Healthcare Staffs’ Experiences and Perceptions of Caring for People with Dementia in the Acute Setting: Qualitative Evidence Synthesis

Background Dementia is a global issue, with increasing prevalence rates impacting on health services internationally. People with dementia are frequently admitted to hospital, an environment that may not be suited to their needs. While many initiatives have been developed to improve their care in the acute setting, there is a lack of cohesive understanding of how staff experience and perceive the care they give to people with dementia in the acute setting. Objectives The aim of this qualitative synthesis was to explore health care staffs’ experiences and perceptions of caring for people with dementia in the acute setting. Qualitative synthesis can bring together isolated findings in a meaningful way that can inform policy development. Settings A screening process, using inclusion/exclusion criteria, identified qualitative studies that focused on health care staff caring for people with dementia in acute settings. Participants Twelve reports of nine studies were included for synthesis. Data extraction was conducted on each report by two researchers. Methods Framework synthesis was employed using VIPS framework, using Values, Individualised, Perspective and Social and psychological as concepts to guide synthesis. The VIPS framework has previously been used for exploring approaches to caring for people with dementia. Quality appraisal was conducted using Critical Appraisal Skills Programme (CASP) and NVivo facilitated sensitivity analysis to ensure confidence in the findings. Results Key themes, derived from VIPS, included a number of specific subthemes that examined: infrastructure and care pathways, person-centred approaches to care, how the person interacts with their environment and other patients, and family involvement in care decisions. The synthesis identified barriers to appropriate care for the person with dementia. These include ineffective pathways of care, unsuitable environments, inadequate resources and staffing levels and lack of emphasis on education and training for staff caring for people with dementia. Conclusions This review has identified key issues in the care of people with dementia in the acute setting: improving pathways of care, creating suitable environments, addressing resources and staffing levels and placing emphasis on the education for staff caring for people with dementia. Recommendations are made for practice consideration, policy development and future research. Leadership is required to instil the values needed to care for this client group in an effective and personcentred way. Qualitative evidence synthesis can inform policy and in this case, recommends VIPS as a suitable framework for guiding decisions around care for people with dementia in acute settings.

Rethinking the Eclectic Paradigm: Explaining MNE E-Commerce Corporations' Activity in the Chinese Digital Sector

We use the eclectic paradigm as an analytical framework to explain the MNE e-commerce company’s activities in China. Grounded in the rich data, we argue that the dynamic interplay between the ownership advantage and local institutional context that have emerged—particularly in the information age—plays a significant role in explaining the trajectory of MNE e-commerce companies in China. We propose On, Ln and In by embedding network-based advantages within the OLI paradigm. With the acceleration of technological change and non-ergodic uncertainty, such a network-embedded eclectic paradigm will lead to MNE e-commerce companies’ sustainable development in the emerging economy.

Wasta in the Jordanian Culture: a Study in the Banking Sector

Due to globalisation, the emergence and expansion of new overseas markets, extensive use of information and communication technologies in global trade and growing competition between multinational companies, international Human Resource Management (HRM) is an increasingly attractive and popular area of study. However, much of our knowledge is built on an Anglo-Saxon/ European base and there is a paucity of research that considers the transfer of modern (western) principles of HRM to developing countries, particularly in the Middle East. Arguably, Jordan is one country that may benefit from the promise of quality, equality and profitability offered by the systemic approach to managing people. Thus, this paper introduces a PhD research project, currently in its first year, that considers the transfer of western recruitment and selection frameworks into Jordanian culture.

Alternaria Spores in the Air Across Europe: Abundance, Seasonality and Relationships with Climate, Meteorology and Local Environment

We explored the temporal and spatial variations in airborne Alternaria spore quantitative and phenological features in Europe using 23 sites with annual time series between 3 and 15 years. The study covers seven countries and four of the main biogeographical regions in Europe. The observations were obtained with Hirst-type spore traps providing time series with daily records. Site locations extend from Spain in the south to Denmark in the north and from England in the West to Poland in the East. The study is therefore the largest assessment ever carried out for Europe concerning Alternaria. Aerobiological data were investigated for temporal and spatial patterns in their start and peak season dates and their spore indices. Moreover, the effects of climate were checked using meteorological data for the same period, using a crop growth model. We found that local climate, vegetation patterns and management of landscape are governing parameters for the overall spore concentration, while the annual variations caused by weather are of secondary importance but should not be neglected. The start of the Alternaria spore season varies by several months in Europe, but the peak of the season is more synchronised in central northern Europe in the middle of the summer, while many southern sites have peak dates either earlier or later than northern Europe. The use of a crop growth model to explain the start and peak of season suggests that such methods could be useful to describe Alternaria seasonality in areas with no available observations.