Search

Assessing workforce diversity is an increasing area of evolution. A comprehensive assessment of socioeconomic diversity is important in that it can help identify needs and enable planned inclusion across a range of students. Subsequently, a more comprehensive set of background indicators is needed. The purpose of this brief report is to describe the approach we are using to determine socioeconomic background among individuals participating in a behavioral health workforce program. By using 3 strategies to assess background, we were able to determine that 4 individuals reported being unable to pay for housing, 3 indicated they had sold plasma, and 1 had experienced homelessness since starting graduate school. Our findings provide a starting point for using a comprehensive set of indicators to guide the recruitment and selection process in workforce development programs. Keywords: culturally responsive, linguistically responsive, rural, mental health, Behavioral health workforce development programs recognize that a diverse workforce can improve client outcomes (Neely-Barnes et al., 2020). As workforce programs seek to become more inclusive, more guidance is needed [...]

Definitions, differences and relationships between formal, non-formal and informal learning have long been contentious. There has been a significant change in language and reference from adult education to what amounts to forms of learning categorised by their modes of facilitation. Nonetheless, there is currently a renewed interest in the recognition of non-formal and informal learning internationally and in Australia. This has been evidenced through the New OECD Activity on Recognition of Non-Formal and Informal Learning and recent policy developments in Australia. These developments have implications for the recognition of skills derived from informal and non-formal learning, especially for those disadvantaged in the labour market. This paper reports on data from a learning grid in a Learning Survey of labour market program participants (n = 172) from northern New South Wales and southern Queensland. We find that life (informal learning) and work experience (non-formal learning) are relatively more important for gaining self-reported skills than formal training/study. We conclude by arguing for a holistic focus on the dynamic interrelatedness of these forms of learning rather than being constrained by a deterministic dichotomy between formality and informality. (Contains 3 tables, 4 figures, and 3 footnotes.)

The authors explore the Foucauldian concept of self-surveillance in the context of the use of Individual Action Planning (IAP) as a central process of a 1-year teacher training course. Drawing on work that examined whether IAP was experienced by student-teachers as empowerment or control, the article postulates that Action Planning can be seen as a central technique of a system of self-surveillance. The effect of IAPs in creating self-surveillance is investigated empirically, utilizing an original and non-Foucaldian pre-post questionnaire technique, in order to attract the widest possible audience to the idea of self-surveillance as a key process of governance in advanced liberal societies. The findings support the idea that self-surveillance is one of the outcomes of the IAP process, but also finds Foucauldian 'resistances' among the cohort investigated.

Explores whether Postgraduate Certification in Education student teachers felt that the Individual Action Planning (IAP) process either gave them personal control or controlled them. Concludes that neither elements of empowerment nor discipline are an adequate conceptualization of IAP, although from the student perspective feelings of 'control' predominate. (CMK)

Copyright of Canadian Journal of Counselling & Psychotherapy / Revue Canadienne de Counseling et de Psychothérapie is the property of Canadian Counselling & Psychotherapy Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To motivate students toward higher achievement and encourage mingling across racial and socioeconomic groups, a team of Florida seventh-grade teachers developed a plan featuring a rotating schedule, enrichment classes for all students, long time-blocks two days weekly, and heterogeneous cohesive groups. The program exposed all students to a challenging math curriculum stressing high performance standards and algebraic concepts. (MLH)

Reallocation of nutrients from roots to shoots is essential for plant regrowth in grasslands, particularly in nutrient‐poor conditions. However, the response of root nutrient reallocation to changes in nitrogen (N) and water availability remains largely unknown.Using a novel 15N and 32P labelling technique, we quantified the contribution of N and phosphorus (P) to shoot regrowth from either root reallocation or direct soil uptake for perennial grasses exposed to high‐frequency deficit irrigation (HFDI) and N addition.Without N addition, HFDI showed no impact on uptake and reallocation of N and P, likely due to unaffected soil N availability and a greater diffusion barrier offsetting increased accumulation in plant‐available soil P. With N addition, HFDI increased plant N rather than P uptake, because of increasing soil N availability instead of P under combined HFDI and N addition. The HFDI decreased both N and P reallocation with N addition, possibly due to exhaustion of nutrient reserves in roots that were re‐allocated above‐ground. Reallocation contributed 48%–97% of N and 58%–79% of P required during the first 2 weeks of shoot regrowth.Synthesis. Our results highlight the importance of N and P reallocation from roots to buffer against changes in soil N and P availability and to maintain N:P ratio in shoot regrowth. [ABSTRACT FROM AUTHOR]

