Support Practitioners Research Articles

Impact of a videoconferencing educational programme for the management of concurrent disorders on nurses’ competency development and clinical practice: protocol for a convergent mixed methods study

IntroductionExtension for Community Healthcare Outcomes (Project ECHO©) is an innovative model for continuing professional development that uses videoconferencing technology to support and train general practitioners remotely. The model has been...

Scarcity signaling in sales promotion: An evolutionary perspective of food choice and weight status

Obesity rates are increasing worldwide, with an alarming number of associated co-morbidities and deaths. Evolutionary psychology explains this development with an inherent preference for fatty and sweet foods. Recent evidence shows that consumers with a low socioeconomic status are more prone to being obese, but also that consumers with few resources respond more to scarcity signals. Based on this background, this paper investigates whether overweight individuals with a low income respond more to scarcity signaling in terms of sales promotions than others.To this end, a large-scale online survey was conducted across four food product categories in the setting of an online supermarket. Results show that overweight or obese individuals with low income levels responded more strongly to scarcity signaling. The findings inform researchers in terms of explaining different responses to sales promotions and support practitioners in aligning sales promotions to target group-specific behavior.

Supply chain strategies as drivers of financial performance in liquefied natural gas networks

PurposeThe purpose of this study is to identify and evaluate supply chain strategies (SCSs) that drive financial performance to guide practitioners, especially in liquefied natural gas (LNG) networks, to review and adopt SCSs that drive competitiveness and value creation for investors.Design/methodology/approachAnalytical hierarchy process (AHP) was deployed to prioritise SCSs according to their relative impact on financial performance in LNG networks. Interviews with experts were analysed using template analysis to establish latent drivers of financial performance specific to LNG networks.FindingsResults support the significant role of SCSs in improving financial performance. Although findings prioritised collaborative strategy as the most important driver of financial performance in LNG networks, to fully optimise financial outcomes, all the SCSs should be implemented across LNG networks as no single strategy in isolation is a standalone driver of financial performance.Practical implicationsThe AHP model provides a novel ranking for SCSs and measures to guide decision-makers. LNG practitioners may exploit the results to make informed decisions.Originality/valueThe study extends previous literature by proposing a framework and a new LNG empirical model that facilitates understanding of how SCSs contribute positively to financial performance and support practitioners in making strategic supply chain decisions.

Positive risk management: Staff perspectives in acute mental health inpatient settings.

To explore inpatient staff's understanding and implementation of positive risk management. Risk management is an essential skill for staff working in acute mental health inpatient settings. National policies advocate the use of positive risk management as a form of collaborative, recovery-focused risk management. However, little is known about how staff understand, operationalize, and use positive risk management in practice. Qualitative reflexive thematic analysis study. The authors recruited a purposive sample of healthcare professionals working in acute inpatient settings (N=16) in 2019 across three National Health Service Trusts in the North-West of England. Participants completed semi-structured interviews which were analysed using reflexive thematic analysis. The analysis generated three themes: (a) within staff barriers; (b) within service user barriers; and (c) delivery in practice. Understanding and implementation of positive risk management was dependant on multiple factors, including staffs' beliefs about mental health, levels of worry and anxiety, and amount of experience and seniority. Staff were more likely to use positive risk management with service users that they perceived as being trustworthy and less risky. Use of positive risk management was reliant on the support practitioners received, how able they were to view situations from multiple perspectives, and the degree to which they felt able to prioritize positive risk management. Although staff expressed the desire and intention to practice positive risk management, the current study highlights challenges around operationalization and implementation. The authors discuss the clinical implications of the findings.

How can mental health practitioners collaborate with child welfare practitioners to improve mental health for young people in out of home care?

Young people who grow up in out of home care have higher risk of poor mental health outcomes than peers who grow up with their family-of-origin. Interagency collaboration is an important service-level intervention to improve access to mental healthcare. However, few descriptions of collaboration provide guidance about collaboration between individual practitioners. This substudy aimed to contribute to a larger study-the Ripple project-through exploring the experiences of practitioners working across child welfare and mental health services regarding collaboration in the care of young people; and to identify practices that might enhance collaborative work and improve mental health outcomes. Practitioners from across child welfare and mental health services were purposively sampled and participated in focus groups. Recordings and transcriptions of focus groups were analysed to identify themes within and between groups. A cross-sector expert advisory group was involved in this work. Focus groups were convened with 43 practitioners. We identified four themes during analysis, these were: shared understanding of the history and context of problems; specific skills and practices; self-awareness of workers and carers; and involving and supporting carers. A number of practices were identified that might lead to enhanced collaboration between agencies and across interdisciplinary care teams. Supporting mental health practitioners to adopt these might assist interagency and interdisciplinary working.

Implementing the Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: mixed-method process evaluation alongside a pragmatic randomised trial

Objectives The DESCANT (Dementia Early Stage Cognitive Aids New Trial) intervention provided a personalised care package designed to improve the cognitive abilities, function and well-being of people with early-stage dementia and their carers, by providing a range of memory aids, together with appropriate training and support. This sub-study aimed to assess implementation and identify contextual factors potentially associated with participant outcomes. Method A mixed-methods approach was adopted alongside the pragmatic randomised trial. Data were obtained from intervention records and interviews with five dementia support practitioners across seven National Health Service Trusts in England and Wales. A reporting framework was constructed from available literature and data assessed by descriptive statistics and thematic analysis. Results Participation and engagement was high with 126 out of 128 participants completing the intervention with packages tailored to individual participants. Misplacing items and poor orientation to date and time were common areas of need. Memory aids frequently supplied included orientation clocks (91%), whiteboards (60%), calendars (43%) and notebooks (32%), plus bespoke items. Intervention duration and timing were broadly consistent with expectations. Variation reflected participants’ needs, circumstances and preferences. Qualitative findings suggested a potentially positive impact on the well-being of people with dementia and their carers. Issues associated with successful roll-out of the intervention are explored in the discussion. Conclusion Successful implementation increased confidence in future findings of the randomised trial. Depending on these, DESCANT may prove a scalable intervention with potential to improve the function and quality of life of people with dementia and their carers.

