A systematic review of evidence for the psychometric properties of the Strengths and Difficulties Questionnaire

This paper synthesised evidence for the validity and reliability of the Strengths and Difficulties Questionnaire in children aged 3-5. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was carried out. Study quality was rated using the Consensus-based Standards for the Selection of Health Measurement Instruments. 41 studies were included (56 manuscripts). Two studies examined content and cultural validity, revealing issues with some questions. Six studies discussed language validations with changes to some wording recommended. There was good evidence for discriminative validity (Area Under the Curve ≥0.80), convergent validity (weighted average correlation coefficients ≥0.50, except for the Prosocial scale), and the 5-factor structural validity. There was limited support for discriminant validity. Sensitivity was below 70% and specificity above 70% in most studies that examined this. Internal consistency of the total difficulty scale was good (weighted average Cronbach’s alpha parents’ and teachers’ version 0.79 and 0.82) but weaker for other subscales (weighted average parents’ and teachers’ range 0.49-0.69 and 0.69-0.83). Inter-rater reliability between parents was moderate (correlation coefficients range 0.42-0.64) and between teachers strong (range 0.59-0.81). Cross-informant consistency was weak to moderate (weighted average correlation coefficients range 0.25-0.45). Test-retest reliability was mostly inadequate. In conclusion, the lack of evidence for cultural validity, criterion validity and test-retest reliability should be addressed given wide-spread implementation of the tool in routine clinical practice. The moderate level of consistency between different informants indicate that an assessment of a pre-schooler should not rely on a single informant

The Impact of In-Kind Food Assistance on Pastoralist Livelihoods in Humanitarian Crises

Pastoralists rely on coping and adaptation strategies that have historically allowed them to achieve high levels of productivity, manage the hazards and unpredictability of life in the marginal areas that they occupy and moderate the impacts of shocks (Butt et al., 2009; Hesse and Pattison, 2013; Morton, 2006). But despite the unique suitability of these strategies to their livelihoods, the food security of many pastoralist populations - especially in Africa - is increasingly under threat. Crises faced by pastoralists have increased in frequency and intensity in recent decades. Assistance has taken many forms, but nutrition and food security have been the priorities of most humanitarian interventions, which have usually involved direct provision of food in-kind to affected populations. But can such food aid address food security? Does it contribute to the erosion of livelihoods? Does it lead to a change in mobility patterns?This evidence synthesis represents the first ever attempt to identify, synthesize and evaluate existing evidence on both the short- and long-term impacts of in-kind food assistance on pastoralist populations and their livelihoods in humanitarian crises. It is accompanied by a stand-alone executive summary and evidence brief. It forms part of a series of humanitarian evidence syntheses and systematic reviews commissioned by the Humanitarian Evidence Programme

Living with dementia : the felt worth of support workers

Considering the important role that paid support workers play in care of older people with dementia, it is vital that researchers and relevant organisations understand the factors that lead to them feeling valued for the work that they do, and the consequences of such valuing (or lack thereof). The current study employed semi-structured interviews to understand the individual experiences of 15 support workers based both in residential care homes and private homes. The General Inductive Approach was used to analyse the interview transcriptions and to develop a conceptual model that describes the conditions that lead to support workers feeling valued for the work that they do. This model consists of organisational or individual strategies, the context in which support work takes place, and various interactions, actions and intervening conditions that facilitate or prevent support workers feeling valued. A significant finding in this research was the role of interpersonal relationships and interactions which underlie all other aspects of the conceptual model developed here. By understanding the importance of how employers, families of older adults with dementia and peers interact with support workers, we may promote not only the quality of work that support workers deliver, but also the wellbeing of the support workers themselves

Constructing normalcy in dementia care : carers' perceptions of their roles and the supports they need

Background and Objectives: People with dementia are critically dependent on their carers when accessing and utilizing health care. To inform health care development and delivery, we aimed to explore carers’ perceptions of their role in caring for a family member with dementia and to identify carers’ skills and attributes and factors impacting on care. Research Design and Methods: We used semistructured interviews to collect data from 25 carers supporting older adults with dementia. Data were thematically analyzed and the paradigm model was used to guide theory development. Results: “Constructing normalcy” was central to all carers did, impacted by stage of life and relationship status and driven by a holistic focus on their care-recipient’s quality of life. Goals guiding care were: keeping the peace; facilitating participation, happiness and independence; and ensuring safety. Enablers included: social contact; knowledge; and quality social services. Barriers included health and legal issues; symptoms of dementia; and reduced knowledge. These goals kept the peace and reduced stress for the cared-for person, but often at the cost of unrelenting responsibility and loss of carers’ original roles. Discussion and Implications: As carers are so critical to the access and uptake of health care of those with dementia, health professionals and services need to support carers in their quest to construct normalcy. Our findings provide guidance to assist in ensuring appropriate support and understanding of carers work in order to optimize dementia health care delivery