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Aims and objective: To test a spaced retrieval intervention using spaced retrieval to alleviate mealtime difficulties in older people with dementia. Design: A single‐case study design. Setting: Nursing Homes in North Central England, United Kingdom. Participants: Older people with Alzheimer's disease. Methods: A single‐case study using an ABA design was used. Data were collected using the Edinburgh Feeding Evaluation in Dementia scale, Mini Nutritional Assessment, and Body Mass Index before intervention, postintervention and following 3 months of postintervention. Realist evaluation was used to identify for which participants the intervention was effective, and an economic evaluation was also carried out. Finding Of 15 participants who entered the study, eight completed all phases of the study. A mean 104.4 h were needed to deliver the intervention. The number of sessions required ranged from 90–222. The length of time each participant retained information (for all sessions) ranged from 13–28 min. Participants had most difficulty with: "putting food into mouth and chewing it"; "realizing it was mealtime"; and "eating a whole meal continuously." A reduction in the difficulty with mealtimes occurred between phase A1–A2 for most participants. Six participants maintained this in phase A3. Similar patterns were evident for nutritional scores. For most participants, the effect size of the intervention was moderate or large. Conclusions: Spaced retrieval is useful in reducing mealtime difficulties in older participants with dementia. While the results of this study are promising, further large and multicentre trials are needed to explore the effectiveness of the intervention in diverse populations. [ABSTRACT FROM AUTHOR]

Withdrawal of artificially delivered nutrition and hydration (ANH) from patients in a permanent vegetative state (PVS) requires judicial approval in England and Wales, even when families and healthcare professionals agree that withdrawal is in the patient's best interests. Part of the rationale underpinning the original recommendation for such court approval was the reassurance of patients' families, but there has been no research as to whether or not family members are reassured by the requirement for court proceedings or how they experience the process. The research reported here draws on in-depth narrative interviews with 10 family members (from five different families) of PVS patients who have been the subject of court proceedings for ANH-withdrawal. We analyse the empirical evidence to understand how family members perceive and experience the process of applying to the courts for ANH-withdrawal and consider the ethical and practice implications of our findings. Our analysis of family experience supports arguments grounded in economic and legal analysis that court approval should no longer be required. We conclude with some suggestions for how we might develop other more efficient, just and humane mechanisms for reviewing best interests decisions about ANH-withdrawal from these patients. [ABSTRACT FROM AUTHOR]

To explore final year student midwives' experiences of breastfeeding education and clinical experience during their three year pre-registration midwifery degree course. Despite an increasing research base about what helps or hinders breastfeeding, there is a dramatic drop in breastfeeding prevalence within the first six weeks of birth. Breastfeeding support and education have been identified as influencing factors associated with breastfeeding prevalence, yet there is a paucity of evidence exploring infant feeding education for pre-registration student midwives. Qualitative data was gathered using semi-structured interviews with seventeen final year midwifery students in a Higher Education Institution in the North of England. Interviews were audio recorded, transcribed verbatim, and analysed using thematic analysis. Three core themes were identified: The Mentor-Student Relationship, Midwives and student midwives' attitudes towards breastfeeding and Theory-Practice Disassociation. University-based input provided them with underpinning knowledge but provided little opportunity to develop skills. Attitudes towards breastfeeding were predominantly negative, and these negative descriptions were frequently linked by students to time constraints and workload pressures. The relationship between students and mentors had a direct impact on students' development of breastfeeding support skills and confidence: students who had mentors who were enthusiastic about their role in facilitating learning in clinical practice were confident in supporting women with infant feeding. However, many students described the hospital environment as too busy for infant feeding skills teaching and guidance. Although few participants were dissatisfied with how their pre-registration midwifery education prepared them for clinical practice in general, the majority would have liked more opportunities to support women with infant feeding in complex and challenging cases, both in University and in clinical practice. There is a need for midwifery students to be provided with a variety of educational experiences such as theoretical classroom-based learning, simulation-based learning, peer learning, clinical care practice and direct service user engagement. These learning experiences need to include artificial feeding and breastfeeding. [ABSTRACT FROM AUTHOR]

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Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty‐one women were recruited on low‐risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire‐Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez‐faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression). [ABSTRACT FROM AUTHOR]

The article presents a case study of 32 years old women, who is suffering from Anorexia Nervosa after sexual abuse in her childhood. Topics discussed include patient's refusal of lifesaving treatment, evaluation of patient's frustration and decision-making competence for refusing treatment, and neurobiological traits and temperament construct of patient.

Focuses on the high court rules to stop feeding a severely brain damaged patient in Yorkshire, England. Withdrawal of artificial nutrition, hydration and other medical support measures; Objections regarding the rule; Role of physicians in making a clinical decisions in stopping the treatment.