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Introduction: The implementation of the Screening Identification Assessment and Support (SIAS) policy has been ongoing for almost a decade to provide care and support to all learners, including those with neurodevelopmental challenges such as dyslexia. Despite these efforts, many primary school learners continue to experience barriers to learning associated with dyslexia. This phenomenon is of great concern in rural communities where dyslexia is generally ignored and misunderstood. On the other hand, there is a lack of research investigating the effectiveness of the SIAS policy in supporting learners with dyslexia. Existing studies often focus on dyslexia and the SIAS policy in isolation. Methods: The 'qualitative research' approach was adopted. Autoethnography was employed as the study's design, positioned within the interpretivism paradigm to investigate the effectiveness of the SIAS policy in supporting learners with dyslexia characteristics in Tlokweng village. The sample consists of (5) participants and Critical reflection and auto-interviewing methods were used to generate data, which was thematically analysed. Bronfenbrenner's Ecological Systems Theory was used to understand the interaction between learners, their environment, and the SIAS policy. Results and discussion: The findings suggest that the SIAS policy is ineffective in its screening process. Also, learners' perceptions indicate a gap in teachers' readiness to address learning barriers associated with the characteristics of dyslexia. Lastly, there is a need for continuous monitoring of the SIAS implementation. [ABSTRACT FROM AUTHOR]

Though most people wish to live long and see old age, ageing is associated with psychological, emotional, physical, social, health, and economic problems. Many older adults and retirees have died untimely as a result of lack of care and support, abandonment, loneliness, abuse and neglect, and complications from health issues. Reliance on informal care and support and the lack of functional formal living arrangements for older adults have compounded their woes. This study is aimed at finding out the problems associated with the lack of formal living arrangements, care, and support services for older adults and retirees in Nigeria, and the need to revamp social protection mechanisms to enhance the welfare of older adults. Twenty-eight participants were selected for the study, using qualitative methods of sample selection. Data were collected using in-depth interviews and analysed thematically. Findings revealed that older adults and retirees lack social protections, care, and support and suffer from poverty, nonpayment of retirement benefits, and lack of welfare visits by social workers. The study recommended the need for revamping social protection strategies for older adults and the involvement of social workers as caregivers for older adults. [ABSTRACT FROM AUTHOR]

As a signatory to the applicable United Nations declarations, South Africa is obliged to ensure that all children have access to quality education. The reality, though, is that there are many barriers that make access to education difficult if not impossible. School violence, an escalating worldwide phenomenon, is widely cited as one of the challenges that schools face. The problem, as research has shown, is most prevalent and disruptive in poor communities. Many teachers reportedly leave the profession because they fear school violence or after they have been victims of violent attacks at their schools. In this article we explore the effect that violence in schools can have on teachers, as experienced by a case of three teachers. An interpretative phenomenological design was used to examine closely the participants' experiences of school violence. The study used the concepts of care and support as theoretical lenses to explore the relationship between sustainable development goals 3 (good health and well-being) and 4 (quality education) of the United Nations in relation to teachers' health as inclusive teachinglearning environments for all school members. Data were collected through narratives that were thematically analysed. The findings revealed that school violence has a negative impact on the general well-being of teachers and can produce what we call narratives of disillusionment. [ABSTRACT FROM AUTHOR]

IntroductionThe implementation of the Screening Identification Assessment and Support (SIAS) policy has been ongoing for almost a decade to provide care and support to all learners, including those with neurodevelopmental challenges such as dyslexia. Despite these efforts, many primary school learners continue to experience barriers to learning associated with dyslexia. This phenomenon is of great concern in rural communities where dyslexia is generally ignored and misunderstood. On the other hand, there is a lack of research investigating the effectiveness of the SIAS policy in supporting learners with dyslexia. Existing studies often focus on dyslexia and the SIAS policy in isolation.MethodsThe ‘qualitative research’ approach was adopted. Autoethnography was employed as the study’s design, positioned within the interpretivism paradigm to investigate the effectiveness of the SIAS policy in supporting learners with dyslexia characteristics in Tlokweng village. The sample consists of (5) participants and Critical reflection and auto-interviewing methods were used to generate data, which was thematically analysed. Bronfenbrenner’s Ecological Systems Theory was used to understand the interaction between learners, their environment, and the SIAS policy.Results and discussionThe findings suggest that the SIAS policy is ineffective in its screening process. Also, learners’ perceptions indicate a gap in teachers’ readiness to address learning barriers associated with the characteristics of dyslexia. Lastly, there is a need for continuous monitoring of the SIAS implementation.

