A study to explore influences on acceptance and rejection of psychosocial interventions by people with early dementia

Background: Health policy promotes post-diagnostic support for people affected by dementia. Evidence suggests psychosocial interventions can support people with dementia. Yet what influences people with dementia accept interventions is poorly understood. This research aimed to identify influences on acceptance or rejection of psychosocial interventions by people with early dementia. Methods: Sixteen face-to-face semi-structured interviews with people with early dementia (either alone or with a family member/s). Twelve staff participate in semi-structured interviews or a focus group. Thematic analysis and triangulation enabled integration of findings and identification of themes across all data sources. Findings, along with key themes from literature reviewed, informed a summary framework of influences on acceptance and rejection of psychosocial interventions by people with early dementia. Main Findings: Five overarching themes were identified. Individual responses to diagnosis, experiences of dementia and dementia services influenced uptake. Adjustment and awareness affected whether people felt they needed interventions. Whether activities offered appealed and benefit was influenced uptake. Interventions offering social contact, peer support, information, enjoyable activities and mental stimulation were valued. Group interventions or interventions specifically aimed at people with dementia did not appeal to all. Continuing with community activities was valued. Ability to travel and convenience of locations was important Stigma seemed to discourage uptake. Emotional and practical support from family was key to facilitating uptake and relationships between people affected by dementia and staff were also important. Conclusion: A complex interplay of individual, service and societal influences affect uptake of psychosocial interventions by people with early dementia. How interventions, and which services, should enable people with early dementia remain engaged in their everyday lives needs consideration. Further research to examine acceptance and rejection of specific interventions commonly offered to those with early dementia is needed. Involving people with early dementia in the design of interventions aiming to support them is paramount

Pay-for-performance in nursing homes.

Information on the impact of pay-for-performance programs is lacking in the nursing home setting. This literature review (1980-2007) identified 13 prior examples of pay-for-performance programs in the nursing home setting: 7 programs were active as of 2007, while 6 had been terminated. The programs were mostly short-lived, varied considerably in the choice of performance measures and pay incentives, and evaluations of the impact were rare

Review of SIPHER-7 wellbeing indicators

The SIPHER (Systems Science in Public Health and Health Economics Research) Consortium examines the complex causal relationships between upstream policies and wellbeing, economic and equality outcomes, and in so doing, it needs a common set of wellbeing indicators. SIPHER-7 is a suite of seven wellbeing indicators developed for this purpose between October 2019 and February 2020. This note reports on a subsequent review conducted in March 2022, to improve the clarity of the item wording, and the link between SIPHER-7 and the UK Household Longitudinal Study (“Understanding Society”)

Weaving a clinical academic career: illuminating the method and pattern to follow

The benefits of developing occupational therapists as clinical academics are well recognised. They include improved healthcare outcomes and experiences for service users, efficiencies for organisations and increased prominence of occupational therapy within healthcare. Yet occupational therapists describe uncertainty about how best to navigate clinical academic career pathways. We suggest that occupational therapists can increase their research aspirations, confidence and capacity by following a four-step method, weaving together clinical, academic and personal development. We outline our view of clinical academic development as a process with flexibility to incorporate occupational therapists’ diversity of interests and circumstances. By demystifying and illuminating the process of clinical academic development, we believe that occupational therapists may be able to weave more clinical academic development opportunities into their careers and increase the profession’s research capacity

Prospectus, December 18, 1974

REID IS LANDSLIDE VEEP VICTOR: MANDEL, PFAAB, HEDRON ALSO ASSUME OFFICE; Nutritional Labeling To Become Law Jan. 1; Boneyard Hassle May Be Nearing An End; New Debaters Impressive At Greenville; Vets\u27 Benefits Slow In Arriving (Again); The Sky Is Falling, The Sky...; ISU Announces 18 Scholarships For Top JC Applicants; Bouncing Bob Bonanza; Support Grape Boycott; Christmas Is What You Make It; Saturday On The Mall In Words And Action-Packed Pictures; Keeping Our Share; The Short Circuit; The Strange Case Of Del Boyd; The Kaleidoscope; A Column By And For Women; True Happenings; essay; letters; Peace On Earth?; \u27Silver Morning\u27 Rankin\u27s Return A Culmination; Share This One With A Friend; \u27War Child\u27 Return Of The Mutant Minstrel; Young Volunteers Here Working With The Aged; Blues At Ruby Gulch, Advice Well Taken; Rec Music Sponsors Christmas Singalong; Classified Ads; Ski Trip Leaves In Mid-January; Bank Offers PC License Plates; Student Association Rips State Pot Laws; Electronics Association Sponsors \u27Ham\u27 Giveaway; Cobra Offense Improving ; PC Cagers 5-0; Intramural Basketball Scores; Lee Oswald - Killer or Patsy?; Schoolboy All-Stater Davidson Joins Cagers; Fast Freddy\u27s Football Forecasthttps://spark.parkland.edu/prospectus_1974/1000/thumbnail.jp

