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Background: There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's health and well‐being. However, there remains a paucity of evidence for assessment and intervention practices for dysphagia and mealtime difficulties. Furthermore, there is a limited understanding of how speech and language therapists (SLTs) support people with these dementia‐related issues and what are the barriers and facilitators to practice. Further research is therefore needed to guide policy as well as service guideline and delivery development. Aims: To establish the current practices of SLTs managing dementia‐related dysphagia and mealtime difficulties in the UK and Republic of Ireland (ROI), and to establish their opinions and experiences of what challenges or supports to practice they have encountered. Methods & Procedures: An anonymous, cross‐sectional web‐based survey was developed and distributed to SLTs working in the UK and ROI. Respondents completed a questionnaire that consisted of open and closed questions across nine topic areas. Closed responses were evaluated using descriptive statistics; open‐ended questions were analysed using conventional content analysis. Outcomes & Results: A total of 310 people accessed the survey, and 125 respondents completed it fully. While respondents agreed on their role in dysphagia management, they varied in their views on the extent of their role in managing mealtime difficulties. Additionally, their self‐rated knowledge of mealtime difficulties in dementia was lower than their dysphagia knowledge. The respondents predominantly based their management decisions on their clinical experience of working with people with dementia. They primarily used compensatory strategies and frequently cited the need for family and care staff training. Respondents also highlighted barriers to effective management and training provision such as inefficient referral systems, a lack of carer knowledge and lack of SLT resources. Conclusions & Implications: The results provide valuable insight into the issues facing SLTs practising in this area. The SLTs surveyed considered dysphagia a core part of their role when supporting people with dementia; however, respondents' views on mealtime difficulties varied. This highlights the need to establish consensus guidelines on the SLT's role in order to avoid variations in service delivery that could negatively impact the health and well‐being of people with dementia. Moreover, further research to develop efficient and effective training for care staff supporting mealtime difficulties and dysphagia is essential. What this paper addsWhat is already known on the subjectResearch indicates that people with dementia develop dysphagia and mealtime difficulties as dementia progresses. SLTs often manage these, but there is no research on the effective assessment and management procedures, or guidance on best practice.What this paper adds to existing knowledgeThis paper provides an understanding of the variation in practice across the UK and ROI. Respondents described barriers to delivering an effective service and frequently linked these to the SLTs' resources as well as service constraints.What are the potential or actual clinical implications of this work?These findings support the need for future research to develop guidelines for SLT practice in this area. They also support the need to examine resource allocation and workforce management to enable SLTs to manage dementia‐related dysphagia and mealtime difficulties effectively. [ABSTRACT FROM AUTHOR]

The evidence base available to trialists to support trial process decisions-e.g. how best to recruit and retain participants, how to collect data or how to share the results with participants-is thin. One way to fill gaps in evidence is to run Studies Within A Trial, or SWATs. These are self-contained research studies embedded within a host trial that aim to evaluate or explore alternative ways of delivering or organising a particular trial process.SWATs are increasingly being supported by funders and considered by trialists, especially in the UK and Ireland. At some point, increasing SWAT evidence will lead funders and trialists to ask: given the current body of evidence for a SWAT, do we need a further evaluation in another host trial? A framework for answering such a question is needed to avoid SWATs themselves contributing to research waste.This paper presents criteria on when enough evidence is available for SWATs that use randomised allocation to compare different interventions. [ABSTRACT FROM AUTHOR]

The aim of the paper is to assess open disclosure in Ireland following clinical adverse events in healthcare. A number of areas were examined from the patient's and healthcare team's perspectives. The barriers/constraints to open disclosure, the extent of policies, procedures or guidelines that are available for staff to consult with, inclusive of how they are implemented, harvested valuable insight. The supports available for healthcare staff following an adverse event and patients' expectations after such an event are also encompassed to include the relationship open disclosure has on concerns regarding litigious intent. The questionnaire was disseminated to a multidisciplinary healthcare group. The questions were numbered 1-9, with a mixture of open and closed questions. A five-point Likert format was used with three questions in attitudinal/ opinion statements, regarding supports available for staff following an adverse event. A Statistical Package for Social Sciences was used to assist with the interpretation of data. This study was directed at the multidisciplinary healthcare team and senior management within the Health Service Executive (HSE) and Voluntary sectors. The oldest hospitals in Ireland are voluntary public hospitals some of them originating from the 18th century, having been established by charities and religious orders. Voluntary hospitals are partly funded by the HSE, specifically having their own governance structure. There was a response rate of 67% (n ¼ 192). A total 56.5% of respondents stated their organization did not have an open disclosure policy, procedure or guideline in place however, 16% of the attendees stated there was one in place. A total of 54.4% (104) acknowledged barriers/concerns surrounding open disclosure, with fear of litigious intent noted by 24% of respondents. A total of 52.3% (101) identified support availability to staff following an adverse event, 38.9% (10) felt there was little/no follow-up support, with 11.1.% (2) stating they were made to feel guilty, and associated it with being "on trial". Findings demonstrate an unstructured approach to disclosure of adverse events in Ireland, with fear of litigation a major concern for healthcare professionals. Error awareness among the general public, the introduction of protective legislation and implementation of a national standard on open disclosure in conjunction with practical training and education will all positively and practically influence open disclosure of adverse events in Ireland. [ABSTRACT FROM AUTHOR]