• Dementia Care Mapping as a research instrument.

      Sloane, P.; Brooker, Dawn J.R.; Cohen, L.; Douglass, C.; Edelman, P.; Fulton, B.R.; Jarrott, S. (2006)
      Introduction Dementia Care Mapping (DCM) was originally developed as a clinical tool but has attracted interest as a potential observational measure of quality of life (QOL) and well-being of long-term care residents with dementia. DCM coding involves continuous observation over a 6-h period, with observers recording a Behavior Category Code (BCC, a recording of activity/interaction) and a Well/Ill Being (WIB) score at 5 min intervals. Method Descriptive data from several different research teams on the distribution and psychometric properties of DCM data were compiled and summarized. Results Issues and problems identified include: complex scoring algorithms, inter-rater reliability of the BCCs, limited variability of WIB values, associations between resident characteristics and DCM assessments, rater time burden, and comparability of results across study settings. Conclusions Despite the identified limitations, DCM has promise as a research measure, as it may come closer to rating QOL from the perspective of persons with dementia than other available measures. Its utility will depend on the manner in which it is applied and an appreciation of the measure's strength and limitations. Possible changes that might improve the reliability, validity, and practicality of DCM as a research tool include coding the predominant event (rather than the best event), shortening the observation period, and adding 0 as a neutral WIB coding option.
    • Dementia care mapping in long-term care settings: a systematic review of the evidence

      Barbosa, Ana; Lord, Kathryn; Blighe, Alan J.; Mountain, Gail (2017-10)
      This systematic review identifies and reports the extent and nature of evidence to support the use of Dementia Care Mapping as an intervention in care settings. The review was limited to studies that used Dementia Care Mapping as an intervention and included outcomes involving either care workers and/or people living with dementia. Searches were conducted in PubMed, Web of Knowledge, CINAHL, PsychINFO, EBSCO and Scopus and manually from identified articles reference lists. Studies published up to January 2017 were included. Initial screening of identified papers was based on abstracts read by one author; full-text papers were further evaluated by a second author. The quality of the identified papers was assessed independently by two authors using the Cochrane Risk of Bias Tool. A narrative synthesis of quantitative findings was conducted. We identified 6 papers fulfilling predefined criteria. Studies consist of recent, large scale, good quality trials that had some positive impacts upon care workers’ stress and burnout and benefit people with dementia in terms of agitated behaviours, neuropsychiatric symptoms, falls and quality of life. Available research provides preliminary evidence that Dementia Care Mapping may benefit care workers and people living with dementia in care settings. Future research should build on the successful studies to date and use other outcomes to better understand the benefits of this intervention.
    • Dementia Care Mapping: Building Up a Bigger Picture.

      Jones, S.; Hamilton, J.; Surr, Claire A. (2014)
    • Dementia detectives: Busting the myths

      Parveen, Sahdia; Robins, Jan; Griffiths, Alys W.; Oyebode, Jan R. (2015-07)
      Describes the one-hour dementia awareness programme developed for secondary schools.
    • Dementia-friendly communities

      Henwood, C.; Downs, Murna G. (2014)
    • Depressive Symptoms Increase the Likelihood of Cognitive Impairment in Elderly People with Subclinical Alzheimer Pathology

      Nagy, Z.; Anderson, Elizabeth J. (formerly Milwain) (2005)
      The objective of this study was to investigate whether the presence of depressive symptoms influences the clinical expression of Alzheimer's pathology. We have analysed the relationships between the severity of Alzheimer's pathology and cognitive decline in two patient groups defined by the presence or absence of depressive symptoms. The study included 89 subjects who participated in a longitudinal research programme prior to death, underwent post-mortem examination and were found to have only Alzheimer-type pathology in their brains, ranging in severity from the entorhinal to neocortical stages. Our results indicate that depressive symptoms did not influence cognition in the early (entorhinal) stages of Alzheimer's disease (AD; where cognition was good regardless of whether or not there was evidence for depressive symptoms) or in the late (neocortical) stages (where cognition was poor regardless of whether or not there was evidence for depression). However, in the intermediate (limbic) stages, patients with depressive symptoms had significantly worse cognitive performance (mean CAMCOG of 32) than those who did not (mean CAMCOG of 73). We conclude that depressive symptoms may contribute to the cognitive decline of AD patients in that pathology, that would be otherwise silent, becomes clinically apparent. Therefore, a multiple diagnosis of early AD and depression should be more widely considered in elderly persons presenting with mild cognitive decline and depression. Treating the depressive symptoms would benefit the patient, but the cognitive improvement may not indicate that AD is absent.
    • Design and characteristics of a new birth cohort, to study the early origins and ethnic variation of childhood obesity: the BiB1000 study