This multi-jail study examines the behavioral health needs and service use in a sample of 3,787 individuals in jail, to compare women in rural jails to their gender and geography counterparts (that is rural men, urban women, and urban men). Compared to urban women (17.9%, n = 677), rural men (18.2%, n = 690), and urban men (56.1%; n = 2,132), rural women (7.6%, n = 288) had significantly higher odds of serious mental illness and co-occurring mental health and substance use disorders. Rural woman were nearly 30 times more likely to receive jail-based mental health services; however, a discrepancy between screened mental health need (43.1%, n = 124) and jail-identified mental health need (8.4%, n = 24) shows rural women are severely under-identified compared to their gender/geography counterparts. These findings have implications for the changing nature of jail populations and suggests the need to improve behavioral health identification methods. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on the perceived individual‐level demand‐side barriers to and benefits from seeking and following financial advice. Our review reveals that poor financial literacy, lack of trust and financial adviser anxiety have all been found to dissuade individuals from pursuing professional financial advice. The limited literature on the effectiveness of financial advice in terms of financial well‐being suggests a positive link. However, no study has collectively examined the influence of financial literacy, trust and financial adviser anxiety on financial advice seeking and well‐being in Australia. We conclude by discussing further gaps, policy recommendations, the recently introduced amendments to the Australian Corporations Act and several directions for future research, which may provide theoretical and practical benefits to policy‐makers, industry professionals, academics and individuals. [ABSTRACT FROM AUTHOR]

The current sexual offender literature focuses on recidivism reduction in an effort to increase public safety. While cognitive-behavioral therapy (CBT) programs are considered a mainstream treatment method, it is essential to study recidivism as an indicator of treatment effectiveness. This meta-analysis examines research published since 1970 to determine the overall effectiveness of treatments in reducing recidivism among adult male sexual offenders. Decade of implementation and CBT treatment features are also assessed as moderator variables. The results from the 25 studies identified were converted into 42 weighted effect sizes utilizing a random-effects model. Significant overall effect sizes were found for sexual and violent/combination recidivism; however, multiple indices indicate heterogeneity in the effect sizes. Significant differences were found in the overall effectiveness of the treatments by decade, and the treatments delivered during the 1990s were found to be related to lower levels of sexual and violent/combination recidivism. [ABSTRACT FROM AUTHOR]

Purpose Recent research has found that a technique called feedforward interviewing (FFI) can be used to develop employees on the job. Currently the mechanisms and boundary conditions of the FFI-performance relationship are unexplored. Using a positive psychology framework, the purpose of this paper is to discuss how FFI supports the creation of personal and relational resources, and explores the contextual and environmental limits to the effectiveness of the technique.Design/methodology/approach Through a review of the literature as well as examination through appropriate theoretical lenses, moderators of FFI are proposed and the implications for the effectiveness of the technique are examined.Findings The FFI model explored in this paper is rooted in broaden and build theory as well as other theories from the positive psychology literature. Design recommendations and future research directions are discussed.Originality/value Through a scholarly review of the literature, the potential for the effective use of a new developmental technique is explored. Direct guidance on how to apply FFI in organizations is given. [ABSTRACT FROM AUTHOR]

Background: moving into long-term institutional care is a significant life event for any individual. Predictors of institutional care admission from community-dwellers and people with dementia have been described, but those from the acute hospital setting have not been systematically reviewed. Our aim was to establish predictive factors for discharge to institutional care following acute hospitalisation. Methods: we registered and conducted a systematic review (PROSPERO: CRD42015023497). We searched MEDLINE; EMBASE and CINAHL Plus in September 2015. We included observational studies of patients admitted directly to long-term institutional care following acute hospitalisation where factors associated with institutionalisation were reported. Results: from 9,176 records, we included 23 studies (n = 354,985 participants). Studies were heterogeneous, with the proportions discharged to a care home 3-77% (median 15%). Eleven studies (n = 12,642), of moderate to low quality, were included in the quantitative synthesis. The need for institutional long-term care was associated with age (pooled odds ratio (OR) 1.02, 95% confidence intervals (CI): 1.00-1.04), female sex (pooled OR 1.41, 95% CI: 1.03-1.92), dementia (pooled OR 2.14, 95% CI: 1.24-3.70) and functional dependency (pooled OR 2.06, 95% CI: 1.58-2.69). Conclusions: discharge to long-term institutional care following acute hospitalisation is common, but current data do not allow prediction of who will make this transition. Potentially important predictors evaluated in community cohorts have not been examined in hospitalised cohorts. Understanding these predictors could help identify individuals at risk early in their admission, and support them in this transition or potentially intervene to reduce their risk. [ABSTRACT FROM AUTHOR]

