Embracing DDMT Teaching Model and Design Thinking for Organization Development

The multi-generational workforce presents challenges for organizations, as the needs and expectations of employees vary greatly between different age groups. To address this, organizations need to adapt their development and learning principles to better suit the changing workforce. The DDMT Teaching Model of Tsing Hua STEAM School, which integrates design thinking methodology, aims to address this challenge. DDMT stands for Discover, Define, Model & Modeling, and Transfer. The main aim of this study is to identify the organization development practices (OD) and gaps through interdisciplinary models such as DDMT and design thinking. In collaboration with a healthcare nursing home service provider, a proof of concept using the DDMT-DT model was conducted to understand the challenges in employment and retention of support employees between nursing homes under the healthcare organization. The paper highlights the rapid change in human experiences and mindsets in the work culture and the need for a design curriculum that is more relevant to the current and future workforce. The DDMT-DT approach can help organizations address these challenges by providing a framework for HR personnel to design training curricula that are more effective in addressing the issues of hiring and employee retention. By applying the DDMT-DT model, HR personnel can better understand the needs and motivations of the workforce and design training programs that are more relevant to their needs. The proof-of-concept research pilot project conducted with the healthcare nursing home service provider demonstrated the effectiveness of the DDMT-DT model in addressing the issues of hiring and employee retention. The project provides a valuable case study for other organizations looking to implement the DDMT-DT model in their HR practices. Overall, the paper highlights the importance of adapting HR practices to better suit the changing workforce. The DDMT-DT model provides a useful framework for organizations looking to improve their HR practices and better address the needs of their workforce.

COVID in Nursing Homes: A Call to Repentance: A Journal of Bible and Theology

This essay details the author's experiences as a medical director at Canterbury Rehabilitation and Healthcare Center in Richmond, Virginia, the first nursing home to have a COVID-19 outbreak in the Commonwealth of Virginia. It explores how the deaths of his patients challenged his faith and raised issues of theodicy. Ultimately, the author does not ask for an explanation of evil, but urges us to examine our culpability and our responsibility, then listen to Jesus's call to repentance (Luke 13:1–5). In the end, our light, as weak as it is, must persist in the darkness.

NOT ALONE IN YOUR HOME: LIBRARY SERVICES IN HOMES FOR THE OLDER ADULTS IN ZAGREB DURING THE COVID-19 PANDEMIC

Goal. The goal of the paper is to show the implementation of library services in the homes for older adults in the city of Zagreb during the COVID-19 pandemic from March 2020 to June 2022. Approach/methodology/design. Library services in homes for the older adults in the city of Zagreb are implemented within the Books at your door programme of the 65 plus project at the Zagreb City Libraries. The COVID-19 pandemic and related restrictions have made it difficult to design and implement library services for older people in libraries. Due to the protection of health, particularly large restrictions have been placed on contacts with elderly people in homes for the older adults. As a result of this challenge, the librarians have devised ways to stay in touch and provide library services to the home users during periods of greater and lesser restrictions on access to the homes. Results. The paper describes in detail the implementation and the results of the Books at your door programme from March 2020 to June 2022. Library services and various cultural programs that were carried out during the pandemic in homes for the older adults, organized by the Zagreb City Libraries, are presented and described. The results are based on and supported by the statistical data from the annual reports of the 65 plus project. Originality/value. The cultural activities that are carried out for the older adults by the libraries, sometimes in difficult business circumstances, are examples of good practice aimed at sensitizing the public and increasing care for the well-being of the elderly people. The experiences gained during the implementation of the Books at your door programme in difficult conditions during the pandemic can help experts and practitioners in designing library services in times of crisis. The data recorded in this paper also represent a kind of public archive on the cooperation between libraries and homes for the older adults in the Zagreb area during the COVID-19 pandemic. © 2023, Hrvatsko Knjiznicarsko Drustvo. All rights reserved.

How to find undetected cases of dementia in care homes: A new approach to dementia diagnosis using a diagnostic tool with five criteria to check and specialist nurses going into care homes and assessing residents could improve detection rates

The pandemic took its toll on memory clinics with many forced to close or scale back their services. This led to lengthening waits for dementia assessment and left many without a diagnosis.

