Search results

Post-diagnostic dementia care is often fragmented in the United Kingdom, with great variation in provision. Recent policies suggest moving towards better community-based care for dementia; however, little is known on how this care is delivered. This study aimed to map the post-diagnostic dementia support provided in England a decade after the introduction of a National Dementia Strategy.

A mixed-methods e-survey (open Nov 2018–Mar 2019) of dementia commissioners in England recruited through mailing lists of relevant organisations was conducted. The authors descriptively summarised quantitative data and carried out thematic analysis of open-ended survey responses.

52 completed responses were received, which covered 82 commissioning bodies, with representation from each region in England. Respondents reported great variation in the types of services provided. Information, caregiver assessments and dementia navigation were commonly reported and usually delivered by the voluntary sector or local authorities. Integrated pathways of care were seen as important to avoid overlap or gaps in service coverage. Despite an increasingly diverse population, few areas reported providing dementia health services specifically for BME populations. Over half of providers planned to change services further within five years.

There is a need for greater availability of and consistency in services in post-diagnostic dementia care across England.

Post-diagnostic dementia care remains fragmented and provided by a wide range of providers in England.

The National Dementia Strategy is a challenge to commissioners of health and local government services to knit a thick pullover out of thin wool. The thick pullover is necessary because dementia is a progressive neurodegenerative disorder that erodes the capacity of those affected by it, and absorbs increasing resources as it progresses. The thin wool is the limited evidence that investment in new kinds of services will produce benefits for people with dementia and their carers, while being affordable. This paper reviews the scale of the problem of dementia and its likely impact on services in the near future. It discusses some of the key recommendations of the National Dementia Strategy and explores debates about dementia advisors, economic modelling of innovative dementia services and the need for widespread training in the recognition of and response to dementia. Finally, it offers an approach to changing professional practice that is based on adult learning principles and workplace‐based reflective practice.

This article reports on the findings of the inspections and consultations undertaken as part of the evaluation of the National Service Framework for Older People. It focuses on what was found about the implementation of adult protection systems, by synthesising the inspectors' findings, drawing on older people's comments in meetings and interviews concerning care in hospitals, as an illustration, and by reporting the results from a survey. Together these sources of information revealed that adult protection systems are in place, and that the majority of older people say that they know to whom they can report concerns, but that older people and their families weigh up the decision to make complaints carefully. Questions are raised about the interface between adult protection and concerns about dignity and quality of hospital care.

Mental health problems in later life are common and damaging experiences for individuals, their families and those who support them. Some become almost the defining feature of the older person and, while they are challenging professionally and costly for society, they are also influenced by the twin discriminations of stigma and ageism. In this, the last in our series on older people's mental health, we pull together some other key messages from the series and set them in the context of current and future service commissioning and provision. We point to remaining gaps in provision and suggest how commissioners might approach the problems of mental ill‐health in later life in a context of declining resources.

Behavioural and psychological symptoms of dementia (BPSD) are a far too common and disturbing occurrence for people with dementia, their families and those who care for them. The consequences can be not only devastating personally and challenging professionally, but also costly for service providers. In this, the fourth of this series on older people's mental health services, we describe what BPSD are, what we know about current service provision for this group and the gaps, and how commissioners might approach these issues when developing services for older people with dementia.

Local authorities and primary care trusts receive regular instructions to put new legislation into practice, and to ensure appropriate training. This article takes the implementation of the Mental Capacity Act as a case study of how commissioners are involved in such changes, and reports on two models. The MCA is an example of the gains that can be made if commissioners think about implementation across agencies, and between public and private sectors.

Occupational choice describes the process that leads to occupational engagement as a result of intrinsic and extrinsic influences. There has been a considerable amount of research concerning occupational choice, gender and adolescence. However, this has largely focused on the areas of career choice and engagement in risky health behaviours. This paper aims to expand on the literature by providing a broader scope of occupation more aligned with the concept associated with occupational science. Furthering this, the researcher aims to examine the influence of gender as an extrinsic influence on occupational choice. The researcher aims to explore how contextual influences inform gendered occupational choice.

An exploratory qualitative approach was used in the current study. Incorporating photographs as a means of elucidating conversation during the interview process, photo-elicitation interview techniques were used as part of the data collection. This involved using a collection of photographs to prompt participants to discuss their interpretations of various occupations. Six adolescent boys and girls aged 11-14 years participated in the study. Participants were recruited from mixed-gendered sports clubs in the West of Ireland. Thematic analysis was used to analyse the data. An occupational justice perspective was used to interpret the data.

Responses suggest that gender informs occupational choice through different mechanisms. These included social systems, physical and institutional opportunities as well as expectations participants held of themselves and others they considered to be within their social grouping. Social systems included groups such as friends and family. The ease of access to physical and institutional resources was another factor that informed choice. Participants projected views of expectations they perceived others held for them informed how the participants made their choices. These factors varied across gender. Despite opportunities being available to both sexes, choices were often restricted to particular occupations.

The findings suggest that factors informing the occupational choices of adolescents included a combination of intrinsic factors such as gender and perspectives, as well as external factors including peers, family and opportunities in the local community. Practical applications of this involve acknowledging and further understanding the contextually situated nature of choice to provide more equitable practice. The results of the study may provide more insight into the factors that enable and inhibit occupation. A further understanding of these influences can redirect how we view adolescent occupations in a way that promotes health.