Prospectus, January 20, 1975

STUDENTS RESPOND TO BOYCOTT; CU Mass Transit Increases Service; Few Support Canteen, Hate Food And Prices; A Separate Reality?; Dental Hygiene Gives Students Free Care; Trustees Approve Funding For New (Yellow Bricj?) Road; Amateur Radio Class To Begin; String Club To Present Music Festival; Sangamon State Rep. Here Feb. 4; Handicapped Left Out In Parking Lot Cold; Walker Blasts Fed Agencies, Refuses State-Level Tax Cut; \u27Sorry, Wrong Number\u27 Is PC Players\u27 Hit; Mighty Joe Young Sings Blues With Style; Right To Life To Meet; \u27Front Page\u27 A Flat Disappointing Comedy; what happens after boycott?; The Kaleidoscope; letters; PSA President Answers Day Care Questions; Monroe Doctrine Plays Bluegrass at PC Friday; New Student Privacy Law In Effect; The People\u27s Choice; Lit One: The Obscure Poet, Laying play dreaming..., Li Po..., Snow on the high Mountains..., Survival, Ode to you, O School!; Milhouse & Outhouse; Christmas Reprise; Classified Ads; Jack Ruby: Cubans And Strippers; File Petition For Graduation; Cobras Meet Top-Ranked Lakeland Tonight; Oliver Nets 40 Points As Cagers Rebound To Dump Springfield; Parkland No. 2 In Basketball; New Fencing Club Strives To Gain Members, Recognition; Women Cobras Open Season; Intramural Basketball; Parkland Events; Bouncing Bob\u27s Basketball Bonanzahttps://spark.parkland.edu/prospectus_1975/1018/thumbnail.jp

Prospectus, September 16, 1974

STUGO ELECTIONS SEPT. 25, 26; Student Senate Positions To Be Filled; Meet The New Prospectus Staff; 29 Added To Parkland Staff; BSA Sponsors Black Queen Contest; Lit. Page To Take Place of \u27Quill\u27; The $150,000 Gift; Letters To the Editor; The Short Circuit; Crime Pays . . . Well; The Kaleidoscope; This Is Your Newspaper; Opinion; Essay: Eulogy for Simple Justice; In The Dark With Craig Hoff; Parkland Debate Is Now Forming; International Meditation Society; Art Association; Stevie Wonder\u27s Latest \u27Beautiful, Creative\u27; Fewer And Fewer Fabulous Fashions; Right To Life To Reorganize; Really Raunchy Record Review; Heartsfield Rocks Gulch; Alpha Phi Omega; Health Insurance; Newman Club; Activities Budget Figures Released; Young Republicans To Reconvene; Republicans Plan Candidate Debate; Postage Machine; Classified Ads; Security Guard Enjoys His Job; A Column By And For Women: Continuing Education For Women; Rape Hotline System Available To Victims; Road Rally; Christian Fellowship; Jock Talk; PC Faculty Routs Maynards. Grabs Seecond; Fast Freddy\u27s Football Forecast: Rules Of The Game; Brock Expresses Relief After Breaking Record; Baseball Tryouts; Golfer At Bradley; Ski Club; Cross Country; Golf Schedule; Parkland Basketball Meeting; Callboard; Newman Club Welcomes Students; Bake Sale; TB Skin Tests; ID Cards; Bridge Clubhttps://spark.parkland.edu/prospectus_1974/1010/thumbnail.jp