      Bryant, M.; Santorelli, G.; Fairley, L.; West, Jane; Lawlor, D.A.; Bhopal, R.S.; Petherick, E.S.; Sahota, P.; Hill, A.; Cameron, N.; et al. (2013)
      Epidemiological evidence indicates that early life factors are important for obesity development but there are gaps in knowledge regarding the impact of exposures during pregnancy and early life, especially in South Asian children. There is a corresponding lack of evidence to guide development of culturally-appropriate, obesity prevention programmes. This paper describes the methodology and characteristics of participants in Born in Bradford 1000 (BiB1000), a nested cohort of the Born in Bradford prospective birth cohort. BiB1000 aims to enable a deep and extensive understanding of the predictors and influences of health-related behaviours to develop a culturally-specific obesity prevention intervention. 1,735 mothers agreed to take part in detailed assessments focused on risk factors of obesity. Of these, 1,707 had singleton births. Data were collected from the families during pregnancy, at birth and when the infant was aged 6, 12, 18, 24 and 36 months. Approximately half of the mothers (n=933) are of South Asian ethnicity; of which, just under half were born in the UK. Prevalence of obesity in BiB1000 is similar to the full BiB cohort and to UK national averages. In addition to pre-specified hypothesised targets for obesity prevention, (e.g. parental feeding styles, diet and activity), BiB1000 is exploring qualitative determinants of behaviours andother exposures with a lesser evidence base (e.g. food environments, sleep, parenting practices). These data will enable a rich understanding of the behaviours and their determinants in order to inform the development of a culturally-relevant, childhood obesity prevention intervention.
    • Design, development and deployment of a hand/wrist exoskeleton for home-based rehabilitation after stroke - SCRIPT project

      Amirabdollahian, F.; Ates, S.; Basteris, A.; Cesario, A.; Buurke, J.H.; Hermens, H.J.; Hofs, D.; Johansson, E.; Mountain, Gail; Nasr, N.; et al. (2014-12)
      Changes in world-wide population trends have provided new demands for new technologies in areas such as care and rehabilitation. Recent developments in the the field of robotics for neurorehabilitation have shown a range of evidence regarding usefulness of these technologies as a tool to augment traditional physiotherapy. Part of the appeal for these technologies is the possibility to place a rehabilitative tool in one’s home, providing a chance for more frequent and accessible technologies for empowering individuals to be in charge of their therapy. Objective: this manuscript introduces the Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT) project. The main goal is to demonstrate design and development steps involved in a complex intervention, while examining feasibility of using an instrumented orthotic device for home-based rehabilitation after stroke. Methods: the project uses a user-centred design methodology to develop a hand/wrist rehabilitation device for home-based therapy after stroke. The patient benefits from a dedicated user interface that allows them to receive feedback on exercise as well as communicating with the health-care professional. The health-care professional is able to use a dedicated interface to send/receive communications and remote-manage patient’s exercise routine using provided performance benchmarks. Patients were involved in a feasibility study (n=23) and were instructed to use the device and its interactive games for 180 min per week, around 30 min per day, for a period of 6 weeks, with a 2-months follow up. At the time of this study, only 12 of these patients have finished their 6 weeks trial plus 2 months follow up evaluation. Results: with the “use feasibility” as objective, our results indicate 2 patients dropping out due to technical difficulty or lack of personal interests to continue. Our frequency of use results indicate that on average, patients used the SCRIPT1 device around 14 min of self-administered therapy a day. The group average for the system usability scale was around 69% supporting system usability. Conclusions: based on the preliminary results, it is evident that stroke patients were able to use the system in their homes. An average of 14 min a day engagement mediated via three interactive games is promising, given the chronic stage of stroke. During the 2nd year of the project, 6 additional games with more functional relevance in their interaction have been designed to allow for a more variant context for interaction with the system, thus hoping to positively influence the exercise duration. The system usability was tested and provided supporting evidence for this parameter. Additional improvements to the system are planned based on formative feedback throughout the project and during the evaluations. These include a new orthosis that allows a more active control of the amount of assistance and resistance provided, thus aiming to provide a more challenging interaction.
    • Destitution in pregnancy: Forced migrant women’s lived experience

