Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review

Background: Tailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes. Aims: To understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered. Method: A systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012. Results: We identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in ‘feeling bereft’; and perceptions of transgressions against social norms associated with ‘misunderstandings about behaviour’ in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging. Conclusions: Family carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their ‘personhood’. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers

Development of a structural model for quality cultural heritage tourism

The aim of this research is to develop and test a theoretical model of quality cultural heritage tourism. It offers an integrated approach to understanding cultural heritage development and management of tourist destinations, and attempts to extend the theoretical and empirical evidence regarding causal relationships including quality of experience, perceived quality, satisfaction and behavioural intentions. The previous literature has already presented the relationship among perceived quality, quality of experience, satisfaction and behavioural intentions in cultural heritage tourism. However, there is a relative lack of academic interest, particularly in Macao. Thus, this research tries to investigate the quality and related constructs in cultural heritage tourism. It seeks to understand the major constructs considered by local stakeholders and visitors in evaluating the quality in cultural heritage tourism, the importance of the availability of quality in the overall experience, visitors‘ behaviour toward quality cultural heritage tourism and also the constructs related to quality. The methodological approach of this research includes qualitative and quantitative methods in the field research in Macao, China. Semi-structured interviews with Macao stakeholders and a questionnaire survey with Macao visitors were used for data collection. A structural model of the relationships between perceived quality, quality of experience, satisfaction and behavioural intentions was tested SEM used in quantitative study tested the validity, reliability and potential of the quality models developed from literature reviews and grounded theory

Distributed Leadership and Employee Cynicism: Trade unions as joint change agents

The themes of change management and workplace partnership continue to attract significant academic interest – albeit within discreet literatures. Drawing on longitudinal, qualitative data in a heavy engineering organization this article details how a collaborative partnership between management and trade unions, encompassing a distributed’ leadership format, was configured to enhance organizational capacity for change in the context of significant employee cynicism. Bridging human resource management/organizational behaviour and industrial relations perspectives the works makes a theoretical contribution to our understanding of the factors underpinning the successful implementation of workplace partnership and the utilisation of distributed leadership configurations. More generally the work informs leadership theory through its scrutiny of distributed leadership in situations of high conflict

A qualitative study exploring medication management in people with dementia living in the community and the potential role of the community pharmacist

Background The prevalence of dementia is increasing rapidly. People with dementia may be prescribed complex medication regimens, which may be challenging for them and any carers involved to safely manage. Objective To describe and understand the key challenges, in relation to medication issues, experienced by people with dementia and their informal carers dwelling in the community and the potential role of community pharmacists. Design Qualitative semi‐structured interviews. Participants People with dementia, informal carers and health and social care professionals (HSCPs). Results Thirty‐one participants (eleven informal carers, four people with dementia and sixteen HSCPs) were interviewed. Three key themes were identified: the key challenges, improving medication management and the role of pharmacists. The caring role commonly included responsibility for medication management which created both practical problems and an emotional burden. This burden was worsened by any difficulty in obtaining support and if the person with dementia was on a complex regimen. Participants believed that the process could be improved by coordinated and on‐going support from HSCPs, which should focus on the informal carer. Medication reviews, particularly when conducted in the home environment, could be helpful. Conclusion Medication management for people with dementia living in the community is a complex process, and informal carers have a key role, which they frequently find challenging. Community pharmacists could have an enhanced role in this area, but would need to work within a more multidisciplinary environment outside the pharmacy

An anthropological analysis of peper harow therapeutic community with particular reference to the use of myth, ritual and symbol

This thesis describes and analyses the treatment world created and sustained by a therapeutic community for emotionally disturbed adolescents. The thesis intends to demonstrate that healing at Peper Harow therapeutic community is a ritual process that contains and frames symbols. The construction of this treatment world of symbols, derived from the wider culture, is analysed in terras of anthropological concepts of myth, ritual and symbol. The thesis concludes that the treatment world is also constituted through the imputation of therapeutic meaning into the social and physical structure of the community by the Director and analyses this process of assertion as an example of charismatic leadership

What makes adoptive family life work? Adoptive parents’ narratives of the making and remaking of adoptive kinship

