Examination of students' ability to observe domains of client behaviour in therapeutic recreation

When observing client behaviours, a therapeutic recreation specialist must have a base understanding of typical client behaviours to provide an informed analysis (burlingame & Blaschko, 2010). Providing students with the necessary tools for client observation is significant to the success of this process. The purpose of this study was to assess the relationships amongst the TR student demographic characteristics on acquiring the observation competency necessary to conduct a TR assessment. One hundred seventy-two TR college and university students, enrolled in post-secondary undergraduate TR programs across Ontario, observed a client assessment via video, and recorded their observations using the Tracking Behavioural Assessment (TBA) (Passmore, 2002). Independent samples t-tests and analysis of variance were calculated for the different student characteristics on the domains of the TBA. Significant findings indicated that university students scored more accurately than college students, and advanced students more accurately than novice students, on the emotional and socialization domains.

Mistreatment and self-neglect in community dwelling older adults: Studies of construct validity, measurement invariance and latent classes

Mistreatment and self-neglect significantly increase the risk of dying in older adults. It is estimated that 1 to 2 million older adults experience elder mistreatment and self-neglect every year in the United States. Currently, there are no elder mistreatment and self-neglect assessment tools with construct validity and measurement invariance testing and no studies have sought to identify underlying latent classes of elder self-neglect that may have differential mortality rates. Using data from 11,280 adults with Texas APS substantiated elder mistreatment and self-neglect 3 studies were conducted to: (1) test the construct validity and (2) the measurement invariance across gender and ethnicity of the Texas Adult Protective Services (APS) Client Assessment and Risk Evaluation (CARE) tool and (3) identify latent classes associated with elder self-neglect. Study 1 confirmed the construct validity of the CARE tool following adjustments to the initial hypothesized CARE tool. This resulted in the deletion of 14 assessment items and a final assessment with 5 original factors and 43 items. Cross-validation for this model was achieved. Study 2 provided empirical evidence for factor loading and item-threshold invariance of the CARE tool across gender and between African-Americans and Caucasians. The financial status domain of the CARE tool did not function properly for Hispanics and thus, had to be deleted. Subsequent analyses showed factor loading and item-threshold invariance across all 3 ethnic groups with the exception of some residual errors. Study 3 identified 4-latent classes associated with elder self-neglect behaviors which included individuals with evidence of problems in the areas of (1) their environment, (2) physical and medical status, (3) multiple domains and (4) finances. Overall, these studies provide evidence supporting the use of APS CARE tool for providing unbiased and valid investigations of mistreatment and neglect in older adults with different demographic characteristics. Furthermore, the findings support the underlying notion that elder self-neglect may not only occur along a continuum, but that differential types may exist. All of which, have very important potential implications for social and health services distributed to vulnerable mistreated and neglected older adults.^

HACC food service client cultural food preferences assessment tool

This assessment form is designed to help your HACC service provider arrange for the most appropriate food and meal services that they can. It includes questions relating to food preferences, health and nutrition, abilities to source and prepare foods as well as questions to highlight if you are at risk of not having adequate access to appropriate foods. It is understood that some people from certain cultures may not feel comfortable answering some of these questions. Therefore, please do not answer those questions with which you are not comfortable.

Assessment of costs : challenge to validity of client agreement between party entitled to costs and its solicitors

In ASIC v Atlantic 3 Financial (Aust) Pty Ltd [2006] QCA 540 the Queensland Court of Appeal dismissed an appeal from the decision of Mullins J at first instance in ASIC v Atlantic 3 Financial (Aust) Pty LTd [2006] QSC 152, the majority concluding that the client agreement in issue was not inconsistent with s48 of the Queensland Law Society Act 1952.

Client's assessment of architects' performance in building delivery process: Evidence from Nigeria

The overall intent of this research is to provide architects with information that can be used to improve their performance so as to optimally satisfy the client's requirements and achieve high-quality overall project performance in Nigerian construction industry. Architect performance criteria were identified based on literature within the domain of architect responsibilities. The assessment of architects’ performance was carried out through a questionnaire survey of clients of recently completed building projects in Nigeria. Analysis of data includes comparison of criteria using importance–performance index analysis. Factor analysis was carried out on criteria where architects are falling below average, to group and explore the latent structure of the criteria in the data. The results showed that the architect needs to focus on management skills and ability, buildability, design quality, project communication, project integration and client focus. These results would encourage architects to perform better within their full responsibilities in the building delivery process and deliver high-quality projects within Nigerian construction industry.

Development of a psychological assessment battery to measure client beliefs about the effectiveness of psychotherapy

The author attempted to develop a brief scale to measure clients' beliefs about the effectiveness of psychotherapy. The study is an early pilot study to determine if the scale can predict therapy outcomes. While the scale did differ significantly between clients who were active in therapy and those who were not, higher scores on the instrument were not indicative of greater involvement. Possibilities for future research to refine the instrument are discussed.

Legal Profession Act 2004 (NSW) : costs agreement between law practice and client - whether binding on non-associated third party payer

The decision in the New South Wales Supreme Court in Boyce v McIntyre [2008] NSWSC 1218 involved determination of a number of issues relating to an assessment of costs under the Legal Profession Act 2004 (NSW). The issue of broad significance was whether a non-associated third party payer must pay the fixed fee that was agreed between the law practice and the client. The court found that the client agreement did not form the basis of assessing costs for the non-associated third party payer.