      Ellul, R.; McCarthy, R.; Haith-Cooper, Melanie (2020-11-02)
      Forced migrant women are increasingly becoming destitute whilst pregnant. Destitution may exacerbate their poor underlying physical and mental health. There is little published research that examines this, and studies are needed to ensure midwifery care addresses the specific needs of these women. This study aimed to explore vulnerable migrant women's lived experience of being pregnant and destitute. Six in-depth individual interviews with forced migrant women who had been destitute during their pregnancy were conducted over one year. A lack of food and being homeless impacted on women's physical and mental health. Women relied on support from the voluntary sector to fill the gaps in services not provided by their local authorities. Although midwives were generally kind and helpful, there was a limit to how they could support the women. There is a gap in support provided by local authorities working to government policies and destitute migrant pregnant women should not have to wait until 34 weeks gestation before they can apply for support. Home office policy needs to change to ensure pregnant migrant women receive support throughout their pregnancy.
    • Destructive Interpersonal Conflict in the Workplace: The Effectiveness of Management interventions

      Hoel, H.; Giga, Sabir I. (Manchester Business School, 2006)
      This report, by Helge Hoel and Sabir I Giga of the University of Manchester Business School, with contributions from Brian Faragher, can be accessed here. The research has resulted in the successful completion of the first academic anti-bullying intervention study, comparing the effectiveness of interventions across different organisational contexts and involving the implementation of a complex design in order to apply scientific rigour. Phase 1 established for the first time the apparent scale of bullying at work, and the sectors in which it appears to be most prevalent. Research evidence obtained from this work was input to phase 2 which was completed in 2006 and was designed to Establish a risk assessment tool kit for assessing the risk of bullying in organisations Identify the interventions most likely to be effective in given situations Although the study was unable to establish beyond doubt the efficacy of a particular intervention, there is evidence to suggest that theoretically sound, well planned and aptly delivered interventions can make a difference, particularly when sufficient time is allocated and the proportion of staff being trained is significant enough to have an impact upon behaviour. A conference to launch the findings of this research took place in November 2006. It attracted substantial media attention. The application of these tools in organisations where bullying does occur had the capability to substantially improve morale and staff retention, and to reduce risk of claims for compensation or at employment tribunals.
    • Developing a Management Guide (the DemPower App) for Couples Where One Partner Has Dementia: Nonrandomized Feasibility Study

      Lasrado, R.; Bielsten, T.; Hann, M.; Schumm, J.; Reilly, Siobhan T.; Davies, L.; Swarbrick, C.; Dowlen, R.; Keady, J.; Hellström, I. (2021-11-16)
      Promoting the health and well-being of couples where one partner has dementia is an overlooked area of care practice. Most postdiagnostic services currently lack a couple-centered approach and have a limited focus on the couple relationship. To help address this situation, we developed a tablet-based self-management guide (DemPower) focused on helping couples enhance their well-being and relationship quality. The aim of this study is to investigate the feasibility and acceptability of the DemPower app. A nonrandomized feasibility design was used to evaluate the DemPower intervention over 3 months among couples where a partner had a diagnosis of dementia. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. Outcome measures were obtained at baseline and postintervention. The study process and interventions were evaluated at various stages. The study was completed by 48% (21/44) of couples where one partner had dementia, of whom 86% (18/21) of couples accessed all parts of the DemPower app. Each couple spent an average of 8 hours (SD 3.35 hours) using the app during the study period. In total, 90% (19/21) of couples reported that all sections of DemPower were useful in addressing various aspects of daily life and helped to focus on how they interacted in their relationship. Of the 4 core subjects on which the DemPower app was structured, home and neighborhood received the highest number of visits. Couples used activity sections more often than the core subject pages. The perception of DemPower's utility varied with each couple's lived experience of dementia, geographic location, relationship dynamics, and opportunities for social interaction. A 5.2-point increase in the dementia quality of life score for people with dementia and a marginal increase in the Mutuality scale (+1.23 points) for caregiver spouses were found. Design and navigational challenges were reported in the DemPower app. The findings suggest that the DemPower app is a useful resource for couples where one partner has dementia and that the implementation of the app requires the support of memory clinics to reach couples at early diagnosis. ISRCTN Registry ISRCTN10122979; http://www.isrctn.com/ISRCTN10122979.
    • Developing a mobile learning solution for health and social care practice

