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The number of Americans with dementia is expected to triple in 30 years. A workforce prepared to care for those persons is critical. A unique course at Arizona State University was created to address that need. Students enrolled in a course with weekly lectures by professionals working in dementia care, and also visited a person living with dementia each week, journaling about their visits. Journals were analyzed to explore the evolution of student attitudes throughout the semester. The states of "Exploration," "Letting Go," and "Connection" are described, with examples of journal entries provided. The course was successful in inspiring students to see persons living with dementia as fellow humans deserving of respect with whom they could enjoy rewarding relationships. This experience may lead them to have a special interest in persons living with dementia throughout their careers. Collaboration to create a similar course is invited.

Middle leadership is a dynamic area of policy in Scottish and Irish education to build leadership capacity. This article reports on a critical policy analysis of sequential sets of Scottish and Irish policy on middle leadership to identify codes of meaning. Two aspects are reported: (1) constructions of the purposes of middle leadership and (2) key themes in changing policy paradigms. While there is a development of policy ideas from delegated tasks to management functions to leadership for learning, there is little on the practice of leading learning. The findings are reviewed to identify issues related to middle leadership professional development.

Leadership is central to policy ambitions for improvement in Scottish education with leadership positioned as one of the key drivers for improvement to achieve excellence and equity for all learners. To foster teacher engagement in and leadership of change and to prepare enough teachers for headship, building leadership capacity is crucial. The question we explore is: how is it possible to design a career-long leadership development strategy to secure the capacity necessary to fulfil these policy intentions while fostering the autonomy of teachers in professional learning? First, we examine leadership development in the reform agenda and second, we consider the task of balancing system and individual needs in career-long leadership development. We then detail the approaches used to build a cohesive leadership system and its ongoing development.

This article explores some of the key issues that emerged in the revision of the professional standards in Scottish education. The revision of the professional standards was part of a wider project to build teacher professional learning in ways that had an impact on practice and on pupil learning. The article begins by examining the international literature to consider the two critical aspects of the design and the use of professional standards. The article then explores issues raised in the work to take forward the two recommendations from the Donaldson report related to, firstly, the professional standards providing a coherent framework and, secondly, the development of a "standard for active registration". The article then considers the tensions posed by the dual purposes ascribed to standards, those of regulation and development. The focus then turns to an alternative way of constructing a professional standard in order to foster authentic forms of professional learning. The article concludes by exploring the issues that need to be addressed to facilitate the productive use of professional standards in the career-long professional learning of teachers.

Background: Sapropterin has been approved as a treatment option for individuals with Phenylketonuria in the United Kingdom. Individuals are assessed as responsive to Sapropterin by a ≥30% reduction in Phenylalanine (Phe) concentrations using dried blood spot (DBS) specimens. DBS quality is critical for accurate and precise measurement of Phe. Currently, UK national guidelines for DBS specimen acceptance do not exist for patient-collected DBS specimens. We adopted evidence-based guidelines for specimen acceptance criteria and retrospectively assessed the impact of introducing these guidelines on specimen rejection rates. Methods: Laboratories were invited to audit the quality of DBS specimens routinely received for Phe monitoring using: (1) existing acceptance/rejection criteria and (2) proposed national guidelines. Results: Ten laboratories audited 2111 specimens from 1094 individuals. Using existing local guidelines, the median rejection rate was 4.0% (IQR 1.5–7.2%). This increased to 21.9% (IQR 10.0–33.0%) using the proposed guidelines. Where reason(s) for rejection were provided (n = 299); 211/299 (70.6%) of DBS specimens were too small or multi-spotted. 380 individuals had more than one sample evaluated; 231/380 (60.8%) provided specimens of acceptable quality, 37/380 (9.7%) consistently provided poor-quality DBS specimens. Conclusions: There is significant variability in the quality of patient-collected DBS specimens. If unacceptable specimens are not rejected, imprecise/inaccurate results will be used in clinical decision making. Using annual workload data for England, this equates to 12,410 incorrect results. Individuals and parents/carers should receive ongoing training in blood collection technique to ensure use of evidence-based acceptability criteria does not cause undue distress from increased sample rejection rates. [ABSTRACT FROM AUTHOR]

Intergenerational visitation programs have demonstrated advantages for the young and old, but few programs last more than a year or two. Weaving long-term intergenerational programs into the fabric of both school curricula and community cultural life was the goal of a project launched in 1988 in Phoenix, Arizona. Classrooms of children visit weekly or biweekly with nearby nursing home residents, developing friendships while pursuing educational activities. Carefully planned and widespread community support through board participation, donations, and publicity has allowed the program to continue to expand, while the budget has decreased. Materials are available which facilitate program replication. Key Words: Children, Nursing homes, Aging, Training

1. Participants will gain the knowledge to develop a cost-effective palliative care for dementia program with cultural adaptations that will reduce neurobehavioral symptoms of patients, reduce caregiver stress, reduce hospitalizations, and increase hospice admissions. 2. Participants will learn how to gather data to obtain insurance reimbursement for a low-cost and highly effective palliative care for dementia program. This session will describe and help others to create a hospice-supported 6-month palliative care model for dementia at any stage which reduced behavioral symptoms, caregiver stress, and hospitalizations, leading to insurance reimbursement and 24% of patients admitted to hospice. Varying results and adaptations for Native Americans, Hispanics, African Americans, Asians, and whites will be described. Persons living with dementia alone (homeless or in dwellings) or with family need social and medical support from those with specialized knowledge of dementia. Supportive Care for Dementia, a six-month program, was created to meet that need and has grown rapidly to over 600 patients. 1) Know the components of a successful palliative care program with cultural adaptations for persons living with dementia alone or with family. 2) Understand how to gather data to obtain insurance reimbursement. Data was gathered for 3000 patients living with caregivers and 350 patients living alone admitted to the program over 3 years. Gender and racial/ethnic data, Zarit Burden Interview (ZBI) and Neuropsychiatric Interview (NPI) scores, hospitalizations, and hospice admissions were tracked. For those living alone, quality of life was tracked. Cost of the program was calculated. Caregiver burden (ZBI) and NPI scores were reduced significantly (p <.001). Hospitalizations were reduced during and after the program. Challenges caring for those living alone (homeless or in dwellings) were analyzed and interventions developed. Results for Hispanics, African Americans, Native Americans, and Asians showed significant differences. Cost of the program was $260/patient/month. Supportive Care for Dementia is a successful palliative care program for patients with any stage of dementia with overwhelming community support. It significantly reduces behaviors for patients, reduces caregiver stress, reduces costs for insurers, and increases hospice admissions. Models of Palliative Care Delivery / Disease Specific Management [ABSTRACT FROM AUTHOR]

Notarial documentations of apprenticeship contracts in Quebec have provided accurate information on the employment of apprentices in Montreal during the 19th century. Records show that the length of apprenticeship are indirectly related to the age of the apprentices. It has also been observed that master craftsmen determine the value of apprentices on the number of probationary terms served by said apprentices.