scholarly journals Co-designing complex interventions with people living with dementia and their supporters

Dementia ◽  
2021 ◽  
pp. 147130122110424
Author(s):  
Kathryn Lord ◽  
Daniel Kelleher ◽  
Margaret Ogden ◽  
Clare Mason ◽  
Penny Rapaport ◽  
...  
Keyword(s):  
Professional Training ◽  
Complex Interventions ◽  
Training Programme ◽  
Family Carers ◽  
Evaluation Tool ◽  
Telephone Interviews ◽  
Health And Social Care ◽  
The Right ◽  
Home Care Workers ◽  
Design And Methods

Background and objectives We engaged people living with dementia, family carers and health and social care professionals in co-designing two dementia care interventions: for family carers and people living with dementia (New Interventions for Independence in Dementia Study (NIDUS)-family and home-care workers (NIDUS-professional training programme). Research design and methods Over October 2019–March 2020, we invited public and patient (PPI) and professional members of our NIDUS co-design groups to complete the PPI Engagement Evaluation Tool (designed to assess engagement activities), and non-professional PPI members to participate in qualitative telephone interviews. We thematically analysed and integrated mixed-methods findings. Results Most (15/20; 75%) of the PPI members approached participated. We identified four themes: (1) Creating the right atmosphere: participants found group meetings positive and enabling, though one health professional was unsure how to position themselves within them; (2) Participants influencing the outcome: while most members felt that they had some influence, for one carer consultation seemed too late to influence; (3) Having the right information: several carers wanted greater clarity and more regular updates from researchers; (4) Unique challenges for people living with dementia: memory problems presented challenges in engaging with substantial information, and within a large group. Discussion and implications We reflect on the importance of providing accessible, regular updates, managing power imbalances between co-design group members with lived and professional experiences; and ensuring needs and voices of people living with dementia are prioritised. We encourage future studies to incorporate evaluations of co-design processes into study design.

scholarly journals Supporting family carers in home-based end-of-life care: using participatory action research to develop a training programme for support workers and volunteers

2017 ◽  
Vol 9 (1) ◽  
pp. e4-e4 ◽  
Author(s):  
Glenys Caswell ◽  
Beth Hardy ◽  
Gail Ewing ◽  
Sheila Kennedy ◽  
Jane Seymour
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
End Of Life ◽  
Third Sector ◽  
Training Programme ◽  
Family Carers ◽  
Participatory Action ◽  
Health And Social Care ◽  
Carer Support ◽  
Support Family

BackgroundFamily carers are crucial in enabling dying people to stay at home, but are often not prepared for their caring role, receiving little support from formal health and social care services. It is increasingly likely that any help or support family carers receive will be provided by a third sector organisation on either a voluntary basis or by untrained carer support workers.ObjectivesTo produce a training programme designed to equip carer support workers and volunteers with the basic skills and knowledge needed to support family carers.Process of developmentParticipatory action research, a collaborative form of working in which those who are affected by an issue take a lead role in the research, was used. Bereaved carers acting as research partners, support workers and representatives of third sector organisations took an active part in designing, developing, piloting and refining the programme in a number of interlinked stages. During development, the programme was piloted on four occasions and evaluated by 36 trainees and 3 trainers.Final training programmeThe outcome of the project is an innovative, 1-day training programme, offering an introduction to supporting family carers who are looking after someone approaching the end of life. The use of participatory action research methods enabled the development of a programme that addresses support needs identified by bereaved carers and training needs identified by carer support workers.The finished programme includes all the materials necessary to run a training day for support workers and volunteers: facilitator’s notes, trainee workbook, slides, promotional poster and pre-course reading for trainees. Knowledge of issues involved in end-of-life and palliative care is not required, although some experience in delivering training is advisable.ConclusionThe programme evaluated well during development, but further research is required to examine the transfer of learning into the workplace.

scholarly journals Hand Preference and Performance in Basketball Tasks

2019 ◽  
Vol 16 (22) ◽  
pp. 4336 ◽  
Author(s):  
Emanuela Gualdi-Russo ◽  
Natascia Rinaldo ◽  
Alba Pasini ◽  
Luciana Zaccagni
Keyword(s):  
Professional Training ◽  
Factor Model ◽  
Hand Preference ◽  
Control Group ◽  
Basketball Players ◽  
Confirmatory Factor Analyses ◽  
Left Hand ◽  
Confirmatory Factor ◽  
And Performance ◽  
The Right

