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Background: A range of strategies are available that can improve the outcomes of older persons particularly in relation to basic activities of daily living during and after an acute care (AC) episode. This paper outlines the original development of outcome-oriented quality indicators (QIs) in relation to common geriatric syndromes and function for the care of the frail aged hospitalized in acute general medical wards. Methods: Design QIs were developed using evidence from literature, expert opinion, field study data and a formal voting process. A systematic literature review of literature identified existing QIs (there were no outcome QIs) and evidence of interventions that improve older persons' outcomes in AC. Preliminary indicators were developed by two expert panels following consideration of the evidence. After analysis of the data from field testing (indicator prevalence, variability across sites), panel meetings refined the QIs prior to a formal voting process. Setting: Data was collected in nine Australian general medical wards. Participants: Patients aged 70 years and over, consented within 24 h of admission to the AC ward. Measurements: The interRAI Acute Care – Comprehensive Geriatric Assessment (interRAI AC-CGA) was administered at admission and discharge; a daily risk assessment in hospital; 28-day phone follow-up and chart audit. Results: Ten outcome QIs were established which focused on common geriatric syndromes and function for the care of the frail aged hospitalized in acute general medical wards. Conclusion: Ten outcome QIs were developed. These QIs can be used to identify areas where specific action will lead to improvements in the quality of care delivered to older persons in hospital. [ABSTRACT FROM AUTHOR]

We tell the story of an experience Kate Dawson, her students, and three eagles had at an outdoor preschool. The experience profoundly affected Kate, and prompted us to ask the following questions: What made this experience feel so magical, and what caused it to happen? Why are these "magical moments" valuable, and how might they impact our pedagogical practices? We posit that magical moments in outdoor early childhood education depend upon relational and "pathic" knowledge, and understanding of place, rather than intellectual or cognitive knowledge "about" place. We suggest conditions and practices educators may employ to foster magical moments, including slow ecopedagogy and embodied, sensory, and spiritual attunement to place. We consider our role as educators in the educator-students-place system, particularly when acknowledging that place is agentic, and acts as learner, knower and teacher. To understand place pedagogically, we must think of ourselves as learners and as the objects of learning, as much as thinking of ourselves as "knowers." This requires a pedagogy of embodied responsiveness and a surrender to place as teacher. Far from simplifying the work of the educator, living within a relationship of educator-students-place complexifies the practice of teaching.

Background: In Australia, 243 000 individuals live in approximately 2700 residential aged care facilities yearly. In 2019, a National Aged Care Mandatory Quality Indicator programme (QI programme) was implemented to monitor the quality and safety of care in facilities. Aim: To examine the validity of the QI programme indicators using explicit measure review criteria. Methods: The QI programme manual and reports were reviewed. A modified American College of Physicians Measure Review Criteria was employed to examine the QI programme's eight indicators. Five authors rated each indicator on importance, appropriateness, clinical evidence, specifications and feasibility using a nine‐point scale. A median score of 1–3 was considered to not meet criteria, 4–6 to meet some criteria and 7–9 to meet criteria. Results: All indicators, except polypharmacy, met criteria (median scores = 7–9) for importance, appropriateness and clinical evidence. Polypharmacy met some criteria for importance (median = 6, range 2–8), appropriateness (median = 5, range 2–8) and clinical evidence (median = 6, range 3–8). Pressure injury, physical restraints, significant unplanned weight loss, consecutive unplanned weight loss, falls and polypharmacy indicators met some criteria for specifications validity (all median scores = 5) and feasibility and applicability (median scores = 4 to 6). Antipsychotic use and falls resulting in major injury met some criteria for specifications (median = 6–7, range 4–8) and met criteria for feasibility and applicability (median = 7, range 4–8). Conclusions: Australia's National QI programme is a major stride towards a culture of quality promotion, improvement and transparency. Measures' specifications, feasibility and applicability could be improved to ensure the programme delivers on its intended purposes. [ABSTRACT FROM AUTHOR]

