for specialist areas. Subsequently, the phenomenon of adolescent paediatric nursing students being required to care for adolescents and their families on the children's wards did not exist some 60 years ago. A brief description of the highiights of the présentation: This présentation will focus on adolescent transitions with particular reference to issues that could arise when young students are required to care for young people and their families, particularly when there is a diagnosis of self harm or substance abuse. A summary of findings and/or other relevant information: Preliminary findings have indicated that very young student nurses find caring for adolescents to be particularly challenging. Health issues pertinent to young people appear to présent particular challenges for the students which raises questions in respect of the quality of care that the young people and their families may receive. A conclusion and implications: The following need to be further explored: i) Support within the clinical areas and adequate de-briefing strategies, ii) The efficacy of single registration to children's nursing, iii) Young people and their family's perception of the quality of care they receive from very young students.