Why carers use adult day respite: a mixed method case study

BACKGROUND: We need to improve our understanding of the complex interactions between family carers’ emotional relationships with care-recipients and carers use of support services. This study assessed carer’s expectations and perceptions of adult day respite services and their commitment to using services. METHODS: A mixed-method case study approach was used with psychological contract providing a conceptual framework. Data collection was situated within an organisational case study, and the total population of carers from the organisation’s day respite service were approached. Fifty respondents provided quantitative and qualitative data through an interview survey. The conceptual framework was expanded to include Maslow’s hierarchy of needs during analysis. RESULTS: Carers prioritised benefits for and experiences of care-recipients when making day respite decisions. Respondents had high levels of trust in the service and perceived that the major benefits for care-recipients were around social interaction and meaningful activity with resultant improved well-being. Carers wanted day respite experiences to include all levels of Maslow’s hierarchy of needs from the provision of physiological care and safety through to the higher levels of belongingness, love and esteem. CONCLUSION: The study suggests carers need to trust that care-recipients will have quality experiences at day respite. This study was intended as a preliminary stage for further research and while not generalizable it does highlight key considerations in carers’ use of day respite services

The utilisation of a standardised educational framework to develop and deliver impactful programmes of simulation-based learning

Simulation has become a well-integrated modality of learning in pre- and postgraduate healthcare education programmes. The use of advanced technologies and the delivery of complex simulation-based learning opportunities require adequate preparation of healthcare educators. This paper details a European collaborative development and utilisation of an educational framework designed to prepare educators for the delivery of simulation-based learning strategies. The framework was subsequently adapted by a commercial partner and an evaluative study identified the impact of this programme of education on United Kingdom Faculty and within the National Health Service utilising qualitative methods of enquiry.The evaluation study demonstrated that the use of the educational framework effectively educates faculty to construct and deliver simulation-based learning. Furthermore, the valuation demonstrated positive impacts on patient safety by increasing the confidence and skills of frontline staff and by improving the ‘preparedness’ of systems. It has also contributed to significant economic benefits within healthcare organisations

The utilisation of a standardised educational framework to develop and deliver impactful programmes of simulation-based learning

Simulation has become a well-integrated modality of learning in pre- and postgraduate healthcare education programmes. The use of advanced technologies and the delivery of complex simulation-based learning opportunities require adequate preparation of healthcare educators. This paper details a European collaborative development and utilisation of an educational framework designed to prepare educators for the delivery of simulation-based learning strategies. The framework was subsequently adapted by a commercial partner and an evaluative study identified the impact of this programme of education on United Kingdom Faculty and within the National Health Service utilising qualitative methods of enquiry.The evaluation study demonstrated that the use of the educational framework effectively educates faculty to construct and deliver simulation-based learning. Furthermore, the valuation demonstrated positive impacts on patient safety by increasing the confidence and skills of frontline staff and by improving the ‘preparedness’ of systems. It has also contributed to significant economic benefits within healthcare organisations

The governance of sociotechnical transformations to sustainability

The contribution makes use of a sociotechnical imaginaries (STI) framework to expose crucial but neglected governance issues in sociotechnical areas of key relevance to sustainability transformations such as energy systems. It explores how the STI concept can contribute to understanding transformations to sustainability (T2S) by illustrating their multidimensionality and temporality. It takes as its starting point a ‘co-productionist’ view illuminating how collective visions of desirable (or resisted) environmental futures limit or enable political imagination and the search for alternative transformative practices. It demonstrates how a focus on imaginaries can help reveal the complex multidimensionality of human needs, expectations, and uses of natural resources — and associated societal phenomena to enable T2S. By more explicitly addressing the technical as well as political and normative dimensions of T2S, this approach helps uncover the taken-for-granted assumptions that often shut down potentially promising imaginations, as well as makes visible alternate pathways and possible constitutional relationships in the triad of state and society

The rural and regional ambulance paramedic : moving beyond emergency response - report to the Council of Ambulance Authorities Inc. March 2006

Serious long-term recruitment and retention problems amongst rural health workers in Australiacontribute to inequitable health service access for rural Australians. In response, new healthcaremodels with flexible workforce roles are emerging including expanded-scope paramedic roles.This research project was born from the view that expanding ambulance paramedics’ scope ofpractice offers the potential to improve patient care and the general health of the community.New healthcare models with flexible workforce roles are clearly needed in rural Australia andexpanded-scope paramedic roles are valuable innovations

Delivering Patient Decision Aids on the Internet: Definitions, Theories, Current Evidence, and Emerging Research Areas

Background: In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension — the delivery of patient decision aids on the Internet — is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods: An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results: The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration ’ s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and identifying emerging areas of research. Conclusions: As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies

