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Self-concept research in early adolescence typically measures young people’s self-perceptions of competence in specific, adult-defined domains. However, studies have rarely explored young people’s own views of valued self-concept factors and their meanings. For two major self domains, the active and the social self, this mixed-methods study identified factors valued most by 526 young people from socioeconomically diverse backgrounds in Ireland (10-12 years), and explored the meanings associated with these in a stratified subsample ( n = 99). Findings indicate that self-concept scales for early adolescence omit active and social self factors and meanings valued by young people, raising questions about content validity of scales in these domains. Findings also suggest scales may under-represent girls’ active and social selves; focus too much on some school-based competencies; and, in omitting intrinsically salient self domains and meanings, may focus more on contingent (extrinsic) rather than true (intrinsic) self-esteem.

Background Dementia is the most common neurological disorder worldwide and is a life-limiting condition, but very often is not recognised as such. People with dementia, and their carers, have been shown to have palliative care needs equal in extent to those of cancer patients. However, many people with advanced dementia are not routinely being assessed to determine their palliative care needs, and it is not clear why this is so. Main body An interdisciplinary workshop on “Palliative Care in Neurodegeneration, with a focus on Dementia”, was held in Cork, Ireland, in May 2016. The key aim of this workshop was to discuss the evidence base for palliative care for people with dementia, to identify ‘gaps’ for clinical research, and to make recommendations for interdisciplinary research practice. To lead the discussion throughout the day a multidisciplinary panel of expert speakers were brought together, including both researchers and clinicians from across Ireland and the UK. Targeted invitations were sent to attendees ensuring all key stakeholders were present to contribute to discussions. In total, 49 experts representing 17 different academic and practice settings, attended. Key topics for discussion were pre-selected based on previously identified research priorities (e.g. James Lind Alliance) and stakeholder input. Key discussion topics included: i. Advance Care Planning for people with Dementia; ii. Personhood in End-of-life Dementia care; iii. Topics in the care of advanced dementia at home. These topics were used as a starting point, and the ethos of the workshop was that the attendees could stimulate discussion and debate in any relevant area, not just the key topics, summarised under iv. Other priorities. Conclusions The care experienced by people with dementia and their families has the potential to be improved; palliative care frameworks may have much to offer in this endeavour. However, a solid evidence base is required to translate palliative care into practice in the context of dementia. This paper presents suggested research priorities as a starting point to build this evidence base. An interdisciplinary approach to research and priority setting is essential to develop actionable knowledge in this area.

Background The importance of the therapeutic relationship in the delivery of palliative care is well recognised. Little has been published on the nature or quality of relationships formed between staff and patients with intellectual disabilities despite case reports suggesting that difficulties exist in providing palliative care to this group. Aims This study was part of a project that aimed to describe the delivery of palliative care to people with intellectual disabilities in a region of Ireland and to conduct a corporate assessment of palliative care need. We detail findings that explore the nature and importance of the quality of relationship in the delivery of care. Methods 91 staff from palliative care and intellectual disability services participated in 16 focus groups. Findings Staff valued their relationships with service users, and felt that the quality of their relationship affected its therapeutic potential. Participants described factors fundamental to the development of quality relationships. Palliative care and intellectual disability staff commented on the importance of trust, of continuity of relationship and of knowing the individual. However, palliative care staff admitted to difficulties in these areas when providing care to people with intellectual disabilities. It appeared that quality of care was affected in situations where staff failed to form authentic relationships. Conclusions This study adds to our knowledge of the processes of delivery of care to people with intellectual disabilities. The description of difficulties experienced by palliative care staff gives us an opportunity to develop strategies to improve the quality of services provided.

Objective A systematic review and qualitative synthesis was undertaken to deduce the knowledge, attitudes, skills and training of mental health professionals regarding complicated grief (CG). Methods PsychInfo, Embase, Medline, CINAHL, PBSC, Web of Science and ERIC databases were used to identify relevant literature. Searches were executed from inception to September 2014. Results The electronic search yielded 305 results. Forty-one papers were selected for full text review, 20 were included for analysis. 6 examined primary data, the remaining 14 being reviews, opinion or guideline pieces. Conclusions Despite the lack of consensus on terminology, criteria and diagnosis, it appears that there is more than sufficient agreement within the CG research community regarding the knowledge and skills required to assist someone presenting with CG. A palpable fear of medicalising grief exists, but this would seem to be based on a conflation of normal grief and CG. This review highlights the mainly unidirectional nature of current research, the voice of the practitioner being largely unheard. A need for and an interest in training in CG was expressed. Practice implications There is an urgent need to translate research findings into clinical practice. Training must take account of attitudinal barriers to implementation, balancing evidence and stories.

Multidisciplinary research is characterised by two or more disciplines coming together to address the same issue or area of interest from their respective paradigms. Interdisciplinary research arguably moves several steps further to bring two or more distinct academic fields together, integrating theory, methodology, terminology and/or data to address critical and complex health issues (National Institutes of Health, 2007). A range of environmental, group and individual factors have been found to influence interdisciplinary working including organisational commitment, availability of resources, effective communication, strong leadership, mutual trust between partners, flexibility in addition to specific scholarly competencies (Aboelala et al., 2007; Gebbie et al., 2008). Porter et al., (2012) describe the correlation between funded interdisciplinary networking and scholarly impact noting that research articles arising from interdisciplinary research are more likely to be published in high impact journals and be highly cited. This paper aims to provide a high-level overview of the highlights and challenges to adopting an interdisciplinary research approach in palliative care drawing on Irish, European and international experiences.

Background The growing demand to address significant public health issues such as ageing populations, changing patterns of chronic diseases, individuals living longer with life-limiting conditions and so on increases the pressure on researchers to produce high quality, clinically relevant, innovative palliative care research so as to improve the quality of life for service users and carers. Aim All Ireland Institute of Hospice and Palliative Care (AIIHPC) believes that one way to meet this demand is through research capacity building which is being taken forward via the Institute’s Palliative Care Research Network. Method Capacity building is defined as a “process where individuals, groups, networks, organisation and the wider community are encouraged and facilitated in enhancing their knowledge and skills so as to increase their ability to perform innovative and high quality research” (Moley and Seale, 2009). It is a major component of large national and international funding that seek to enhance and develop research expertise and leadership in specific health areas, for example, Irish Health Research Board, Public Health Agency (Northern Ireland), Horizon 2020, Canadian Institutes of Health Research). Conclusion AIIHPC’s Palliative Care Research Network is taking forward a multi-tiered approach to research capacity building ranging from awareness-raising of research, to providing more extensive support to those who want to progress elements of palliative care research, to providing tailored support and leadership opportunities for more advanced researchers.

