Drivers and barriers to educational success : evidence from the longitudinal study of young people in England

This study examined why young people from poor families have lower attainment in school, are more likely to become NEET (Not in Education, Employment or Training) after compulsory education, and are more likely to participate in a range of risky behaviours whilst teenagers. The Longitudinal Study of Young People in England is combined with school and neighbourhood information to document the links between lower socio-economic position and poorer outcomes: identifying the key factors amongst parental education and material resources; school and neighbourhood peer groups; and the attitudes and beliefs of young people and their parents that help sustain those links

Supporting general hospital staff to provide dementia sensitive care: A realist evaluation

© 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0).Background: There are an increasing number of interventions to improve hospital care for patients with dementia. Evidence for their impact on staff actions and patient outcomes is, however, limited and context dependent. Objective: To explain the factors that support hospital staff to provide dementia sensitive care and with what outcomes for patients with dementia. Design: A realist evaluation using a two-site case study approach. Setting: Two hospital trusts in the East of England. Site 1 had a ward for patients with dementia that would address their medical and mental health needs. Site 2 used a team of healthcare assistants, who had support from dementia specialist nurses, to work with patients with dementia across the hospital. Participants: Hospital staff who had a responsibility for inpatients with dementia (healthcare assistants, nurses, medical staff, allied healthcare professionals and support staff) (n = 36), patients with dementia (n = 28), and family carers of patients with dementia (n = 2). Methods: A three stage realist evaluation: 1) building the programme theory of what works and when; 2) testing the programme theory through empirical data (80 h non-participant observation, 42 interviews, 28 patient medical notes, 27 neuropsychiatric inventory, and documentary review); 3) synthesis and verification of findings with key stakeholders. Findings: The programme theory comprised six interconnected context-mechanism-outcome configurations: 1) knowledge and authority to respond to an unmet need; 2) role relevant training and opportunities for reflection; 3) clinical experts and senior staff promoting practices that are patient-focused; 4) engaging with opportunities to spend time with patients; 5) risk management as an opportunity for person-centred care; 6) valuing dementia care as skilled work. Effective interactions reduced patient distress and supported patient orientation. Training and allocation of staff time were of themselves insufficient to ensure dementia care was prioritised and valued as skilled work. Staff concerns about the consequences of adverse incidents and work pressures on the ward, even with support, took precedence and influenced the quality of their interactions with patients with dementia. A key finding linked to staff retention and developing capacity in the workforce to provide expert dementia care was that despite extra training and organisational endorsement, nursing staff did not regard dementia care as skilled nursing work. Conclusions: There is increased awareness and organisational commitment to dementia-friendly healthcare in general hospitals. However, in addition to training and adapting the environment to the patient, further work is needed to make explicit the specialist skills required for effective dementia care.Peer reviewe

What research we no longer need in neurodegenerative disease at the end of life : The case of research in dementia

A complete silence. That was what we got back from the European experts who had been energetically discussing research priorities in palliative care in neurodegenerative disease (ND) until a short while ago.1 The chair, an entertaining professor with good manners, must have felt the unease and quickly refocused the group to their task. But, wasn’t this the best question of all day? What research we no longer need? As scientists able to consider different perspectives, shouldn’t we have some idea of what research is, by contrast, no longer necessary? Palliative care research and research with people who have ND and are at the end of their life is, by definition, difficult. Making choices is a sensitive issue, but funds are limited. Therefore, we take a counterpoint to the research agenda recently reported by European Union (EU) Joint Programme – Neurodegenerative Disease Research (JPND),1 and consider whether there are studies we no longer need or are low priority, taking the example of dementiaPeer reviewedFinal Accepted Versio

Which Skills Matter?

