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Background: Across the globe, shortages of nurses and midwives in rural regions persist. Advanced practice nursing has been found to address workforce shortages through career progression aimed at retention. A regional health service sought to consult with staff about developing an advanced practice nursing framework. Aims: This study aimed to explore the perspectives of nurses and midwives at a regional health service on (i) how their roles aligned with the modified Advanced Practice Role Delineation (APRD) tool and (ii) the potential for implementation of such a framework at their service. Design: A case study conducted at Goulburn Valley Health (GVH) in southeast Australia used a mixed method design with a survey of all nursing and midwifery staff and focus groups with senior staff. Methods: All nurses and midwives were asked to complete a validated modified ARPD questionnaire and those in Grades 3–6 were asked to participate in a focus group. Results: From 183 questionnaires and 38 participants in the focus group discussions, findings concurred that nurses and midwives at GVH reported spending most time on direct patient care and minimal time on research activities, publication and/or leadership. While education was strongly embraced and advanced practice usually supported, senior staff cited the lack of resources, the culture and staff shortages as restricting opportunities for education, career development and implementation of an advanced practice framework. Conclusions: While an advanced practice framework could address staff shortages at this health service, implementation of such a framework is constrained by the lack of resources and workforce shortages common in rural health services. A national strategy that embeds advanced practice roles and resources implementation of advanced practice nursing and midwifery frameworks in areas of need is recommended. [ABSTRACT FROM AUTHOR]

Problem behaviors among persons with Alzheimer's Disease (AD) have a significant impact on caregivers. However, caregivers' subjective reaction to the problem behaviors better predicts the caregiving outcomes than the objective frequency of problem behaviors. With a sample recruited from community agencies serving Alzheimer's Disease (AD) caregivers (n = 108), this study examined the effect of various factors on the caregivers 'reaction to different types of problem behaviors, including demographics, caregivers' knowledge about the AD, and resilience level, controlling for the frequency of problem behaviors and other caregiving context factors. Caregivers' reaction to problem behaviors was measured by the Revised Memory and Behavior Problem Checklist. Findings indicated that African American caregivers had a lower level of reactions to disruptive (B = −3.956; p <.01) and depressive behaviors (B = −2.443; p <.05) than white caregivers, but not for memory-loss problems. Age, being spousal caregivers, and knowledge of AD only affected reactions to memory-loss problems but not for other types of behaviors. No effects were observed for personal resilience. Intervention should be tailored to the varied needs of family caregivers to deal with problem behaviors among people with AD to delay institutionalization. More training/resources at the skill level over the information-only caregiver intervention should be promoted. [ABSTRACT FROM AUTHOR]

Background: Case management is one of the most frequently performed interventions to mitigate the negative effects of high healthcare use on patients, primary care providers and the healthcare system. Reviews have addressed factors influencing case management interventions (CMI) implementation and reported common themes related to the case manager role and activities, collaboration with other primary care providers, CMI training and relationships with the patients. However, the heterogeneity of the settings in which CMI have been implemented may impair the transferability of the findings. Moreover, the underlying factors influencing the first steps of CMI implementation need to be further assessed. This study aimed to evaluate facilitators and barriers of the first implementation steps of a CMI by primary care nurses for people with complex care needs who frequently use healthcare services. Methods: A qualitative multiple case study was conducted including six primary care clinics across four provinces in Canada. In-depth interviews and focus groups with nurse case managers, health services managers, and other primary care providers were conducted. Field notes also formed part of the data. A mixed thematic analysis, deductive and inductive, was carried out. Results: Leadership of the primary care providers and managers facilitated the first steps of the of CMI implementation, as did the experience and skills of the nurse case managers and capacity development within the teams. The time required to establish CMI was a barrier at the beginning of the CMI implementation. Most nurse case managers expressed apprehension about developing an "individualized services plan" with multiple health professionals and the patient. Clinic team meetings and a nurse case managers community of practice created opportunities to address primary care providers' concerns. Participants generally perceived the CMI as a comprehensive, adaptable, and organized approach to care, providing more resources and support for patients and better coordination in primary care. Conclusion: Results of this study will be useful for decision makers, care providers, patients and researchers who are considering the implementation of CMI in primary care. Providing knowledge about first steps of CMI implementation will also help inform policies and best practices. [ABSTRACT FROM AUTHOR]