Looking in the Rearview Mirror and to the Road Ahead on Dementia & Living Well

The number of Americans living with Alzheimer's and all other dementias continues to increase. Most of them will need long-term and community-based services as the disease progresses. While medical research is making advances, there is more work to be done to ensure that every person receives care that is person-centered and allows them to live with dignity and respect.

The Detection of Abnormal Behavior in Healthcare IoT Using IDS, CNN, and SVM

Health care is always a top priority, and that has not changed no matter how far we have come in terms of technology. Since the coronavirus epidemic broke out, almost every country has made health care a top priority. Therefore, the best way to deal with the coronavirus pandemic and other urgent health problems is through the use of IoHT. The tremendous growth of IoT devices and networks especially in the healthcare domain generates massive amounts of data, necessitating careful authentication and security. Other domains include agriculture, smart homes, industry, etc. These massive data streams can be evaluated to determine undesirable patterns. It has the potential to reduce functional risks, avoid problems that are not visible, and eliminate system downtime. Past systematic and comprehensive reviews have significantly aided the field of cybersecurity. However, this research focuses on IoT issues relating to the medical or healthcare domain, using the systematic literature review method. The current literature in health care is not enough to analyze the anomaly of IoHT. This research has revealed that fact. In our subsequent work, we will discuss the architecture of IoHT and use AI techniques such as CNN and SVM to detect intrusions in IoHT. In the interest of advancing scientific knowledge, this study identifies and suggests potential new lines of inquiry that may be pursued in this area of study. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Exploring how care home staff manage responsive behaviours, associated with dementia, in care homes in Ireland, during the COVID-19 pandemic

Introduction: Care home residents with dementia often exhibit responsive behaviours including agitation, aggression and wandering. Psychotropic drugs are often prescribed to manage responsive behaviours but contravene guidance as they increase the risk of serious adverse events and death in people with dementia. Aim: This thesis aims to understand how care home staff manage responsive behaviours to identify the barriers and facilitators to implementing a non-pharmacological approach to behaviour management. Methods: This thesis was underpinned by the transformative paradigm and critical theory. A review of qualitative studies was conducted to synthesise understanding of the facilitators or barriers to implementing non-pharmacological strategies to behaviour management (PROSPERO protocol registration CRD42020165948). The findings from the review, in addition to a qualitative survey and patient and public Involvement informed the design of the qualitative interview study to understand how responsive behaviours are managed by care home staff in the Republic of Ireland (ROI) prior to, and during the Covid-19 pandemic. In total, 25 interviews were conducted with staff from 21 care homes across Ireland. Reflexive thematic analysis of qualitative data was informed by Braun and Clarke (2019). All participants provided written informed consent. Ethical approval was obtained from Lancaster University. Findings: The findings from the systematic review and qualitative study found the barriers to taking a non-pharmacological approach to manage responsive behaviours included inadequate staff training and multidisciplinary collaboration. The qualitative study extends current knowledge by showing that a power hierarchy exists between healthcare assistants and nurses that posed a barrier to taking a non-pharmacological approach to behaviour management. Facilitators to taking a non-pharmacological approach included effective leadership and family involvement in resident care. Conclusion: This thesis extends knowledge by conceptualising how responsive behaviours are managed using both pharmacological and non-pharmacological approaches to identify the facilitators and barriers to implementing non-pharmacological strategies to behaviour management. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The relationship of attachment styles and sense of cohesion with perceived stress in the elderly in nursing home during the outbreak of coronavirus: The mediating role of spiritual intelligence

The spread of Coronavirus is an important challenge for health care systems in Iran. Attachment styles, self-coherence and spiritual intelligence are the variables that can have a significant impact on mental health and quality of life in the elderly during the outbreak of Coronavirus. Therefore, the current study aimed to investigate the mediating role of spiritual intelligence in the relationship between attachment styles and self-coherence with perceived stress during the outbreak of coronavirus in the elderly. This was a correlational study of path analysis type. The statistical population included all the elderly living in nursing homes in Sanandaj in 2021, among whom 270 (146 men and 124 women) people were selected using convenience sampling method. Data were collected using Collins's adult attachment styles, Antonovsky's sense of cohesion, Cohen et al.'s perceived stress, and King's spiritual intelligence scales. The results of path analysis revealed that the hypothetical model has a good fit in the sample of this study. As such, secure, avoidant and ambivalent attachment styles had an indirect relationship with perceived stress in the elderly through spiritual intelligence, and sense of cohesion indicated an indirect relationship with perceived stress in the elderly through spiritual intelligence (P < 0.05). The findings emphasize the importance of the relationship between attachment styles and a sense of cohesion with respect to the mediating role of spiritual intelligence in providing psychological assistance for the elderly in order to manage their perceived stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A Survey of Human-Computer Interaction Technology in Intelligent Home for Children's Learning