As a signatory to the United Nations, South Africa is obliged to ensure that all children have access to quality education. The reality though is that there are many barriers which make access to education difficult if not impossible. School violence, an escalating worldwide phenomenon, is widely cited as one of the challenges that are faced by schools. The problem, as research has shown, is most prevalent and disruptive in poor communities. Many teachers are reportedly leaving the profession because they fear school violence or after being victims of violent attacks in their schools. In this article we demonstrate that violence in schools can have a debilitating effect on teachers as experienced by a case of two teachers. An interpretative phenomenological design was used to examine closely the participants’ experiences of school violence. The study was framed around the concepts of care and support in order to understand how sustainable development goals 3 (good health and wellbeing) and 4 (quality education) in relation to teachers’ health are important pillars for inclusive teaching-learning environments for all school members. Data was collected through narratives which were thematically analysed. The findings reveal that school violence has a negative impact on the general wellbeing of teachers and can produce what we call narratives of disillusionment.

Fetal alcohol spectrum disorder (FASD) is a lifelong disability of varying severity that occurs among individuals prenatally exposed to alcohol. Among Aboriginal and Torres Strait Islander (Indigenous) Australians, the effects of colonisation and ongoing racism could increase the risk of alcohol consumption during pregnancy. Much of the research and the effort towards prevention of and caring for people with FASD in Indigenous communities has been targeted towards women and children. More support and effort towards prevention of FASD is needed across the whole Indigenous community. In this paper, we discuss several areas for increased involvement by Indigenous men in future FASD research, prevention, care and support. [ABSTRACT FROM AUTHOR]

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In recognition of the broader relational aspects of viral infections, family support is considered important when someone is diagnosed with a blood-borne virus (BBV), such as HIV, hepatitis C (HCV) and hepatitis B (HBV). However, families' own support needs are often not a priority in service provision within the BBV sector. In this article, we draw on qualitative interviews with 20 key informants working in various professional capacities in health, social policy, care and advocacy sectors in Australia, and explore their experiences and perspectives on family inclusivity in their services. Overall, key informants acknowledged the diversity of what constitutes family, and consistently viewed family engagement as beneficial to both diagnosed individuals and the wider familial networks affected by a diagnosis. However, prioritising individual care in support services presented barriers to engaging families, which are further complicated by the role of stigma in shaping the social realities of living with a BBV. Increasing understanding in service provision settings that serodiscordance can be a family experience has the potential to widen this analytic lens to consider the support needs of families in their own right. [ABSTRACT FROM AUTHOR]

The experiences of women in low and middle-income countries following perinatal death remains difficult and challenging, thereby increasing their susceptibility to negative psychological impact particularly with insufficient bereavement care and support. Perinatal death invariably brings intense grief which significantly impacts women, and requires adequate bereavement care to limit negative outcomes in the short and long-term. To develop deeper understanding of women's experience of care and support following perinatal death in high burden settings. Six electronic databases were searched with relevant terms established using the SPIDER tool, supplemented by hand search of reference lists. Studies were independently screened for inclusion by all authors. Meta-ethnography (Noblit and Hare,1988) was used to synthesise existing qualitative studies. Eight studies conducted in Sub-Saharan African and South Asian countries namely South Africa, Uganda, Ghana, Kenya, India and Malawi were included, and three main themes were identified; mothers' reaction to their baby's death, care and support after perinatal death, and coping strategies in the absence of care and support. Perinatal death was not appropriately acknowledged therefore care and support was inadequate and, in some cases, non-existent. Consequently, mothers resorted to adopting coping strategies as they were unable to express their grief. There is insufficient care and support for women following perinatal death in high burden settings. Further research is required into the care and support being given by healthcare professionals and families in high burden settings, thereby ultimately aiding the development of guidance on perinatal bereavement care. [ABSTRACT FROM AUTHOR]

