Connecting older grandmothers raising grandchildren with community resources improves family resiliency, social support, and caregiver self-efficacy.

Custodial grandparenting can be especially challenging for older grandmothers facing age specific issues. Kinship navigator programs are social service delivery programs intended to inform grandparents and other relatives raising children about available resources and services, provide information specific to their individual needs, and help families navigate service systems. Our study utilizes self-report data from one kinship navigator federal demonstration project, which used a randomized control trial, to examine demographic characteristics for grandmothers under and over 55 years of age, whether grandmother caregivers (≥55 years) improve family resilience, social support, and caregiver self-efficacy, and which interventions improved outcomes for grandmothers (≥55 years). Each participant was randomly assigned to one of four groups: Usual Care (traditional child welfare services), Standard Care (family support and case management), Peer-to-Peer Care Only, and Full Kin Tech Care (peer navigators with computer access and interdisciplinary team). Thirty-nine percent of grandmothers (55-75 years) were mostly living in poverty, predominantly Caucasian, with 36% identifying as African American/Black, with at least one to two children at home. Repeated-measures ANOVAs for each subscale showed statistically significant within- and between-group differences for Family Functioning, Social Supports, Concrete Supports, Child Development, and Nurturing and Attachment, with the exception of Usual Care, which showed a decline in protective factors consistently across subscales. Future research with kinship families could qualitatively examine the experiences for older women in navigator programs and replication of kinship navigator programs could build capacity in data collection and maintenance systems to gain better perspective about how systems of care impact families.

Appropriate Medical Care Standards for Organizations Sponsoring Athletic Activity for the Secondary School-Aged Athlete: A Summary Statement.

OBJECTIVE: To present the appropriate medical care standards for organizations that sponsor athletic activities for secondary school-aged athletes. DATA SOURCES: To develop the current standards and identify current best-practices evidence, the task force used a multistep process that included reviewing the existing 2004 Appropriate Medical Care for Secondary School-Aged Athletes consensus points and cross-referencing of National Athletic Trainers' Association (NATA) statements and official documents from the strategic alliance (the NATA, NATA Foundation, Board of Certification, and Commission on Accreditation of Athletic Training Education). Gaps in the recommendations from the 2004 Appropriate Medical Care for Secondary School-Aged Athletes document were identified by the task force, and the new appropriate medical care standards were developed and refined. CONCLUSIONS AND RECOMMENDATIONS: Twelve standards, with supporting substandards, were developed that encompassed readiness to participate in activity; facilities; equipment; protective materials; environmental policies; nutrition, hydration, and dietary supplementation; wellness and long-term health; comprehensive emergency action plans; on-site immediate care; on-site therapeutic interventions; psychological concerns; and athletic health care administration. Collectively, these standards describe a comprehensive approach to providing appropriate health care to secondary school-aged athletes and should serve as a framework with which organizations can evaluate and improve the medical care supplied to adolescent athletes.

National Athletic Trainers' Association Position Statement: Facilitating Work-Life Balance in Athletic Training Practice Settings.

OBJECTIVE:: To illustrate the concept of work-life balance and those factors that influence it and to provide recommendations to facilitate work-life balance in athletic training practice settings. To present the athletic trainer with information regarding work-life balance, including those factors that negatively and positively affect it within the profession. BACKGROUND:: Concerns for work-life balance have been growing within the health care sector, especially in athletic training, as it is continuously linked to professional commitment, burnout, job satisfaction, and career longevity. The term work-life balance reflects those practices used to facilitate the successful fulfillment of the responsibilities associated with all roles one may assume, including those of a parent, spouse, partner, friend, and employee. A host of organizational and individual factors (eg, hours worked, travel demands, flexibility of work schedules, relationship status, family values) negatively influence the fulfillment of work-life balance for the athletic trainer, but practical strategies are available to help improve work-life balance, regardless of the practice setting. RECOMMENDATIONS:: This position statement is charged with distributing information on work-life balance for athletic trainers working in a variety of employment settings. Recommendations include a blend of organizational and personal strategies designed to promote work-life balance. Establishing work-life balance requires organizations to have formal policies that are supported at the departmental and personal level, in addition to informal policies that reflect the organizational climate of the workplace. Individuals are also encouraged to consider their needs and responsibilities in order to determine which personal strategies will aid them in attaining work-life balance.

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active.

OBJECTIVE: To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals. BACKGROUND: Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluid-replacement strategies for physically active individuals. RECOMMENDATIONS: Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.

Nursing home compare: web site offers critical information to consumers, professionals.

The U.S. Department of Health and Human Services has launched a Nursing Home Quality Initiative that provides nursing home consumers and healthcare professionals with publicly reported quality information about every Medicare- or Medicaid-certified nursing facility in the United States. The initiative also offers assistance to nursing homes in their continuing efforts to improve the quality of the care they offer. This article provides an overview of that initiative, and discusses information available on the Nursing Home Compare Web site that case managers will find useful for helping clients in their nursing home decision-making process.

Home health compare: Web site offers critical information to consumers, professionals.

The Centers for Medicare & Medicaid Services, a federal agency of the U.S. Department of Health and Human Services, has released new data about the quality of care provided by Medicare-certified home health agencies as part of an expanding initiative to continue to improve the home care services that are provided to millions of Americans. The initiative combines information about the quality of care provided by individual home health agencies-for use by consumers, their families, and healthcare professionals-with important resources to assist home health agencies working to improve quality of care. This article provides an overview of that initiative, and discusses information available on the Home Health Compare Web site that case managers and discharge planners will find useful for helping patients and their families select a home health agency.

Home Health Compare: Web site offers critical information to consumers and professionals.

The Centers for Medicare & Medicaid Services (CMS), a federal agency of the U.S. Department of Health and Human Services, has released new data about the quality of care provided by Medicare-certified home health agencies as part of an expanding initiative to continue to improve the home care services that are provided to millions of Americans. The initiative combines information about the quality of care provided by individual home health agencies-for use by consumers, their families, and health care professionals-with important resources to assist home health agencies working to improve quality of care. This article provides an overview of that initiative, and discusses information available on the Home Health Compare Web site that case managers and discharge planners will find useful for helping patients and their families select a home health agency.

Managing troubled data: coastal data partnerships smooth data integration.

Understanding the ecology, condition, and changes of coastal areas requires data from many sources. Broad-scale and long-term ecological questions, such as global climate change, biodiversity, and cumulative impacts of human activities, must be addressed with databases that integrate data from several different research and monitoring programs. Various barriers, including widely differing data formats, codes, directories, systems, and metadata used by individual programs, make such integration troublesome. Coastal data partnerships, by helping overcome technical, social, and organizational barriers, can lead to a better understanding of environmental issues, and may enable better management decisions. Characteristics of successful data partnerships include a common need for shared data, strong collaborative leadership, committed partners willing to invest in the partnership, and clear agreements on data standards and data policy. Emerging data and metadata standards that become widely accepted are crucial. New information technology is making it easier to exchange and integrate data. Data partnerships allow us to create broader databases than would be possible for any one organization to create by itself.