A multidimensional model of client success when engaging external consultants

Too often the relationship between client and external consultants is perceived as one of protagonist versus antogonist. Stories on dramatic, failed consultancies abound, as do related anecdotal quips. A contributing factor to many "apparently" failed consultancies is a poor appreciation by both the client and consultant of the client's true goals for the project and how to assess progress toward these goals. This paper presents and analyses a measurement model for assessing client success when engaging an external consultant. Three main areas of assessment are identified: (1) the consultant;s recommendations, (2) client learning, and (3) consultant performance. Engagement success is emperically measured along these dimensions through a series of case studies and a subsequent survey of clients and consultants involved in 85 computer-based information system selection projects. Validation fo the model constructs suggests the existence of six distinct and individually important dimensions of engagement success. both clients and consultants are encouraged to attend to these dimensions in pre-engagement proposal and selection processes, and post-engagement evaluation of outcomes.

The clinical utility of the Cornell Scale for Depression in Dementia as a routine assessment in nursing homes

Objective To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes. Setting 14 nursing homes in Sydney and Brisbane, Australia. Participants 92 residents with a mean age of 85 years. Measurements Consenting residents were assessed by care staff for depression using the CSDD as part of their routine assessment. Specialist clinicians conducted assessment of depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders for residents without dementia or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease for residents with dementia to establish expert clinical diagnoses of depression. The diagnostic performance of the staff completed CSDD was analyzed against expert diagnosis using receiver operating characteristic (ROC) curves. Results The CSDD showed low diagnostic accuracy, with areas under the ROC curve being 0.69, 0.68 and 0.70 for the total sample, residents with dementia and residents without dementia, respectively. At the standard CSDD cutoff score, the sensitivity and specificity were 71% and 59% for the total sample, 69% and 57% for residents with dementia, and 75% and 61% for residents without dementia. The Youden index (for optimizing cut-points) suggested different depression cutoff scores for residents with and without dementia. Conclusion When administered by nursing home staff the clinical utility of the CSDD is highly questionable in identifying depression. The complexity of the scale, the time required for collecting relevant information, and staff skills and knowledge of assessing depression in older people must be considered when using the CSDD in nursing homes.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Trainee-therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training

Objective Contemporary research demonstrates the feasibility of assessing therapeutic performance of trainee-therapists through the use of objective measures of client treatment outcome. Further, significant variation between individual therapists based on their client treatment outcomes has been demonstrated. This study sets out to determine whether a reliable composite measure of therapeutic efficiency, effectiveness and early dropout can be developed and used to objectively compare trainee-therapists against each other. Design and methods Treatment outcomes of 611 clients receiving treatment from 58 trainee-therapists enrolled in a professional training programme were tracked with the OQ-45.2 over a 6-year period to assess therapeutic efficiency, therapeutic effectiveness and early client dropout. Results Significant variation between trainee-therapists was observed for each index. Findings of a moderately strong correlation between therapeutic efficiency and effectiveness enabled the ranking of trainee-therapists based upon a composite measure of these indexes. A non-significant correlation was found between early client dropout and measures of therapeutic effectiveness and efficiency. Conclusions The findings stress the importance of utilizing objective measures to track the treatment outcomes. Despite all trainee-therapists being enrolled in the same training programme, significant variation between trainee-therapists' therapeutic efficiency and effectiveness was found to exist. Practitioner points Developing of potential benchmarking tools that enable trainee-therapists, supervisors and educational institutions to quickly assess therapeutic performance can become part of a holistic assessment of a trainee-therapist's clinical development. Despite an inherent optimistic belief that therapists do not cause harm, there appears to be a small and significant proportion of trainee-therapists who consistently evidence little therapeutic change. Considerable variability in trainee-therapists' therapeutic efficiency and effectiveness can exist in the one training programme. Early client dropout may not be associated with therapists' therapeutic effectiveness and efficiency.

Tailored sustainability assessment for urban masterplanning

Tailored sustainability assessment represents one approach to addressing sustainability issues on large-scale urban projects with varying geographical, social and political constraints and diverse incentives among stakeholders. This paper examines the value and limitations of this approach. Three case studies of tailored systems developed by the authors for three unique masterplanning projects are discussed in terms of: contextual sustainability drivers; nature and evolution of systems developed; outcomes of implementation; and overall value delivered. Analysis Leads to conclusions on the key features of effective tailored assessment, the value of tailored sustainability assessment from various perspectives (including client, designer, end-users and the environment), and the limitations of tailored assessment as a tool for comparative analysis between projects. Although systems considered here are specific to individual projects and developed commercially, the challenges and lessons learned are relevant to a range of sustainability assessment approaches developed under different conditions.

The sustainability and assessment of drystone retaining walls

The art of drystone walling is a highly sustainable traditional practice which uses local materials and craftsmen. As no
mortar is used they have low embodied carbon, and much repair work or rebuilding can be carried out using very little if any new
materials. However local practices developed to suit local materials, leading to a range of construction styles, making them difficult to
assess. This paper examines a range of construction styles of drystone retaining walls in use across the United Kingdom.
Understanding of the substantial variations of construction style is essential to enable proper assessment of these structures. Different
frictional and weathering characteristics, and the naturally occurring shapes of stone found in an area, all affect the ways in which the
stones have traditionally been assembled into walls. Ease of construction also plays a part, as the craftsman will naturally wish to
achieve a robust construction in a way that is economical of time and effort. Aesthetics may be very important, for both client and
craftsman. It is also shown that construction style is influenced by the location and function of the structures, with harbour walls
particularly likely to have unique characteristics, and the reasons for this are explored.