Adoption theory, policy and practice have undergone considerable change in the period between the introduction of the Adoption Act (1976) and the Adoption and Children Act (2002). In this period, in particular, adoption has increasingly come to be understood within the context of an ethic of 'openness'. This has had implications for the day to day lives of members of the adoption triad, that is, adoptive parents, adoptees and birth family members, and their attempts to 'make adoption work’ across their lifecourse. The thesis draws on theories of family and kinship in order to develop understandings of day to day family practices that emerge in adoptive families and the way these shape and are shaped by adoption discourse. The thesis provides an analysis of local and national statistical data and the biographical accounts of twenty two adoptive parents who had children placed with them between 1977 and 2001. These were all domestic 'stranger' adoptions. From the adopters’ narratives it was apparent that the core and ongoing challenge facing adoptive parents was to find a unique way of 'doing' adoptive family life which acknowledged the importance both of biological ties and legal kinship. This was the ease regardless of the year of the adoption and continues to challenge these families today. The thesis explores the tasks which flow from this core challenge, that is, developing and maintaining family relationships between adopters and adoptees where none previously existed, finding a place for birth relatives within the adoptive kinship model and developing a positive identity as a non conventional family. The thesis challenges the conceptualisation of adoptive relations as 'fictive kinship' and biological connectedness as 'real' kinship and presents evidence of the fragility of both the biological family and the adoptive family where there has been a legal adoption of a child. At the same time the thesis reveals the ability of both biological and adoptive family ties to endure over time despite cultural barriers. The study also reveals that existing typologies of adoption as 'confidential', 'mediated' and 'fully disclosed' fail to capture the complexity of adoptive family life. A new definition of both adoptive kinship and 'openness' in adoption are developed and the implications of these redefinitions for adoption policy and practice are explore

Background briefs on the Livestock and Fish Program’s work on dairy value chain development in Tanzania

Prepared for the Science and Partnership Advisory Committee, Morogoro, Tanzania, 9-11 December 201

Evidence for the frontline

This UK report explores what can be drawn from the advances across a range of fields to mobilise research knowledge more effectively across social policy and practice.It frames the issue by looking at the individual elements of an effective evidence chain – production, synthesis, transformation and implementation – whilst at the same time considering what needs to be done to integrate these elements more coherently. As well as looking at gaps in current infrastructure, it also picks out some exciting new initiatives and ideas that can hopefully produce tangible benefits for professional practice.The report draws on the themes raised at the Alliance for Useful Evidence ‘Evidence for the Frontline; What Works for Practitioners?’ event in Autumn 2012, which included inputs from social care, policing and education, as well as on previous literature, events and seminars that have explored the interface between research and practice

Towards a new approach for teaching Religious Education in Catholic schools

How should Catholic Religious Education look in the twenty-first century? Today’s challenges are many, including diverse student faith backgrounds and levels of teachers’ religious knowledge, understanding and commitment. There are differing curriculum structures, time and space constraints, challenges in accessing suitable resources, and the authentic use of proven pedagogical practice. This study was a journey that explored these challenges. It followed a path opened by Maria Montessori, trodden in turn by Sofia Cavalletti and, more recently, developed by Gerard O’Shea into a way for teaching religious education in Catholic schools. This was a design-based research study that adapted, trialled and refined O’Shea’s work, under the name of the Scripture and Liturgy Teaching Approach (the SALT Approach). The journey, following a design-based research structure, was completed in stages. The landscape was first scanned through the review of literature and then preparations were made, with the building of the first prototype. Then the road was trodden for one year, accompanied by teachers and twenty-six Year Two students. During that time, the road was refined and restructured. Following the journey, there was a time of reflection, when conclusions were drawn in preparation for the next stage. The lenses used on the journey brought valuable confirmations and discoveries: that children, given the opportunity, are drawn to the spiritual and can respond with sensitivity; that teachers can become co-learners alongside the child, as they, themselves, are drawn towards a more personal relationship with God, as well as becoming aware of key pedagogical strategies that will draw out children’s contributions, reflect respect for the child, and develop trust in the child’s ability to learn through making choices; that accountability demands can be met, even if they run contrary to the holistic approach at the core of the SALT Approach; and that the approach can be successful within a diversely populated school, bringing a fresh response to the call for a new evangelisation. The results confirmed that the SALT Approach that can offer a paradigm for religious education, involving a move away from the restrictive demands on school and teacher accountability and towards the recognition of religious education’s own iv valid academic approach, fostering the spirituality, faith and response of both students and teachers. The study points towards further research and the possibility of building a network of academics and educators, working closely together to develop the SALT Approach within a variety of educational climates both within Australia and beyond