Dementia-friendly wards: a review of the literature and pilot study of patient interaction and daily activity engagement

Purpose: The purpose of this paper, practice-based mixed methods small-scale study, is to explore the design features of a “dementia friendly” acute ward environment and, staff views on the implications of daily activity engagement for patients with dementia. Design/methodology/approach: Eight staff members of the multidisciplinary team who work full time on an acute “dementia friendly” ward completed semi-structured questionnaires. Thematic analysis explored responses to the open-ended questions, and a further environmental assessment tool rated features of the “dementia friendly” ward design, on promoting aspects of well-being in patients with dementia. Findings: Six overarching themes were found. These included: contrasting ward colours; clear ward signage; positive staff interaction; memorabilia, and activity rooms and items, had a positive influence on patient interaction, well-being and engagement in daily activities. The audit scores were rated highly for various aspects of the ward design. These included: the ward design promoting patient interaction, well-being, mobility, orientation, continence, eating and drinking and calm and security. Research limitations/implications: This practice-based small-scale study highlights the importance that a “dementia friendly” ward environment may have on patient engagement and well-being, from a daily activity perspective. Further research into the key aspects of design that enable meaningful daily activity engagement is required. Practical implications: This study supports staff perceived views of the positive influence that “dementia friendly” design may have for patients with dementia. Both the physical design modifications of the ward and staff interaction were highlighted as positively influencing patient well-being, and daily activity engagement. Staff members also felt that they needed to balance the clinical ward priorities, with the contextual requirements of patients with dementia, to establish an effective “dementia friendly” ward. Originality/value: The value of this research is the combined consideration of an environmental assessment tool and qualitative interviews with members of the multidisciplinary team

Big dreams, small towns: tracking journalism students' changing attitudes and perceptions about journalism at two Queensland universities - year 2

This collaborative research project began in 2012 between two academics from two regional Queensland universities. This is year 2 data. In the first year, both researchers conducted a survey among incoming first year Journalism students to find out these students' background, as well as set a benchmark of their attitudes and perceptions about the university experience, their views and perceptions of the journalism profession and their aspirations. The initial research yielded a unique profile of these students who have decided on a journalism education. In 2013, the same cohort of students were resurveyed to track changes, if any, in their responses to the same questions in 2012. A Focus Group Discussion (FGD) was conducted to provide qualitative data to explain the data. In year three of the research, the cohort was once again surveyed and interviewed as they leave university. This study offers a unique longitudinal view of the development of a student into a journalist as well as track any changes in the student's attitudes and perceptions about journalism as a chosen profession

Big dreams, small towns: tracking journalism students' changing attitudes and perceptions about journalism at two Queensland universities - year 1

This collaborative research project began in 2012 between two academics from two regional Queensland universities. In the first year, both researchers conducted a survey among incoming first year Journalism students to find out these students' background, as well as set a benchmark of their attitudes and perceptions about the university experience, their views and perceptions of the journalism profession and their aspirations. The initial research yielded a unique profile of these students who have decided on a journalism education. In 2013, the same cohort of students were resurveyed to track changes, if any, in their responses to the same questions in 2012. A Focus Group Discussion (FGD) was conducted to provide qualitative data to explain the data. In year three of the research, the cohort was once again surveyed and interviewed as they leave university. This study offers a unique longitudinal view of the development of a student into a journalist as well as track any changes in the student's attitudes and perceptions about journalism as a chosen profession

Sexual and reproductive health clinical consultations: preconception care

Scenario: Sofia, aged 32 years, wants another child. She has used a contraceptive implant for contraception for 2 years and attends her local sexual health clinic to have it removed. Before starting the removal the healthcare professional (HCP) asks about her general health and obstetric history. She is well and does not take regular medication. Her body mass index (BMI) is 33 kg/m2 and her last cervical screening test was 6 years ago. She drinks socially and does not smoke or use recreational drugs. She has two children aged 7 and 4 years. Her first pregnancy was uncomplicated, and she had a vaginal birth. She had gestational diabetes in her second pregnancy and opted for an elective caesarean for fetal macrosomia. She cannot recall if she had testing for diabetes after birth. She has a palpable implant. Before starting the implant removal, the HCP discusses pregnancy planning with Sofia. They advise her to consult her general practitioner (GP) to start 5 mg/day folic acid (table 1), have a cervical screening test and be tested for diabetes. The HCP sensitively brings up Sofia’s weight and alcohol intake. They explain that she could reduce her risk of complications during pregnancy and delivery by aiming for 5–10% weight loss and signposts her to the National Health Service (NHS) ‘Live Well’ website. The HCP also discusses the benefits of not drinking alcohol before and during the pregnancy, and encourages her to discuss these lifestyle changes with her partner as well, as men can also optimise their health to improve fertility. The HCP also uses the opportunity to screen for reproductive coercion and domestic abuse as pregnancy is associated with an increased risk