Evidence based medicine tells us that we should not accept published research at face value. Even research from established teams published in the highest impact journals can have methodological flaws, biases and limited generalisability. The critical appraisal of research studies can seem daunting, but tools are available to make the process easier for the non-specialist. Understanding the language and process of quality assessment is essential when considering or conducting research, and is also valuable for all clinicians who use published research to inform their clinical practice. We present a review written specifically for the practising geriatrician. This considers how quality is defined in relation to the methodological conduct and reporting of research. Having established why quality assessment is important, we present and critique tools which are available to standardise quality assessment. We consider five study designs: RCTs, nonrandomised studies, observational studies, systematic reviews and diagnostic test accuracy studies. Quality assessment for each of these study designs is illustrated with an example of published cognitive research. The practical applications of the tools are highlighted, with guidance on their strengths and limitations. We signpost educational resources and offer specific advice for use of these tools. We hope that all geriatricians become comfortable with critical appraisal of published research and that use of the tools described in this review - along with awareness of their strengths and limitations - become a part of teaching, journal clubs and practice. [ABSTRACT FROM AUTHOR]

Background: In a research study, to give a comprehensive evaluation of the impact of interventions, the outcome measures should reflect the lived experience of the condition. In dementia studies, this necessitates the use of outcome measures which capture the range of disease effects, not limited to cognitive functioning. In particular, assessing the functional impact of cognitive impairment is recommended by regulatory authorities, but there is no consensus on the optimal approach for outcome assessment in dementia research. Our aim was to describe the outcome measures used in dementia and mild cognitive impairment (MCI) intervention studies, with particular interest in those evaluating patient-centred outcomes of functional performance and quality of life. Methods: We performed a focused review of the literature with multiple embedded checks of internal and external validity. We used the Cochrane Dementia and Cognitive Improvement Group’s register of dementia studies, ALOIS. ALOIS was searched to obtain records of all registered dementia and MCI intervention studies over a 10-year period (2004–2014). We included both published and unpublished materials. Outcomes were categorised as cognitive, functional, quality of life, mood, behaviour, global/disease severity and institutionalisation. Results: From an initial return of 3271 records, we included a total of 805 records, including 676 dementia trial records and 129 MCI trial records. Of these, 78 % (630) originated from peer-reviewed publications and 60 % (487) reported results of pharmacological interventions. Cognitive outcomes were reported in 70 % (563), in contrast with 29 % (237) reporting measures of functional performance and only 13 % (102) reporting quality of life measures. We identified significant heterogeneity in the tools used to capture these outcomes, with frequent use of non-standardised tests. Conclusions: This focus on cognitive performance questions the extent to which intervention studies for dementia are evaluating outcome measures which are relevant to individual patients and their carers. The heterogeneity in measures, use of bespoke tools and poor descriptions of test strategy all support the need for a more standardised approach to the conduct and reporting of outcomes assessments. [ABSTRACT FROM AUTHOR]

The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controlling blood pressure (BP) and if there are subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful. Robust evidence is scant, trials of antihypertensive medications have generally excluded those with dementia. Observational data show changes in risk association over the life course, with high BP being a risk factor for cognitive decline in mid-life, while low BP is predictive in later life. It is therefore possible that excessive BP lowering in older people with dementia might harm cognition. From the existing literature, there is no direct evidence of benefit or harm from treating hypertension in people with dementia. So what practical steps can the clinician take? Assess capacity, establish patient preferences when making treatment decisions, use ambulatory monitoring to thoroughly assess BP, individualise and consider deprescribing where side effects (e.g. hypotension) outweigh the benefits. Future research might include pragmatic randomised trials of targeted deprescribing, which include patient-centred outcome measures to help support decision-making and studies to address mechanistic uncertainties. [ABSTRACT FROM AUTHOR]