The development of the COVID-19 epidemic has increased the home learning time of children. More researchers began to pay attention to children's learning in home. This survey reviewed the frontier and classic cases in the field of interactive design of children's home learning in the past five years, analyzed tangible user interface, augmented reality, and multimodal interaction in human-computer interaction of children's home learning. This paper reviewed the application of interactive system in children's learning and points out its positive side in development of ability, process of learning, habits of learning, and environment of learning of children. Through analysis, we advise that it is necessary to create home learning applications, link smart home systems, and build an interactive learning environment for smart home learning environment design. Finally, we point out the technical and ethical problems existing in the current research, proposes that intelligent perception, emotion recognition, and expression technologies should be introduced in the future, and looks forward to the development of this field. © 2023 Institute of Computing Technology. All rights reserved.

Should age matter in COVID-19 triage? A deliberative study

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and 'anticipatory triage' likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public's moral intuitions. Our study aimed to explore general public views in the UK on the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public (n = 22). Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected 'fair innings' and 'life projects' principles as justifications for age-based allocation. They were also wary of the 'maximise life-years' principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This 'triad' of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Role of homestay in reviving tourism in Shimla

Background: At seasonal tourist destinations like Shimla, rooms may remain vacant and unoccupied during lean periods. To add on, pandemic has already shut many small lodging facilities. Background: The aim of this study is to improve our understanding of how homestay activities can contribute to revitalize sustainable tourism trends in Shimla, the study assumes particular importance in a period of economic crisis characterized by post COVID trauma. Methodology: A survey was conducted in Shimla after first wave of corona virus from September 20 to December 20 as soon as the travel restrictions were uplifted. The travel and accommodation preferences of tourists were observed and found to be shifting towards less frequently visited places avoiding mass tourism. To highlight the role of homestays in reviving these tourism trends, three objectives were identified. Two separate questionnaires were developed to get the quantitative and qualitative data for this research. The data was tabulated and evaluated using SPSS tool. Results: The findings presented the analysed profile of the potential homestay operators as well as visitors seeking homestay tourism. It also reports the motivations, expectation and experience of the tourists regarding various aspects of homestay. Conclusion: Homestays can act as potential vital tool in reviving tourism.

Effectiveness of a complex advance care planning intervention focusing on nursing home residents: first results of the cluster-randomized controlled BEVOR-trial

BackgroundFew trials on advance care planning (ACP) have investigated the clinical effect on care consistency with care preferences (3CP) in the nursing home (NH) setting.MethodsBEVOR is a multi-centre, cluster-randomized controlled trial aimed to improve 3CP in NH residents (09/2019–02/2023). A total of 44 NHs from 4 German regions were randomized either to the control group (n=24) or the intervention group (n=24). The complex ACP intervention comprised the offer to lead ACP conversations with qualified facilitators on the individual (resident) level and offers for organizational development and staff education on the institutional (NH) level. Educational ACP modules were offered to emergency medical services, hospitals and other regional players relevant for these residents' medical care.After a run-in phase of the intervention, which was extended due to the Covid19-pandemic from originally 9 to (up to) 18 months, the observation period was 12 months from September 2021 to August 2022. Primary outcome was defined as hospitalization rate, understood as a surrogate parameter for 3CP, collected as anonymous data from all residents of the participating NHs. Main secondary outcome is 3CP, taken from a subset of 892 residents (20.5%) who gave informed consent. To measure 3CP, treatment decisions in potentially life-threatening events (‘care delivered') were identified retrospectively every 3 months from the NH records. Correspondingly, ‘care preferences' were assessed retrospectively, integrating data from residents' files and interviews with residents, proxies and nurses, also taking into account the effected level of shared decision making. Analysis of the primary outcome follows the intention-to-treat principle.ResultsThe main outcomes will be available by the time of the acp-i conference.ConclusionResults of the BEVOR trial will give insights into possible clinical effects of a complex regional ACP intervention.

