Roles and responsibilities in integrated care for dementia.

PURPOSE Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. This study aimed to provide additional understanding of roles and responsibilities in relation to integrated care from the perspective of massive open online course (MOOC) participants. METHODOLOGY MOOC discussion board posts were analysed using Framework analysis consisting of transcription, familiarisation, coding, developing an analytical framework and application of the framework. FINDINGS Boundaries and key issues surrounding roles and responsibilities were highlighted and participants suggested a number of enablers that could remove barriers, thereby enhancing integrated care. ORIGINALITY/VALUE Enablers included introduction of shared communication and IT systems to support continuity of care. Awareness and understanding of dementia was seen as crucial to promote person centred care and care planning. The roles of education in, and experience of, dementia care were highlighted. Barriers affecting the roles and responsibility professionals exercise include funding, role conflicts, time constraints and time-consuming paperwork.N/

Are physiotherapy students adequately prepared to successfully gain employment?

This is the post-print version of the final paper published in Physiotherapy. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2010 Elsevier B.V.Objectives - To explore the preparedness of final-year physiotherapy students for their progression into employment, and identify what universities can do to facilitate a smooth transition. Design - A single-cohort study, utilising a qualitative design incorporating a survey followed by transcribed and coded semi-structured interviews. Setting - Interviews were held in the Placement and Careers Centre at Brunel University, London. Participants - Sixty final-year full- and part-time students participated in the survey, and 12 final-year full- and part-time students participated in the semi-structured interviews. Methods - Sixty students completed a questionnaire which explored their preparedness for employment. Questions related to the current job situation, the application process and the student's ideal first post. Responses from the questionnaire were analysed and discussed further through a digitally recorded interview. Twelve students were interviewed by an experienced interviewer from a non-physiotherapy background. Results - Students felt unprepared for employment. Forty-seven per cent wanted a rotational post, but 26% would only spend 6 months and 39% would only spend 1 year looking for a job. Seventy-one percent would change career and 99% would work abroad if they were unable to secure a post in the UK. Most importantly, students could not identify transferable skills required by potential employers; only 25% cited effective communications, and 10% cited flexible working as a transferable skill. Self-management skills (e.g. prioritisation, time management and documentation) were not perceived as essential for employment. Conclusions - The job market requires physiotherapy graduates to possess transferable skills which can be applied to any situation. Many are integral to the profession and the undergraduate curriculum; however, analysis and assimilation of these skills cannot be assumed. Universities should reflect on their curriculum delivery to produce graduates who meet employers’ expectations and make a smooth transition into the workplace

Risk and teenage parenthood: an early sexual health intervention

Purpose - This paper outlines the development of a resource designed to support practitioners, who were not sexual health specialists, but who worked with young people who may be at risk of teenage pregnancy or parenthood. Its aim was to enable practitioners to carry out an assessment using a screening tool, and to use educational interventions designed to reduce risk-taking behaviour or refer to a sexual health specialist. We report a research project to examine the perceptions of practitioners who had used the resource. Design/methodology/approach – The resource was based on a local needs assessment and developed by a multi-agency working group. The research utilised an on-line questionnaire and telephone interviews with practitioners. Findings - Practitioners reported using the screening tool with young people with an average age of 13.1 years. They thought the educational interventions provided knowledge and helped with communication, self-awareness, reflection, confidence, attitudes and values clarification. Research limitations/implications - The project was based in one county in England. A sample of seventeen per cent of the practitioners responded to the questionnaire, and they might be those who had engaged most, or most positively, with the resource. Three practitioners undertook interviews. The views and behaviours of young people are yet to be evaluated. Originality/value - Within a climate of limited resources, the findings suggest that the project was providing an acceptable proportionate universalist, early sexual health intervention for young people

Can cross sectional imaging contribute to the investigation of unexplained child deaths? A literature review.