It is well accepted that the preferred place of care for many people is in their own homes and that home care services have the potential to allow people to remain in their own homes for as long as possible. This narrative review aimed to summarize the existing literature on person-centered practices in home care and develop a conceptual framework, based on The Health Information and Quality Authority’s (HIQA) standards development principles, to achieve high-quality person-centered home care. A narrative review was conducted using the academic databases Embase, APA PsychInfo, Social Services Abstracts and CINAH. A qualitative content analysis was used to analyze and synthesize the findings. In total 39 studies were included in this narrative review. This review emphasizes four key principles for person-centered home care. A human-rights based approach ensures care is delivered with dignity, respect, and non-discrimination, guaranteeing equitable access for all. The safety and wellbeing principle focuses on preventing health decline and harm, while promoting the overall well-being of the care recipient. Responsiveness centers on how staff identify and address individual needs, with their skills and competencies playing a crucial role. Finally, the accountability principle underlines the importance of strong leadership, clear governance, and effective collaboration between home care and other services. The approach of using principles as a framework to underpin this study can inform policymakers, home care providers and others in good practice in upholding person-centered care during the development of home care policy and care delivery. [ABSTRACT FROM AUTHOR]

Few theory-informed interventions to support people who use drugs during sex have been conceptualized and developed. We conceptualize sexualized drug use, also referred to as chemsex or pharmacosex, as a self-control challenge, and draw on extant theory and research to propose intervention approaches that can be tailored to meet the differing needs of people who engage in sexualized drug use. We draw on a continuum perspective of sexualized drug use, in particular chemsex, and discuss the role of reasoned and automatic processes in behavioral decisions, as well as critical components of effective self-control of behavior. A self-control approach can empower people to tackle their sexualized drug use, and classify their experienced sex-related drug use as problematic. Self-control encompasses clarifying one's goals and identifying strategies to mitigate behaviors to achieve these goals, despite competing pharmacosex desires. Our approach to self-control sexualized drug use contains three critical components: goal setting, goal enactment, and goal progress appraisal and goal adjustment. Goals should be formulated specific, ambitious yet realistic, and tailored to the individual's needs and wishes. Goals may target aspects of drug use, protecting sexual health and mitigating negative impacts. Implementing goal enactment implies translating goals into concrete (short-term) actions to move toward the higher-order goal via goal intentions and action/coping plans. During the goal progress appraisal and adjustment stage, people compare their actual with their planned behavior. This reflection may result in goal adjustment through feedback loops to adjust their goals and action/coping plans. We propose that our self-control approach can guide the development of interventions to effectively support people to prevent or limit pharmacosex, and helps to effectively mitigate or reduce negative impacts via self-help, peer support or professional support, offered via personal counseling or digital tools.

Introduction: Parental satisfaction is one of the indicators of quality care. An understanding of the satisfying areas would help to identify and prioritize care and support areas for infants and parents. Therefore, this study was conducted to find out the parental satisfaction with care and support in neonatal care units (NCUs). Methods: Cross-sectional descriptive study was conducted in NCUs of five selected public hospitals. The study was conducted among 305 parents of preterm infants (PTIs). After obtaining ethical approval, in-person interviews were conducted with parents using a satisfaction questionnaire. Both descriptive and inferential statistics were used for data analysis. Results: Parents were moderately satisfied with care and support with a median score and interquartile range of 3.4 (3.1- 3.8). They were highly satisfied with the infant care and least satisfied with the attachment and care guidance support with median scores of 4.0 (3.5 - 4.0) and 3.1 (2.6 - 3.8) respectively. Parental satisfaction was significantly associated with parental age, gestational age at birth, and birth weight (P value < 0.05). Conclusions: Parents are moderately satisfied with the care and support received in the NCUs. Their satisfaction is lower with the support for attachment and care guidance. In addition to competent and affectionate care to PTIs, parental support for attachment, guidance, and involvement in care need to be considered by NCU personnel. [ABSTRACT FROM AUTHOR]

From 2011, Suffolk County Council ("SCC") provided direct payments of between £108-150 per week to both BG and KG. Eligible needs, Care Act 2014, carers, care and support, judicial review, wellbeing principle BG and KG sought a judicial review of the Council's decisions to cease the payments. [Extracted from the article]