Cognitive Skills, non-cognitive skills, NCDS, Schooling, Labour Market Outcomes

Explaining the socio-economic gradient in child outcomes: the intergenerational transmission of cognitive skills

Papers in this volume and elsewhere consistently find a strong relationship between children's cognitive abilities and their parents' socio-economic position (SEP). Most studies seeking to explain the paths through which SEP affects cognitive skills suffer from a potentially serious omitted variables problem, as they are unable to account for an important determinant of children's cognitive abilities, namely parental cognitive ability. A range of econometric strategies have been employed to overcome this issue, but in this paper, we adopt the very simple (but rarely available) route of using data that includes a range of typically unobserved characteristics, such as parental cognitive ability and social skills. In line with previous work on the intergenerational transmission of cognitive skills, we find that parental cognitive ability is a significant predictor of children's cognitive ability; moreover, it explains one sixth of the socio-economic gap in those skills, even after controlling for a rich set of demographic, attitudinal and behavioural factors. Despite the importance of parental cognitive ability in explaining children's cognitive ability, however, the addition of such typically unobserved characteristics does not alter our impression of the relative importance of other factors in explaining the socio-economic gap in cognitive skills. This is reassuring for studies that are unable to control for parental cognitive ability.

Supporting experienced hospital nurses to move into community matron roles

Report of a study to examine the key knowledge and support required by nurses, experienced in the management of patients with long term conditions, to work in primary care contexts in undertaking community matron roles. Commissioned by the Department of Health (England) 200

Dementia Education and Training in Hertfordshire and Bedfordshire : An organisational audit commissioned by Health Education England

This audit established the range of dementia education available to NHS staff, social care staff and GPs across the two counties. It reports on current uptake of training, course content, assessment and accreditation of training. Future commissioning for dementia education and training might need to consider i) who in the workforce needs to be targeted, ii) whether or not there should be different sets of competencies for various professional groups, iii) accreditation that leads to recognised steps of progression; iv) joint commissioning of health and social care to deliver dementia education and trainin

An evaluation of the role of the Admiral Nurse : a systematic evidence synthesis to inform service delivery and research

Two thirds of people with dementia live in the community and receive support from family members. There is a great deal of evidence to suggest that caring for a person with dementia impacts on the health and wellbeing of family carers. Despite this the provision of funded support for family carers is often limited or inadequate. Admiral Nurses, developed in the 1990s, were specifically designed by the charity for dementia (now Dementia UK) to support the family carers of people with dementia. Admiral Nurses are mental health nurses specialising in the care of people with dementia. They are mainly employed by local providers of care for people with dementia but dementia UK is involved in setting up new posts and providing ongoing practice development. There are currently around 100 Admiral Nurses employed in England. In addition the charity has a national helpline provided by experienced Admiral Nurses. The evidence synthesis presented here was commissioned by Dementia UK in order to establish what is currently known about the scope, nature and effectiveness of Admiral Nurse

Health and wellbeing promotion strategies for ‘hard to reach’ older people in England: a mapping exercise.

The version of the article that has been accepted for publication. This version may include revisions resulting from peer review but may be subject to further editorial input by Cambridge University Press.Background: Older people from deprived areas, the oldest old and those from ethnic minorities engage less in health promotion interventions and related research, potentially generating inequities. Aim: To explore and map the extent to which such ‘hard to reach’ groups of older people, are the focus of local health and wellbeing strategies in England. Methods: Document analysis of current health and wellbeing promotion strategies in a purposive sample of 10 localities in England with high proportions of some or all of the three hard-to-reach groups. Documents were analysed using an interpretive approach. Findings: A total of 254 documents were retrieved and reviewed. Much of the content of the documents was descriptive and reported the implications for resources/services of population ageing rather than actual initiatives. All localities had an Older People’s Strategy. Strategies to counter deprivation included redistribution of winter fuel payments, income maximisation, debt reduction and social inclusion initiatives, a focus on older owner occupiers and recruitment of village ‘agents’ to counter rural deprivation. The needs of the oldest old were served by integrated services for older people, a community alarm service with total coverage of the 85+ population, and dietary advice. The needs of Black and Ethnic Minority (BME) older people were discussed in all localities and responses included community work with BME groups, attention to housing needs and monitoring of service use by BME older people. Three other themes that emerged were: use of telecare technologies; a challenge to the idea of ‘hard to reach’ groups; and outreach services to those at most risk. Conclusions: Document analysis revealed a range of policy statements that may indicate tailoring of policy and practice to local conditions, the salience of national priorities, some innovative local responses to policy challenges and even dissenting views that seek to redefine the policy problem.Peer reviewe