Background: Studies have highlighted common challenges and barriers to patient engagement in research, but most were based on patient partners' or academic researchers' experiences. A better understanding of how both groups differentially experience their partnership could help identify strategies to improve collaboration in patient engagement research. Aim: This study aimed to describe and compare patient partners' and academic researchers' experiences in patient engagement research. Methods: Based on a participatory approach, a descriptive qualitative study was conducted with patient partners and academic researchers who are involved in the PriCARE research programme in primary health care to examine their experience of patient engagement. Individual semi‐structured interviews with patient partners (n = 7) and academic researchers (n = 15) were conducted. Academic researchers' interview verbatims, deidentified patient partners' summaries of their interviews and summaries of meetings with patient partners were analysed using inductive thematic analysis in collaboration with patient partners. Results: Patient partners and academic researchers' experiences with patient engagement are captured within four themes: (1) evolving relationships; (2) creating an environment that fosters patient engagement; (3) striking a balance; and (4) impact and value of patient engagement. Evolving relationships refers to how partnerships grew and improved over time with an acceptance of tensions and willingness to move beyond them, two‐way communication and leadership of key team members. Creating an environment that fosters patient engagement requires appropriate structural support, such as clear descriptions of patient partner roles; adequate training for all team members; institutional guidance on patient engagement; regular and appropriate translation services; and financial assistance. For patient partners and academic researchers, striking a balance referred to the challenge of reconciling patient partners' interests and established research practices. Finally, both groups recognized the value and positive impact of patient engagement in the programme in terms of improving the relevance of research and the applicability of results. While patient partners and academic researchers identified similar challenges and strategies, their experiences of patient engagement differed according to their own backgrounds, motives and expectations. Conclusion: Both patient partners and academic researchers highlighted the importance of finding a balance between providing structure or guidelines for patient engagement, while allowing for flexibility along the way. Patient or Public Contribution: Patient partners from the PriCARE research programme were involved in the following aspects of the current study: (1) development of the research objectives; (2) planning of the research design; (3) development and validation of data collection tools (i.e., interview guides); (4) production of data (i.e., acted as interviewees); (5) validation of data analysis tools (code book); (6) analysis of qualitative data; and (7) drafting of the manuscript and contributing to other knowledge translation activities, such as conference presentations and the creation of a short animated video. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to identify stressors of Black family caregivers (FCGs) of persons with memory problems (PWMPs), services of interest, and barriers to use of these services. Black FCGs were recruited from the Alzheimer's family program at the University of Alabama at Birmingham and affiliated geriatric clinics, media sources, and word-of-mouth referrals. Of 38 Black FCGs interviewed, 26 (68%) were female, 18 (47%) were employed, and 21 (55%) were adult children. Average age of FCGs was 52.11 years. Mean scores for the AD8 Dementia Screening Scale (mean = 13.95, SD = 2.17) and Clinical Dementia Scale Sum of Boxes (mean = 7.29, SD = 0.87) were higher than clinical cutoffs. The most common stressors for Black FCGs were PWMPs' inability to remember who they were, managing care recipients' financial affairs, and managing PWMPs' comorbid conditions. FCGs were most interested in educational material regarding treatment and diagnosis (55.3%), caring for people with dementia (52.6%), understanding dementia (52.6%), and financial/legal services (52.6%). FCGs stated that transportation difficulties and the need for a relief person were barriers to use of services. Results suggest that Black FCGs may be more likely to participate in interventions that include virtual conferencing modalities. [Journal of Gerontological Nursing, 48(6), 13–18.] [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has inundated the capacity of hospitals across the globe, exhausting resources, and placing extreme burden on health care workers (HCWs). Hospital preparedness during infectious disease outbreak involves development and implementation of appropriate strategies, procedures, and adequate training for HCWs. Reliable and valid tools to evaluate the perception of HCWs on the effectiveness of hospital preparedness strategies are imperative and literature is yet to fill that gap.Methods: Items for 'The Staff Questionnaire for Infectious Disease Outbreak Readiness and Preparedness (SQIDORP)' were selected from literature that addressed hospital preparedness during novel pandemic outbreaks. The SQIDORP was distributed within a regional hospital in Victoria, Australia. Psychometric evaluation included estimates of reliability and factor analysis while factors associated with the questionnaire were explored using regression analysis.Results: Omega coefficient of 0.89, Cronbach's alpha coefficient of 0.88 and item-total correlations (> 0.3) indicated adequate reliability of the SQIDORP. Factor Analysis yielded three meaningful latent factors that are effectiveness of training (Factor 1), self-confidence (Factor 2) and risk to self and stress (Factor 3). Demographic factors did not influence the correlation with SQIDORP. However, rating 'the current plan for management of COVID-19 in your ward' and 'personal knowledge/skills in caring for patients with COVID-19' had significant positive correlation and accounted for 33% of the variance in readiness and preparedness using SQIDORP (R2 = 0.33, F = 10.227, P < 0.001).Conclusion: Most of the items of SQIDORP questionnaire achieved adequate internal consistence reliability. This is a valuable tool that can be utilized by hospitals to explore aspects of preparedness and give insights to the knowledge, skills, and mental health of HCWs, as perceived by the HCW themselves. [ABSTRACT FROM AUTHOR]

