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Abstract Background Frailty interventions such as Comprehensive Geriatric Assessment (CGA) can provide significant benefits for older adults living with frailty. However, incorporating such proactive interventions into primary care remains a challenge. We developed an IT-assisted CGA (i-CGA) process, which includes advance care planning (ACP). We assessed if, in older care home residents, particularly those with severe frailty, i-CGA could improve access to advance care planning discussions and reduce unplanned hospitalisations. Method As a quality improvement project we progressively incorporated our i-CGA process into routine primary care for older care home residents, and used a quasi-experimental approach to assess its interim impact. Residents were assessed for frailty by General Practitioners. Proactive i-CGAs were completed, including consideration of traditional CGA domains, deprescribing and ACP discussions. Interim analysis was conducted at 1 year: documented completion, preferences and adherence to ACPs, unplanned hospital admissions, and mortality rates were compared for i-CGA and control (usual care) groups, 1-year post-i-CGA or post-frailty diagnosis respectively. Documented ACP preferences and place of death were compared using the Chi-Square Test. Unplanned hospital admissions and bed days were analysed using the Mann-Whitney U test. Survival was estimated using Kaplan-Meier survival curves. Results At one year, the i-CGA group comprised 196 residents (severe frailty 111, 57%); the control group 100 (severe frailty 56, 56%). ACP was documented in 100% of the i-CGA group, vs. 72% of control group, p

Abstract Background As we experience a shortage of healthcare providers in Canada, it has become increasingly challenging for healthcare educators to secure quality clinical placements. We evaluated the impact of virtual simulations created for the virtual work-integrated learning (Virtu-WIL) program, a pan-Canadian project designed to develop, test, and offer virtual simulations to enrich healthcare clinical education in Canada. Evaluation was important since the virtual simulations are freely available through creative commons licensing, to the global healthcare community. Methods Students self-reported their experiences with the virtual simulations and the impact on their readiness for practice using a survey that included validated subscales. Open-ended items were included to provide insight into the students’ experiences. Results The evaluation included 1715 Nursing, Paramedicine and Medical Laboratory students enrolled in the Virtu-WIL program from 18 post-secondary universities, colleges, and institutions. Results showed most students found the virtual simulations engaging helped them learn and prepare for clinical practice. A key finding was that it is not sufficient to simply add virtual simulations to curriculum, careful planning and applying simulation pedagogy are essential. Conclusion Virtual simulation experiences are increasingly being used in healthcare education. Results from this rigorous, large-scale evaluation identified ways to enhance the quality of these experiences to increase learning and to potentially decrease the number of hours healthcare students need in clinical practice to meet professional competencies. Further research is needed regarding many aspects of virtual simulations and, in particular, curriculum integration and the timing or sequencing of virtual simulations to best prepare students for practice.

Background NHS England’s ‘Enhanced Health in Care Homes’ specification aims to make the healthcare of care home residents more proactive. Primary care networks (PCNs) are contracted to provide this, but approaches vary widely: challenges include frailty identification, multidisciplinary team (MDT) capability/capacity and how the process is structured and delivered.Aim To determine whether a proactive healthcare model could improve healthcare outcomes for care home residents.Design and setting Quality improvement project involving 429 residents in 40 care homes in a non-randomised crossover cohort design. The headline outcome was 2-year survival.Method All care home residents had healthcare coordinated by the PCN’s Older Peoples’ Hub. A daily MDT managed the urgent healthcare needs of residents. Proactive healthcare, comprising information technology-assisted comprehensive geriatric assessment (i-CGA) and advanced care planning (ACP), were completed by residents, with prioritisation based on clinical needs.Time-dependent Cox regression analysis was used with patients divided into two groups:Control group: received routine and urgent (reactive) care only.Intervention group: additional proactive i-CGA and ACP.Results By 2 years, control group survival was 8.6% (n=108), compared with 48.1% in the intervention group (n=321), p

Debates about the true purpose of education have increased globally in recent years, with climate change and the COVID-19 pandemic accelerating interest in the subject. It has become clear that education systems play a vital role not only in shaping the values, mindsets and ethical behaviours that we need for caring and responsible societies, but also in influencing our everyday interactions with the environment. To that end, wellbeing always concerns the triple nature of self, others and the natural world and there is increasing recognition of the need to move from a primary focus on personal happiness and attainment to a more balanced interest in the optimisation of human flourishing within the context of sustainable and regenerative futures. This article introduces the educational work of the Flourish Project, exploring the degree to which schools need to be understood as living systems and the way curricular frameworks, as they currently stand, may be inadvertently contributing to human languishing rather than flourishing. It explains the thinking behind the Flourish Model and describes the way in which the educational aspect of the Flourish Project hopes to contribute not only to the ongoing debate concerning the role of flourishing in education, but also to the growing global interest in the Inner Development Goals (IDGs) as skills and qualities that are vital for purposeful, sustainable, and productive lives.

This study examined how emotional distress mediated the relationship between cyber dating abuse and self-esteem. Participants were 155 undergraduate students (105 females; 50 males) ranging from 17 to 25 years old (M = 19.38, SD = 1.65) with dating experience and a minimum relationship duration of 3 months. Self-report assessments of cyber dating abuse, self-esteem, and emotional distress from the relationship were completed. Mediation analysis using multiple regressions revealed a full mediation model. Cyber dating abuse predicted lowered self-esteem and greater emotional distress. However, when emotional distress was entered as a predictor of self-esteem, cyber dating abuse became non-significant, indicating full mediation. Early-onset of dating was also a risk factor for cyber dating abuse and emotional distress. Few gender differences were evident. These findings add to the growing body of evidence on the negative effects of cyber dating abuse and suggest that distressing emotional reactions may underlie the deleterious consequences of this form of abuse.

March 24, 2005: While studying Gender Issues in Distance Education at Athabasca University, I read about the nomadic Fulbe women in Nigeria who learned by radio. I could understand their concerns with uninspired educational radio programs that did “not take into consideration the rhythm of . . . [their] lives” (Usman, 2001, p. 98). There was one tiny reference to a drama series, but as a scriptwriter and a woman interested in the power of storytelling as education, I was intrigued. The idea of serial drama as education was planted in my mind...