Workplace shortage Impact on Vermont Developmental Service Organizations

Background: Difficulty in maintaining workforce serving the Intellectual development disabled (IDD) population and the recruitment and training of direct support professionals (DSPs) is a barrier to care for the IDD population. A high turnover rate can put a large financial burden on these organizations and have a negative impact on the quality of life of the IDD population. Our study aimed to address the current understaffing of Vermont developmental services organizations, like Champlain Community Services (CCS) on the health of individuals with IDD and the surrounding community. Methods: We utilized raw data collected from CSS addressing employee satisfaction, consumer satisfaction and employee turnover. Additionally, focus groups of public health workers in the VT care partner network and CCS consumers were completed. Results: CCS data from 2016-2022 showed a higher turnover rate for employees with less tenure, appearing to indicate that employees who are new to the company may struggle with adjusting to the job. When surveyed on different dimensions of satisfaction from 2019-2022, CCS employees reported the lowest satisfaction in Work Life Balance and Pay/Benefits. These outcomes were supported in the qualitative data collected in the focus groups. Employment Support services—measured in VT population receiving Disability services— appeared to show a downward trend in all services received from 2018-2022. Conclusion: The results provide a framework for local care partners to improve their staffing crisis and the health of VT residents with developmental disabilities and suggest a focus for more standard data collection in the future to show correlative outcomes.https://scholarworks.uvm.edu/comphp_gallery/1352/thumbnail.jp

Conservation of pattern as a tool for inference on spatial snapshots in ecological data

As climate change and other anthropogenic factors increase the uncertainty of vegetation ecosystem persistence, the ability to rapidly assess their dynamics is paramount. Vegetation and sessile communities form a variety of striking regular spatial patterns such as stripes, spots and labyrinths, that have been used as indicators of ecosystem current state, through qualitative analysis of simple models. Here we describe a new method for rigorous quantitative estimation of biological parameters from a single spatial snapshot. We formulate a synthetic likelihood through consideration of the expected change in the correlation structure of the spatial pattern. This then allows Bayesian inference to be performed on the model parameters, which includes providing parameter uncertainty. The method was validated against simulated data and then applied to real data in the form of aerial photographs of seagrass banding. The inferred parameters were found to be able to reproduce similar patterns to those observed and able to detect strength of spatial competition, competition-induced mortality and the local range of reproduction. This technique points to a way of performing rapid inference of spatial competition and ecological stability from a single spatial snapshots of sessile communities

An evaluation of 9-1-1 calls to assess the effectiveness of dispatch-assisted cardiopulmonary resuscitation (CPR) instructions: design and methodology

<p>Abstract</p> <p>Background</p> <p>Cardiac arrest is the leading cause of mortality in Canada, and the overall survival rate for out-of-hospital cardiac arrest rarely exceeds 5%. Bystander cardiopulmonary resuscitation (CPR) has been shown to increase survival for cardiac arrest victims. However, bystander CPR rates remain low in Canada, rarely exceeding 15%, despite various attempts to improve them. Dispatch-assisted CPR instructions have the potential to improve rates of bystander CPR and many Canadian urban communities now offer instructions to callers reporting a victim in cardiac arrest. Dispatch-assisted CPR instructions are recommended by the International Guidelines on Emergency Cardiovascular Care, but their ability to improve cardiac arrest survival remains unclear.</p> <p>Methods/Design</p> <p>The overall goal of this study is to better understand the factors leading to successful dispatch-assisted CPR instructions and to ultimately save the lives of more cardiac arrest patients. The study will utilize a before-after, prospective cohort design to specifically: 1) Determine the ability of 9-1-1 dispatchers to correctly diagnose cardiac arrest; 2) Quantify the frequency and impact of perceived agonal breathing on cardiac arrest diagnosis; 3) Measure the frequency with which dispatch-assisted CPR instructions can be successfully completed; and 4) Measure the impact of dispatch-assisted CPR instructions on bystander CPR and survival rates.</p> <p>The study will be conducted in 19 urban communities in Ontario, Canada. All 9-1-1 calls occurring in the study communities reporting out-of-hospital cardiac arrest in victims 16 years of age or older for which resuscitation was attempted will be eligible. Information will be obtained from 9-1-1 call recordings, paramedic patient care reports, base hospital records, fire medical records and hospital medical records. Victim, caller and system characteristics will be measured in the study communities before the introduction of dispatch-assisted CPR instructions (before group), during the introduction (run-in phase), and following the introduction (after group).</p> <p>Discussion</p> <p>The study will obtain information essential to the development of clinical trials that will test a variety of educational approaches and delivery methods for telephone cardiopulmonary resuscitation instructions. This will be the first study in the world to clearly quantify the impact of dispatch-assisted CPR instructions on survival to hospital discharge for out-of-hospital cardiac arrest victims.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov NCT00664443</p