Psycho-educational group intervention for family caregivers of hospitalized palliative care patients:pilot study

Family caregivers of patients requiring palliative care commonly experience physical, social, and psychological burdens. Although family caregivers are acknowledged as valid service recipients of palliative care, many have unmet needs, and systematic reviews have shown there are limited evidence-based supportive interventions.

Wellbeing, academic buoyancy and educational achievement in primary school students

The study explored the relationship between student wellbeing and academic achievement among 7–11 years old students and whether the relationship was moderated by gender and deprivation. 1081 students in Northern Ireland participated in a crosssectional survey that captured data on academic achievement and a range of wellbeing indicators. Findings suggested the existence of an underlying wellbeing factor, which was positively related to achievement. The relationship was not moderated by gender and/or deprivation. Findings were explored using a model of ‘academic buoyancy’. There was no evidence that suggested efforts to improve achievement that focus on wellbeing should be targeted speci?cally at students in economically deprived areas or be modi?ed in terms of gender.

Educational assessment policy and practice - a matter of ethics

Long-standing concerns within the field of educational assessment consider the impact of assessment policy and practice as matters of equity, inequality and social justice.Yet educational assessment policy and practice continues to have powerful social consequences for key users such as children and young people.This paper re-positions these consequences as a matter of ethics.It uses the work of Messick to frame how ethical matters extend beyond test instruments into the realm of uses and impact. A case study of the 11+ school transfer system in Northern Ireland is presented to illustrate ethical dilemmas emerging as a consequence of actions and decisions of using assessment systems for particular purposes.In looking forward to how we might attend to ethical matters in assessment policy and practice, a consideration of a children’s rights approach is outlined that may provide a moral and legal framework for action.

Understanding Parental Influence on Educational Outcomes Among 9 Year Olds in Ireland: The Mediating Role of Resources, Attitudes and Children's Own Perspectives

The relationship between parental background and children's educational outcomes has been a dominant theme within the sociology of education. There has been an on-going debate as to the relative merits of explanations which focus on the role of socio-cultural reproduction and those which focus on rational choice. However, many empirical studies within the social stratification tradition fail to allow for children's own agency in shaping the relationship between social background and schooling outcomes. This paper draws on the first wave of a large-scale longitudinal study of over 8,000 nine-year-old children in Ireland, which combines information from parents, school principals, teachers and children themselves. Both social class and parental education are found to have significant effects on reading and mathematics test scores among nine year olds. These effects are partly mediated by home-based educational resources and activities, parents' educational expectations for their child, and parents' formal involvement in the school. More importantly, children's own engagement with, and attitudes to, school significantly influence their academic performance. The influence of children's own attitudes and actions can thus reinforce or mitigate the effect of social background factors. The analysis therefore provides a bridge between the large body of research on the intergenerational transmission of inequality and the emerging research and policy literature on children's rights.

Class inequalities in educational attainment among the adult population in the Republic of Ireland

Substantial increases in participation rates at secondary and third level in recent years have often been assumed to be associated with increased equality of opportunity. However, there is little evidence from elsewhere that expansion per se, except when it takes the form of saturation of the demand from higher classes, leads to a reduction in class inequalities. In exploring the factors that contribute to trends over time, or to a distinctive position in comparison with other countries, we have drawn on the recent literature to argue that the crucial factors are those which affect decisions to continue in education. We have also operated on the assumption that students and their parents rationally consider the costs and benefits associated with educational choices. The most recent evidence relating to the adult population provides no support for the existence of any trend towards equality of educational opportunity. It is, rather consistent with the class reproduction perspective that stresses the ability of privileged classes to maintain their advantages.

Neurological, psychological and educational sequelae of low birth weight

In a prospective study of 501 infants of low birth weight (LBW) who mostly weighed 2,041 g (4 1/2 lb) or less, and of 203 control infants of full birth weight (FBW > 2,500 g), 335 LBW and 139 FBW children were followed beyond the age of 6 years and 6 months. The incidence of neurological defects was negatively correlated with birth weight, and the mean "global" IQ of different birth weight groups retained a direct relationship. While the relationship of birth weight to IQ gradually became less marked, the effect of social class was increasingly evident from the age of 2 years and 6 months. The preterm children whose birth weight was appropriate for gestational age (AGA) attained a slightly higher mean IQ and significantly better grade placement in the third school year than the children who were unduly light for their gestational age. Details of the neurological and ophthalmological defects are given, and the predictive significance of neonatal variables is analyzed.

Student's journey through a Trauma Studies Educational programme: A Northern Irish perspective.

This paper presents findings of a qualitative research study which explored the experiences of part time students who completed a BSc(Hons) Trauma studies programme in Northern Ireland. Data collection involved semi structured interviews with seven students. Findings indicate a journey through the programme, during which students experienced both challenges and opportunities for development. Such challenges included responses to emotive content and barriers to sharing in classroom based dialogue. Moreover, participants felt the programme enhanced their knowledge as well as the supportive services they provided to those who have experienced a trauma. Findings suggest participants who had experienced a personal trauma appeared drawn to this programme.