A greater number of people with intellectual disability are living into older age and are at increased risk of developing conditions such as dementia. Caring for a person with dementia presents several challenges for formal caregivers due to the progressive nature of the disease. An interpretive phenomenological analysis was used to understand the lived experiences of a purposive sample of formal caregivers in caring for people with intellectual disability and dementia. Discussions from 14 individual interviews generated data were analysed. Four key super-ordinate themes emerged which were: (1) recognising early indicators and diagnosis, (2) post diagnostic support, (3) coping with change and (4) need for future development. Themes reflected the experiences, barriers to dementia diagnosis and provide a valuable insight into the challenges faced by formal caregivers in providing aged care services., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abstract Background The number of older people with unmet care and support needs is increasing substantially due to the challenges facing the formal and informal care system in the United Kingdom. Addressing these unmet needs is becoming one of the urgent public health priorities. In order to develop effective solutions to address some of these needs, it is important first to understand the care and support needs of older people. Methods A scoping review was conducted, using the Arksey and O’Malley original and enhanced framework, to understand the care and support needs of older people, focusing on those living at home with chronic conditions in the UK. The search was conducted using five electronic data bases, grey literature and reference list checks. The WHO International Classification of Functioning, Disability and Health (ICF) framework was used to analyse and categorise the literature findings. Results Forty studies were included in the final analysis- 32 from academic literature and 8 from grey literature. The review highlighted that older adults faced a range of physical, social and psychological challenges due to living with chronic conditions and required care and support in three main areas: 1) social activities and relationships; 2) psychological health; and 3) activities related to mobility, self-care and domestic life. The review also highlighted that many older people demonstrated a desire to cope with their illness and maintain independence, however, environmental factors interfered with these efforts including: 1) lack of professional advice on self-care strategies; 2) poor communication and coordination of services; and 3) lack of information on services such as care pathways. A gap in the knowledge was also identified about the care and support needs of two groups within the older population: 1) older workers; and 2) older carers. Conclusions The review highlighted that older people living with chronic conditions have unmet care needs related to their physical and psychological health, social life, as well as the environment in which they live and interact. Findings of this review also emphasized the importance of developing care models and support services based around the needs of older people.

Abstract Background Frail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality. People in need of help do not always find their way to care and support services and are left undetected. The aim of the D-SCOPE project is to detect frail community-dwelling older adults who previously went unnoticed and to improve their access to care and support. Goal is to increase their frailty-balance, quality of life, meaning in life, life satisfaction, mastery, community inclusion and ageing well in place. Methods/design The study is a prospective, longitudinal randomized four-armed controlled trial with follow-up at 6 months. The study group aims to include 900 community-dwelling older adults aged 60 years and over from 3 municipalities in Flanders (Belgium). While selecting the study group, risk profiles for frailty will be taken into account. Participants will be randomly selected from the census records in each municipality. Data will be collected prospectively at baseline (T0) and at follow-up, 6 months after baseline (T1). At baseline, participants who are at least mild frail on one of the 5 domains of frailty (CFAI-plus) or feel frail based on the subjective assessment of frailty will be randomly assigned to (1) the study group or (2) the control group. A mixed method design with the inclusion of quantitative and qualitative data analyses will be used to evaluate the efficacy and experiences of the detection and prevention program on frailty. Discussion The study will contribute to an innovative vision concerning the organization of care and support, and a timely and accurate detection and support of community-dwelling older adults at risk for frailty. Trial registration This trial was registered at ClinicalTrials.gov, on May 26, 2017, identifier: NCT03168204.

The recent COVID-19 pandemic has led to an unprecedented global health crisis. The susceptibility of pregnant women to infections has raised many questions about the risk of transmission, teratogenic risk and maternal and fetal complications. The speed at which the infection advanced as well as the ambiguity effects on pregnancy, due to the absence of scientific data, led obstetricians to adapt their practice according to pragmatic approach. We focused on this subject declared by the WHO as a global pandemic in early March 2020 to develop a plan for obstetric management of SARS-CoV-2 infected patients on the basis of current data. Based on the literature and the case of a patient hospitalized in our Department of Gynecology in Mahdia, the purpose of this study was to describe the possible clinical manifestations of COVID-19 infection in pregnant women and to develop principles of management of patients with COVID-19 infection. [ABSTRACT FROM AUTHOR]