That ice‐creams prepared with dirty materials and under dirty conditions will themselves be dirty is a proposition which, to the merely ordinary mind, appears to be sufficiently obvious without the institution of a series of elaborate and highly “scientific” experiments to attempt to prove it. But, to the mind of the bacteriological medicine‐man, it is by microbic culture alone that anything that is dirty can be scientifically proved to be so. Not long ago, it having been observed that the itinerant vendor of ice‐creams was in the habit of rinsing his glasses, and, some say, of washing himself—although this is doubtful—in a pail of water attached to his barrow, samples of the liquor contained by such pails were duly obtained, and were solemnly submitted to a well‐known bacteriologist for bacteriological examination. After the interval necessary for the carrying out of the bacterial rites required, the eminent expert's report was published, and it may be admitted that after a cautious study of the same the conclusion seems justifiable that the pail waters were dirty, although it may well be doubted that an allegation to this effect, based on the report, would have stood the test of cross‐examination. It is true that our old and valued friend the Bacillus coli communis was reported as present, but his reputation as an awful example and as a producer of evil has been so much damaged that no one but a dangerous bacteriologist would think of hanging a dog—or even an ice‐cream vendor—on the evidence afforded by his presence. A further illustration of bacteriological trop de zèle is afforded by the recent prosecutions of some vendors of ice‐cream, whose commodities were reported to contain “millions of microbes,” including, of course, the in‐evitable and ubiquitous Bacillus coli very “communis.” To institute a prosecution under the Sale of Food and Drugs Act upon the evidence yielded by a bacteriological examination of ice‐cream is a proceeding which is foredoomed, and rightly foredoomed, to failure. The only conceivable ground upon which such a prosecution could be undertaken is the allegation that the “millions of microbes ” make the ice‐cream injurious to health. Inas‐much as not one of these millions can be proved beyond the possibility of doubt to be injurious, in the present state of knowledge; and as millions of microbes exist in everything everywhere, the breakdown of such a case must be a foregone conclusion. Moreover, a glance at the Act will show that, under existing circumstances at any rate, samples cannot be submitted to public analysts for bacteriological examination—with which, in fact, the Act has nothing to do—even if such examinations yielded results upon which it would be possible to found action. In order to prevent the sale of foul and unwholesome or actual disease‐creating ice‐cream, the proper course is to control the premises where such articles are prepared; while, at the same time, the sale of such materials should also be checked by the methods employed under the Public Health Act in dealing with decomposed and polluted articles of food. In this, no doubt, the aid of the public analyst may sometimes be sought as one of the scientific advisers of the authority taking action, but not officially in his capacity as public analyst under the Adulteration Act. And in those cases in which such advice is sought it may be hoped that it will be based, as indeed it can be based, upon something more practical, tangible and certain than the nebulous results of a bacteriological test.

The purpose of this paper is to propose a new measure for organization health. It is proposed that the Donohue tripartite paradigm model can be used to pierce the veneer of the satisficing account to identify the moral appraisal stakeholders have made of corporate strategies based on external (i.e. economic, etc.) standards.

A cognitive mapping process through narratives is used to operationalize a tripartite paradigm framework to measure human capital. An existential‐phenomenological approach is adopted to ensure the figural integrity of data.

This paper can be viewed as the prototypical development phase for a methodology to support future real‐time ethical inquiry concerning social responsibility within the corporate world.

The tripartite paradigm model expressed by Donohue was intended for “real‐time” application. This study, however, proposed a retrospective analysis of stakeholder decision‐making within a firm as a means of unearthing any deficiencies that might block the operationalization of Donohue's generalist theory.

This appraisal can identify the conflict of conscience that characterizes a stakeholder's “lived‐worlds” based on their participation and exposure to company decision making. This diagnostic tool can assist stakeholders in identifying evidence of decline early enough in the history of an organization for proactive remedial action to be taken.

It is the hope of this study that the proposed cognitive mapping process can derive a measure of organizational health through an existential‐phenomenological approach to ensure the integrity of the data. Ultimately, the aim is that this will be a tool that can explore the phenomenon of misrepresentation and its effect on social cooperation within a market culture.

The purpose of this paper is to utilise the comprehensive Food Safety Knowledge Instrument to compare food hygiene knowledge across a population of high school and university students in Australia and the UK.

In total, 475 students from secondary schools and universities in Australia and the UK took part in a survey, which included a Food Safety Knowledge Instrument and demographic items.

Food safety knowledge was generally very low. High school students had a mean score of only 38 per cent, while university students just reached a “pass” with a mean of 54 per cent. Demographics accounted for 41 per cent of variance in food knowledge scores. Female gender, being at university rather than high school, and living out of home rather than with parents were associated with greater food knowledge. Residing in Australia rather than the UK and being older were also associated with greater knowledge; however, these findings were subsumed by education group. Socio-economic status was not a significant predictor of food knowledge.

Identifying demographic and cultural differences in food knowledge can help to identify at-risk populations to better target in theory and knowledge-based interventions.

This study is the first to apply the knowledge instrument in an Australian population. Understanding the baseline knowledge in this population is an important first step at developing effective interventions for food safety.