scholarly journals Factors associated with successful dementia education for practitioners in primary care: an in-depth case study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cara Sass ◽  
Natasha Burnley ◽  
Michelle Drury ◽  
Jan Oyebode ◽  
Claire Surr
Keyword(s):  
Primary Care ◽  
Service Providers ◽  
Prescribing Practices ◽  
Care Needs ◽  
Complex Needs ◽  
People With Dementia ◽  
Wide Range ◽  
The Impact ◽  
Dementia Education

Abstract Background With increasing numbers of people in the UK living with dementia, the provision of good quality person-centred care that meets the often complex needs of this population is required. Given the majority of people with dementia live in the community, significant care and support will be provided by primary care services. This means the primary care workforce needs appropriate education to ensure they have the right knowledge, skills and attitudes to meet these care needs. However, little is understood about the most successful approaches to dementia education in this setting. Methods An in-depth case study was undertaken in a single primary care organisation with the aim of exploring the impact of a person-centred dementia educational programme, and identify barriers and facilitators to implementation. Data was gathered from a wide range of sources and analysed using Kirkpatrick’s evaluative framework. Results Initially, staff learners struggled to incorporate the ‘whole-person’ approach to dementia care, but gained knowledge and confidence through self-directed learning. They reacted positively to the training and appreciated opportunities to learn from peers in other services. They identified improvements in communication and prescribing practices, despite difficulties implementing changes during busy periods. Resultant impact for service users included more timely routine appointments, and positive satisfaction ratings from patients and families. Conclusions The findings indicate the perceived value of person-centred dementia education for primary care. Further recommendations for provision in this service setting include tailored programmes designed collaboratively with clinical service providers, and bringing together an interdisciplinary mix of learners to enhance knowledge exchange.

scholarly journals Evaluating the efficacy of technical measures: a case study of selection device legislation in the UK Crangon crangon (brown shrimp) fishery

2008 ◽  
Vol 65 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Tom L. Catchpole ◽  
Andrew S. Revill ◽  
James Innes ◽  
Sean Pascoe
Keyword(s):  
Brown Shrimp ◽  
Crangon Crangon ◽  
Shrimp Fishery ◽  
The North ◽  
Ex Post ◽  
Wide Range ◽  
The Uk ◽  
The Impact ◽  
Technical Measures

Abstract Catchpole, T. L., Revill, A. S., Innes, J., and Pascoe, S. 2008. Evaluating the efficacy of technical measures: a case study of selection device legislation in the UK Crangon crangon (brown shrimp) fishery. – ICES Journal of Marine Science, 65: 267–275. Bycatch reduction devices are being introduced into a wide range of fisheries, with shrimp and prawn fisheries particularly targeted owing to the heavy discarding common in these fisheries. Although studies are often undertaken to estimate the impact of a technical measure on the fishery before implementation, rarely have the impacts been assessed ex post. Here, the efficacy of the UK legislation pertaining to the use of sievenets in the North Sea Crangon crangon fishery is assessed. Three impacts were evaluated: on fisher behaviour (social), on the level of bycatch (biological), and on vessel profitability (economic). An apparent high level of compliance by skippers was identified despite a low level of enforcement. The estimated reduction in fleet productivity following the introduction of the legislation was 14%, equalling the mean loss of Crangon landings when using sievenets calculated from catch comparison trawls. Sievenets did reduce the unnecessary capture of unwanted marine organisms, but were least effective at reducing 0-group plaice, which make up the largest component of the bycatch. Clearly the legislation has had an effect in the desired direction, but it does not address sufficiently the bycatch issue in the Crangon fishery.

scholarly journals Systematic Review Investigating Multi-disciplinary Team Approaches to Screening and Early Diagnosis of Dementia in Primary Care – What are the Positive and Negative Effects and Who Should Deliver It?

2017 ◽  
Vol 15 (1) ◽  
pp. 5-17 ◽  
Author(s):  
Toby Smith ◽  
Jane Cross ◽  
Fiona Poland ◽  
Felix Clay ◽  
Abbey Brookes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Early Diagnosis ◽  
Service Providers ◽  
Care Practice ◽  
Initial Contact ◽  
Negative Effects ◽  
People With Dementia ◽  
Health And Social Care ◽  
Early Diagnostic

Background: Primary care services frequently provide the initial contact between people with dementia and health service providers. Early diagnosis and screening programmes have been suggested as a possible strategy to improve the identification of such individuals and treatment and planning health and social care support. Objective: To determine what early diagnostic and screening programmes have been adopted in primary care practice, to explore who should deliver these and to determine the possible positive and negative effects of an early diagnostic and screening programme for people with dementia in primary care. Methods: A systematic review of the literature was undertaken using published and unpublished research databases. All papers answering our research objectives were included. A narrative analysis of the literature was undertaken, with the CASP tools used appropriately to assess study quality. Results: Thirty-three papers were identified of moderate to high quality. The limited therapeutic options for those diagnosed with dementia means that even if such a programme was instigated, the clinical value remains questionable. Furthermore, accuracy of the diagnosis remains difficult to assess due to poor evidence and this raises questions regarding whether people could be over- or under-diagnosed. Given the negative social and psychological consequences of such a diagnosis, this could be devastating for individuals. Conclusion: Early diagnostic and screening programmes have not been widely adopted into primary care. Until there is rigorous evidence assessing the clinical and cost-effectiveness of such programmes, there remains insufficient evidence to support the adoption of these programmes in practice.