ObjectivesTo explore the reasons why lay community first responders (CFRs) volunteer to participate in out-of-hospital cardiac arrest response and the realities of their experience in providing this service to the community.DesignA qualitative study, using in-depth semistructured interviews that were recorded and transcribed. Thematic analysis was undertaken and credibility checks conducted.SettingNine geographically varied lay CFR schemes throughout Ireland.ParticipantsTwelve experienced CFRs.ResultsCFRs were motivated to participate based on a variety of factors. These included altruistic, social and pre-existing emergency care interest. A proportion of CFRs may volunteer because of experience of cardiac arrest or illness in a relative. Sophisticated structures and complex care appear to underpin CFR involvement in out-of-hospital cardiac arrest. Strategic and organisational issues, multifaceted cardiac arrest care and the psychosocial impact of participation were considered.ConclusionsHealth systems that facilitate CFR out-of-hospital cardiac arrest response should consider a variety of relevant issues. These issues include the suitability of those that volunteer, complexities of resuscitation/end-of-life care, responder psychological welfare as well as CFRs’ core role of providing early basic life support and defibrillation in the community.

Knowledge transfer is recognized as a vital stage in evidence-informed nursing with several models available to guide the process. Although the main components commonly involve identification of messages, stakeholders, processes and contexts, the underpinning models remain largely unrefined and untested; and they need to be evaluated. We set out to explore the use of our “Evidence-based Model for Transfer & Exchange of Research Knowledge” (EMTReK) within palliative care research. Between January 2016 and May 2017, data were collected from five case studies which used the EMTReK model as a means to transfer knowledge relating to palliative care research, undertaken in Ireland. A qualitative approach was taken with thematic analysis of case documentation, semistructured interviews, and field notes from the case studies. Qualitative analysis supports the core components of EMTReK as a model of knowledge transfer and exchange in palliative care. Results focused upon identification of messages to be transferred to defined stakeholders through interactive processes that take account of context. Case study findings show how the model was interpreted and operationalized by participants and demonstrate its impact on knowledge transfer and exchange. Eight themes were drawn from the data: Credibility of the Model, Model Accessibility, Applicability to Palliative Care, A Matter of Timing, Positive Role of Facilitation, Required Resources, Enhancing Research Quality, Limitations or Areas for Further Consideration. Study participants found EMTReK to be a useful guide when making knowledge transfer plans. Success depended upon adequate facilitation and guidance. Further exploration of the model's utility is warranted.

The aim of this project was to replicate and extend findings from two recent studies on parent-child relatedness in autism (Beurkens, Hobson, & Hobson, 2013; Hobson, Tarver, Beurkens, & Hobson, 2013, under review) by adapting an observational assessment and coding schemes of parent-child relatedness for the clinical context and examining their validity and reliability. The coding schemes focussed on three aspects of relatedness: joint attentional focus (Adamson, Bakeman, & Deckner, 2004), the capacity to co-regulate an interaction and the capacity to share emotional experiences. The participants were 40 children (20 with autism, 20 without autism) aged 6–14, and their parents. Parent-child dyads took part in the observational assessment and were coded on these schemes. Comparisons were made with standardised measures of autism severity (Autism Diagnostic Observation Schedule, ADOS: Lord, Rutter, DiLavore, & Risi, 2001; Social Responsiveness Scale, SRS: Constantino & Gruber, 2005), relationship quality (Parent Child Relationship Inventory, PCRI: Gerard, 1994) and quality of parent-child interaction (Dyadic Coding Scales, DCS: Humber & Moss, 2005). Inter-rater reliability was very good and, as predicted, codes both diverged from the measure of parent-child relationship and converged with a separate measure of parent-child interaction quality. A detailed profile review revealed nuanced areas of group and individual differences which may be specific to verbally-able school-age children. The results support the utility of the Relationship Development Assessment – Research Version for clinical practice.

The aim of the current paper was to examine reflections on the foundation of the Psychological Society of Ireland (PSI) and its impact on the development of academic psychology in the Republic of Ireland. The study was conducted using interview data from participants who were involved in the organisation and foundation of psychology in the Republic of Ireland. Themes were identified in relation to the foundation and development of psychology in Ireland. Results suggested that PSI had an influence on the organisation and consolidation of the discipline as well as an impact on the internationalising of psychology in Ireland. Beyond this, the foundation of the PSI itself was found to have been influenced by international experiences and the presence of a professional body in Northern Ireland. Future research may focus on documentary material on the foundation of the professional body and the impact of international influence on the foundation of PSI

This research examined the needs and experiences of people with sight loss regarding access to bus and rail services in a large urban area in Ireland. A broad qualitative approach was used, so as to investigate people’s lived experiences both as passengers and as providers of public transport. Participants included 13 people with differing levels of sight loss and the Access Officers from two public transport organisations in the area. From this research, it is apparent that travel in the area by people with sight loss has improved since the introduction of key pieces of legislation. Awareness of sight loss and assistance given by staff members was the most prominent area of improvement reported by the participants. However, there appeared to be an inequality in access among people with sight loss, in that people with low vision appear to benefit more from access services than people who are totally blind. Research also showed that although technologies, including audible announcements, to assist passengers with more severe sight loss exist, they are not all available in Ireland yet or are not always effective. People’s own experience of sight loss and travelling as a person with reduced vision seems also to contribute to how accessible a transport service is and further research in this area is recommended.

This study set out to examine the impact of a health and personal development programme (the Social, Personal and Health Education Programme) which had been 'enhanced' by the addition of a mental health promotion component. Students aged 12-16 years attending 17 secondary schools were randomly allocated as clusters to participate in either the standard programme (SP) or the enhanced programme (EP). Both programmes were delivered over an eight-month period. Questionnaires assessing help-seeking, emotional and behavioural difficulties and students' views of school social environment were completed by students in both groups at pre-intervention, post-intervention and at six-month follow-up. One thousand and seventy-two students participated. Analyses were carried out on the 782 students (72.9%) for whom data were available at all three time points. Both groups showed improvement over time in terms of emotional and behavioural difficulties, with male students identified as 'at risk' in the EP showing significantly greater improvements than males 'at risk' in the SP. Although there were few differences in outcomes between the groups, males identified as 'at risk' appeared to benefit selectively from the EP.

