• Dancing to the music of time: an experiential learning exercise in dementia care.

      Capstick, Andrea (28/05/2013)
      This article presents findings from an experiential learning exercise in which 34 care practitioners enrolled on a part-time BSc programme in Dementia Studies were asked to identify their own favourite music, and then to investigate the musical preferences of one of their clients with dementia. For both groups, practitioners and clients, three dominant themes influencing choice of music emerged: loving relationships; significant life events and places, and a sense of physical enjoyment. This exercise enabled the group of practitioners involved to identify commonalities between their own musical memories and those of their clients with dementia. They also uncovered considerable amount of new information about their client¿s life histories. On this basis they were able to make a number of new recommendations for improving care practice.
    • Death in the Spanish fire services: a curriculum development study

      Santos, J.P.L.; García-Llana, H.; Pablo, V.; Liébana, M.; Kellehear, Allan (2017)
      Purpose – The purpose of this paper is to understand the need and resources firefighters have to deal with death and dying (D&D) that they encounter whilst on duty and to present a curriculum to support D&D issues for firefighters. Design/methodology/approach – A qualitative methodology involving focus groups was conducted in two fire stations in Spain. The sample was 38 male participants with a mean age of 46 y/o (range: 30-59 years) and an average tenure of employment of 18 years (range: 6-35 years). Data were subjected to a thematic analysis. Dual coding of the transcripts in addition to member checking enhanced analysis. Findings – Nine themes emerged: witnessing D&D during rescue operations;memories about D&D and trauma; impact on firefighter’s families; decision-making process under stress; teamwork: protective and self-support; inadequate D&D preparation and training; adequate technical and physical training preparation; relationship between equipment, legal-moral obligation, and victims’ outcomes; communication issues: toward the victim and/or their relatives. These themes were subsequently framed into three basic domains: personal impact of D&D, team impact of D&D, and victim impact. Each domain, in its turn, is covered by three curriculum topics. The curriculum’s pedagogy is primarily based on experimental-reflective activities during 16 study-hours. Research limitations/implications – The absence of female participants. All fire stations were in cities with no more than 150,000 inhabitants. Practical implications – Individuals who take this curriculum will: increase their ability for self-care and resilience; improve teamwork, leadership skills, and to decrease burnout; provide more effective care for victims; provide skills to cope with compassion fatigue; reduced the levels of post-traumatic stress disorders. Originality/value – Understanding firefighters’ needs with relation to D&D, and assessing the resources available to mitigate these issues will provide a comprehensive approach to their education and promote health both personally and professionally. A comparable curriculum or proposal has not been previously identified.
    • Decision-making and dementia: Towards a social model of understanding

      O'Connor, D.; Purves, B.; Downs, Murna G. (2009)
    • Decomposing the misery index: A dynamic approach

      Cohen, I.K.; Ferretti, F.; McIntosh, Bryan (2014-12-13)
      The misery index (the unweighted sum of unemployment and inflation rates) was probably the first attempt to develop a single statistic to measure the level of a population’s economic malaise. In this letter, we develop a dynamic approach to decompose the misery index using two basic relations of modern macroeconomics: the expectations-augmented Phillips curve and Okun’s law. Our reformulation of the misery index is closer in spirit to Okun’s idea. However, we are able to offer an improved version of the index, mainly based on output and unemployment. Specifically, this new Okun’s index measures the level of economic discomfort as a function of three key factors: (1) the misery index in the previous period; (2) the output gap in growth rate terms; and (3) cyclical unemployment. This dynamic approach differs substantially from the standard one utilised to develop the misery index, and allow us to obtain an index with five main interesting features: (1) it focuses on output, unemployment and inflation; (2) it considers only objective variables; (3) it allows a distinction between short-run and long-run phenomena; (4) it places more importance on output and unemployment rather than inflation; and (5) it weights recessions more than expansions.
    • Define, Inform, Dictate and Deliver