Professional Identity

2020 ◽  
pp. 227-246
Author(s):  
Aaron Ackerley
Keyword(s):  
Professional Identity ◽  
Cultural Changes ◽  
Newspaper Industry ◽  
Fourth Estate ◽  
Wide Range ◽  
Key Topics ◽  
British Press ◽  
The Impact ◽  
And Training

This chapter surveys changing notions of professional identity in the twentieth-century British press. The term ‘journalist’ is highly contested, covering a wide range of figures with different forms of experience and training as well as a wide range of roles within and beyond news organisations. Journalism has also lacked the clearly defined rules of practice and established pathways into the occupation evident in other careers that are classed as professions, such as medicine and law. By exploring key topics such as continuities from the nineteenth-century press, the rise of professionalism and journalists’ associations and unions, the myth of the ‘Fourth Estate’ and struggles over press regulation, and the impact of digitisation, this chapter explains how notions of professional identity within journalism have changed in response to wider social and cultural changes and changes within the newspaper industry itself. These topics are also explored in short case study, focused on the Guardian.

scholarly journals Involving people with dementia and their carers in dementia education for undergraduate healthcare professionals: a qualitative study of motivation to participate and experience

2018 ◽  
Vol 31 (06) ◽  
pp. 869-876 ◽  
Author(s):  
Zoe Cashin ◽  
Stephanie Daley ◽  
Molly Hebditch ◽  
Leila Hughes ◽  
Sube Banerjee
Keyword(s):  
Qualitative Study ◽  
Family Involvement ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Therapeutic Benefits ◽  
People With Dementia ◽  
Motivation To Participate ◽  
Face Time ◽  
The Impact ◽  
Dementia Education

ABSTRACTBackground:There is a need to improve dementia education to prepare future generations of healthcare professionals to deal with the increasing challenges they will face. Time for Dementia is an innovative undergraduate education program for medical, nursing, and paramedic students in the south of England. Success of the program is dependent upon the participation of families (people with dementia and their carers). This qualitative study seeks to explore the motivation and experiences of the families taking part in the program.Methods:A topic guide was developed to understand factors influencing motivation and retention. A purposeful sample of participant families, who had at least 12 months of involvement in the program, were selected from a cohort of 282 families and were invited to take part in an in-depth qualitative interview. Interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. This was subsequently refined in an on-going process of analysis aided by the use of Nvivo 11. Interviewing stopped when thematic saturation was reached.Results:Eighteen families took part in an in-depth qualitative interviews. Four themes were identified from the analysis. These themes were motivators, value to family, value to the person with dementia, and student factors.Conclusions:This study identifies underpinning factors that motivate families to join dementia education programs and the impact of such programs upon them. We found that engagement in such programs can have therapeutic benefits to participants, and do not cause harm. These findings can be used to strengthen recruitment and enhance family involvement in similar programs.

Social connectivity and creative approaches to dementia care: the case of a poetry intervention

2018 ◽  
pp. 65-86
Author(s):  
Kate de Medeiros ◽  
Aagje Swinnen
Keyword(s):  
Social Bonds ◽  
Care Facility ◽  
Human Beings ◽  
Social Connectivity ◽  
People With Dementia ◽  
Time Space ◽  
Imaginative Play ◽  
Participatory Arts ◽  
The Impact

This chapter draws together four concepts — resilience and flourishing, creativity and play — to explore the impact of poetry interventions in the lives of people with dementia living in a care facility. Participatory arts programmes can provide opportunities for people to be reminded of their humanness and re-membered as valuable human beings. Opportunities to be creative and engage with others contribute to resilience or the ability to transcend many dementia-associated losses. Through imaginative play, regardless of cognitive ability, people can express and/or enact important aspects of meaning and selfhood/personhood that might otherwise go unacknowledged in the care environment. While arts interventions may not be able to reverse cognitive decline, the case study points to ways that the poetry intervention creates a time–space in which people can ‘flourish’, express affinity with others, and foster social bonds, and how, in turn, these contribute to meaningful moments in people's lives.

scholarly journals A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges

2018 ◽  
Vol 8 (4) ◽  
pp. 178 ◽  
Author(s):  
Grainne Hickey ◽  
Sinead McGilloway ◽  
Yvonne Leckey ◽  
Ann Stokes
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Service Providers ◽  
Practice Change ◽  
Parenting Education ◽  
Local Context ◽  
Programme Implementation ◽  
Community Based ◽  
Early Parenting ◽  
The Impact

Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.

scholarly journals Sensitivity of Characterizing the Heat Loss Coefficient through On-Board Monitoring: A Case Study Analysis

Energies ◽  
2019 ◽  
Vol 12 (17) ◽  
pp. 3322 ◽  
Author(s):  
Marieline Senave ◽  
Staf Roels ◽  
Stijn Verbeke ◽  
Evi Lambie ◽  
Dirk Saelens
Keyword(s):  
Sensitivity Analysis ◽  
Steady State ◽  
Data Analysis ◽  
Heat Loss ◽  
Input Data ◽  
Loss Coefficient ◽  
Wide Range ◽  
Board Monitoring ◽  
The Impact

Recently, there has been an increasing interest in the development of an approach to characterize the as-built heat loss coefficient (HLC) of buildings based on a combination of on-board monitoring (OBM) and data-driven modeling. OBM is hereby defined as the monitoring of the energy consumption and interior climate of in-use buildings via non-intrusive sensors. The main challenge faced by researchers is the identification of the required input data and the appropriate data analysis techniques to assess the HLC of specific building types, with a certain degree of accuracy and/or within a budget constraint. A wide range of characterization techniques can be imagined, going from simplified steady-state models applied to smart energy meter data, to advanced dynamic analysis models identified on full OBM data sets that are further enriched with geometric info, survey results, or on-site inspections. This paper evaluates the extent to which these techniques result in different HLC estimates. To this end, it performs a sensitivity analysis of the characterization outcome for a case study dwelling. Thirty-five unique input data packages are defined using a tree structure. Subsequently, four different data analysis methods are applied on these sets: the steady-state average, Linear Regression and Energy Signature method, and the dynamic AutoRegressive with eXogenous input model (ARX). In addition to the sensitivity analysis, the paper compares the HLC values determined via OBM characterization to the theoretically calculated value, and explores the factors contributing to the observed discrepancies. The results demonstrate that deviations up to 26.9% can occur on the characterized as-built HLC, depending on the amount of monitoring data and prior information used to establish the interior temperature of the dwelling. The approach used to represent the internal and solar heat gains also proves to have a significant influence on the HLC estimate. The impact of the selected input data is higher than that of the applied data analysis method.

scholarly journals Geriatric Resource Teams: Equipping Primary Care Practices to Meet the Complex Care Needs of Older Adults

Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 59 ◽  
Author(s):  
Gwendolen Buhr ◽  
Carrissa Dixon ◽  
Jan Dillard ◽  
Elissa Nickolopoulos ◽  
Lynn Bowlby ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Assessment Process ◽  
Complex Care ◽  
Care Needs ◽  
Care Practices ◽  
Primary Care Practices ◽  
Complex Care Needs ◽  
The Impact

Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cognitive impairment. As the US population ages, discovering strategies to address these complex care needs within primary care are urgently needed. This article describes the development of an innovative, team-based model to improve the diagnosis and care of older adults with cognitive impairment in primary care practices. This model was developed through a mentoring process from a team with expertise in geriatrics and quality improvement. Refinement of the existing assessment process performed during routine care allowed patients with cognitive impairment to be identified. The practice team then used a collaborative workflow to connect patients with appropriate community resources. Utilization of these processes led to reduced referrals to the geriatrics specialty clinic, fewer patients presenting in a crisis to the social worker, and greater collaboration and self-efficacy for care of those with cognitive impairment within the practice. Although the model was initially developed to address cognitive impairment, the impact has been applied more broadly to improve the care of older adults with multimorbidity.

scholarly journals Impact probability under aleatory and epistemic uncertainties

2020 ◽  
Vol 132 (11-12) ◽  
Author(s):  
Chiara Tardioli ◽  
Davide Farnocchia ◽  
Massimiliano Vasile ◽  
Steve R. Chesley
Keyword(s):  
Risk Assessment ◽  
Orbital Evolution ◽  
Upper Bounds ◽  
Force Model ◽  
Statistical Distributions ◽  
Unknown Parameters ◽  
Wide Range ◽  
Parametric Families ◽  
The Impact

AbstractWe present an approach to estimate an upper bound for the impact probability of a potentially hazardous asteroid when part of the force model depends on unknown parameters whose statistical distribution needs to be assumed. As case study, we consider Apophis’ risk assessment for the 2036 and 2068 keyholes based on information available as of 2013. Within the framework of epistemic uncertainties, under the independence and non-correlation assumption, we assign parametric families of distributions to the physical properties of Apophis that define the Yarkovsky perturbation and in turn the future orbital evolution of the asteroid. We find $${\mathrm{IP}}\le 5\times 10^{-5}$$ IP ≤ 5 × 10 - 5 for the 2036 keyhole and $${\mathrm{IP}}\le 1.6\times 10^{-5}$$ IP ≤ 1.6 × 10 - 5 for the 2068 keyhole. These upper bounds are largely conservative choices due to the rather wide range of statistical distributions that we explored.

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