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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]

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 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 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.

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.

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.

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.

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 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.