Identifying educational needs in end-of-life care for staff and families of residents in care facilities.

AIM: the purpose of this article is to describe educational needs in end-of-life (EoL) care for staff and families of residents in long-term care (LTC) facilities in the province of Ontario, Canada. Barriers to providing end-of-life care education in LTC facilities are also identified. DESIGN, SETTING AND PARTICIPANTS: cross-sectional survey of directors of care in all licensed LTC facilities in the province of Ontario, Canada. RESULTS: directors of care from 426 (76.9% response rate) licensed LTC facilities completed a postal-survey questionnaire. Topics identified as very important for staff education included pain and symptom management and communication with family members about EoL care. Priorities for family education included respecting the residents' expressed wishes for care and communication about EoL care. Having sufficient institutional resources was identified as a major barrier to providing continuing education to both staff and families. CONCLUSION: through examining educational needs in EoL care this study identified an environment of inadequate staffing and over-burdened care providers. The importance of increased staffing concomitant with education is a priority for LTC facilities.

Barriers to providing palliative care in long-term care facilities

OBJECTIVE: To assess challenges in providing palliative care in long-term care (LTC) facilities from the perspective of medical directors. DESIGN: Cross-sectional mailed survey. A questionnaire was developed, reviewed, pilot-tested, and sent to 450 medical directors representing 531 LTC facilities. Responses were rated on 2 different 5-point scales. Descriptive analyses were conducted on all responses. SETTING: All licensed LTC facilities in Ontario with designated medical directors. PARTICIPANTS: Medical directors in the facilities. MAIN OUTCOME MEASURES: Demographic and practice characteristics of physicians and facilities, importance of potential barriers to providing palliative care, strategies that could be helpful in providing palliative care, and the kind of training in palliative care respondents had received. RESULTS: Two hundred seventy-five medical directors (61%) representing 302 LTC facilities (57%) responded to the survey. Potential barriers to providing palliative care were clustered into 3 groups: facility staff's capacity to provide palliative care, education and support, and the need for external resources. Two thirds of respondents (67.1%) reported that inadequate staffing in their facilities was an important barrier to providing palliative care. Other barriers included inadequate financial reimbursement from the Ontario Health Insurance Program (58.5%), the heavy time commitment required (47.3%), and the lack of equipment in facilities (42.5%). No statistically significant relationship was found between geographic location or profit status of facilities and barriers to providing palliative care. Strategies respondents would use to improve provision of palliative care included continuing medical education (80.0%), protocols for assessing and monitoring pain (77.7%), finding ways to increase financial reimbursement for managing palliative care residents (72.1%), providing educational material for facility staff (70.7%), and providing practice guidelines related to assessing and managing palliative care patients (67.8%). CONCLUSION: Medical directors in our study reported that their LTC facilities were inadequately staffed and lacked equipment. The study also highlighted the specialized role of medical directors, who identified continuing medical education as a key strategy for improving provision of palliative care.

Perceptions of resident behavior problems and their clinical management in Long Term Care facilities

The objective of this study was to describe the perceptions of Long Term Care (LTC) service providers in urban Canadian care facilities regarding the prevalence and nature of resident behavior problems and how staff manage these problems. Key informants from 15 LTC facilities housing 1,928 residents, participated in a cross sectional survey which employed semi-structured telephone interviews. Respondents estimated that on average 61% (n = 1,176) of residents had some type of mental health/behavioral problem, with facility estimates ranging from 20% to 90%. The most frequently reported problem behaviors included: general agitation and restlessness (36%); pacing and aimless wandering (28%); hoarding things (24%); hitting either self or others (23%); and verbal aggression (22%). Behaviors reported by respondents as "disruptive" or "very disruptive" were screaming (13%), sexual disinhibition (10%), and hitting either self or others (10%). The most common interventions used by staff were behavioral interventions followed by the use of medications. Low levels of staffing and educational training of staff were among the most common factors recognized as contributing to the difficulty in caring for residents with mental health needs.

Risk factors for falls and injuries in a long-term care facility in Ontario

Objective: To identify risk factors for falls and injuries among seniors living in a long-term care facility. Method: Case-control study of 335 residents living at St. Joseph's Villa, Dundas, Ontario. Cases were defined as residents who fell between July 1, 1996 and June 30, 1997; controls were those who did not fall. To identify risk factors for injury, cases were defined as those with completed incident injury forms and controls as those without. Results: The most important risk factors for falls included: having fallen in the past three months; residing in a secured unit; living in the facility for two or more years; having the potential to cause injury to others; and having an illness, disease or behaviour that may cause a fall. The most important risk factor for injury among those who fell was altered mental state. Conclusion: The risk factors identified may be helpful to those planning falls prevention initiatives within long-term care settings.