Background This review examines the factors that can influence an investigation into the unexpected death of a child before considering if using imaging techniques could be of benefit. Method A systematic search strategy was adopted to search databases using keywords, these results were then subjected to inclusion and exclusion criteria to filter and refine the evidence base further. Discussion More research is published on the use of MRI in comparison with other modalities. There is evidence in the case of MRI in particular that its use could be of benefit in identifying and ruling out potential causes of death in children. Conclusion More research is needed on the use of CT but the routine use of MRI in child death investigation could now be considered. Ethical considerations appear to be a barrier to research in this area and discussions as to how such considerations can be overcome is necessary

Utilising a cultural–historical analysis to map the historicity of Social Studies, Natural Science and Technology education in the early years

Background: South Africa needs citizens who are morally sound, adaptive to change, technologically innovative and literate in socio-scientific issues. The young child is apparently being prepared for active citizenry through basic “Social Science, Natural Sciences and Technology” education as encapsulated in the South African curriculum. Aim: We foreground a theoretical and analytical framework to map the cultural–historical trajectory of South Africa’s Beginning Knowledge curriculum. Setting: Cultivating citizenship requires that these science subject domains be incorporated in a coherent, well-conceptualised and relevant early childhood curriculum as suggested by international literature. Educators need to be specialists in socio-scientific issues in both the content and pedagogy of these sciences in order to expound the curriculum. Methods: Our newly coined hybridised theoretical framework - the ‘Hybrid CHAT’ - together with an aligned analytical framework enabled us to illuminate the historical subject-didactical genetic development of Beginning Knowledge. An extensive sample of typographical textbooks, artefacts and cultural tools were analysed and interpreted. Results: Beginning Knowledge is afforded limited teaching time. The knowledge, skills and values associated with these science subjects serve to support and strengthen the acquisition of language and mathematics competencies. Currently, Beginning Knowledge does not sufficiently prepare child citizens for the global demands of the 21st century. Conclusion: Hybrid CHAT could invite further studies to place Beginning Knowledge on par with international curricula. This would also align the curriculum with the aspirations for an ideal South African citizenry as well as prepare child citizens to pursue Science and Technology for social development

Choice and caring : the experiences of parents supporting young people with Autistic Spectrum Conditions as they move into adulthood

This paper reports findings about parents' experiences of caring for young people with Autistic Spectrum Conditions (ASCs) moving into adulthood. In-depth interviews were conducted with 38 parents of young people (15-21 years) with ASCs. Data were analysed thematically. In the perceived absence of service support, parents acted as 'care-coordinators' and 'life-supporters' for their child as they moved into adulthood. These roles came with little choice, emotional demands and personal restrictions. Being supported was important for parents, but preferences differed regarding what this should look like. Implications for policy are discussed

Developing criteria for Cesarean Section using the RAND appropriateness method

<p>Abstract</p> <p>Background</p> <p>Cesarean section rates are increasing worldwide, and a rapid increase has been observed in Iran. Disagreement exists between clinicians about when to use cesarean section. We aimed to identify the appropriateness criteria for the use of cesarean section in Iran.</p> <p>Method</p> <p>A consensus development study using a modified version of the RAND Appropriateness Method (RAM). We generated scenarios from valid clinical guidelines and expert opinions. A panel of experts participated in consensus development: first round via mail (12 members), second round face-to-face (9 members). We followed the RAM recommendations for the development of the scenario lists, rating scales, and statistical analyses.</p> <p>Results</p> <p>294 scenarios relevant to cesarean section were identified. 191 scenarios were considered appropriate, of which 125 scenarios were agreed upon. The panel found cesarean inappropriate for 21% of scenarios, and 'equivocal' for 14% of scenarios.</p> <p>Conclusion</p> <p>RAM is useful for identifying stakeholder views in settings with limited resources. The participants' views on appropriateness of certain indications differed with available evidence. A large number of scenarios without agreement may partly explain why it has been difficult to curb the growth in cesarean section rate.</p

Realizing General Education: Reconsidering Conceptions and Renewing Practice

General Education is widely touted as an enduring distinctive of higher education in the United States (Association of American Colleges and Universities, [11]; Boyer, [37]; Gaston, [86]; Zakaria, [202]). The notion that undergraduate education demands wide‐ranging knowledge is a hallmark of U.S. college graduates that international educators emulate (Blumenstyk, [25]; Rhodes, [158]; Tsui, [181]). The veracity of this distinct educational vision is supported by the fact that approximately one third of the typically 120 credits required for the bachelor\u27s degree in the United States consist of general education courses (Lattuca & Stark, [120]). Realizing a general education has been understood to be central to achieving higher education\u27s larger purposes, making it a particularly salient concern