Relationship of "Tooth Condition” with Mobility and Cognitive Function of Residents in Special Elderly Nursing Homes Practicing Functional Recovery Care, Case-control Study

The world continues to struggle with the COVID-19 pandemic, and there is concern over the increase in the needs of older people for nursing care. In this study, the relationships of the "tooth condition” with mobility and cognitive function were investigated in 1,000 residents of 14 special elderly nursing homes. In those using well-fitting dentures, the percentage of those capable of independent indoor mobility was highest at 21.6%, and the percentages of those able to communicate (66.2%), understand routines (47.5%), state their own age (36.2%), remember recent events (45.0%), state their own name (85.7%), understand seasons (43.7%), and understand places (46.4%) were significantly higher than in those in other "tooth conditions”. This study clarified the relationships of the "tooth condition” with mobility and cognitive function, and maintaining an adequate "tooth condition” was suggested to contribute to the prevention of a condition requiring long-term nursing care. © 2023 Asian Society of Human Services.

Covid-19: The support UK care homes need to survive

Help for the social care sector has come late in the day, but it's not just PPE and testing that it needs. Access to clinical expertise, palliative care, and bereavement support is also vital, reports Rachel Carter

Towards A Systematic Literature Review for Evaluating Smart Home Environments using light bulb sensors

As more homes become digitally connected the use of assistive technologies to support the operation in the home environment especially when one thinks of the elderly and the sick, our research shows that there is a gap in the literature with respect to the measure of the effectiveness of the use of these assistive technologies to support the home as a smart home. We conduct quantitative usability experiments supported by a conceptual human interaction framework to assess this effectiveness. We conduct as proof of concept these experiments with the use of a Google mini automated assistant and an internet ready light bulb sensor , to determine the responsiveness to the human voice, at different location proximities around the home, and the correctness to these responses to qualify the effectiveness argument. In this study the authors use their primary residence amidst the COVID19 pandemic to demonstrate the type of concerns. Our explicit contributions in this study are (i) A systematic review of the literature in this area (ii) the design of the smart home network environment with the google mini assistant and light ulb sensor that supports the human voice interactions (iii) Identify a suitable conceptual human interaction framework to support the use of the smart devices connected within the home users environment to support our experiments (iv) Provide critical case evaluation of the measure of effectiveness of the usability experiments supported by this conceptual framework. © 2023 IEEE.

Infectious Morbidity in Closed Long-Term Care Facilities in the «Pre-COVID Stage»

Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases. Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY.ru, Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis. Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations. © 2023, Numikom. All rights reserved.

Caregiving for Older Adults With Dementia During the Time of COVID-19: A Multi-State Exploratory Qualitative Study.

This qualitative semi-structured interview study explores how 64 family caregivers for older adults with Alzheimer's Disease and related dementias across eight states experienced and executed caregiving decisions before and during the COVID-19 pandemic. First, caregivers experienced challenges communicating with loved ones and healthcare workers in all care settings. Second, caregivers displayed resilient coping strategies in adapting to pandemic restrictions, finding novel strategies to balance risks while preserving communication, oversight, and safety. Third, many caregivers modified care arrangements, with some avoiding and others embracing institutional care. Finally, caregivers reflected on the benefits and challenges of pandemic-related innovations. Certain policy changes reduced caregiver burden and could improve care access if made permanent. Telemedicine's increasing use highlights the need for reliable internet access and accommodations for individuals with cognitive deficits. Public policies must pay greater attention to challenges faced by family caregivers, whose labor is both essential and undervalued.

Nursing home staff perceptions of well-being during the COVID-19 pandemic: A qualitative study.