With over two-thirds of people with dementia living in the community and one-third of those living alone, it is important to consider the future housing needs of this population, particularly as symptoms of cognitive impairment increase. Policy in England has focused on enabling people living with dementia to remain in their own homes for as long as possible, often with the support of a family carer. However, many people struggle to maintain an acceptable quality of life in their own homes as their dementia advances, often due to the design limitations of mainstream housing and the challenge of finding specialist domiciliary care that is affordable and of sufficient quality. Extra care housing offers a model that aims to support older people living in their own apartments, whilst also offering specialist person-centred care as and when it is needed. This paper reports on a longitudinal project that explored how extra care housing can respond to the changing social care needs of residents, including those living with dementia. Participants included residents and staff from four extra care housing schemes, one of which was a specialist dementia scheme, in two regions of England. Interviews were carried with 51 residents across 4 rounds at 5 month intervals between October 2015 and June 2017. Interviews were also carried out with 7 managers, 20 care staff and 2 local authority commissioners of housing for older people. Key factors included person-centred care and support, flexible commissioning and staffing, appropriate design of the environment and suitable location of the scheme within the wider community. The challenge of delivering services that addresses these issues during a period of reduced public spending is acknowledged. Further research is suggested to compare different approaches to supporting people with dementia, including integrated and separated accommodation, and different stages of dementia. [ABSTRACT FROM AUTHOR]

Some emerging technologies have potential to address older people’s care and support needs. However, there is still a gap in the knowledge on the potential uses of these technologies in some care domains. Therefore, a two-round Delphi survey was conducted to establish a consensus of opinion from a group of health and social technology experts (n = 21) on the potential of 10 emerging technologies to meet older people’s needs in five care and support domains. Experts were also asked to provide reasons for their choices in free-text spaces. The consensus level was set at 70%. Free-text responses were analyzed using thematic analysis. Voice activated devices was the technology that reached experts consensus in all assessed care domains. Some technologies (e.g., Artificial intelligence (AI) enabled apps and wearables and Internet of things (IoT) enabled homes) also show potential to support basic self-care and access to healthcare needs of older people. However, most of the remaining technologies (e.g., robotics, exoskeletons, virtual and augmented reality (VR/AR)) face a range of technical and acceptability issues that may hinder their adoption by older people in the near future. Findings should encourage the R & D community to address some of the identified challenges to improve the adoption of emerging technologies by older people.

Background: Frail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality. People in need of help do not always find their way to care and support services and are left undetected. The aim of the D-SCOPE project is to detect frail community-dwelling older adults who previously went unnoticed and to improve their access to care and support. Goal is to increase their frailty-balance, quality of life, meaning in life, life satisfaction, mastery, community inclusion and ageing well in place.Methods/design: The study is a prospective, longitudinal randomized four-armed controlled trial with follow-up at 6 months. The study group aims to include 900 community-dwelling older adults aged 60 years and over from 3 municipalities in Flanders (Belgium). While selecting the study group, risk profiles for frailty will be taken into account. Participants will be randomly selected from the census records in each municipality. Data will be collected prospectively at baseline (T0) and at follow-up, 6 months after baseline (T1). At baseline, participants who are at least mild frail on one of the 5 domains of frailty (CFAI-plus) or feel frail based on the subjective assessment of frailty will be randomly assigned to (1) the study group or (2) the control group. A mixed method design with the inclusion of quantitative and qualitative data analyses will be used to evaluate the efficacy and experiences of the detection and prevention program on frailty.Discussion: The study will contribute to an innovative vision concerning the organization of care and support, and a timely and accurate detection and support of community-dwelling older adults at risk for frailty.Trial Registration: This trial was registered at ClinicalTrials.gov, on May 26, 2017, identifier: NCT03168204 . [ABSTRACT FROM AUTHOR]

This paper offers a critical reflection of the field testing of the KwaZulu-Natal Department of Education (KZNDoE) Inclusive Education (IE) strategy. This reflection was greatly informed by empirical data, in the form of field notes and minutes generated from training workshops, consultative school visits, and meetings with Education officials. Inductive data analysis strategy was used in this study. One of the findings of the reflection was that the provision of IE strategy and the accompanying resources required for the implementation, was not sufficient to ensure meaningful implementation of IE as there were systemic issues which needed to be addressed first. Through this reflection, the systemic issues, benefits, and weaknesses of implementing IE in the province are highlighted. Ways in which the systemic issues raised can be addressed are also suggested. [ABSTRACT FROM AUTHOR]