BackgroundImplementation fidelity is poorly addressed within physical therapy interventions, which may be due to limited research on how to develop and implement an implementation fidelity protocol.ObjectiveThe purpose of this study was to develop a feasible implementation fidelity protocol within a pilot study of a physical therapy–led intervention to promote self-management for people with chronic low back pain or osteoarthritis.DesignA 2-phase mixed-methods design was used.MethodsPhase 1 involved the development of an initial implementation fidelity protocol using qualitative interviews with potential stakeholders to explore the acceptability of proposed strategies to enhance and assess implementation fidelity. Phase 2 involved testing and refining the initial implementation fidelity protocol to develop a finalized implementation fidelity protocol. Specifically, the feasibility of 3 different strategies (physical therapist self-report checklists, independently rated direct observations, and audio-recorded observations) for assessing implementation fidelity of intervention delivery was tested, followed by additional stakeholder interviews that explored the overall feasibility of the implementation fidelity protocol.ResultsPhase 1 interviews determined the proposed implementation fidelity strategies to be acceptable to stakeholders. Phase 2 showed that independently rated audio recordings (n=6) and provider self-report checklists (n=12) were easier to implement than independently rated direct observations (n=12) for assessing implementation fidelity of intervention delivery. Good agreement (79.8%–92.8%) was found among all methods. Qualitative stakeholder interviews confirmed the acceptability, practicality, and implementation of the implementation fidelity protocol.LimitationsThe reliability and validity of assessment checklists used in this study have yet to be fully tested, and blinding of independent raters was not possible.ConclusionsA feasible implementation fidelity protocol was developed based on a 2-phase development process involving intervention stakeholders. This study provides valuable information on the feasibility of rigorously addressing implementation fidelity within physical therapy interventions and provides recommendations for researchers wanting to address implementation fidelity in similar areas.

BACKGROUND: Suicidality in people with intellectual disability has not been extensively researched. AIM: To identify the nature of the research that has actually been conducted on this topic. METHOD: A search of research databases was conducted according to predefined criteria. Key information was extracted and rated for methodological merit. RESULTS: Twenty-four studies met the inclusion criteria for this systematic review. The aspects of suicidality investigated, which varied among studies, included suicidal attempts, behavior, ideation, and completed suicide. Thirteen studies highlighted risk factors for suicidality in this population. The most frequently noted risk factors were a concurrent mental health difficulty and the level of intellectual disability. Eight studies referred to people with intellectual disabilities' understanding of the concept of death or suicide. Various methodological issues were identified in the studies included. CONCLUSIONS: In what we believe to be first systematic review of suicidality in people with intellectual disabilities, it was apparent that well-designed, standardized research studies on the topic are scarce. There is consequently limited evidence to guide prevention and intervention strategies for suicidality in this population. Language: en

Introduction International clinical guidelines consistently endorse the promotion of self-management (SM), including physical activity for patients with chronic low back pain (CLBP) and osteoarthritis (OA). Patients frequently receive individual treatment and advice to self-manage from physiotherapists in primary care, but the successful implementation of a clinical and cost-effective group SM programme is a key priority for health service managers in Ireland to maximise long-term outcomes and efficient use of limited and costly resources. Methods/analysis This protocol describes an assessor-blinded cluster randomised controlled feasibility trial of a group-based education and exercise intervention underpinned by self-determination theory designed to support an increase in SM behaviour in patients with CLBP and OA in primary care physiotherapy. The primary care clinic will be the unit of randomisation (cluster), with each clinic randomised to 1 of 2 groups providing the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention or usual individual physiotherapy. Patients are followed up at 6 weeks, 2 and 6 months. The primary outcomes are the (1) acceptability and demand of the intervention to patients and physiotherapists, (2) feasibility and optimal study design/procedures and sample size for a definitive trial. Secondary outcomes include exploratory analyses of: point estimates, 95% CIs, change scores and effect sizes in physical function, pain and disability outcomes; process of change in target SM behaviours and selected mediators; and the cost of the intervention to inform a definitive trial. Ethics/dissemination This feasibility trial protocol was approved by the UCD Human Research Ethics—Sciences Committee (LS-13-54 Currie-Hurley) and research access has been granted by the Health Services Executive Primary Care Research Committee in January 2014. The study findings will be disseminated to the research, clinical and health service communities through publication in peer-reviewed journals, presentation at national and international academic and clinical conferences. Trial registration number ISRCTN 49875385; Pre-results.

Background The Medical Research Council framework provides a useful general approach to designing and evaluating complex interventions, but does not provide detailed guidance on how to do this and there is little evidence of how this framework is applied in practice. This study describes the use of intervention mapping (IM) in the design of a theory-driven, group-based complex intervention to support self-management (SM) of patients with osteoarthritis (OA) and chronic low back pain (CLBP) in Ireland’s primary care health system. Methods The six steps of the IM protocol were systematically applied to develop the self-management of osteoarthritis and low back pain through activity and skills (SOLAS) intervention through adaptation of the Facilitating Activity and Self-management in Arthritis (FASA) intervention. A needs assessment including literature reviews, interviews with patients and physiotherapists and resource evaluation was completed to identify the programme goals, determinants of SM behaviour, consolidated definition of SM and required adaptations to FASA to meet health service and patient needs and the evidence. The resultant SOLAS intervention behavioural outcomes, performance and change objectives were specified and practical application methods selected, followed by organised programme, adoption, implementation and evaluation plans underpinned by behaviour change theory. Results The SOLAS intervention consists of six weekly sessions of 90-min education and exercise designed to increase participants’ physical activity level and use of evidence-based SM strategies (i.e. pain self-management, pain coping, healthy eating for weight management and specific exercise) through targeting of individual determinants of SM behaviour (knowledge, skills, self-efficacy, fear, catastrophizing, motivation, behavioural regulation), delivered by a trained physiotherapist to groups of up to eight individuals using a needs supportive interpersonal style based on self-determination theory. Strategies to support SOLAS intervention adoption and implementation included a consensus building workshop with physiotherapy stakeholders, development of a physiotherapist training programme and a pilot trial with physiotherapist and patient feedback. Conclusions The SOLAS intervention is currently being evaluated in a cluster randomised controlled feasibility trial. IM is a time-intensive collaborative process, but the range of methods and resultant high level of transparency is invaluable and allows replication by future complex intervention and trial developers. Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0418-2) contains supplementary material, which is available to authorized users.