Parent and Family Outcomes of PEERS: A Social Skills Intervention for Adolescents with Autism Spectrum Disorder

Raising a child with an Autism Spectrum Disorder (ASD) is associated with increased family chaos and parent distress. Successful long-term treatment outcomes are dependent on healthy systemic functioning, but the family impact of treatment is rarely evaluated. The Program for the Education and Enrichment of Relational Skills (PEERS) is a social skills intervention designed for adolescents with high-functioning ASD. This study assessed the impact of PEERS on family chaos, parenting stress, and parenting self-efficacy via a randomized, controlled trial. Results suggested beneficial effects for the experimental group in the domain of family chaos compared to the waitlist control, while parents in the PEERS experimental group also demonstrated increased parenting self-efficacy. These findings highlight adjunctive family system benefits of PEERS intervention and suggest the need for overall better understanding of parent and family outcomes of ASD interventions

Treating Substance Use Disorders: Enhancing Attendance at the Weekly Inpatient Medication Assisted Treatment Group

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline. A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%. A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to address these. Among them were the initiation of a KPI to collect patient attendance data and the creation of an IMAT order in EPIC. Since the IMAT order went “live” in EPIC and other countermeasures were started, the goal of 50% has been surpassed. Next steps include ongoing nurse, physician and care management education, and work with nursing informatics to develop an appointment feature for the IMAT order in EPIC

Genomic approaches in the search for molecular biomarkers in chronic kidney disease

Abstract Background Chronic kidney disease (CKD) is recognised as a global public health problem, more prevalent in older persons and associated with multiple co-morbidities. Diabetes mellitus and hypertension are common aetiologies for CKD, but IgA glomerulonephritis, membranous glomerulonephritis, lupus nephritis and autosomal dominant polycystic kidney disease are also common causes of CKD. Main body Conventional biomarkers for CKD involving the use of estimated glomerular filtration rate (eGFR) derived from four variables (serum creatinine, age, gender and ethnicity) are recommended by clinical guidelines for the evaluation, classification, and stratification of CKD. However, these clinical biomarkers present some limitations, especially for early stages of CKD, elderly individuals, extreme body mass index values (serum creatinine), or are influenced by inflammation, steroid treatment and thyroid dysfunction (serum cystatin C). There is therefore a need to identify additional non-invasive biomarkers that are useful in clinical practice to help improve CKD diagnosis, inform prognosis and guide therapeutic management. Conclusion CKD is a multifactorial disease with associated genetic and environmental risk factors. Hence, many studies have employed genetic, epigenetic and transcriptomic approaches to identify biomarkers for kidney disease. In this review, we have summarised the most important studies in humans investigating genomic biomarkers for CKD in the last decade. Several genes, including UMOD, SHROOM3 and ELMO1 have been strongly associated with renal diseases, and some of their traits, such as eGFR and serum creatinine. The role of epigenetic and transcriptomic biomarkers in CKD and related diseases is still unclear. The combination of multiple biomarkers into classifiers, including genomic, and/or epigenomic, may give a more complete picture of kidney diseases

Brief Report: Visuo-spatial Guidance of Movement during Gesture Imitation and Mirror Drawing in Children with Autism Spectrum Disorders

Thirteen autistic and 14 typically developing children (controls) imitated hand/arm gestures and performed mirror drawing; both tasks assessed ability to reorganize the relationship between spatial goals and the motor commands needed to acquire them. During imitation, children with autism were less accurate than controls in replicating hand shape, hand orientation, and number of constituent limb movements. During shape tracing, children with autism performed accurately with direct visual feedback, but when viewing their hand in a mirror, some children with autism generated fewer errors than controls whereas others performed much worse. Large mirror drawing errors correlated with hand orientation and hand shape errors in imitation, suggesting that visuospatial information processing deficits may contribute importantly to functional motor coordination deficits in autism