The sustainable development goals (SDGs) adopted by the United Nations in 2015 include a new target for global health: SDG 3 aims to 'ensure healthy lives and promote well-being for all at all ages.' Dementia care of good quality is particularly important given the projected increase in the number of people living with the condition. A range of assistive technologies have been proposed to support dementia care. However, the World Health organization estimated in 2017 that only one in 10 of the 1 billion or more people globally who could benefit from these technologies in some way actually has access to them. For people living with dementia, there has been little analysis of whether assistive technologies will support their human rights in ways that are consistent with the United Nations Convention on the Rights of Persons with Disabilities. The aim of this paper is to examine the relevant provisions of the convention and consider their implications for the use of assistive technologies in dementia care. Assistive technologies can clearly play an important role in supporting social engagement, decision-making and advance planning by people living with dementia. However, concerns exist that some of these technologies also have the potential to restrict freedom of movement and intrude into privacy. In conclusion, an analysis of the implications of assistive technologies for human rights laws is needed to ensure that technologies are used in ways that support human rights and help meet the health-related SDG 3. Les objectifs de developpement durable (ODD) adoptes par les Nations Unies en 2015 integrent un nouvel objectif de sante mondiale: l'ODD3, qui vise a << permettre a tous de vivre en bonne sante et promouvoir le bien-etre de tous, a tout age >>. Une prise en charge de bonne qualite de la demence est particulierement importante, compte tenu des projections d'augmentation du nombre de personnes atteintes. Plusieurs technologies d'assistance sont proposees pour contribuer a une bonne prise en charge de la demence. Neanmoins, en 2017, l'organisation mondiale de la Sante a estime qu'a l'echelle mondiale, parmi le milliard de personnes -voire plus- susceptibles de beneficier de ces technologies, seule une personne sur 10 peut effectivement y avoir acces. Peu d'analyses ont ete realisees pour determiner si l'utilisation des technologies d'assistance pour les personnes atteintes de demence peut contribuera l'application des droits de l'homme au sens de la Convention des Nations Unies relative aux droits des personnes handicapees. L'objectif de cet article consiste a examiner les dispositions pertinentes de cette convention et a considerer leurs implications pour l'utilisation des technologies d'assistance dans la prise en charge de la demence. Il est clair que les technologies d'assistance peuvent jouer un role important pour aider a l'implication sociale, a la prise de decision et a la planification anticipee des soins chez les personnes atteintes de demence. Mais des doutes existent aussi sur le potentiel de certaines de ces technologies a restreindre la liberte de mouvement et a enfreindre la vie privee. En conclusion, il est necessaire d'analyser les implications de l'usage des technologies d'assistance a la lurniere des legislations sur les droits de l'homme, afin de s'assurer que ces technologies soient employees de maniere a contribuera l'application des droits de l'homme et a atteindre l'ODD3 lie a la sante. Los objetivos de desarrollo sostenible (ODS) adoptados por las Naciones Unidas en 2015 incorporan un nuevo objetivo para la salud mundial: el ODS 3 tiene como objetivo 'garantizar vidas sanas y promocionar el bienestar para todos y para todas las edades'. Una atencion a la demencia de buena calidad es especialmente importante dado el aumento previsto en el numero de personas con dicha enfermedad. Se ha propuesto una gama de tecnologias de asistencia para apoyar la atencion a la demencia. Sin embargo, la organizacion Mundial de la Salud estimo en 2017 que solo una de cada 10 personas de los mil millones de habitantes o mas que hay en el mundo que podrian beneficiarse de tales tecnologias en cierto modo realmente pueden acceder a ellas. Para las personas con demencia, se han realizado pocos analisis de si las tecnologias de asistencia apoyaran sus derechos humanos de forma coherente con la Convencion de las Naciones Unidas sobre los Derechos de las Personas con Discapacidad. El objetivo de este articulo es examinar las disposiciones mas importantes de la convencion y considerar las consecuencias del uso de tecnologias de asistencia para la atencion a la demencia. Sin duda, estas tecnologias pueden tener un papel importante a la hora de apoyar el compromiso social, la toma de decisiones y la planificacion adelantada por parte de las personas que sufren demencia. Sin embargo, existen temores de que algunas de estas tecnologias puedan limitar la libertad de movimiento e invadir la privacidad. En conclusion, es necesario realizar un analisis de las consecuencias de las tecnologias de asistencia sobre las leyes de derechos humanos para garantizar que se utilicen las tecnologias de forma que respalden los derechos humanos y ayuden a lograrei ODS 3 relacionado con la salud., Introduction The sustainable development goals (SDGs) adopted by the United Nations in 2015 propose a new target for global health: the aim of SDG 3 is to 'ensure healthy lives [...]

The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent intervention for spousal caregivers. It is aimed at maintaining well-being by increasing social support and decreasing family discord, thereby delaying or avoiding nursing home placement of the person with dementia. Training in the NYUCI in the United States has, until now, been conducted in person to trainee practitioners. The Internet-based intervention was developed simultaneously for trainees in the U.S. and Australia. In Australia, due to population geography, community healthcare workers, who provide support to older adult caregivers of people with dementia, live and work in many regional and rural areas. Therefore, it was especially important to have online training available to make it possible to realize the health and economic benefits of using an existing evidence-based intervention. This study aimed to transfer knowledge of training in, and delivery of, the NYUCI for an Australian context and consumers. This article details the considerations given to contextual differences and to learners' skillset differences in translating the NYUCI for Australia.