In this study a 29-item version of the systemic clinical outcome and routine evaluation (SCORE), which contained all items from the SCORE-15 and SCORE-28, was used to develop norms for both the 15 and the 28 versions of the SCORE from the same sample. In a random digit dialling telephone survey, a stratified national random sample of 403 adults living in the Republic of Ireland and Northern Ireland completed the SCORE and brief measures of family and personal adjustment. Using receiver operating characteristic curve analyses, cut-off points for the SCORE-28 and 15 were found to identify families of children with significant emotional and behavioural problems. We also established 90th percentile points and percentages of cases falling above each scale point for both versions of the SCORE. Confirmatory factor analyses showed that, for both versions of the SCORE, the data fit the three factor solutions found in previous studies. The SCORE scales also had significant correlations with measures of family, parental and child adjustment, and negligible correlations with socioeconomic variables and social desirability response set.

This study involved a detailed standardized initial research assessment which was carried out with 100 young people aged 12–15 years newly referred to a child and adolescent mental health service. The assessment involved the K-SADS interview with the young person and their parent, the Strengths and Difficulties Questionnaire, the Clinical Global Impression Scale, and the Children’s Global Assessment Scale. Diagnoses resulting from these ‘research assessments’ were compared with clinical diagnoses, which were determined by case note analysis and discussion with the key clinician. Results showed that a clinical diagnosis of depressive disorder was made in only one-third of those who received a ‘research assessment’ diagnosis of depressive disorder, and suicidality was missed in a significant proportion of cases. Those with a diagnosis of depressive disorder had significantly more problems, more comorbidity, more suicidality and greater functional impairment than those without. It is important to keep depression and suicidality in mind when assessing young people with complex mental health difficulties. Unless specific pointers are sought, it is easy to miss these, which may mean that vulnerable young people do not benefit from potentially effective treatments.

The purpose of this study was to provide an ecologically valid account of the experiences of ‘admitted dopers’. In-depth interviews were conducted with five elite athletes from the sports of road cycling, mountain biking and weightlifting. The athletes had either tested positive for banned substances or had admitted to prior drug use after their retirement from competitive sport. Thematic analysis was used to extract meaning from the interview data. Individual psychological factors and contextual influences on the athletes' doping decisions were identified. The conflicting responses of these athletes make the identification of a psychological profile of athletes most at-risk for doping difficult, but morality was consistently cited as an important consideration. The culture of the athletes' team or training group and ‘critical incidents’ during the athletes' careers were often influential in precipitating drug use. Doping deterrents were also discussed, of which guilt and shame were predominant. The athle...

The current study investigated clinicians’ perspectives on the effectiveness of interventions designed to support the development of children with autistic spectrum disorders (ASDs). Researchers developed a semi-structured interview which was administered to 11 clinicians involved in the assessment and treatment of ASDs (5 = clinical psychologists, 6 = psychiatrists). Content analysis of qualitative data revealed that Irish clinicians typically endorse an eclectic approach to treatment, combining facets of different methods of interventions in a complementary fashion. The process that clinicians engaged in when evaluating modes of treatment was assessed. Significant variation was observed in how clinicians merge clinical experience with empirical evidence. Challenges which clinicians face in assessing individuals on the autistic spectrum, such as the proliferation of misinformation on interventions, as well as the role of parents in treatment, were also discussed within the interviews. The implications of the findings for understanding the process of selecting interventions for children with ASDs are discussed.

Accessible summary • People with intellectual disabilities are living for longer than ever before and are experiencing the deaths of their friends and other service users. • This study describes the experiences of people with intellectual disabilities who have lived through the death of a friend or service user from the point of view of staff from intellectual disability and palliative care services. • It is important to understand the experiences of people with intellectual disabilities to try and help people cope with the deaths of their friends. • The study shows that it helps to include people with intellectual disabilities when their friends become unwell and to talk openly with them about what is happening. Summary Research is lacking on the effect of the deaths of fellow service users on people with intellectual disabilities. This qualitative study formed part of a project which aimed to describe the provision of palliative care to people with intellectual disabilities in Ireland and to assess the population’s palliative care needs. We report on findings from 16 focus groups held with staff in which participants described their perception of the experiences of people with intellectual disabilities when other service users die. Interviews were analysed using Framework Analysis. The findings highlight the emotional impact of the death of a friend on people with intellectual disabilities. Situations where staff facilitated the involvement of services users are described, and the study points to the benefits of this approach. Possible barriers to involvement are highlighted. The findings affirm the importance of ensuring that people with intellectual disabilities have a good understanding of the concept of death to alleviate the bereavement experience.

Background Little is known of paid carers’ perspectives when caring for people with intellectual disabilities at the end-of-life. Materials and methods Sixty four individuals from intellectual disability services took part in 12 focus groups. Interviews were analysed using framework analysis. Results Participants wanted to provide palliative care and felt the experience enriched practice. However, they were inadequately prepared to meet need and this often led to staff stress. A number of issues appeared to heighten stress: situations when end-of-life care decision making was challenging, when staff felt ‘pushed out’ by relatives and when staff did not have sufficient support or time to provide care or mourn the loss of service users. Conclusions The study describes issues which contribute to the development of staff stress when providing palliative care and draws attention to areas where strategies should be developed in order to improve the quality of care provided to people with intellectual disabilities.

This study explores the potential of the ‘draw-and-write’ method for inviting children to communicate salient aspects of their self-concept. Irish primary school children aged 10—13 years drew and wrote about their favourite people and things to do (social and active self). Children drew and described many salient activities (39 in total) and people — including pets. Results suggest that widely used, adult-constructed self-esteem scales for children, while multidimensional, are limited, and that ‘draw-and-write’ is an effective multimodal method with which children can express their social and active self-concepts.

Few empirical studies have compared quality and outcomes for residents with intellectual disability across intentional communities such as those organised by the Camphill communities in Ireland.Using a multi-element research protocol developed for an earlier large study, data were gathered about the characteristics of N = 29 participants living in life-sharing residences organised by Camphill, management procedures, and outcomes for residents. Comparable data were available for N = 125 adults in group homes or campus residences.Camphill residents reported a smaller size of household, higher staffing ratios, homely living areas, low levels of institutionalised practices such as social distance, reciprocal relationships with houseparents, and well-developed management procedures, as well as less choice, but were not found to be better on a range of other objective measures.Although modest in scale, present findings suggest that the value of applying distinctive benefits of life-sharing communities in more typical residential settings for people with intellectual disability should be investigated further to inform current policy debates.