      Taylor, J.D.; Dearnley, Christine A.; Laxton, J.C.; Coates, C.A.; Treasure-Jones, T.; Campbell, R.; Hall, I. (2010)
      In this article we share our experiences of a large-scale five-year innovative programme to introduce mobile learning into health and social care (HSC) practice placement learning and assessment that bridges the divide between the university classroom and the practice setting in which these students learn. The outputs are from the Assessment Learning in Practice Settings (ALPS) Centre for Excellence in Teaching Learning (CETL), which is working towards a framework of interprofessional assessment of Common Competences in the HSC professions. The mobile assessment process and tools that have been developed and implemented and the outcomes of the first-stage evaluation of the mobile assessment tools are discussed from the student perspective.
    • Developing a national learning health system

      McIntosh, Bryan (2017-07)
      There is increasing recognition among policymakers that health systems are no longer fit for purpose. Our hospital-centred systems, originally created to deal with communicable disease epidemics, are now faced with the challenge of delivering care to the exponentially increasing number of people living with (typically multiple)≈non-communicable disorders (NCDs). Global economic stagnation has also contributed to the pressures facing health systems – such that there is an imperative to develop new models of care.
    • Developing a nursing dependency scoring tool for children’s palliative care: the impact on hospice care

      Tatterton, Michael J.; Martin, C.; Moore, C.; Walker, C. (2020)
      Background: Occupancy is commonly used to measure bed management in hospices, however increasing complexity of children and young people, and technology dependence mean this is no longer effective. Aim: to develop a dependency tool that enables the hospice to safely and effectively manage the use of beds for planned short breaks (respite), preserving capacity for children requiring symptom management and end of life care. Methods: a comprehensive literature review and existing tools were used to inform the development of the Martin House Dependency Tool Framework. Training was provided to staff and the tool piloted before applying it across the hospice caseload. Findings: The Tool has been used on 431 children (=93.1% of caseload). The Tool enabled consistency of assessment and more effective management of resources, owing to a contemporaneous understanding of the clinical needs of those on the caseload. Conclusion: The tool has enabled consistent and transparent assessment of children, improving safety, effectiveness and responsiveness, and the management of the workforce and resources.
    • Developing a reliable and valid patient measure of safety in hospitals (PMOS): A validation study

      McEachan, Rosemary; Lawton, R.; O'Hara, J.K.; Armitage, Gerry R.; Giles, S.; Parveen, Sahdia; Watt, I.S.; Wright, J.; Yorkshire Quality and Safety Research Group (2014-07)
      Introduction Patients represent an important and as yet untapped source of information about the factors that contribute to the safety of their care. The aim of the current study is to test the reliability and validity of the Patient Measure of Safety (PMOS), a brief patient-completed questionnaire that allows hospitals to proactively identify areas of safety concern and vulnerability, and to intervene before incidents occur. Methods 297 patients from 11 hospital wards completed the PMOS questionnaire during their stay; 25 completed a second 1 week later. The Agency for Healthcare Research and Quality (AHRQ) safety culture survey was completed by 190 staff on 10 of these wards. Factor structure, internal reliability, test-retest reliability, discriminant validity and convergent validity were assessed. Results Factor analyses revealed 8 key domains of safety (eg, communication and team work, access to resources, staff roles and responsibilities) explaining 58% variance of the original questionnaire. Cronbach’s α (range 0.66–0.89) and test-retest reliability (r=0.75) were good. The PMOS positive index significantly correlated with staff reported ‘perceptions of patient safety’ (r=0.79) and ‘patient safety grade’ (r=−0.81) outcomes from the AHRQ (demonstrating convergent validity). A multivariate analysis of variance (MAMOVA) revealed that three PMOS factors and one retained single item discriminated significantly across the 11 wards. Discussion The PMOS is the first patient questionnaire used to assess factors contributing to safety in hospital settings from a patient perspective. It has demonstrated acceptable reliability and validity. Such information is useful to help hospitals/units proactively improve the safety of their care.
    • Developing an obesity research agenda with British Pakistani women living in deprived areas with involvement from multisectoral stakeholders: Research priority setting with a seldom heard group

