Co-designing a dashboard of predictive analytics and decision support to drive care quality and client outcomes in aged care: a mixed-method study protocol

IntroductionThere is a clear need for improved care quality and quality monitoring in aged care. Aged care providers collect an abundance of data, yet rarely are these data integrated and transformed in real-time into actionable information to support evidence-based care, nor are they shared with older people and informal caregivers. This protocol describes the co-design and testing of a dashboard in residential aged care facilities (nursing or care homes) and community-based aged care settings (formal care provided at home or in the community). The dashboard will comprise integrated data to provide an 'at-a-glance' overview of aged care clients, indicators to identify clients at risk of fall-related hospitalisations and poor quality of life, and evidence-based decision support to minimise these risks. Longer term plans for dashboard implementation and evaluation are also outlined.MethodsThis mixed-method study will involve (1) co-designing dashboard features with aged care staff, clients, informal caregivers and general practitioners (GPs), (2) integrating aged care data silos and developing risk models, and (3) testing dashboard prototypes with users. The dashboard features will be informed by direct observations of routine work, interviews, focus groups and co-design groups with users, and a community forum. Multivariable discrete time survival models will be used to develop risk indicators, using predictors from linked historical aged care and hospital data. Dashboard prototype testing will comprise interviews, focus groups and walk-through scenarios using a think-aloud approach with staff members, clients and informal caregivers, and a GP workshop.Ethics and disseminationThis study has received ethical approval from the New South Wales (NSW) Population & Health Services Research Ethics Committee and Macquarie University's Human Research Ethics Committee. The research findings will be presented to the aged care provider who will share results with staff members, clients, residents and informal caregivers. Findings will be disseminated as peer-reviewed journal articles, policy briefs and conference presentations

An exploration and proposed taxonomy of leisure–befriending for adults with learning disabilities

© 2019 The Authors. British Journal of Learning Disabilities Published by John Wiley & Sons Ltd Taking part in leisure activities is beneficial, yet many adults with learning disabilities are unable to participate in their preferred activities because of cost, because not having anyone to go with or because they do not feel welcome. Befriending is where someone volunteers to act as a friend. Befriending may be a way for adults with learning disabilities to participate in leisure activities with someone who is not a paid carer or family. The author spent time with four people with learning disabilities and their befrienders to find out what things they do together and what they both get from it. Friends and family members were also interviewed. Participants enjoyed the time they spent together. However, they often did the same activities they would do with paid carers or family and the relationship was sometimes quite professional. Befriending could be a way for adults with learning disabilities to have new, beneficial experiences, but we need to know more about how relationships work. Abstract: Background Leisure time for adults with learning disabilities is often diversionary and spent doing passive, solitary or family-orientated activities. Befriending, as a hybrid “natural” support, may help adults with learning disabilities overcome the barriers to participation in nonsegregated leisure. Materials and methods Four case studies of pairs of “befrienders” and “befriendees” were recruited purposively. Participant observation was carried out with each case, followed by semi-structured interviews with participants and relevant stakeholders. Data were analysed using thematic analysis. Results Befriending activities were mostly limited to enjoyable yet “casual” leisure activities that adults with learning disabilities might already participate in with family and paid service providers. Negotiating the befriender role between friend and professional was an ongoing challenge. Conclusions Outcomes of leisure–befriending relationships for adults with learning disabilities are linked to both the nature of relationships and the types of activities undertaken. There are four proposed ideal types of leisure–befriending relationship, yet repeating familiar “casual” leisure activities means adults with learning disabilities risk missing out on novel leisure and social experiences

Characteristics, motivations and experiences of volunteer befrienders for people with mental illness: a systematic review and narrative synthesis

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference Number RP-PG-0611-20002

Preferences for befriending schemes: a survey of patients with severe mental illness

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference Number RP-PG-0611-20002). The funding body was not involved in, and did not influence, the design of the study, data collection, analysis or interpretation of the data. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health

Therapeutically relevant structural and functional mechanisms triggered by physical and cognitive exercise

Corrected by: Erratum: Molecular Psychiatry (2016) 21, 1645–1645; doi:10.1038/mp.2016.57; published online 19 April 2016. Following publication of the above article, the authors noticed that the second author’s name was presented incorrectly. The author’s name should have appeared as M Fiatarone Singh. The publisher regrets the error.Physical and cognitive exercise may prevent or delay dementia in later life but the neural mechanisms underlying these therapeutic benefits are largely unknown. We examined structural and functional magnetic resonance imaging (MRI) brain changes after 6 months of progressive resistance training (PRT), computerized cognitive training (CCT) or combined intervention. A total of 100 older individuals (68 females, average age=70.1, s.d.±6.7, 55-87 years) with dementia prodrome mild cognitive impairment were recruited in the SMART (Study of Mental Activity and Resistance Training) Trial. Participants were randomly assigned into four intervention groups: PRT+CCT, PRT+SHAM CCT, CCT+SHAM PRT and double SHAM. Multimodal MRI was conducted at baseline and at 6 months of follow-up (immediately after training) to measure structural and spontaneous functional changes in the brain, with a focus on the hippocampus and posterior cingulate regions. Participants' cognitive changes were also assessed before and after training. We found that PRT but not CCT significantly improved global cognition (F(90)=4.1, P<0.05) as well as expanded gray matter in the posterior cingulate (Pcorrected <0.05), and these changes were related to each other (r=0.25, P=0.03). PRT also reversed progression of white matter hyperintensities, a biomarker of cerebrovascular disease, in several brain areas. In contrast, CCT but not PRT attenuated decline in overall memory performance (F(90)=5.7, P<0.02), mediated by enhanced functional connectivity between the hippocampus and superior frontal cortex. Our findings indicate that physical and cognitive training depend on discrete neuronal mechanisms for their therapeutic efficacy, information that may help develop targeted lifestyle-based preventative strategies.Molecular Psychiatry advance online publication, 22 March 2016; doi:10.1038/mp.2016.19.C Suo, M Fiatarone Singh, N Gates, W Wen, P Sachdev, H Brodaty, N Saigal, GC Wilson, J Meiklejohn, N Singh, BT Baune, M Baker, N Foroughi, Y Wang, Y Mavros, A Lampit, I Leung, and MJ Valenzuel

To befriend or to be a friend: a systematic review of the meaning and practice of "befriending'' in mental health care

Background: "Befriending" involves pairing a volunteer with a person with a mental illness in the community to spend social time together. The term can have very different connotations.To review how "befriending" was used in mental health care. Method: A systematic review with a narrative synthesis was used to explore how befriending is conceptualised and practiced. We extracted descriptions of "befriending" from efficacy studies, befriending manuals, and reports from the gray literature and explored the practical implications of the different concepts of "befriending". Results: The lay understanding of the phrase "to befriend" is "to be a friend to". This contrasts to codes of practice used by befriending organisations, which describes a relationship distinct from friendship. The literature (12 relevant papers total) suggests a spectrum of practices; at one end is a relationship that is professional or therapeutic in nature, while at the other end, the relationship is conceptualised as much closer to a naturally occurring friendship. Conclusion: The different concepts determine distinct practices, which may lead to confusion when the term befriending is used. The term "befriending", may be understood to concern friendship, which may be inappropriate where the organisation offers a professional style relationship.7 page(s