The aims of this study were to develop and validate an instrument to quantitatively assess the handedness of basketballers in basketball tasks (Basketball Handedness Inventory, BaHI) and to compare it with their handedness in daily activities by the Edinburgh Handedness Inventory (EHI). The participants were 111 basketballers and 40 controls. All subjects completed the EHI and only basketballers filled in the BaHI. To validate the BaHI, a voluntary subsample of basketballers repeated the BaHI. Exploratory and confirmatory factor analyses supported a two-factor model. Our results show that: (i) Handedness score (R) in daily actions did not differ between basketball players (R by EHI = 69.3 ± 44.6) and the control group (R by EHI = 64.5 ± 58.6); (ii) basketballers more frequently favored performing certain sport tasks with the left hand or mixed hands (as highlighted by R by BaHI = 50.1 ± 47.1), although their choice was primarily the right hand in everyday gestures; and (iii) this preference was especially true for athletes at the highest levels of performance (R by BaHI of A1 league = 38.6 ± 58.3) and for those playing in selected roles (point guard’s R = 29.4 ± 67.4). Our findings suggest that professional training induces handedness changes in basketball tasks. The BaHI provides a valid and reliable measure of the skilled hand in basketball. This will allow coaches to assess mastery of the ball according to the hand used by the athlete in the different tasks and roles.

Scales of Justice: Defense Counsel and the English Criminal Trial in the Eighteenth and Nineteenth Centuries

1991 ◽  
Vol 9 (2) ◽  
pp. 221-267 ◽  
Author(s):  
J. M. Beattie
Keyword(s):  
Eighteenth Century ◽  
Professional Training ◽  
Common Law ◽  
Criminal Trial ◽  
Criminal Courts ◽  
Defense Counsel ◽  
Trial Procedure ◽  
Eighteenth And Nineteenth Centuries ◽  
The Right

My subject is the story of the entry of lawyers into the English criminal courts and their impact on trial procedure. Until the eighteenth century lawyers played little part in the trial of felonies in England—in the trial, that is, of those accused of the most serious offenses, including murder, rape, arson, robbery, and virtually all forms of theft. Indeed, the defendants in such cases were prohibited at common law from engaging lawyers to act for them in court. In the case of less-serious crimes—misdemeanors—defendants were allowed counsel; and those accused of high treason, the most serious offense of all, were granted the right to make their defense by counsel in 1696. But not in felony. Accused felons might seek a lawyer's advice on points of law, but if they wanted to question the prosecution evidence or to put forward a defense, they had to do that on their own behalf. The victim of a felony (who most often acted as the prosecutor in a system that depended fundamentally on private prosecution) was free to hire a lawyer to manage the presentation of his or her case. But in fact few did so. The judges were generally the only participants in felony trials with professional training. They dominated the courtroom and orchestrated the brief confrontation between the victim and the accused that was at the heart of the trial.

Evaluating complex interventions: A theory-driven realist-informed approach

Evaluation ◽  
2017 ◽  
Vol 23 (3) ◽  
pp. 294-311 ◽  
Author(s):  
Boru Douthwaite ◽  
John Mayne ◽  
Cynthia McDougall ◽  
Rodrigo Paz-Ybarnegaray
Keyword(s):  
Complex Interventions ◽  
Monitoring And Evaluation ◽  
Practical Experience ◽  
Evaluation Systems ◽  
Program Monitoring ◽  
Evaluation Approach ◽  
Different Types ◽  
Theories Of Change ◽  
Design And Methods ◽  
After Action Reviews

There is a growing recognition that programs that seek to change people’s lives are intervening in complex systems, which puts a particular set of requirements on program monitoring and evaluation. Developing complexity-aware program monitoring and evaluation systems within existing organizations is difficult because they challenge traditional orthodoxy. Little has been written about the practical experience of doing so. This article describes the development of a complexity-aware evaluation approach in the CGIAR Research Program on Aquatic Agricultural Systems. We outline the design and methods used including trend lines, panel data, after action reviews, building and testing theories of change, outcome evidencing and realist synthesis. We identify and describe a set of design principles for developing complexity-aware program monitoring and evaluation. Finally, we discuss important lessons and recommendations for other programs facing similar challenges. These include developing evaluation designs that meet both learning and accountability requirements; making evaluation a part of a program’s overall approach to achieving impact; and, ensuring evaluation cumulatively builds useful theory as to how different types of program trigger change in different contexts.