Purpose – Older adults with atrial fibrillation (AF) have put growing demands on a poorly integrated healthcare system. This is of particular concern in rural communities with rapid population aging and few healthcare resources elevating risk of stroke and mortality. The purpose of this paper is to explore healthcare delivery risks for rural older adults with AF. Design/methodology/approach – This qualitative study collected data from AF patients, healthcare providers and decision makers. Ten patients participated in six-month care journeys involving interviews, logs, photos, and chart reviews. In total, 13 different patients and ten healthcare providers participated in focus groups and two decision makers participated in interviews. Findings – Three key health service risks emerged: lack of patient-focussed access and self-management; unplanned care coordination and follow-up across the continuum of care; and ineffective teamwork with variable perspectives among patients, providers, and decision makers. Originality/value – This study extends the understanding of risks to the health system level. Results provide important information for further research aimed at interventions to improve health service delivery and policy change to mitigate risks for this population. [ABSTRACT FROM AUTHOR]

Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child-and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with “care” and “capability” among children and adolescents. Social protection programmes should be dynamic and flexible, and consider age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach and uptake. Effective HIV prevention also requires integrated social protection policies, developed through strong national government ownership and leadership. Future research should explore which combinations of social protection work for sub-groups of children and adolescents, particularly those living with HIV. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to report and discuss the findings of an evaluation of the drama performance and reception of Let’s Talk in the context of interprofessional practice. Design/methodology/approach – This first stage evaluation addresses the initial development stage of the Let’s Talk drama initiative from the perspectives of health and social care participants. Recent policy and research are drawn upon in the presentation of the background to the drama and service integration imperatives. Findings – Most research on the subject of interprofessional education comes from professional training programmes. The development of the drama Let’s Talk provides evidence of how such a narrative can engage with local professionals working in different agencies but with the same patient or user groups. The development of such an initiative takes time and testing of it at early stages appears to be valuable in providing it with greater clarity and authenticity. Research limitations/implications – The paper addresses the developmental stages of an interprofessional drama initiative in one part of England in a locality where there is relative professional stability and reasonable communication across agencies and local support for workforce development. Practical implications – The evaluation may prompt reflection in practice and policy development on the potential for participation in role play and drama to be useful in changing cultures and in increasing interprofessional understanding. Originality/value – The paper contributes to understanding of the need for interprofessional and interagency debates to be informed by cultural change and active engagement with busy professionals. It recommends attention to careful development of such initiatives and to debate about what might be meaningful and long-term impacts. [ABSTRACT FROM AUTHOR]

Introduction Under the U.S. national Alzheimer's plan, the National Institutes of Health identified milestones required to meet the plan's biomedical research goal (Goal 1). However, similar milestones have not been created for the goals on care (Goal 2) and support (Goal 3). Methods The Alzheimer's Association convened a workgroup with expertise in clinical care, long-term services and supports, dementia care and support research, and public policy. The workgroup reviewed the literature on Alzheimer's care and support; reviewed how other countries are addressing the issue; and identified public policies needed over the next 10 years to achieve a more ideal care and support system. Results The workgroup developed and recommended 73 milestones for Goal 2 and 56 milestones for Goal 3. Discussion To advance the implementation of the U.S. national Alzheimer's plan, the U.S. government should adopt these recommended milestones, or develop similar milestones, to be incorporated into the national plan. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the link between one aspect of primary care in England – the annual review by general practitioners for dementia patients – and length of hospital stay (LoS). The annual review should identify the needs of both patients and carers and co-ordinate services across health and social care to address those needs. If this is done well, timely discharge from hospital may be facilitated. Design/methodology/approach – The study uses linked national data from 2006/2007 to 2010/2011 on over 36,000 patients, employing sophisticated statistical techniques to isolate the effect of the annual dementia review on LoS. Findings – Hospital patients discharged to the community have significantly shorter stays if they are cared for by practices that reviewed a higher percentage of their patients with dementia. However, this effect is small and is not evident for patients discharged to care homes or who died in hospital. Longer LoS is associated with a range of co-morbidities, markers of low availability of social care and with intensive provision of informal care. Practical implications – Although the dementia review has only a modest effect on LoS, the components of the review could improve the health and well-being of those with dementia and their carers. Originality/value – The study is the first to employ a robust methodology to investigate the impact of the annual dementia review on hospital LoS, an important aspect of the interface between primary and secondary care. There are implications for clinical and financial aspects of health and social care policy. [ABSTRACT FROM AUTHOR]

