Psychosocial interventions for people with young onset dementia and their carers: a systematic review.

BACKGROUND: Dementia in younger people, known as young (YOD) or early onset dementia (EOD), can pose significant challenges. YOD is often diagnosed in those in paid employment who have relatively young children, leading to different challenges to those for older people. It is therefore very important to provide support tailored to their specific needs. This systematic review aimed to synthesize the literature investigating the impact of psychosocial interventions for people with YOD and their family carers. METHOD: Eight electronic databases were searched and three key journals were also hand searched. Narrative synthesis of the selected articles was undertaken. RESULTS: Of the 498 records identified, 495 were ineligible after application of the exclusion criteria. The final sample included three studies, all of which were employment-based. Two were qualitative and one used mixed methods. Study quality was mixed. People with YOD and their carers reported benefits from participating in work-based interventions designed for those with YOD, including improved self-esteem and sense of purpose. Social contact was highlighted. Despite cognitive decline, maintenance in well-being was also reported. Carers described benefits for people with YOD, which extended outside the intervention, e.g. enhanced sleep and mood. The impact of the interventions on carers was not assessed. CONCLUSIONS: This review suggests work-based interventions providing supported, meaningful work outside the home can be beneficial. However, the dearth of studies, the lack of focus on family carers and their mixed quality demonstrate the need for better quality, mixed methods research with larger sample sizes.

Interventions to enhance the research productivity of academic staff in higher education schools of nursing: A systematic review.

AIM: Synthesize and present peer-reviewed evidence of interventions that enhance the research productivity of academics in Schools of Nursing in Higher Education Institutions. BACKGROUND: Pressures on academics in Schools of Nursing worldwide to increase or maintain high research productivity persist and numerous Higher Education Institutions across the world have developed interventions to increase productivity. Given evidence that the COVID-19 pandemic has resulted in a withdrawal from research, understanding which interventions best support and improve research productivity is urgent. Increasing research capacity is crucial but only one element in increasing productivity. No recent attempt has been made to synthesise the knowledge gained from these more wide-ranging initiatives. DESIGN: A mixed-methods systematic review, registered in PROSPERO, searching four academic databases (CINAHL, ERIC, MEDLINE, PsycINFO) from 1/01/2010-20/04/2022. All primary research studies of relevant interventions were included if they described the intervention, reported its outcomes and were published in the English language in peer-reviewed journals. RESULTS: 1637 studies were assessed against eligibility criteria, resulting in 20 included studies. No studies were excluded based on quality. Data pertaining to understandings of 'research productivity', barriers to research productivity, interventions and outcomes of interventions were extracted. The most often used measures were the frequency or staff-output ratio of funding, publications and presentations, while the less commonly used were the number of conference abstracts submitted/accepted and awards. Subjective measures were less commonly used. Barriers to research productivity fell into three broad categories: resource constraints, lack of priority for research and barriers related to the attitudes, knowledge and skills of School of Nursing academics. Interventions covered nine broad areas. Half of the interventions were multi-stranded, including a wide range of components to increase research productivity while the other half comprised one component only, such as writing groups and mentoring. All interventions had a positive impact on research productivity, however, heterogeneity in the measurement of impact, the duration of interventions, sources of comparative data and research design made comparison of interventions challenging. CONCLUSIONS: The review identified a need for future research to explore the barriers among under-represented groups of academics in Schools of Nursing across a broader geographical area; and what works for various sub-groups of academics. It also identified a need for a valid, standardised tool to assess the effectiveness of interventions to increase research productivity of academics in Schools of Nursing.

Comparison of pressure ulcer grading scales: a study of clinical utility and inter-rater reliability.

Pressure ulcer grading scales are subjective measures of pressure damage. This study measured inter-observer agreement of the Stirling scale (1-digit and 2-digit versions) and the European Pressure Ulcer Advisory Panel Scale, using Cohen's kappa and percentage agreement. Clinical utility was also assessed. Thirty-five observations were made by two Registered Nurses on 30 adult in-patients. The levels of agreement obtained were better than those reported previously and this may be related to the methodology used. The 2-digit Stirling scale gave the best level of chance corrected agreement (kappa=0.457) and was the scale preferred by raters. The 1-digit Stirling scale performed least favourably. Qualitative data identified problems with scale construction relating to visualisation of the base of the wound, discolouration of the skin, abrasions and shallow ulcers. Whilst refinements in scale construction may improve rater reliability, there is a need to develop objective measures of pressure induced tissue damage.