What initiatives do healthcare leaders agree are needed for healthcare system improvement? Results of a modified-Delphi study

2018 ◽  
Vol 32 (8) ◽  
pp. 1002-1012
Author(s):  
Stuart Barson ◽  
Robin Gauld ◽  
Jonathon Gray ◽  
Goran Henriks ◽  
Christina Krause ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Healthcare System ◽  
Professional Training ◽  
Delphi Process ◽  
Content Type ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Health And Social Care ◽  
System Leaders ◽  
Practical Implications

Purpose The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on how these could be implemented. Design/methodology/approach A multi-stage modified-Delphi process was used, blending the Delphi approach of iterative information collection, analysis and feedback, with the option for participants to revise their judgments. Findings The process reached consensus on five initiatives: change information privacy laws; overhaul professional training and work in the workplace; use co-design methods; contract for value and outcomes across health and social care; and use data from across the public and private sectors to improve equity for vulnerable populations and the sickest people. Research limitations/implications Information could not be gathered from all participants at each stage of the modified-Delphi process, and the participants did not include patients and families, potentially limiting the scope and nature of input. Practical implications The practical implications are a set of findings based on what leaders would bring to a decision-making table in an ideal world if given broad scope and capacity to make policy and organisational changes to improve healthcare systems. Originality/value This study adds to the literature a suite of recommendations for healthcare quality improvement, produced by a group of experienced healthcare system leaders from a range of contexts.

scholarly journals Seeing the collective: family arrangements for care at home for older people with dementia

2018 ◽  
Vol 39 (06) ◽  
pp. 1200-1218 ◽  
Author(s):  
CHRISTINE CECI ◽  
HOLLY SYMONDS BROWN ◽  
MARY ELLEN PURKIS
Keyword(s):  
Family Care ◽  
High Volume ◽  
Ethnographic Study ◽  
Family Carers ◽  
Care Giving ◽  
People With Dementia ◽  
Home Based ◽  
Health And Social Care ◽  
Care At Home ◽  
At Home

ABSTRACTWith the predicted growth in the number of people with dementia living at home across the globe, the need for home-based care is expected to increase. As such, it will be primarily family carers who will provide this crucial support to family members. Designing appropriate support for family carers is thus essential to minimise risks to their health, to prevent premature institutionalisation or poor care for persons with dementia, as well as to sustain the effective functioning of health and social care systems. To date, the high volume of research related to care at home and acknowledged low impact of interventions suggests that a re-examination of the nature of care at home, and how we come to know about it, is necessary if we are to advance strategies that will contribute to better outcomes for families. This paper describes findings from an ethnographic study that was designed to support an analysis of the complexity and materiality of family care arrangements – that is, the significance of the actual physical, technological and institutional elements shaping care-giving situations. In this paper, we describe the arrangements made by one family to show the necessary collectivity of these arrangements, and the consequences of the formal care system's failure to respond to these.

scholarly journals Designing Work with People Living with Dementia: Reflecting on a Decade of Research

2021 ◽  
Vol 18 (22) ◽  
pp. 11742
Author(s):  
Paul A. Rodgers
Keyword(s):  
Human Rights ◽  
United Nations ◽  
Cultural Development ◽  
General Assembly ◽  
International Human Rights Law ◽  
Ongoing Research ◽  
Right To Work ◽  
Health And Social Care ◽  
The United Nations ◽  
The Right

The United Nations Universal Declaration of Human Rights is widely acknowledged as a landmark document in the history of human rights. Drafted by representatives from all over the world, the declaration was proclaimed by the United Nations General Assembly in Paris on 10 December 1948 (General Assembly resolution 217 A) as a common standard for all peoples and all nations. The declaration sets out a series of articles that articulate a number of fundamental human rights to be universally protected. Article 23 of the declaration relates to the right to work and states that people have a human right to work, or engage in productive employment, and may not be prevented from doing so. The right to work is enshrined in international human rights law through its inclusion in the International Covenant on Economic, Social and Cultural Rights, where the right to work emphasizes economic, social and cultural development. This paper presents ongoing research that highlights how a disruptive co-design approach contributes to upholding UN Article 23 through the creation of a series of innovative working practices developed with people living with dementia. The research, undertaken in collaboration with several voluntary and third sector organizations in the UK, looks to break the cycle of prevailing opinions, traditional mindsets, and ways-of-doing that tend to remain uncontested in the health and social care of people living with dementia. As a result, this research has produced a series of innovative work opportunities for people living with dementia and their formal and informal carers that change the perception of dementia by showing that people living with dementia are capable of designing and making desirable products and offering much to UK society after diagnosis. In this ongoing research, the right to continue to work for people living with dementia post-diagnosis in creative and innovative ways has clearly helped to reconnect them to other people, helped build their self-esteem, identity and dignity and helped keep the person with dementia connected to their community, thus delaying the need for crisis interventions. This paper reports on a series of future work initiatives for people living with dementia where we have used design as a disruptive force for good to ensure that anyone diagnosed with dementia can exercise their right to work and engage in productive and rewarding employment.