A Mixed-Methods Study To Characterize Pharmaceutical Marketing in the Nursing Home Setting: Off-Label Use of Atypical Antipsychotics

Background: Despite FDA warnings that atypical antipsychotic medications are associated with an increased risk of death when used to treat behavioral disorders in older adults with dementia, they are prescribed to nearly one-third of older U.S. nursing home (NH) residents. Reasons for their high use in NHs are poorly understood, but may include pharmaceutical marketing efforts in the NH setting. Methods: This study is nested within an ongoing cluster randomized trial to improve the use of atypical antipsychotics in NHs. We analyzed semistructured interviews (n = 36) and surveys (n = 139) of administrators, directors of nursing and medical directors from 62 NHs in Connecticut. Using prescription drug claims from a national long-term care pharmacy, we arrayed study NHs into lowest to highest tertile of atypical antipsychotic use. We tested for differences in the receipt of information or clinical tools from pharmaceutical company representatives (PCRs) to manage dementia-related behaviors by medication use tertiles, adjusting for NH profit status, size, quality (overall, health inspections, staffing) and staffing measures (daily nurse hours per resident). Results: Average baseline use of atypical antipsychotics ranged from 6.6 to 44.3 percent of all residents in the facility. Approximately one-quarter of NH leaders presently receive information on dementia-related behavioral management strategies from PCRs through detailing, in-service training, written or Web-based material or sponsorship as speakers. However, we did not detect statistically significant differences in the receipt of information by level of atypical antipsychotic use, NH characteristics, quality and staffing measures. Conclusions: This first attempt to characterize pharmaceutical marketing within the NH setting did not find differences among reports of marketing efforts with respect to medication use and facility-level characteristics. However, studies across a wider geographic area should continue investigating the possible role of marketing efforts on overall use and choice of atypical antipsychotics in the NH setting

Prospectus, December 6, 1974

OTHERS DISAGREE: STAERKEL: \u27DAY CARE JUST A CONVENIENCE\u27; Student Government Up For Grabs Again; P/C Model For Therapeutic Rec; Gunji Coordinator For Recognition Awards Selection; Our First Report On A Cape Kennedy Launch; Pre-Registration Helps Everyone; UPC: Consumer Aid Or Just A bother?; Fool Killer Does Wonder, The Pips Fool Mother Nature; Where Are We? A Few Facts On The New Signs; Prospectus Gets Bomb Threat, Caller \u27Disturbed\u27; Cyclowski Is First Fast Freddy Repeat; getting around day care; The Short Circuit; A Column By And For Women; getting the shaft; summary of report on possible child care services at parkland college; letters; High School Visitation Week; The Five Snow Queen Finalists; All Set For StuGo Election; Classified Ads; Cobras Notch Two Wins; Parkland-Rend Lake; Parkland-Wabash Valley; IM Basketball Starts Tomorrow; High Rollers Squeak Past BMF For IM Championship; Electronic Music Made Easy; 528 Earn Spot On Honors List; Author Richard Farina\u27s Latest \u27Interesting Despite The Flaws\u27; Parkland Events; Callboard; Europe Still Available At Low Cost; IM Basketball Schedulehttps://spark.parkland.edu/prospectus_1974/1001/thumbnail.jp

Community Occupational Therapy in Dementia intervention for people with mild to moderate dementia and their family carers in the UK: the VALID research programme including RCT