Background and objectives: delirium is a distressing but potentially preventable condition common in older people in long-term care. It is associated with increased morbidity, mortality, functional decline, hospitalization and significant healthcare costs. Multicomponent interventions, addressing delirium risk factors, have been shown to reduce delirium by one-third in hospitals. It is not known whether this approach is also effective in long-term care. In previous work, we designed a bespoke delirium prevention intervention, called 'Stop Delirium!' In preparation for a definitive trial of Stop Delirium, we sought to address key aspects of trial design for the particular circumstances of care homes. Design: a cluster randomized feasibility study with an embedded process evaluation. Setting and participants: residents of 14 care homes for older people in one metropolitan district in the UK. Intervention: Stop Delirium!: a 16-month-enhanced educational package to support care home staff to address key delirium risk factors. Control homes received usual care. Measurements: we collected data to determine the following: recruitment and attrition; delirium rates and variability between homes; feasibility of measuring delirium, resource use, quality of life, hospital admissions and falls; and intervention implementation and adherence. Results: two-thirds (215) of eligible care home residents were recruited. One-month delirium prevalence was 4.0% in intervention and 7.1% in control homes. Proposed outcome measurements were feasible, although our approach appeared to underestimate delirium. Health economic evaluation was feasible using routinely collected data. Conclusion: a definitive trial of delirium prevention in long-term care is needed but will require some further design modifications and pilot work. [ABSTRACT FROM AUTHOR]

Background: ambulatory blood pressure monitoring (ABPM) may be helpful for the management of hypertension, but little is known about its tolerability in people with dementia. Objective: to review the published evidence to determine the tolerability of ABPM in people with dementia. Methods: English language search conducted in MEDLINE and EMBASE, using Ambulatory blood pressure' AND 'Dementia' (and associated synonyms) from 1996 to March 2015. Inclusion criteria: people diagnosed with dementia AND in whom blood pressure was measured using ABPM. The initial search was undertaken using title and abstract reviews, with selected papers being agreed for inclusion by two reviewers. Potentially eligible papers were assessed, and high-quality papers were retained. Two reviewers agreed the abstracted data for analysis. Meta-analysis was used to combine results across studies. Results: of the 221 screened abstracts, 13 studies (6%) met inclusion criteria, 5 had sufficient data and were of sufficient quality, involving 461 participants, most of whom had mild--moderate dementia. 77.7% (95% CI 62.2-93.2%) were able to tolerate ABPM; agreement with office BP was moderate to weak (two studies only--coefficients 0.3-0.38 for systolic blood pressure and 0.11-0.32 for diastolic blood pressure). One study compared home BP monitoring by a relative or ambulatory BP monitoring with office BP measures and found high agreement (ϗ 0.81). The little available evidence suggested increased levels of dementia being associated with reduced tolerability. Conclusions: ABPM is well tolerated in people with mild-moderate dementia and provides some additional information over and above office BP alone. However, few studies have addressed ABPM in people with more severe dementia. [ABSTRACT FROM AUTHOR]

Introduction: Delirium is a common and distressing condition associated with frailty, dementia and comorbidity. These are common in long-term care settings. Residents in care homes are therefore at particular risk of delirium. Despite this, methods to detect delirium in care homes are lacking, with existing diagnostic tools taking too long, or requiring specific training to deliver. This limits their feasibility for use for the routine detection of delirium by care home staff. Routine screening for delirium in care homes would allow timely attention to exacerbating factors to attenuate the episode, and facilitate future research into delirium in the care home environment. Methods: Residents from 4 large care homes will be asked to consent (or their consultees asked to provide a declaration of agreement) to participate in the study. Care home staff will administer the 25-item Delirium Observation Screening Scale (DOSS)--a delirium screening tool based on observed behaviours--and this will be tested against the research standard Confusion Assessment Method (CAM) administered by trained research assistants performed two times per week for all participating residents. Analysis: Sensitivity, specificity, positive and negative predictive values, likelihood ratios and a diagnostic OR will be calculated for the detection of delirium with the 25-item DOSS. The feasibility of routine delirium screening and the scaling properties of the 25-item DOSS will also be explored. Ethics and Dissemination: For residents lacking capacity to participate, a consultee will be approached for a declaration of agreement for inclusion in the study. Results will be published in peer-reviewed journals and disseminated in written format to clinical commissioning groups, general practitioners and relevant third parties. [ABSTRACT FROM AUTHOR]

Unscheduled hospital admissions from care homes are common and potentially avoidable but little guidance is available as to what constitutes an appropriate hospital admission. We surveyed healthcare professionals' opinions on a range of common scenarios affecting care-home residents . We developed seven clinical vignettes and an accompanying questionnaire. We used purposive sampling to obtain opinions from relevant primary care and secondary care teams. We asked assessors to comment on whether they would favour hospital admission and to justify their response using pre-selected options and/or free text. Admission to hospital was judged inappropriate in 54.6% of responses. Opinion on admission varied according to the case, with fewer than half of respondents agreeing for three of the seven cases. Recurring themes were uncertainty around services available to care homes and anticipatory care planning. The lack of consensus suggests that concepts surrounding inappropriate care-home admission are not shared by staff who provide care for this patient group. [ABSTRACT FROM AUTHOR]

A correction to the article 'Systematic reviews: guidance relevant for studies of older people" by Susan D. Shenkin et al, is presented.