Aim: The aim of this review is to examine what is known from the existing literature about the characteristics of effective music listening interventions used in analgesic settings. Background: While meta-analyses demonstrate the effectiveness of music listening interventions, regardless of whether they are classed as music medicine or music therapy, it is not yet clear how the positive effects of music listening interventions (MLIs) are mediated. The absence of defined cognitive mechanisms coincides with inconsistencies in terms of how MLIs are delivered and evaluated with wide variability in terms of duration, frequency, style, genre, equipment, preparation, choice, rationale, personnel adopted and often a lack of suitable controls. Future improvement and refinement of MLIs depends on identifying the characteristics that mediate analgesic effects. Design: The protocol was designed using the principles from Arksey and O’Malley (2005) and Levac (2010). Methods: The protocol includes decisions about the review objectives, search strategy, inclusion/exclusion criteria, article selection process, data charting and synthesis and quality assessment. Discussion: The scoping review will help to identify what is known from the existing literature about the characteristics of effective MLIs used in analgesic settings and will contribute to guidance on optimal MLI design.

Objective To report the findings of a systematic review of family-based psychosocial interventions with pediatric oncology populations. Methods A number of intervention studies documenting psychosocial interventions for childhood cancer populations, that incorporated multiple family members, were examined. Results Twenty-one studies were identified that met the criteria for inclusion and provided the data necessary for synthesizing the results. Findings illustrate that multiple family members are integrated into interventions for childhood cancer in a number of ways. Considerable variation was observed regarding the family member combinations targeted and the intervention modalities employed. A minority of interventions met the criteria for empirically validated treatments; however, evidence of beneficial outcomes was observed across the majority of interventions reviewed. Conclusions Findings suggest the feasibility, acceptability, and potential effectiveness of family-based psychosocial interventions in pediatric oncology. Recommendations for conducting future intervention studies are provided including the integration of qualitative methods in evaluations of family-based interventions.

This study describes a national data audit of the National Intellectual Disability Database (NIDD). The NIDD is a national information system for intellectual disability (ID) for Ireland. The purpose of this audit was to assess the overall accuracy of information contained on the NIDD, as well as collecting qualitative information to support the improvement in the quality of data contained on the NIDD. A nationally representative sample was generated from the NIDD. Twenty-five auditors were recruited from senior staff within statutory and voluntary intellectual disability services and trained by the authors. They carried out 250 clinical interviews with individuals with ID, their families and/or paid carers, using structured questionnaires. The data collected were analysed using frequency analyses and compared with the existing NIDD data set to assess accuracy. Qualitative information was also collected. Overall, the results from the audit indicate that almost three quarters (72.2%) of all the data recorded on the NIDD are accurate, with 19.3% inaccurate, and 8.5% of the sought audit data not returned. The audit found that the NIDD significantly overestimated the need for enhanced residential care services. The study highlights the need for clinician and service user involvement in specialist service data collection, in order to both conduct valid research and to best plan for ID service development.

Current research indicates that older persons with intellectual disabilities (ID) are a growing population with very specific needs. There are few existing studies that identify and characterise these needs. This study aimed to assess the health and social care needs of a group of older persons with ID in a community-based service in Ireland. The Camberwell Assessment of Need for Adults with Intellectual Disabilities-Short form (CANDID-S) was used to identify the health and social needs of 75 older persons with ID in a community-based service who were over the age of 50. The mean age of the sample was 57.6 years (SD = 5.4, range 50–72) and 37.3% had mild ID, 46.7% had moderate ID and 16% had severe or profound ID. The most common ‘unmet needs’ reported were basic education and money budgeting (the ability to independently manage one's own finances). The top-rated ‘met needs’ were food and daytime activities. Participants with severe or profound ID reported significantly more ‘unmet needs’ than those with mild or moderate ID. The current study identified education and financial skills as unmet needs for older persons with ID, implying that continuing lifelong learning programmes might be a valuable and appropriate addition to service provision and retirement options. Further research should be carried out to inform a comprehensive evidence base of the health and social care needs of this group.

The aim of this study was to evaluate a manualized cognitive behavioral group intervention for early-stage breast cancer patients. Sixty-nine women were recruited at an Irish specialist oncology hospital and assigned to a 6-week cognitive behavior therapy (CBT) program or an educational control group. Participants were assessed at baseline, 6 weeks, and 6-month follow-up. Groups × Time (2 × 3) ANOVAs showed that the program did not lead to greater improvement on standardized measures of coping, quality of life, or mood compared with the control group. Regression analyses showed that maladaptive coping and distress at baseline were predictive of psychological adjustment at follow-up. Level of distress was also predictive of quality of life at follow-up. Repeated measures ANOVAs of data from cases in the intervention group showed that patients who completed the program showed significant improvement in problem severity, impact of problems, coping ability, and goal attainment from pre- to posttreatment, and these gains were maintained at follow-up for problem severity and impact of problems, but not for coping ability or goal attainment. Participation in the program did not lead to less health service usage during the period from baseline to follow-up, compared with the educational control group. A controlled trial provided limited evidence for the effectiveness of brief cognitive behavior intervention in enhancing psychological adjustment of early-stage breast cancer patients with nonclinically significant levels of psychological distress. Future research should evaluate the effectiveness of the program for patients with elevated levels of psychological distress and limited coping resources. Other funder Saint Luke’s Institute of Cancer Research Irish Research Council for Social and Human Sciences UCD Seed Funding Scheme Irish Cancer Society Author has checked copyright kpw9/12/13