      Hardy, Maryann L.; McIntosh, Bryan (2017)
      In October 2014, Simon Stevens, the chief executive of NHS England, committed the service to plugging £22 billion of the expected £30 billion gap in its finances by 2020 through productivity gains of 2–3% a year by 2020. Since that announcement, the Government promised to provide £8 billion by 2020. This may notionally have been received, but it has not alleviated the severity of these financial constraints (Barnes and Dunhill, 2015). With austerity measures biting even deeper into the budgets of NHS organisations, all staff are under pressure to make cost efficiencies and at the same time improve operational standards and patient outcomes. In this pressured change environment, there are hospitals and departments that have embraced the demand for change, creating innovative skills mix platforms from which to deliver services. But there are also those who have remained entrenched in operational protocols. In both scenarios, the overarching driver for service re-design has been operational efficiency guided by government targets.
    • Defining goal terms in development and health

      Ogbeiwi, Osahon (2016)
      Most academic literature uses ‘goal’, ‘aim’, ‘objective’ and ‘target’ as synonymous terms, but development and healthcare sectors define them as distinct etymological entities with varied and confusing interpretations. This review sought to constructively harmonise and differentiate each definition using a thematic framework. An inductive synthesis of definitions of the goal terms collected from 22 literature sources selected through a systematic internet search. Thirty-three specific definitions were reduced through serial category-building to single general definitions, and a set of theoretical themes generated as characteristic framework of each goal. Seven conceptual themes evolved from the synthesis, including the object, scope, hierarchy, timeframe, measurability, significance and expression of each goal term. Two terms, ‘goal’ and ‘aim’ are thematically similar as broad objects of immeasurable terminal impact, with a long-term timeframe. They signify organisational success, expressed as general purpose statements. ‘Objective’ is differentiated as a specific object of measurable intermediate outcome, with short-term timeframe. It signifies intervention effectiveness, expressed as a SMART statement. ‘Target’ is simply a specific quantifiable level of an indicator. Goal, aim, objective and target are conceptually different. New frameworks for writing complete goal statements are proposed, including impact and timeframe; and outcome, indicator and timeframe frameworks for aim and objective respectively
    • Defining, assessing and managing cavity wounds

      Vowden, Kath (2016-03-21)
      This paper provides an overview of cavity wounds, focusing on the definition, assessment and management of a common clinical problem in wound care. The term cavity wound is applied widely to a diverse range of acute and chronic wound types and, although each type requires a specific wound management approach reflecting the causation, the overall principles of cavity wound assessment and management remain the same. The extent of a cavity wounds can be difficult to visualise and such wounds require precise documentation and wound measurement if progress is to be accurately monitored and patient safety maintained.
    • Delivery suite assessment unit: auditing innovation in maternity triage

      Nolan, Sheila; Morgan, Jane; Pickles, Jacky; Haith-Cooper, Melanie; MacVane Phipps, Fiona E. (2007)
      A Delivery Suite Assessment Unit (DSAU) has been established at a large Northern teaching hospital. This was as a recommendation of ASQUAM (achieving sustainable quality in maternity) to reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment. The DSAU has also provided an effective teaching environment where skills such as effective telephone triage, diagnosis of labour and care of women with pre-labour spontaneous rupture of membranes (SROM) have been developed by junior staff. The first twelve months' audit results indicate that the establishment of the DSAU has been successful in reducing antenatal admissions to delivery suite by increasing the transfers of clients home, rather than to the antenatal wards. This may reflect the confidence of the highly skilled midwives working in this environment and the confidence women feel about their ability to obtain prompt and accurate advice over the telephone.
    • Dementia and minority ethnic carers

      Parveen, Sahdia; Oyebode, Jan R. (2018-06)
    • Dementia as a bio-psychosocial condition: Implications for practice and research.

      Downs, Murna G.; Clare, L.; Anderson, Elizabeth J. (formerly Milwain) (2008)
    • Dementia as a disability: Implications for ethics, policy and practice. A Discussion Paper.