Purpose -- The article seeks to analyse the potential contribution of social work to integration debates. Social work has tended to be seen as marginal to these discussions despite the potential of social work expertise and leadership to help forge effective approaches to joined-up care. The purpose of this paper is to demonstrate how social work is well positioned to help lead and support practice focused change across social care and health. It also seeks to show how professional leadership can be a powerful vehicle for changing professional and organisational cultures. Design/methodology/approach -- The paper draws on practice and research evidence to demonstrate the proposition that social work can make a powerful contribution to debates about integration. Findings -- Three things could help build the cultural capital that is a pre-requisite to building integrated and joined-up approaches. First, the author needs to invest in developing the role of social workers and GPs working together as local professional and practice leaders. Second, there is a real risk that in any discussion about professional leadership and partnership, the author eclipses the singularly critical importance of engaging and involving users and carers in non tokenistic ways. Finally, the author needs to utilise better social work's skills and knowledge in managing risk, building resilience and promoting social inclusion. Research limitations/implications -- Further evaluation and research is needed about the potential for GPs and social workers to develop joined-up approaches to care for and support older and disabled people. Practical implications -- Social workers need to be provided with the tools, support and space in which to develop their practice leadership role, including but not exclusively with GPs. Originality/value -- This paper does not purport to offer any specifically originally research but rather some reflections on how social work expertise might better contribute to integration debates. [ABSTRACT FROM AUTHOR]

Purpose:The purpose of this paper was to capture carers' views of a service in Bristol funded jointly by the Local Authority and the NHS Clinical Commissioning Group, which offers support to carers in the form of a one-off payment which they can use for anything they choose. Design/methodology/approach: A multi-method evaluation of this integrated service was conducted between August 2012 and October 2013 to explore its impact on carers' health and well-being. This paper presents findings from 40 interviews conducted with carers as part of the evaluation. Findings: Many carers have little respite from very stressful situations; the break enabled them to focus on their own needs. Carers' needs included actual short breaks away with or without those being cared for, as well as items like household equipment or exercise classes. Research limitations/implications: The study was centred on an innovation and integrated approach to support carers in one city and provides a snap-shot of the short-term effects. Longer lasting effects are not known. Social implications: Most carers found the support beneficial, and in some cases reported a positive effect on their own health and well-being. Effective inter-agency communication and collaboration is essential for the success of the integrated service. Originality/value: There is limited research available on the outcomes of integrated approaches to support carers. [ABSTRACT FROM AUTHOR]

According to Intergenerational Flow of Wealth Theory of J.C. Cladwell (1976), the decision of having high fertility in the developing countries is very rational from the point of view of the elderly. They are believed to truly act as a long-lasting support system to their parents when they get old in every aspect of life, but the scenario is changing rapidly. With rapid modernization of our society children are no longer the fixeddeposit of support of elderly even in a country like India. Isolation and helplessness have become the part and parcel of life of elderly even in modern India which adversely impacts their wellbeing. This paper is an effort to quantify the level of care and support provided by the children to the elderly of the country and how this quality of care finally affects their wellbeing through their subjective health. This paper has used the data of the recent large scale project of ageing conducted by ISEC, Bangalore and IEG, Delhi in sponsorship of UNFPA, India, named "Building Knowledge Base on Aging in India". The survey is conducted to develop a knowledge base in regard to the demographic, social and economic conditions, health needs and living arrangements and entitlements. Multinomial logit estimation is used to show the impact of socio-economic factors on the different care and support aspect and also on the wellbeing of the elderly. Marginal effect shows that quality of care and support to elderly is fast decreasing. With the expected bulge of elderly population in the coming decades, government must take some steps in advance to combat with this situation. In the light of empirical results, some policy prescription has been suggested for benefit of the elderly. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe lessons learned from a homecare practice for frail elderly people. Design/methodology/approach – It is strictly a description of a point of view in respect of care of frailty designed to avoid institution. Findings – Generally, frail elderly patients choose care focused on comfort and function as opposed to the traditional systematic healthcare goals of rescue and prevention. This choice should be respected. Research limitations/implications – There are no formal research findings. Practical implications – Cost-saving as well as improvement in care is possible through team-based relationship-oriented homecare of the frail elderly where that care emphasizes comfort and function. Originality/value – This paper is authored by Dr John Sloan and is entirely original. [ABSTRACT FROM AUTHOR]