Support groups in online communities provide an anonymous place to exchange information and advice. Previous research has suggested that these groups offer a safe, nonjudgmental forum for new parents to share experiences and interact anonymously. This study investigated how participants in online parenting groups experience support via the Internet and what types of support they receive. All posts made over a 2-week period on the parenting-related discussion boards of an Irish parenting Web site were analyzed using content and thematic analyses. Exploratory, semistructured interviews were also conducted with 2 forum participants to discuss their experience of using the Web site. Themes uncovered from the data gathered included the attempts by posters to dispel the myths surrounding motherhood and the recognition of the superiority of the mother as caregiver. The results revealed that the parenting Web site was seen as a safe, supportive space, in which mothers could develop an enhanced frame of reference in which to better understand the role of parenting. The role of online support groups as a viable solution to the decreasing social networks created by modern society is discussed, along with the implications of the findings for future practice and research. Key Words: parenthood, parenting, social support networks. For most parents, the experience of parenthood is a positive one; however, the period following the arrival of the new family member is often marked by increased conflict and negativity within family relationships. The quality of parenting is a critical factor in long- and short-term child well-being (Belsky, 1984; Bowlby, 1969). According to Belsky's Model of the Determinants of Parenting, psychological stress related to parenting interferes with the quality of parenting, and potentially, the infant's health. Parenting stress affects the mother's ability to assess infant cues and to appropriately provide care and comfort (Pridham, Egan, Chang, & Hansen, 1986; Tessier, Piche, Tarabulsy, & Muckle, 1992). Also, higher parental stress during infancy is associated with less positive father-child interactions when the child is 1 year old (Darke & Goldberg, 1994). Mothers who report more stress in the parenting role are also more likely to view their infants as difficult to care for (Mulsow, Caldera, Pursley, Reifman, & Huston, 2002). Central to addressing parenting stress is the parents' perceptions of having access to resources that support them in meeting the demands of parenthood, such as knowledge about, and competence at, the day-to-day as well as long-term tasks of parenting (Deater-Deckard & Scarr, 1996). Parenting is hypothesized to be more "stressful" for parents who have less knowledge, less perceived competence, and fewer emotional and instrumental supports, such as help from partners, family members, and friends (Mash & Johnston, 1990). Therefore, it is important to consider the types and forms of support that parents find effective. The availability and accessibility of emotional support are crucial ingrethents in positive adaptation to parenting since support buffers the individual from the negative effects of stressors (Lazarus & Folkman, 1984). Modern society, however, has led to changes in the availability of family support due to geographic mobility, changing economic trends, and divorce (Mc Murray, 1999). This creates less opportunities for new mothers and fathers to learn about parenting through role modeling and less access to family-based supports (Guyer, Hughart, Strobino, Jones, & Scharfstein, 2000). Vimpani (2001) highlighted the detrimental effects of isolation from family and neighbors, and this finding suggests that new methods of support may need to be developed. A group setting for parents can supply a highly supportive environment in which parents can share feelings and explore alternative ways of coping with difficult situations (Nathanson, 1986; West, Meli vaine, & Sells, 1979). …

It is posited within the literature that the sexualised challenging behaviour of adults with intellectual disability may be influenced by low levels of sexual knowledge, lack of sexual experience and unmet sexual needs. In this study, individuals with sexualised challenging behaviour were identified and matched for gender, age and ability level with individuals recruited to the non-sexualised and no challenging behaviour groups. All (n=24) were interviewed using the Socio-Sexual Knowledge and Attitudes Tool - Revised (SSKAAT-R) and the Sexual Knowledge, Experience and Needs Scale for Intellectual Disability (Sex-Ken-ID) to assess their sexual knowledge, experience and needs. Adaptive behaviour was measured as a covariate. In the current study, contrary to expectations in the wider literature, the sexualised challenging behaviour group showed significantly higher levels of sexual knowledge in several areas when adaptive behaviour was controlled. Their needs in relation to Dating and Intimacy were also significantly higher but no differences were found between groups in relation to sexual experience. The implications of these findings for service provision are outlined along with the considerations of directions for future research.

El objetivo del estudio fue evaluar la efectividad de la intervención de escuela de padres para niños pequeños con dificultades y examinar si hay diferentes efectos para los niños con dificultades de desarrollo y los que no las tienen. El estudio tuvo un diseño cuasi-experimental con lista de espera y los participantes fueron padres de 81 niños de tres a seis años (M = 53.30 meses; DT = 10.80 meses) con problemas de conducta y/o desarrollo quienes recibieron entrenamiento de escuela de padres (n = 46) o un servicio de «tratamiento habitual» (n = 35) durante 12 semanas. Se llevó a cabo una evaluación antes e inmediatamente después de la intervención de 12 semanas para ambos grupos y cinco meses más tarde para el grupo de escuela de padres. Se encontraron cambios significativos, incluyendo mejoras en los problemas de conducta informados por los padres, estrés paternal y observaciones puntuadas independientemente. Los cambios en las dificultades conductuales fueron mayores para el grupo de la escuela de padres que en tratamiento habitual y no se encontraron diferencias entre niños con y sin dificultades de desarrollo. Los hallazgos sugieren que la escuela de padres es igualmente efectiva para niños con dificultades de conducta y aquellos que presentan también dificultades de desarrollo. Esto subraya la utilidad clínica de escuelas de padres como herramienta para la intervención con niños pequeños en el ámbito de salud mental de primera línea.

Inappropriate sexual behaviors are a subset of challenging behaviors that limit the community integration of individuals with intellectual disabilities. Despite the stigmatizing effect of problematic sexual behavior, research efforts in this area have been limited and often used narrow prospective definitions. As such, research has been limited to a focus on "sexual offending" and "abuse," terms which are often criticized in their applicability to people with intellectual disabilities given their connotations of criminal intent or insight. The authors propose adopting the term "sexualized challenging behavior" and define it by using empirical methods. Using a qualitative methodology, they examined a six-month sample of service-based documentation reporting sexual behaviors that were problematic. They also conducted semi-structured interviews with a staff-based sample and explored their views in relation to sexual behavior. Common themes emerged across both documentation and staff interviews regarding the nature and characteristics of such behaviors. Their proposed definition encompasses a continuum of self- and other-directed behaviors related to touch, exposure, and communication, which they view as distinct from sexual offending. The findings further suggest that sexualized challenging behaviors have distinct characteristics that differentiate them from nonsexualized challenging behaviors. The authors conclude that sexualized challenging behaviors can be defined as a distinct class of behaviors that require further study among a broader cohort of adults with intellectual disabilities.

Accessible summary • This study is about the way that parents are told that their child has disabilities. The researchers talked to families and professionals to find out if parents are given nice and hopeful messages about their child. • The study found that parents and professionals agreed that there should be positive, realistic messages and hope given to parents about their child. • Many parents said that they did not get nice or hopeful messages. The study found that professionals could give realistic and hopeful messages by telling parents that there is help available The study also found that professional could tell parents about the value and importance of every child. • Giving realistic, positive and hopeful messages to parents about their child is the start of providing good support to people with disabilities through their whole lives. Providing good support throughout people’s whole lives is one of the aims of the UN Convention on the Rights of Persons with Disabilities. Summary As part of a larger study to develop best practice recommendations for informing families of their child’s disabilities, this study researched the elements of best practice required when communicating this news to families. It traced the convergence between these practice recommendations and the UN Convention on the Rights of Persons with Disabilities; in particular with regard to the provision of positive, realistic and hopeful communication. The study employed a mixed methodology, involving 22 focus groups and a questionnaire survey of 1588 professionals and 584 families. The study found that a large majority of parents and professionals supported the recommendation of providing families with positive, realistic and hopeful messages at the time of diagnosis but less than half of the parents surveyed reported receiving communication of this type. The findings indicated that some professionals may struggle with fears of providing ‘false hope’, a fear of litigation and a lack of training, when considering providing hope. However the research also identified positive and hopeful messages that are not in conflict with providing honest and realistic communication. These include: acknowledging the dignity and worth of the child as an individual, indicating that there is help available for parents, and informing families about the spectrum of possible outcomes for their child rather than the worst case scenario. The provision of appropriate positive, realistic messages and hope is fully aligned with the principles of the UN Convention.