scholarly journals A IMPORTÂNCIA DA SONDAGEM DA ESCRITA COMO INSTRUMENTO DE AVALIAÇÃO NO PERÍODO DA ALFABETIZAÇÃO

2018 ◽  
Vol 3 (2) ◽  
pp. 453-460
Author(s):  
Patrícia Rodrigues Rocha ◽  
Alessandra de Souza Santos
Keyword(s):  
Elementary School ◽  
Intervention Strategies ◽  
Experience Report ◽  
Evaluation Tool ◽  
Children’S Learning ◽  
The Right ◽  
National Pact ◽  
Writing Analysis ◽  
Children's Learning

Resumo: Este é um relato de experiência sobre a sondagem da escrita realizada com alunos dos três primeiros anos do Ensino Fundamental, uma das atividades propostas pelas Orientadoras de Estudos (OE) do Pacto Nacional pela Alfabetização na Idade Certa (PNAIC) 2016 Polo Nova Iguaçu/RJ. Nosso objetivo com este relato é acentuar a importância da sondagem da escrita como instrumento de avaliação no período da alfabetização. Aplicamos um ditado para a escrita e leitura imediata pelos alunos das escolas em que atuamos como Orientadoras Pedagógicas. Percebemos significativos avanços na aprendizagem das crianças. Concluímos que tal prática deve ocorrer constantemente em todo o período da alfabetização de modo a mobilizar estratégias de intervenção pelo professor e o desenvolvimento dos alunos.Palavras-chave: Avaliação. Sondagem. Alfabetização. Abstract: This is an experience report on the writing analysis conducted with students of the first three years of elementary school, one of the activities proposed by the Trainers of Studies of the National Pact for Literacy in the Right Age (PNAIC) 2016 Polo Nova Iguaçu / RJ. Our objective with this report is to emphasize the importance of the writing analysis as an evaluation tool in the literacy period. We apply a dictation and an immediate reading of by the students of the schools in which we act as Pedagogical Consuellors. We have seen significant advances in children's learning. We concluded that such practice must occur constantly throughout the period of literacy in order to mobilize intervention strategies of the teacher for the students development.Keywords: Evaluation. Probing. Literacy.

scholarly journals ‘I thought it would be a very clearly defined role and actually it wasn’t’: a qualitative study of transition training for pharmacists moving into general practice settings in Wales

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051684
Author(s):  
Sophie Bartlett ◽  
Alison Bullock ◽  
Kate Spittle
Keyword(s):  
General Practice ◽  
Phase 1 ◽  
Qualitative Evaluation ◽  
Phenomenological Approach ◽  
Training Programme ◽  
Learning Needs ◽  
Telephone Interviews ◽  
Need Support ◽  
Interpretative Phenomenological Approach ◽  
Transition Training

ObjectivePharmacists are increasingly contributing to the skill mix of general practice surgeries to help alleviate pressures faced by UK doctors working in primary care. However, they need support in overcoming barriers to their integration. The purpose of this work was to evaluate a programme designed to support pharmacists’ transition to working in general practice settings. We explored the learning needs of pharmacists’, the barriers and enablers to their integration and provide recommendations based on our results.InterventionA qualitative evaluation of a 1-year transition programme in Wales starting in September 2018 to support pharmacists’ transition to working in general practice settings.Design and settingWe employed an interpretative phenomenological approach involving 10 pharmacists across Wales enrolled on the transition to general practice training programme, and their tutors. Data were collected across two sequential phases: in phase 1 telephone interviews were held with pharmacists midway through their training; in phase 2, focus groups were conducted with both pharmacists and tutors towards the end of the programme.ResultsPharmacists enter general practice settings with a variety of prior experience. The programme provided a framework that pharmacists found helpful to map their experience to but the programme needed to be flexible to individual learning needs. The tutor role was typically regarded as the most valuable component, but interaction with the wider general practice team was critical to ease the transition. Pharmacists encountered a lack of clarity about their role which impeded their integration into the workplace team.ConclusionsA formal programme with a designated tutor can support pharmacists’ transition into general practice settings. The programme’s competency framework facilitated reciprocal understanding of the pharmacist’s role in the team, helped to manage expectations and enhanced collaborative practice. Recommendations to facilitate pharmacist integration into general practice settings are provided.

Maintaining independence in older people

2010 ◽  
Vol 20 (2) ◽  
pp. 128-153 ◽  
Author(s):  
AD Beswick ◽  
R Gooberman-Hill ◽  
A Smith ◽  
V Wylde ◽  
S Ebrahim
Keyword(s):  
Older People ◽  
Social Engagement ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Functional Decline ◽  
Complex Interventions ◽  
Preventive Strategies ◽  
Health And Social Care ◽  
Quality Trial ◽  
High Quality Trial

SummaryAppropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.

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