Who Knows, Who Cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia

The number of people with dementia is increasing rapidly worldwide. Commensurate with population ageing, the use of nursing homes in Australia (known as residential aged care facilities) for individuals with dementia is growing. As a terminal condition, dementia is best managed by instituting a palliative approach to care. A good knowledge of dementia, including its progression and management, among staff and families of people living with dementia is essential for clear decision making and the provision of appropriate care. Yet there is limited information regarding relative levels of dementia knowledge. This paper reports the results of a study that assessed dementia knowledge among these two cohorts using the Dementia Knowledge Assessment Tool; the study surveyed 279 staff members and 164 family members of residents with dementia. Dementia knowledge deficits were evident in both cohorts across a range of areas. It is critical that dementia knowledge deficits are identified and addressed in order to support evidence-based dementia care

Grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats-A systematic review

Several studies suggested an informative value of behavioral and grimace scale parameters for the detection of pain. However, the robustness and reliability of the parameters as well as the current extent of implementation are still largely unknown. In this study, we aimed to systematically analyze the current evidence-base of grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats. The following platforms were searched for relevant articles: PubMed, Embase via Ovid, and Web of Science. Only full peer-reviewed studies that describe the grimace scale, burrowing, and/or nest building as pain parameters in the post-surgical phase in mice and/or rats were included. Information about the study design, animal characteristics, intervention characteristics, and outcome measures was extracted from identified publications. In total, 74 papers were included in this review. The majority of studies have been conducted in young adult C57BL/6J mice and Sprague Dawley and Wistar rats. While there is an apparent lack of information about young animals, some studies that analyzed the grimace scale in aged rats were identified. The majority of studies focused on laparotomy-associated pain. Only limited information is available about other types of surgical interventions. While an impact of surgery and an influence of analgesia were rather consistently reported in studies focusing on grimace scales, the number of studies that assessed respective effects was rather low for nest building and burrowing. Moreover, controversial findings were evident for the impact of analgesics on post-surgical nest building activity. Regarding analgesia, a monotherapeutic approach was identified in the vast majority of studies with non-steroidal anti-inflammatory (NSAID) drugs and opioids being most commonly used. In conclusion, most evidence exists for grimace scales, which were more frequently used to assess post-surgical pain in rodents than the other behavioral parameters. However, our findings also point to relevant knowledge gaps concerning the post-surgical application in different strains, age levels, and following different surgical procedures. Future efforts are also necessary to directly compare the sensitivity and robustness of different readout parameters applied for the assessment of nest building and burrowing activities

Climate change threatens polar bear populations : a stochastic demographic analysis

Author Posting. © Ecological Society of America, 2010. This article is posted here by permission of Ecological Society of America for personal use, not for redistribution. The definitive version was published in Ecology 91 (2010): 2883–2897, doi:10.1890/09-1641.1.The polar bear (Ursus maritimus) depends on sea ice for feeding, breeding, and movement. Significant reductions in Arctic sea ice are forecast to continue because of climate warming. We evaluated the impacts of climate change on polar bears in the southern Beaufort Sea by means of a demographic analysis, combining deterministic, stochastic, environment-dependent matrix population models with forecasts of future sea ice conditions from IPCC general circulation models (GCMs). The matrix population models classified individuals by age and breeding status; mothers and dependent cubs were treated as units. Parameter estimates were obtained from a capture–recapture study conducted from 2001 to 2006. Candidate statistical models allowed vital rates to vary with time and as functions of a sea ice covariate. Model averaging was used to produce the vital rate estimates, and a parametric bootstrap procedure was used to quantify model selection and parameter estimation uncertainty. Deterministic models projected population growth in years with more extensive ice coverage (2001–2003) and population decline in years with less ice coverage (2004–2005). LTRE (life table response experiment) analysis showed that the reduction in λ in years with low sea ice was due primarily to reduced adult female survival, and secondarily to reduced breeding. A stochastic model with two environmental states, good and poor sea ice conditions, projected a declining stochastic growth rate, log λs, as the frequency of poor ice years increased. The observed frequency of poor ice years since 1979 would imply log λs ≈ − 0.01, which agrees with available (albeit crude) observations of population size. The stochastic model was linked to a set of 10 GCMs compiled by the IPCC; the models were chosen for their ability to reproduce historical observations of sea ice and were forced with “business as usual” (A1B) greenhouse gas emissions. The resulting stochastic population projections showed drastic declines in the polar bear population by the end of the 21st century. These projections were instrumental in the decision to list the polar bear as a threatened species under the U.S. Endangered Species Act.We acknowledge primary funding for model development and analysis from the U.S. Geological Survey and additional funding from the National Science Foundation (DEB-0343820 and DEB-0816514), NOAA, the Ocean Life Institute and the Arctic Research Initiative at WHOI, and the Institute of Arctic Biology at the University of Alaska–Fairbanks. Funding for the capture–recapture effort in 2001–2006 was provided by the U.S. Geological Survey, the Canadian Wildlife Service, the Department of Environment and Natural Resources of the Government of the Northwest Territories, and the Polar Continental Shelf Project, Ottawa, Canada