Given the research evidence that people with intellectual disability (ID) do grieve following bereavement, the present study aimed to describe and gather preliminary psychometric data for a version of the Inventory of Complicated Grief [Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., et al. (1995). Inventory of Complicated Grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65-79] adapted for use with this population. Carers completed the Complicated Grief Questionnaire for People with ID (CGQ-ID) for 76 individuals with ID, half of whom had experienced a parental bereavement within the last 2 years. The final scale and subscales (Separation Distress and Traumatic Grief) showed very good internal and inter-rater reliability and distinguished between the two groups. While the findings suggest that the CGQ-ID is suitable for identifying complicated grief-type symptoms among adults with ID, further research must be conducted to ascertain whether the findings can be replicated.

The Attention-Distraction, Inhibition-Excitation Classroom Assessment Scale (ADIECAS) [Evans, P. L. C. (1975). Inhibition and stimulus generalization in the discrimination learning of ESN(S) and ESN(M) children. Unpublished Ph.D. thesis. Manchester, UK: University of Manchester] assesses attention-related difficulties in children with intellectual disabilities (ID). The present study explored the psychometric properties of the ADIECAS with a sample of 84 children with moderate and severe ID whose teachers completed the ADIECAS and the Conners' Teachers Rating Scale [Goyette, C. H, Conners, C. K., & Ulrich, R. F. (1978). Normative data on revised Conners' parent and teachers rating scales. Journal of Abnormal Child Psychology, 6, 221-236]. Following factor analysis the Evans and Hogg [Evans, P. L. C., & Hogg, J. (1984). A classroom rating scale for use with mentally retarded children. British Journal of Clinical Psychology, 23, 187-194] structure was the most appropriate for use with this sample. Moderate to strong positive relationships were found between the ADIECAS and the Conners', and the ADIECAS factors were significant predictors of the Conners' subscales. This study provides further support for the ADIECAS as a reliable and valid measure of ADHD-related symptoms among children with moderate and severe ID.

This is the first study to compare the social competence of children with moderate intellectual disability in inclusive versus segregated school settings in the Republic of Ireland. A convenience sample was recruited through two large ID services. The sample comprised 45 children across two groups: Group 1 (n=20; inclusive school) and Group 2 (n=25; segregated school). Parents and teachers completed the Strengths and Difficulties Questionnaire and the Adaptive Behaviour Scale-School: 2nd edition. A series of 2 x 2 ANOVAs were carried out on social competence scores using educational placement type (inclusive vs segregated school) and proxy rater (parent vs teacher) as the independent variables. Key findings indicated that children in inclusive schools did not differ significantly from children in segregated schools on the majority of proxy ratings of social competence. This supports the belief that children with intellectual disabilities can function well in different educational settings. Present findings highlight the importance of utilising the functional model of ID when selecting and designing school placements for children with moderate ID.

Background Individuals with intellectual disabilities (I.D.) who are not accessing any specialist services are a vulnerable group, especially with advancing age. In Ireland, the National Intellectual Disability Database (N.I.D.D.) records the current and future service needs of people with intellectual disabilities, as well as those individuals who are not in receipt of services. Methods This two-part study firstly used the N.I.D.D. to look at the number and characteristics of those older individuals outside services. Following this, a questionnaire was developed to examine the contact and assessment procedures practised with people who are listed on the N.I.D.D. as not requiring any specialist service. Results Analysis of the database showed that 7.5% of people on the N.I.D.D. with moderate, severe or profound I.D., over the age of thirty and living at home with family were awaiting, or were not in receipt of specialist services. For these people not accessing any services, the questionnaire responses highlighted poor assessment practices including significant periods of time passing between contacts with the individual and limited contact regarding service planning. Conclusions Specialist services need to be more pro-active in engaging vulnerable older individuals in services. A standardised approach needs to be developed in the assessment and monitoring of individuals and families refusing services.

Working Things Out is a DVD resource developed by young people who had experienced a mental health difficulty in which they tell their stories of how they successfully got through their own ‘tough times’. Participants in an Irish community-based epidemiological study, who had recovered from a mental health difficulty, joined young people attending a Child and Adolescent Mental Health Service to develop the resource to assist other young people in coping with their own mental health difficulties. While originally developed for use with clinical populations, the resource has been developed to enhance the Mental Health promotion component of the Social, Personal and Health Education (SPHE) Programme, which supports the personal development, health and well-being of Irish young people, and forms part of the school curriculum at both primary and secondary school levels. A preliminary pilot study evaluating its use in enhancing the effectiveness of mental health promotion in the SPHE programme has shown promisi...

The Confusion Assessment Method (CAM) is widely used in the palliative care setting despite the fact that its performance in this population has not been validated. The aim of the study was to determine the sensitivity and specificity of the CAM when used by Non-Consultant Hospital Doctors (NCHDs) working in a specialist palliative care unit. A pilot phase was performed in which NCHDs received a 1-hour training session based on the original CAM training manual. 32 patients underwent 33 assessments in the pilot phase but the sensitivity of the CAM was only 0.5 (0.22–0.78) and specificity was 1.0 (0.81–1.0). An 'enhanced' training programme was devised that took place over two 1-hour sessions and involved case-based learning focused on the areas where the NCHDs were experiencing difficulty. 52 patients underwent 54 assessments in the main phase of the study and the performance of the CAM improved significantly. Sensitivity was 0.88 (0.62–0.98) and specificity was 1.0 (0.88–1.0). The results suggest that the CAM is a valid screening tool for delirium in the palliative care setting but its performance is dependent on the skill of the operator. NCHDs require a certain standard of training before becoming proficient in its use.

A longitudinal study was initiated by the authors in September 2001 to monitor the changing attitudes, perceptions, concerns and experiences of 32 social work students during their two‐year MSW training at University College Dublin, subsequently following the students into their first three years of practice. This paper reports on the findings from the first two years of the study, exploring how much the attitudes of the respondents changed towards different areas of social work practice while they were full‐time students. Both quantitative and qualitative data have been collected by means of mixed method questionnaires, taken at four points over a two‐year period, and a focus group. Issues examined included the students' changing perceptions of stress, job satisfaction and levels of expertise in different areas of social work practice. The study also monitored their willingness to work in specific areas of social work after graduation. Statistical analysis revealed that students consistently rated social...