As stroke care has developed, there has been a need to robustly assess the efficacy of interventions both at the level of the individual stroke survivor and in the context of clinical trials. To describe stroke-survivor recovery meaningfully, more sophisticated measures are required than simple dichotomous end points, such as mortality or stroke recurrence. As stroke is an exemplar disabling long-term condition, measures of function are well suited as outcome assessment. In this review, we will describe functional assessment scales in stroke, concentrating on three of the more commonly used tools: the National Institutes of Health Stroke Scale, the modified Rankin Scale, and the Barthel Index. We will discuss the strengths, limitations, and application of these scales and use the scales to highlight important properties that are relevant to all assessment tools. We will frame much of this discussion in the context of "clinimetric" analysis. As they are increasingly used to inform stroke-survivor assessments, we will also discuss some of the commonly used quality-of-life measures. A recurring theme when considering functional assessment is that no tool suits all situations. Clinicians and researchers should chose their assessment tool based on the question of interest and the evidence base around clinimetric properties. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to test the null hypothesis that there is no significant association between perceived environmental uncertainty (PEU) and a three component conceptualisation of commitment. Design/methodology/approach - Data were collected from owner/managers of community pharmacy businesses in New South Wales, Australia, with 268 responses analysed by confirmatory factor analysis to test a measurement model for each construct and a structural model to test the paper's hypothesis. Findings - The hypothesis was partially supported with results indicating that greater PEU is associated with lower instrumental and normative commitment. The association with affective commitment was more complex. No direct association with PEU was evident, however a standardised indirect effect was identified. Research limitations/implications - The primary theoretical implications are that commitment in business-to-business channels is evidently affected by PEU, suggesting in part that PEU is likely to have a moderating effect on previously identified antecedents of commitment - including power, idiosyncratic investments, interdependence, trust, and conflict. For practitioners, the implications include the complication that PEU is a relative concept felt by various agents in a market to varying extents. As such, a supplier may benefit by maintaining a watching brief on PEU within a given channel and consider altering the channel strategy to either manage PEU and/or maintain commitment. Originality/value - The findings provide original evidence that PEU is an antecedent of commitment with no other studies examining this relationship identified. The value lays both in the theoretical and practical implications highlighted in the paper. [ABSTRACT FROM AUTHOR]

The Hydrological Land Use Change model was used to assess the range of water resource impacts associated with four potential energy tree species ( Eucalyptus nitens, Eucalyptus gunnii, Nothofagus sp., and Fraxinus excelsior) at eight United Kingdom locations under present and future, Environment Agency Rainfall and Weather Impacts Generator, climate scenarios generated using UK Climate Impacts Programme 2002 (UKCIP02). Parameter values were derived using expert opinion and interpolation because of limited data. For Fraxinus excelsior, there are questions concerning the unusual, in a world context, published findings that evaporation from a tree crop is less than that from grass. Model predictions indicated that under the present climate all tree species, excepting Fraxinus excelsior, at all sites have greater mean annual evaporation, (8 to 84%) and reduced water yields (−6 to −97%) compared with grass. The predicted increase in tree evaporation arises from parameter values reflecting both increased rainfall interception and higher transpiration due to deeper rooting depths. Under future climate scenarios, (1) 'potential annual yield' (difference between actual rainfall and potential evaporation) will decrease, becoming negative at all studied sites in England and Wales by 2080; (2) at drier sites and for species with highest evaporation rates, E. nitens and Nothofagus, evaporation rates will decrease; (3) at wetter sites and for all species, evaporation rates will increase; (4) at all sites and for all species, water yields will decrease; (5) differences between species remain the same, with evaporation rates increasing and water yield decreasing in the order Fraxinus excelsior, grass, E. gunnii, Nothofagus, and E. Nitens; and (6) there is an overall trend through time toward convergence in water yields from trees and grass. If higher water yield predictions for Fraxinus excelsior are proved correct, this would represent an attractive land use option for water and energy production. Field research is required to validate these predictions. Assuming future climate changes match those predicted, soil moisture deficits will occur for longer periods during the year and will become increasingly limiting for evaporation. The monitoring of soil moisture may then provide one of the most sensitive methods of both determining model parameter values and testing predictions of differences in evaporation between species and changes in evaporation over time. [ABSTRACT FROM AUTHOR]