      Iqbal, Halima; West, Jane; McEachan, Rosemary; Haith-Cooper, Melanie (2022-08)
      Introduction: British Pakistani women have exceptionally high rates of obesity and yet are seldom heard in a research priority setting concerning weight management. The objectives of this study were (i) to ascertain what multisectoral professionals perceive to be the most pressing unmet obesity needs or topic areas that need more research in relation to Pakistani women living in deprived areas of Bradford and (ii) to determine the top 10 obesity health priorities for this group to develop an obesity research agenda. Methods: A two‐step process was adopted using the following: (i) a survey of a wide range of multisectoral professional stakeholders (n= 159) and (ii) a ranking exercise involving Pakistani women living in deprived areas of Bradford (n= 32) to select and prioritize their top 10 obesity health concerns and unmet needs from a list of 31statements identified in the survey and previous research. Survey data were analysed using inductive content analysis and themes were identified. Themes were translated into statements to be ranked by Pakistani women. The ranking exercise was conducted by telephone either via voice or video call. Data were analysed using a reverse scoring system. Results: Survey responses were grouped into statements reflecting the following three categories: education needs; healthy behaviour barriers and mental well‐being. The highest rankings were given by Pakistani women to statements on mental health and the need for education. The top 10 prioritized statements were developed with members of the public into an obesity research agenda that reflected the target population. Conclusion: Actively engaging British Pakistani women in setting research priorities provided a unique opportunity to understand the key areas they think are important for future research. The culminating research agenda can be used by researchers to advance the field of obesity research in Pakistani communities, thus producing research outputs that are relevant to and have impact in this population. Patient or Public Contribution: Participants in the ranking exercise collected data. Public contributors were involved in developing the prioritized statements into are search agenda.
    • Developing conflict resolution strategies and building resilient midwifery students: A mixed methods research protocol

      Simpson, Naomi; Steen, M.; Vernon, R.; Wepa, Dianne (2022-02-18)
      This study will undertake a preparatory phase summarising the body of literature on midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence.
    • Developing supportive local communities: Perspectives from people with dementia participating in the IDEAL programme

      Quinn, Catherine; Hart, N.; Henderson, C.; Litherland, R.; Pickett, J.; Clare, L. (2021)
      Communities play an important role in supporting people living with affected by dementia. The aim of this study was to explore what could be changed in the local community to enable those with dementia to live well. People with dementia and carers taking part in the IDEAL programme responded to open-ended questions. Responses from 1,172 people with dementia and 702 caregivers were analysed using thematic analysis. Four themes were identified: raising awareness, improving access to support services, providing social events and activities, and supporting people to engage in the community. These highlight the role of individuals, resources and the environment in supporting those with dementia. Longer-term investment in services is needed to underpin dementia-inclusive communities.
    • Developing the New Interventions for independence in Dementia Study (NIDUS) theoretical model for supporting people to live well with dementia at home for longer: a systematic review of theoretical models and Randomised Controlled Trial evidence

      Lord, Kathryn; Beresford-Dent, Jules; Rapaport, P.; Burton, A.; Leverton, M.; Walters, K.; Lang, I.; Downs, Murna G.; Manthorpe, J.; Boex, S.; et al. (2020-01)
      Purpose: To build an evidence-informed theoretical model describing how to support people with dementia to live well or for longer at home. Methods: We searched electronic databases to August 2018 for papers meeting predetermined inclusion criteria in two reviews that informed our model. We scoped literature for theoretical models of how to enable people with dementia to live at home independently, with good life quality or for longer. We systematically reviewed Randomised Controlled Trials (RCTs) reporting psychosocial intervention effects on time lived with dementia at home. Two researchers independently rated risk of bias. We developed our theoretical model through discussions with experts by personal, clinical and academic experiences, informed by this evidence base. Results: Our scoping review included 52 studies. We divided models identified into: values and approaches (relational and recovery models; optimising environment and activities; family carer skills and support); care strategies (family carer-focused; needs and goal-based; self-management); and service models (case management; integrated; consumer-directed). The 11 RCTs included in our systematic review, all judged at low risk of bias, described only two interventions that increased time people with dementia lived in their own homes. These collectively encompassed all these components except for consumer-directed and integrated care. We developed and revised our model, using review evidence and expert consultation to define the final model. Conclusions: Our theoretical model describes values, care strategies and service models that can be used in the design of interventions to enable people with dementia to live well and for longer at home.