The Development of Environmental Assessment Tools to Support the Creation of Dementia Friendly Care Environments: Innovative Practice

The need for more dementia friendly design in hospitals and other care settings is now widely acknowledged. Working with 26 NHS Trusts in England as part of a Department of Health commissioned programme, The King’s Fund developed a set of overarching design principles and an environmental assessment tool for hospital wards in 2012. Following requests from other sectors, additional tools were developed for hospitals, care homes, health centres and housing with care. The tools have proven to be effective in both disseminating the principles of dementia friendly design and in enabling the case to be made for improvements that have a positive effect on patient outcomes and staff morale. This paper reports on the development,use and review of the environmental assessment tools, including further work that is now being taken forward by The Association for Dementia Studies, University of Worcester.

Expert Insight into the Assessment of Competence in Cognitive–behavioural Therapy: a Qualitative Exploration of Experts' Experiences, Opinions and Recommendations

To offer insight into how cognitive–behavioural therapy (CBT) competence is defined, measured and evaluated and to highlight ways in which the assessment of CBT competence could be further improved, the current study utilizes a qualitative methodology to examine CBT experts’ (N = 19) experiences of conceptualizing and assessing the competence of CBT therapists. Semi-structured interviews were used to explore participants’ experiences of assessing the competence of CBT therapists. Interview transcripts were then analysed using interpretative phenomenological analysis in order to identify commonalities and differences in the way CBT competence is evaluated. Four superordinate themes were identified: (i) what to assess, the complex and fuzzy concept of CBT competence; (ii) how to assess CBT competence, selecting from the toolbox of assessment methods; (iii) who is best placed to assess CBT competence, expertise and independence; and (iv) pitfalls, identifying and overcoming assessment biases. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings.

Evaluation and Application of Environmental Flows in Running Waters in Slovenia

Water use invariably results in major impacts on river flows. Environmental Flows (EF) are defined as the quantity and quality of water that is needed to preserve the structure and the function of the river and riparian zone ecosystem and sufficient quantity of water to enable the survival and reproduction of aquatic organisms in different hydraulic habitats. This paper describes the criteria and methods used to determine EF and experiences with their application in Slovenia. The diversity of running waters of Slovenia demand special treatment and determination of EF for each individual section of the river system. Using hydrological, morphological and ecological criteria, two different approaches are used for the determination of EF in Slovenia, a rapid assessment method and a detailed assessment method. For both methods, data are then analyzed by an expert panel in order to determine an EF. Since 1994, more than 180 study sites have been examined for research and application of EF in Slovenia. Determination of EF for existing users has prioritized their water requirements so they can remain economically viable. Where new schemes are proposed, there has been much greater scope to prioritize ecosystem requirements. EF determination is receiving growing attention and will continue to increase in importance, driven by research that aids our understanding of flow-biota relationships and recent environmental policy and legislation at both the national and European level.