AIMS: To explore how nursing home staff perceived their work environment during the COVID-19 pandemic and how this impacted their well-being. DESIGN: A qualitative interview study. METHODS: Interviews were held with twenty-two registered nurses and assistant nurses from five nursing homes in the Netherlands between April 2021 and July 2021. The interviews were analysed using qualitative content analysis. The Standards for Reporting Qualitative Research (SRQR) were followed. RESULTS: Five themes emerged from the interviews and indicated that working during the COVID-19 pandemic impacted perceived well-being of nursing home staff. Three themes concerned experiences at work: eroding care, additional roles and workplace support. Specifically, the increased workload with additional tasks, the constant stream of new guidelines and constrictive personal protective equipment caused discomfort and anxiety. Two other themes concerned experiences outside of work: work-life interference and social interactions and status. The nurses reported that when they returned home after work, they were tired and worried about spreading the virus while facing limited social interactions and support. CONCLUSION: The social distancing measures due to the COVID-19 pandemic negatively impacted nursing home staff well-being by increasing demands in the absence of adequate resources. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The well-being needs of nurses should receive continued attention to ensure the sustainability of healthcare during future crises. PATIENT OR PUBLIC CONTRIBUTION: The nursing home managers participated in recommending the topics to be covered during interviews. IMPACT: What problem did the study address? The pressure of stressful working conditions on the well-being of nurses during the pandemic. What were the main findings? Nurses created strategies to cope with declining well-being. However, the available resources did not alleviate the increased demands caused by the pandemic. Where and on whom will the research have an impact? This study is important for healthcare organizations to understand how the COVID-19 pandemic affected nurses so that they may better prepare for future crises.

COVID-19 in older adult residents in nursing homes: factors associated with mortality and impact on functional capacity.

Objective: To verify if the functional capacity prior to COVID-19 infection was different between Survivor and Non-survivor older adults. Also, to verify the effect of the isolation period after COVID-19 infection on the functional capacity of the Survivors residing in nursing homes. Materials and methods: Older adults residing in nursing homes were evaluated 30 days before the COVID-19 outbreak at the site for (i) general health characteristics (obtained from medical records); (ii) gait speed, handgrip strength and 30-s sit-to-stand; (iii) sarcopenia and (iv) estimated muscle mass. Comparisons were made between Survivors and Non-survivors of COVID-19. After the isolation, the Survivors performed the assessments again. Results: Twenty-one (81 ± 9.3 years) participants tested positive for COVID-19 and participated in the study, 12 survivors. No difference was observed between Survivors and Non-survivors in any of the outcomes evaluated. However, a moderate effect size was observed for handgrip strength, with lower values for the Non-survivors group (- 16%; d = 0.53). The isolation period reduced the number of sit-to-stand repetitions with moderate effect size in the Survivors (p = 0.046, gav = 0.66). Conclusion: Although the null hypothesis analysis did not find significant differences between the groups, the effect size suggests that older adults residing in nursing homes who died from COVID-19 had lower handgrip strength. In the survivors, the isolation period after COVID-19 infection only negatively impacted the sit-to-stand performance.

Prevalence of SARS-CoV-2 antibodies among Belgian nursing home residents and staff during the primary COVID-19 vaccination campaign.

BACKGROUND: Nursing home residents (NHR) and staff have been disproportionally affected by the COVID-19 pandemic and were therefore prioritised in the COVID-19 vaccination strategy. However, frail older adults, like NHR, are known to have decreased antibody responses upon vaccination targeting other viral antigens. OBJECTIVES: As real-world data on vaccine responsiveness, we assessed the prevalence of SARS-CoV-2 antibodies among Belgian NHR and staff during the primary COVID-19 vaccination campaign. METHODS: In total, we tested 1629 NHR and 1356 staff across 69 Belgian NHs for the presence of SARS-CoV-2 IgM/IgG antibodies using rapid tests. We collected socio-demographic and COVID-19-related medical data through questionnaires. Sampling occurred between 1 February and 24 March 2021, in a randomly sampled population that received none, one or two BNT162b2 vaccine doses. RESULTS: We found that during the primary vaccination campaign with 59% of the study population fully vaccinated, 74% had SARS-CoV-2 antibodies. Among fully vaccinated individuals only, fewer residents tested positive for SARS-CoV-2 antibodies (77%) than staff (98%), suggesting an impaired vaccine-induced antibody response in the elderly, with lowest seroprevalences observed among infection naïve residents. COVID-19 vaccination status and previous SARS-CoV-2 infection were predictors for SARS-CoV-2 seropositivity. Alternatively, age ≥ 80 years old, the presence of comorbidities and high care dependency predicted SARS-CoV-2 seronegativity in NHR. CONCLUSION: These findings highlight the need for further monitoring of SARS-CoV-2 immunity upon vaccination in the elderly population, as their impaired humoral responses could imply insufficient protection against COVID-19. TRIAL REGISTRATION: This study was retrospectively registered on ClinicalTrials.gov (NCT04738695).