BackgroundPeople with dementia find it increasingly difficult to carry out daily activities (activities of daily living), and may require increasing support from family carers. Researchers in the Netherlands developed the Community Occupational Therapy in Dementia intervention, which was delivered in 10 1-hour sessions over 5 weeks to people with dementia and their family carers at home. Community Occupational Therapy in Dementia was found to be clinically effective and cost-effective.ObjectivesTranslate and adapt Community Occupational Therapy in Dementia to develop the Community Occupational Therapy in Dementia - the UK version intervention and training programme and to optimise its suitability for use within the UK. To estimate the clinical effectiveness and cost-effectiveness of Community Occupational Therapy in Dementia - the UK version for people with mild to moderate dementia and their family carers compared with treatment as usual.DesignThe development phase used mixed methods to develop Community Occupational Therapy in Dementia - the UK version: translation, expert review, and adaptation of the manual and training materials; training occupational therapists; focus groups and interviews, including occupational therapists, managers, people with dementia and family carers; consensus conference; and an online survey of occupational therapists to scope UK practice. A multicentre, two-arm, parallel-group, single-blind individually randomised pragmatic trial was preceded by an internal pilot. Pairs were randomly allocated between Community Occupational Therapy in Dementia - the UK version and treatment as usual. A cost–utility analysis, fidelity study and qualitative study were also completed.SettingCommunity services for people with dementia across England.ParticipantsPeople with mild to moderate dementia recruited in pairs with a family carer/supporter.InterventionsCommunity Occupational Therapy in Dementia - the UK version is an activity-based, goal-setting approach for people with dementia and family carers, and is delivered at home by an occupational therapist for 10 hours over 10 weeks. Treatment as usual comprised the usual local service provision, which may or may not include standard occupational therapy.Main outcome measuresData were collected through interviews conducted in person with dyads at baseline and at 12 and 26 weeks post randomisation, and then over the telephone with a reduced sample of just carers at 52 and 78 weeks post randomisation. The primary outcome was the Bristol Activities of Daily Living Scale at 26 weeks. The secondary outcomes were as follows: person with dementia – cognition, activities of daily living, quality of life and mood; carer – sense of competence, quality of life and mood; all participants – social contacts, leisure activities and serious adverse events.ResultsThe Community Occupational Therapy in Dementia manual and training materials were translated and reviewed. In total, 44 occupational therapists were trained and delivered Community Occupational Therapy in Dementia to 130 pairs. A total of 197 occupational therapists completed the survey, of whom 138 also provided qualitative data. In total, 31 people attended the consensus conference. Community Occupational Therapy in Dementia - the UK version has more flexibility than Community Occupational Therapy in Dementia in terms of content and delivery; for example, occupational therapists can use the wider range of assessment tools that are already in regular use within UK practice and the time span for delivery is 10 weeks to better meet the needs of pairs and be more feasible for services to deliver. In total, 31 occupational therapists provided Community Occupational Therapy in Dementia - the UK version within the randomised controlled trial. A total of 468 pairs were randomised (249 pairs to Community Occupational Therapy in Dementia - the UK version, 219 pairs to treatment as usual). People with dementia ranged in age from 55 to 97 years (mean 78.6 years), and family carers ranged in age from 29 to 94 years (mean 69.1 years). The majority of those with dementia (74.8%) were married; 19.2% lived alone. Most family carers (72.6%) were spouses but 22.2% were adult children. At 26 weeks, 406 (87%) pairs remained in the trial, and the Bristol Activities of Daily Living Scale total score did not differ at the 5% level when comparing groups (adjusted mean difference estimate 0.35, 95% confidence interval –0.81 to 1.51; p = 0.55). The adjusted (for baseline Bristol Activities of Daily Living Scale total score and randomised group) intracluster correlation coefficient estimate at week 26 was 0.043. There were no significant differences in secondary outcomes. At 52 and 78 weeks, there were no differences between the two groups in Bristol Activities of Daily Living Scale total score and secondary outcomes. The probability that Community Occupational Therapy in Dementia - the UK version is cost-effective at a threshold of willingness to pay per quality-adjusted life-year of £20,000 is 0.02%. In the qualitative interviews, participants reported positive benefits and outcomes. Of the 249 pairs allocated to Community Occupational Therapy in Dementia - the UK version, 227 reached the goal-setting phase, and 838 of the 920 goals set (90.8%) were fully or partially achieved.LimitationsThe development phase took longer than estimated because of translation time and organisational delays in delivering the intervention. Recruitment to the randomised controlled trial took longer than expected. Fidelity overall was moderate, with variation across sites and therapists. It is possible that Community Occupational Therapy in Dementia - the UK version did not work well in the UK service model in which usual care differs from that in the Netherlands.ConclusionsThis programme used a rigorous process to develop Community Occupational Therapy in Dementia - the UK version but found no statistical evidence of clinical effectiveness or cost-effectiveness compared with usual care. Qualitative findings provided positive examples of how Community Occupational Therapy in Dementia - the UK version had enabled people to live well with dementia