Caring for an individual living with Alzheimer's disease and other forms of dementia is especially challenging and impacts every aspect of the lives of the family caregivers. Family caregiving is defined as informal, unpaid care provided by family or friends to people with a chronic illness or disability. Caregiver burden, often experienced by a caregiver for a cognitively impaired family member, is multifaceted involving physical, psychological, social, and emotional problems. To date, little has been done to examine the relationship between the knowledge of Alzheimer's disease and memory loss and caregiver burden. To fill this gap, a cross sectional, correlational design was employed to collect data from a convenience sample (N = 104) of African American and Caucasian dementia family caregivers. For this study, caregivers ranged from 25 to 89 years of age with African American caregivers possessing significantly lower levels of knowledge about Alzheimer's disease and other dementias compared to Caucasian caregivers, p <.001. There were 44 caregivers who scored 41 or greater on the Caregiver Burden Inventory corresponding to moderate to severe and higher levels of burden. Results of hierarchical multiple regression models indicated that higher levels Alzheimer's disease knowledge was significantly associated with lower caregiver burden for all caregivers, B = −0.294, p <.01. Additionally, employment status was significantly associated with caregiver burden. This study highlights the benefits of including disease specific knowledge within educational components of dementia related interventions and programs involving families. [ABSTRACT FROM AUTHOR]

The article focuses on the practical application of derivatives in asset management, particularly in light of the Securities and Exchange Commission's new Rule 18f-4. Topics include the need for a risk manager to draft a derivatives risk management program, the significance of educating investment fund boards on derivatives use, and the articles in the special issue providing a guided tour of foundational concepts.

The article presents Jean Brunel, Managing Principal of Brunel Associates, and his frustration over the wealth management industry's slow take-up of goals-based investing. Topics discussed include a method he favors called forward sequencing which addresses goals and breaks them down into need, wants, wishes and dreams, the role of an advisor in helping his firm deliver to the client what the client actually needs and his lament that present managers are structured with too many chiefs.

The article discusses a new marketplace where investors has to understand and optimize the sources of their returns and managers need to deliver active returns beyond static exposures to smart-beta factors. Topics discussed include a suggested framework for understanding strategy returns and risks and constructing portfolios with a blend of active, smart beta and index products and the need for active managers to deliver pure alpha or see their fees compress dramatically.

The article discusses Marty Leibowitz, Stan Kogelman and Anthony Bova's practical applications and their discovery that culminated in "Forward Curve Shifts and Return Convergence." Topics discussed include Leibowitz's discovery that the average rolling yield of a laddered bond portfolio will always be its starting top-rung yield and their assumption that when there are parallel shifts in a positively sloped yield curve, a portfolio's return will converge to its average starting rolling yield.

The author looks at the future of market capitalization-weighted indices. Topics discussed include the alternatives to cap-weighted indices and their incorporation into policy portfolios, the evolution of capital asset pricing models (CAPM), and the academic and real-life rationale for the growth of cap-weighted indices during the 1980s and 1990s.

The article examines the practical applications of high-conviction active management or the selection of securities that managers strongly believe will outperform. Topics discussed include the identification of high-conviction active managers with the highest information ratio, the need to view manager structure optimization as a way to build a portfolio of managers, and the fundamental law of active management.

An interview with John C. Bogle, founder of the investment management company, The Vanguard Group, is presented. Topics discussed include the company's launch of the world's first index mutual fund, his views on smart beta and high-frequency trading, and the state of finance and its major players during the 1970s.

An interview with professor David Nanigian about his research on the use of R-squared mutual fund selection strategy and the benefits of multiple-fund portfolio published in "The Journal of Investing" is presented. When asked about the difference between the active share measure and the R-squared method, he explains that R-squared is an alternative way of gauging strategy distinctiveness. He also notes the use of R-squared to detect whether or not a mutual fund is engaging in closet indexing.

An interview with David Laster, head of Retirement Strategies at Merrill Lynch Wealth Management, about his article "When Should You Claim Social Security?" published in "The Journal of Retirement" is presented. He discusses the potential impact of waiting to claim Social Security on monthly benefits and notes that the most popular time to claim benefits is at age 62. He also presents the shortcomings of breakeven analysis and explains how a couple can take advantage of the survivor's benefit.