Introduction Previous studies have shown a significant association between familial bereavement and the onset of challenging behaviours and psychopathology in people with intellectual disabilities (ID). However, little work has been done to accurately describe the specific symptoms of grief, in particular symptoms of complicated grief in this population. Consensus criteria for the diagnosis of complicated grief have been drawn up and tested for validity in the general population. Aims To examine the occurrence of symptoms of complicated grief, and to explore the relationships between complicated grief and bereavement experience. Method A bereavement history questionnaire and a newly developed measure examining for symptoms of complicated grief were administered to a group of carers of people with mild or moderate ID, who had experienced a parental bereavement within the previous 2 years. The questionnaires were also administered to a matched comparison group, who had not been bereaved. Results/Conclusions This carer-based comparison study has revealed that bereaved individuals with ID experience complicated grief symptoms following the death of a parent, with one-third of the bereaved group experiencing 10 or more clinically apparent symptoms. In addition, complicated grief symptoms were more likely to occur with higher rates of bereavement ritual involvement. These findings have both clinical and research implications.

The impact of a staff-training program on knowledge and confidence in supporting people with intellectual disabilities (ID) at the time of bereavement was examined. Thirty-three staff members from a Dublin, Ireland-based ID support service participated in the study. Both the training (n = 17) and control (n = 16) groups completed measures of confidence at the beginning and end of a 4-week period around supporting service users through a bereavement survey designed for the study, as well as the Staff Support and Satisfaction Questionnaire. During this interval, the training group completed a two-day training focusing on exploring existing strategies for supporting service users and providing staff with additional skills. Staff members also completed a survey of knowledge at the outset of the study. Over the 4 weeks, there was a significant increase in confidence among the training group, with no comparable changes in the control group. However, as predicted, neither group showed significant changes in general support or job satisfaction. The findings suggest that the training significantly increased staff members' confidence in their ability to respond to the challenges of support service users during bereavement. The study's findings also have a number of practical implications, including the need to provide appropriate support for staff.

Background The prevalence of features of attention deficit hyperactivity disorder (ADHD) in children with intellectual disabilities (ID) in Irish schools is unknown. The aim of this study was to examine the prevalence of features of ADHD in a special school, in order to ascertain the number of children who may need further assessment for ADHD. The study also explores the reliability of the Conners Teachers Rating Scale in this population. Method All teachers in a special school for children with ID were asked to complete the Conners Teachers Rating Scale and the Attention-Distractibility, Inhibition–Excitation Classroom Assessment Rating Scale, for those children whose parents had consented for them to take part in this study. Consent was obtained for 84 children a response rate of 71%, between the ages of 5 and 18 (mean = 10.5 years; SD = 3.7). Results The Conners Teachers Rating Scale was found to be internally reliable and had a normal distribution with our results. Overall, 55.9% of participants (47/84) had markedly elevated scores (T > 69) for at least one of the target subscales, which were the ‘Hyperactivity’, ‘Inattention’ and the ‘ADHD Index’ subscales of the Conners Teachers Rating Scales. In addition, the findings would suggest that the Conners Teachers Rating Scale can be a useful screening tool in the population of school children with ID. Conclusions The study suggests that ADHD may be under diagnosed in children with ID. This has practical implications for the mental health needs of these children. It is recommended that further studies are carried out to determine the prevalence of ADHD in this population.

Injury is an unfortunate outcome of participation in competitive sport. While sports injuries have attracted considerable research interest in recent years, few authors have investigated athletes’ beliefs about, or experiences of, these potentially traumatic events. As a result of such neglect, at least three important questions remain unresolved in this field. First, what do athletes perceive as the main consequences of their injuries? Second, what practical coping techniques do they use in an attempt to deal with such injuries? Finally, what factors shape athletes’ overall experience of their injuries? This study set out to answer these three questions using a qualitative research design. Twenty-two injured athletes aged 16 to 29 years (M=21.86 years, SD=3.56) took part in one of six focus groups. Overall, the results suggest that athletic injury is experienced in a multifaceted way, with negative and positive perceptions sometimes alternating during the recovery process. Following a discussion of the key results, specific suggestions are provided for further research in this field. For example, the athletes who participated in this study sustained injuries from which they could recover. It is suggested that an investigation in the future should include athletes whose sporting careers have been terminated by injury, in order to establish how such outcomes impact on the athletes’ experiences of injury.

Aim To review knowledge transfer and exchange frameworks used in health, to analyse the core concepts of these frameworks and appraise their potential applicability to palliative care. Background Although there are over 60 different models of knowledge transfer and exchange designed for various areas of the fields of health care, many remain largely unrefined and untested. There is a lack of studies that create guidelines for scaling-up successful implementation of research findings and of proven models ensuring that patients have access to optimal health care, guided by current research. Design The protocol for this scoping review was devised according to the guidelines proposed by Arksey and O'Malley (2005) and Levac et al. (2010). Methods The protocol includes decisions about the review objectives, inclusion criteria, search strategy, study selection, data extraction, quality assessment, data synthesis and plans for dissemination. Discussion The review will allow us to identify the currently used models of knowledge transfer and exchange in healthcare setting and analyse their applicability to the complex demands of palliative care. Results from this review will identify effective way of translating different types of knowledge to different PC providers and could be used in hospital, community and home based PC and future research.

This study assessed the impact of a multitiered oral health educational program on the oral health and oral hygiene of people with intellectual disabilities (ID). In a controlled pretest, posttest trial, with cluster randomization, a pyramidal training program was delivered to residential staff who cared for a randomly allocated, purposively stratified intervention group of people with ID living in community care homes. A control group lived in centers where staff received no training. Clinical measures were carried out pre- and posttest. Difference in Modified Gingival Index (MGI) and Plaque Index (PI) was measured posttest using ANCOVA. Seventy-six participants took part, representing 49.0% of the invited sample (n = 155). Fourteen did not receive clinical examination. There was one dropout 6-9 months later. A 10.5% and 8.5% reduction in mean MGI and PI was evident at posttest but did not show statistically significant difference, when controlling for baseline covariates (p0.05, ANCOVA). Mean MGI and PI scores were not significantly different among people with ID whose care staff had and had not received oral health training. Limitations are discussed. The results indicate that this program failed to significantly improve oral health or oral hygiene, despite the intervention being "educationally" successful. More research is needed.

Child-centred research shows a respect for children and promotes their entitlement to be considered as persons of value and persons with rights. With the growing interest in this approach to psycho...

In recent decades the phenomenon of bullying has attracted a great deal of research interest within the field of developmental psychology. Researchers have explored the nature of bullying behaviour...