      Gove, Dianne M.; Andrews, J.; Capstick, Andrea; Geoghegan, C.; Georges, J.; Libert, S.; McGettrick, G.; Rochford-Brennan, H.; Rohra, H.; Vehmas, S.; et al. (2017)
      People experience dementia in different ways, not just in terms of the type and severity of symptoms, but also in terms of how they react to and manage living with dementia. Increasingly, people with dementia are expressing a desire to get on with their everyday lives. They want to avoid being defined solely in relation to dementia and to continue to be considered as valued members of society. This is particularly important as the term dementia often has negative connotations. It is widely considered as a stigma. Neurological impairment may interfere with people’s ability to get on with their lives, as may differences in coping skills, financial resources, the emotional and psychological impact of dementia, and access to timely and good quality support. Reactions of relatives, friends and fellow citizens are also important, as well as society’s response to dementia. This was highlighted by Kitwood in the 1990s when he outlined what came to be known as the biopsychosocial model of dementia . There are also differences at the level of society, reflected in practices, attitudes and structures. These may, on the surface, seem fair or neutral (i.e. “that’s just the way it is”). In many cases, however, they reflect a lack of consideration and failure to act in a responsible, ethical and even legal way towards people with dementia... In this report, we focus on the possible implications for ethics, policy and practice of raising awareness about the potential of framing dementia as a potential disability.
    • Dementia Care 1: Person-centred approaches help to promote effective communication

      Wheeler, N.; Oyebode, Jan R. (2010-06)
      Background: This first in a three part series on dementia care explores communication. The Gold Standards Framework includes a workstream on improving end of life care in care homes; communication is one of seven key tasks within the GSF. Aim and method: This study aimed to gather care home staff views on communication issues. Focus groups were conducted with 36 members of direct care staff from nine nursing and residential care homes. Results: Three types of communication were identified: staff to staff; staff to resident; and staff to family. Discussion and conclusion: The implications of different approaches to communication are discussed, and recommendations made for practice.
    • Dementia Care Mapping (DCM): A Review of the research literature

      Brooker, Dawn J.R. (2005)
      The published literature on dementia care mapping (DCM) in improving quality of life and quality of care through practice development and research dates back to 1993. The purpose of this review of the research literature is to answer some key questions about the nature of the tool and its efficacy, to inform the ongoing revision of the tool, and to set an agenda for future research. Design and Methods: The DCM bibliographic database at the University of Bradford in the United Kingdom contains all publications known on DCM (http://www.bradford.ac.uk/acad/health/dcm). This formed the basis of the review. Texts that specifically examined the efficacy of DCM or in which DCM was used as a main measure in the evaluation or research were reviewed. Results: Thirty-four papers were categorized into five main types: (a) cross-sectional surveys, (b) evaluations of interventions, (c) practice development evaluations, (d) multimethod evaluations, and (e) papers investigating the psychometric properties of DCM.
    • Dementia Care Mapping (DCM): initial validation of DCM 8 in UK field trials.

      Brooker, Dawn J.R.; Surr, Claire A. (2006)
      Objectives This paper describes DCM 8 and reports on the initial validation study of DCM 8. Methods Between 2001-2003, a series of international expert working groups were established to examine various aspects of DCM with the intention of revising and refining it. During 2004-2005 the revised tool (DCM 8) was piloted in seven service settings in the UK and validated against DCM 7th edition. Results At a group score level, WIB scores and spread of Behavioural Category Codes were very similar, suggesting that group scores are comparable between DCM 7 and 8. Interviews with mappers and focus groups with staff teams suggested that DCM 8 was preferable to DCM 7th edition because of the clarification and simplification of codes; the addition of new codes relevant to person-centred care; and the replacement of Positive Events with a more structured recording of Personal Enhancers. Conclusions DCM 8 appears comparable with DCM 7th edition in terms of data produced and is well received by mappers and dementia care staff.
    • Dementia Care Mapping as a tool for Safeguarding

      Crossland, Jo; Downs, Murna G. (2011)
    • 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)