Clinical governance : a friend or foe to dental care practice in the UK?

This paper presents a literature review of clinical governance and its impact upon dental health care in the UK. Whilst the value of clinical governance is recognised, the findings illustrate that the concept of clinical governance remains challenging to dental care practitioners, illustrated by lack of knowledge and confidence in its application and evaluation. The study also identifies a distinct paucity of research concerning impact and makes recommendations to enhance clinical governance in practice

Mentoring and you

This research based case study explores and illustrates the benefits of mentoring and the place of clinical governance in enhancing dental care practice

Stakeholder perceptions of dignity therapy for children and young people with life-limiting and life-threatening conditions in the UK

In palliative and end of life care settings supporting people to make sense of their lives is as important as managing disease symptoms. Dignity Therapy is a validated psychotherapeutic intervention designed to bring about a sense of meaning and purpose for individuals at the end of life. Dignity Therapy has primarily been implemented and evaluated in adult palliative care settings. Prior to designing studies that evaluate Dignity Therapy for children and young people with life-limiting and life-threatening conditions, it is essential to establish stakeholders’ perceptions of Dignity Therapy, and whether adaptations would be required for this client group. We aimed to explore the acceptability of Dignity Therapy for children and young people with life-limiting and life-threatening conditions and health professionals, and report findings from our stakeholder activities. Stakeholder consultation activities involved one Death Café and two workshops, with over 80 health professionals, hosted at two hospice settings, and a range of social media activities including feedback from five young people with life-limiting and life-threatening conditions via a closed Facebook group and a twitter chat with 22 contributors. Data included field notes, workshop outputs (‘post-it ideas storm’ and ‘diamond ranking’) and social media postings that were analysed using thematic analysis. Across stakeholders, there was overwhelming support for explicit interventions that support the psychosocial and spiritual needs of children and young people with life-limiting conditions. Dignity Therapy could be a supportive intervention to promote open conversations about life, meaning and purpose and dying, between the child or young person, family members and health professionals, but needs adapting to meet their needs. A tool kit of interventions, appropriate to a range of ages and cognitive abilities was suggested, for example a storybook for young children and a digitalised version of dignity therapy for older children/young people. Collaboration with stakeholders is the first stage in developing, or adapting an existing intervention in a different context, a complex intervention. Our stakeholder consultation highlighted that Dignity Therapy has potential to improve the psychosocial and spiritual wellbeing of children and young people with life-limiting and life-threatening conditions, through recalling memories and thinking about the things that are important to them and what they want to be remember for. Research is now needed to develop and test a Dignity Therapy intervention for children and young people with life-liming and life-threatening conditions in the UK

Retrieval, reuse, revision and retention in case-based reasoning

El original está disponible en www.journals.cambridge.orgCase-based reasoning (CBR) is an approach to problem solving that emphasizes the role of prior experience during future problem solving (i.e., new problems are solved by reusing and if necessary adapting the solutions to similar problems that were solved in the past). It has enjoyed considerable success in a wide variety of problem solving tasks and domains. Following a brief overview of the traditional problem-solving cycle in CBR, we examine the cognitive science foundations of CBR and its relationship to analogical reasoning. We then review a representative selection of CBR research in the past few decades on aspects of retrieval, reuse, revision, and retention.Peer reviewe

The qualitative DIGNISPACE study: The co-design of a life review, meaning-making and legacy leaving digital intervention for young people with life-limiting conditions

Background: Young people with life-limiting conditions have unmet psycho-spiritual needs. Dignity Therapy is a psycho-therapeutic end-of-life intervention that addresses life review, meaning making and legacy leaving. Studies of Dignity Therapy including young people are limited. Aim: To co-design a digital Dignity Therapy-based intervention for young people with life-limiting conditions (DIGNISPACE). Design: A qualitative study including focus groups (n=5) with hospice-based healthcare professionals (n=23), semi-structured interviews with young people with life-limiting conditions (n=13) and family carers (n=12). Data were analyzed using framework analysis. Results: Three main themes were derived; intervention purpose, amendments to the Dignity Therapy question protocol and content for a digital application. Findings influenced the development of DIGNISPACE and a model of dignity in young people with life-limiting conditions. Conclusions: DIGNISPACE addresses the psycho-spiritual needs of young people with life-limiting conditions, including tenets of the model of dignity in young people with life-limiting conditions in its content and delivery

The Qualitative DIGNISPACE Study: The Co-Design of a Life Review, Meaning-Making and Legacy Leaving Digital Intervention for Young People with Life-Limiting Conditions

Background: Young people with life-limiting conditions have unmet psycho-spiritual needs. Dignity Therapy is a psycho-therapeutic end-of-life intervention that addresses life review, meaning making and legacy leaving. Studies of Dignity Therapy including young people are limited. Aim: To co-design a digital Dignity Therapy-based intervention for young people with life-limiting conditions (DIGNISPACE). Design: A qualitative study including focus groups (n=5) with hospice-based healthcare professionals (n=23), semi-structured interviews with young people with life-limiting conditions (n=13) and family carers (n=12). Data were analyzed using framework analysis. Results: Three main themes were derived; intervention purpose, amendments to the Dignity Therapy question protocol and content for a digital application. Findings influenced the development of DIGNISPACE and a model of dignity in young people with life-limiting conditions. Conclusions: DIGNISPACE addresses the psycho-spiritual needs of young people with life-limiting conditions, including tenets of the model of dignity in young people with life-limiting conditions in its content and delivery