The aim of this qualitative study was to explore the impact of a home-based, personalised reminiscence programme facilitated through an iPad app on people living with dementia and their family carers. Semi-structured interviews were used to collect data from 15 people living with dementia and 17 family carers from a region of the United Kingdom. The interviews were recorded, transcribed and analysed using thematic analysis. Six key themes emerged related to usability ('It's part of my life now'); revisiting the past ('Memories that are important to me'); home use ('It was homely'); impact on the person living with dementia ('It helped me find myself again'); gains and abilities ('There is still so much inside') and impact on relationships ('It's become very close'). These themes highlighted the impact of the reminiscence experience at an individual and relationship level for people living with dementia and their carers. The reminiscence experience also appeared to facilitate the development of new insights among participants that emphasised abilities and gains rather than disabilities and losses. The significance of personal memories was a core theme although this was not without its challenges, particularly if memories were distressing. The reminiscence experience was differentiated by individual roles. Carers tended to become more relationship-focused, whereas people living with dementia highlighted the significance of learning new skills. The study concluded that individual specific reminiscence supported by an iPad app can have a positive impact on people living with dementia and their carers at an individual and relationship level.
Recent studies have focused on the use of technology to support reminiscence but there remains a dearth of research on the health costs and benefits associated with this intervention. The aim of this study was to estimate costs and quality of life associated with a home based, individual specific reminiscence intervention, facilitated by an iPad app for people living with dementia and their family carers, with a view to informing a future cost-effectiveness analysis. Use of community health and social care services, hospital services, prescribed medication and informal caregiving was assessed using an adapted version of the Client and Socio-Demographic Service Receipt Inventory (CSRI) at baseline and 3-month follow-up. Quality of life was assessed at baseline, 6-week and 3-month follow-up using the EQ5D, DEMQOL and DEMQOL proxy instruments. Results showed that average health and social care costs were £29,728 per person at baseline (T0) and £33,436 after 3 months (T2). Higher T2 costs were largely accounted for by higher informal caregiving costs. There was an overall increase in health-related quality of life over the duration of the intervention, although there were notable differences in index scores generated by the EQ5D (0.649, 0.652 and 0.719) and DEMQOL instruments (0.845, 0.968 and 0.901). The study concluded that a full cost-effectiveness analysis could incorporate a similar range of cost-categories with minor amendments to the CSRI to improve the accuracy of cost estimation. Furthermore, a larger sample size, randomisation and longer follow-up period are required to allow potential effects of the intervention to be realised and differences between intervention and control groups to be accurately detected.
Insulin is one of the top ten high-alert medications worldwide. Approximately 30% of people with diabetes in the UK use injectable therapies, most commonly insulin, to manage their condition. With an increasing number of people with diabetes being managed within the community, district nurses play an important role in the safe and effective use of insulin. This study surveyed a convenience sample of 164 district nurses working within one Health and Social Care Trust in Northern Ireland to ascertain their knowledge and practice regarding insulin. Study response rate was 38% (n=63). It was found that district nurses' knowledge and practice relating to insulin therapy was lacking as indicated by a total mean score of 53.1%. Total knowledge scores were slightly higher (58%) than total practice scores (46%). Nevertheless, 79.4% of district nurses felt secure and 6.3% felt very secure in managing diabetes. Deficits in district nurses' knowledge and practice were identified in areas relating to insulin action, dosage, storage, injection site technique and rotation, hypoglycaemic/hyperglycaemic management, pharmacological action and prescription format. These deficits highlight the need for workplacebased learning and development programmes, incorporating real time, point of care interventions, to enhance and maintain district nurses' insulin knowledge and practice.
This article presents results of survey data showing teacher qualifications for their assignments that are comparable from state-to-state as well as data trends over time. The analysis is intended to help state leaders, educators, and others obtain a picture of highly qualified teachers in their state, and to be able to compare their state statistics with states across the nation. Since states have some flexibility in meeting the standard for highly qualified teachers outlined by NCLB, the analyses presented in this paper from a national survey may be useful as a common benchmark for use by states as they develop their own state-specific definitions and measures.
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