An interview with professor and investment strategy advisor to Man Group Campbell R. Harvey about his article on trading strategies, which was awarded the 2015 Best Article in the 16th Annual Bernstein Fabozzi/Jacob Levy Awards, is presented. When asked why he wrote the article with assistant professor Yan Liu, Harvey relates that they got interested in looking outside of finance. He also notes that the U.S. financial industry received the findings of the research article positively.

An interview with Marcos López de Prado, senior managing director at financial services firm Guggenheim Partners, about his article on the deflated Sharpe ratio (DSR) that he co-authored with financial mathematician David H. Bailey, is presented. When asked about the fundamental cause of performance inflation, he explains that it is caused by the multiple testing problem. He also offers examples of investment strategies that have been overfit.

The stromal domain (PsaC, PsaD, and PsaE) of photosystem I (PSI) reduces transiently bound ferredoxin (Fd) or flavodoxin. Experimental structures exist for all of these protein partners individually, but no experimental structure of the PSI/Fd or PSI/flavodoxin complexes is presently available. Molecular models of Fd docked onto the stromal domain of the cyanobacterial PSI site are constructed here utilizing X-ray and NMR structures of PSI and Fd, respectively. Predictions of potential protein-protein interaction regions are based on experimental site-directed mutagenesis and cross-linking studies to guide rigid body docking calculations of Fd into PSI, complemented by energy landscape theory to bring together regions of high energetic frustration on each of the interacting proteins. The results identify two regions of high localized frustration on the surface of Fd that contain negatively charged Asp and Glu residues. This study predicts that these regions interact predominantly with regions of high localized frustration on the PsaC, PsaD, and PsaE chains of PSI, which include several residues predicted by previous experimental studies. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article presents an interview with Senior Advisor to the Pew Charitable Trusts Sheila C. Bair conducted during the 67th CFA Institute Annual Conference in May 2014. Topics of the interview include the role of investors and asset managers in the financial crisis, Bair's criticism of U.S. monetary policy, and her opinion on U.S. Department of the Treasury's floating-rate note program.

A review of the article “Is Smart Beta Still Smart After Taxes?” written by Paul Bouchey and Hemambara Vadlamudi which appeared in the Summer 2014 issue of “The Journal of Portfolio Management” is presented.

The article presents excerpts from an interview with the managing and founding principal of AQR Capital Management Clifford S. Asness, conducted during the 67th CFA Institute Annual Conference in May 2014. Topics include the Efficient Market Hypothesis (EMH), the Capital Asset Pricing Model (CAPM), and economic bubbles.

The article presents an interview with Robert Litterman, Chairman of the Risk Committee at Kepos Capital, conducted during the 67th CFA Institute Annual Conference in May 2014. Topics of the interview include the efficiency of financial markets, the utilization of big data and machine learning in financial services, and derivative instruments.

An excerpt from the interview with financial executives, Robert Schwartz and Nazli Sila Alan is presented.

An interview with Johns Hopkins Carey Business School assistant professor Jim Kyung-Soo Liew and Investment Research Foundation fellow Andrew Marks is presented. They explained the impact of inflation on the value of a portfolio. They talked about inflation as an international phenomenon. They also expressed their views on the possibility of predicting the extent of inflation.

An interview with Windham Capital Management president and chief executive officer (CEO) Mark Kritzman, State Street Global Exchange managing director David Turkington, and State Street senior managing director Will Kinlaw is presented. Kritzman talks about the struggle of investors concerning liquidity in portfolio construction. Turkington offers information on the benefits of liquidity. Kinlaw expresses his views on liquidity assets.

Caring for an individual with Alzheimer's disease is at times challenging and can lead to caregiver burden. Resilience is a personality characteristic that has emerged as a protective factor among aging individuals. This study was conducted to examine the moderating effect of resilience between caregiver stressors and caregiver burden. The results indicate that resilience was not identified as a moderator between stressors and caregiver burden; however, a relationship exists between resilience and caregiver burden. Specifically, as resilience in Alzheimer's disease caregivers increases, their caregiver burden decreases. These findings highlight the importance of supportive interventions that will increase resilience in Alzheimer's disease caregivers. [ABSTRACT FROM AUTHOR]

The article presents a study of the diversification benefits of frontier market exchange-traded funds (ETFs) as of July 2014. The authors demonstrate the lack of interrelation between frontier and global markets and conclude that investments in frontier market ETFs offer lower volatility. Other topics include the impact of frontier markets on mean returns. Several terms including frontier markets, minimum variance, and idiosyncratic risk are also discussed.

An introduction is presented in which the editor discusses the various articles within the issue on topics, including the use of valuation in sector rotation strategies, the impact of crowding on quantitative equity portfolios, and the use of liquidity signals in the construction of asset allocation models.