Farm-based day care services – a prospective study protocol on health benefits for people with dementia and next of kin

Introduction: The increasing number of people with dementia will place a considerable challenge on the health care system and will necessitate innovation and new solutions. Day care services aim to provide meaningful activities and coping experiences for the target group. The aim of the present study is to explore the experience and potential health benefits for people with dementia attending farm-based day care services in Norway and their next of kin. Methods and design: The present study is a prospective study organized into several qualitative and quantitative sub-studies. Study period will last from 2016–2020. We use a multi-method approach and both an empirical and a constructivist view on knowledge to explore this multi-facetted phenomenon. Discussion: Several challenges are expected, for instance, the ability to include participants with dementia and keep them within the study for the whole study period. The functioning level of participants regarding language and understanding could challenge their ability to answer. Despite having several limitations, we believe that this study with its different approaches and methods will add important knowledge to the field. Knowledge from our study could be essential for creating day care services of good quality for people with dementia and such services could reduce the burden of care for their next of kin.publishedVersio

Omatt: Nesten en sirkulærøkonomisk suksess fra Bodø

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Farm-based day care services – a prospective study protocol on health benefits for people with dementia and next of kin

Introduction: The increasing number of people with dementia will place a considerable challenge on the health care system and will necessitate innovation and new solutions. Day care services aim to provide meaningful activities and coping experiences for the target group. The aim of the present study is to explore the experience and potential health benefits for people with dementia attending farm-based day care services in Norway and their next of kin. Methods and design: The present study is a prospective study organized into several qualitative and quantitative sub-studies. Study period will last from 2016–2020. We use a multi-method approach and both an empirical and a constructivist view on knowledge to explore this multi-facetted phenomenon. Discussion: Several challenges are expected, for instance, the ability to include participants with dementia and keep them within the study for the whole study period. The functioning level of participants regarding language and understanding could challenge their ability to answer. Despite having several limitations, we believe that this study with its different approaches and methods will add important knowledge to the field. Knowledge from our study could be essential for creating day care services of good quality for people with dementia and such services could reduce the burden of care for their next of kin. Keywords: care farms, coping, farm-based activities, green care, meaningful activities, multi-method approac

“I couldn't carry on taking a drug like that”: A qualitative study of patient perspectives on side effects from rheumatology drugs

ObjectivesThere is growing interest in collecting outcome information directly from patients in clinical trials. This study evaluates what patients with rheumatic and musculoskeletal diseases (RMDs) consider important to know about symptomatic side effects they may experience from a new prescription drug.MethodsPatients with inflammatory arthritis, who had one or more prescribed drugs for their disease for at least 12 months, participated in focus groups and individual interviews. Discussions were analysed using reflexive thematic analysis.ResultsWe conducted seven focus groups with 34 participants across three continents. We found four overarching and two underpinning themes. The ‘impact on life’ was connected to participants ‘daily life’, ‘family life’, ‘work life’, and ‘social life’. In ‘psychological and physical aspects’ participants described ‘limitation to physical function’, ‘emotional dysregulation’ and ‘an overall mental state’. Extra tests, hospital visits and payment for medication were considered a ‘time, energy and financial burden’ of side effects. Participants explained important measurement issues to be ‘severity’, ‘frequency’, and ‘duration’. Underpinning these issues, participants evaluated the ‘benefit-harm-balance’ which includes ‘the cumulative burden’ of having several side effects and the persistence of side effects over time.ConclusionsIn treatment for RMDs, there seems to be an urgent need for feasible measures of patient-reported bother (impact on life and cumulative burden) from side effects and the benefit-harm-balance. These findings contribute new evidence in support of a target domain - an outcome that represents the patient voice evaluating the symptomatic treatment-related side effects for people with RMDs enrolled in clinical trials

The Impact of Institutional Coup-Proofing on Coup Attempts and Coup Outcomes

Coup-proofing pertains to political leaders’ strategies that will prevent groups inside or outside the state apparatus from seizing power via a coup d’état. One particular form of these strategies divides a country’s military into rivaling organizations, thereby creating an artificial balance between and structural obstacles for the armed forces. Despite the general claim that this institutional coup-proofing is indeed effective, a recent empirical study does not obtain evidence for a negative impact on the risk of coup attempts or coup outcomes. The authors take this finding as a motivation for their re-evaluation of the effect of institutional coup-proofing on coup risk and outcomes. By developing an argument that rests on the concepts of collective action and polarization, it is contended that institutional coup-proofing and coups are characterized by a U-shaped relationship: Institutional coup-proofing is likely to lower the likelihood of coup onsets and successful outcomes, yet only until a tipping point of about two equally strong military organizations. After this turning point, the risk of coup onset as well as coup success may increase again. Using time-series cross-section data for 1975–1999, the authors find strong and robust support for their claims in terms of coup onset, but not coup outcomes