Priority Species Lists to Restore Desert Tortoise and Pollinator Habitats in Mojave Desert Shrublands

Mojave Desert shrublands are home to unique plants and wildlife and are experiencing rapid habitat change due to unprecedented large-scale disturbances; yet, established practices to effectively restore disturbed landscapes are not well developed. A priority species list of native plant taxa was developed to guide seed collectors, commercial growers, resource managers, and restoration practitioners in support of the Bureau of Land Management's Mojave Desert Native Plant Program. We identify focal plant taxa that are important for habitats of the threatened Mojave desert tortoise (Gopherus agassizii), a widely distributed herbivore in low and middle elevations, and pollinator taxa, including mostly Lepidopterans and Apoidean bees, some of whose populations are in decline. We identified 201 unique plant taxa in the diets of tortoises, and 49 taxa that provide thermal cover for tortoises with some overlapping taxa that provide both diet and cover. We discuss 134 native pollinators associated with plants used for nectaring, larval hosts, or cover and nesting materials. Detailed plant species accounts describing the status-of-knowledge for 57 plant taxonomic groups including detailed information on life history, ecology, and pollinator syndrome relevant to restoration success, methods of seed harvesting, propagation, and historical use in restoration. Our approach for developing a priority plant species list for the Mojave Desert provides a data-guided listing of species for restoration practitioners and identifies knowledge gaps for future investigation.

Supporting practitioners in developing effective decision support tools for natural resource managers

In the United States, there is a growing interest in the participatory development of agricultural and natural resource–focused decision support tools (DSTs). To provide greater insight for practitioners developing these DSTs, we conducted a review of manuscripts ( n = 23) that describe DSTs in US agricultural and forestry sectors, both those designed through participatory processes and otherwise. Our work operationalizes a novel conceptual framework developed to support participatory DST development, as recent scholarship suggests participatory processes lead to better adoption and use of DSTs. Our analysis suggests that tool developers should, in reporting on their efforts, more clearly articulate the ways decision makers are included in DST development, from problem identification through evaluation. Failure to do so limits our collective understanding of the utility of these tools. Following our review, we present recommendations for DST developers and other practitioners who want to support effective and transparent development of stakeholder-driven DSTs. We propose practitioners (1) implement complete assessments of relevant stakeholder network(s) that might use new DSTs; (2) engage stakeholders iteratively throughout the development process; (3) improve evaluation of DSTs, including an assessment of the usability, usefulness and usage of tools across their life cycle; and (4) and describe the process of stakeholder engagement process in published …

Extent of post-traumatic stress disorder among Eastern Cape emergency care workers in the public health care sector

Background: Pre-hospital emergency care workers (PECWs) often struggle to cope with an increasingly hostile environment while on duty. As a result, the prevalence of post-traumatic stress disorder (PTSD) amongst PECWs is on the rise and negatively affects their ability to treat patients. Further, PTSD could cloud PECWs’ clinical decision-making and judgement. This ultimately places strain on emergency care departments’ resources and directly affects patient care and service delivery. The aim of the study was to determine the extent to which PECWs experience PTSD symptoms in Nelson Mandela Bay (NMB). Methods: A quantitative design and convenience sampling method were used. The research population for this study was all operational PECWs employed by the Eastern Cape Department of Health within the emergency medical services (EMS) in NMB. Data were collected by means of a self-administered questionnaire comprising two sections; the first section focused on respondents’ demographic information, and the second section was a validated PTSD questionnaire. Descriptive and inferential statistics were reviewed using Microsoft Excel. Results: Sixty-eight PECWs took part in the study. It was identified that of the 68 respondents, 41 (60.3%) showed symptoms of PTSD and could possibly be diagnosed with PTSD. The mean PTSD score was 42.01±17.354, ranging in the category of ‘possible diagnosis of PTSD’. The highest mean PTSD scores were reported among respondents who identified themselves as female (p<0.001). Those within the age category of 51–60 years, those who were Advanced Life Support (ALS) practitioners, and those with 20 years or more work experience also had high mean PTSD scores. Conclusion: PTSD remains a burden on both the individual and the organisation employing the individual. This study highlighted that many PECWs employed in the Eastern Cape public health care sector showed symptoms and could be diagnosed with PTSD, with female PECWs being at the highest risk.

CREATIVITY CENTRED BRAND MANAGEMENT MODEL FOR THE POSTCOVID MARKETING 5.0 WORLD

This article directly responds to the call for new visions that impact the field of brand communications in the Marketing 5.0 world. It does so by using creative principles to deconstruct and reconceptualize an important marketing management tactic namely brand management. Brand management is a polarizing tactic in the overall strategic marketing planning. It is easy to find scholars and practitioners in support of it as well as opposing it. This article reviews popular existing brand management strategies to see how creativity is treated and presents a new futuristic model of where and how should creativity be in the overall brand communication and management process. This model helps marketers take advantage of creativity principles. The model will reimagine the narrative of brand management and creativity will be included in the dynamic mix where the changes will hopefully have a deeper impact on the future brand management practices and its positioning in the overall marketing management.

The Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: A goal attainment scaling approach to promote self-management.

This study investigated goals identified by people with dementia and their carers to promote the self-management of symptoms and abilities; measured achievement using goal attainment scaling (GAS); and explored the reflections of Dementia Support Practitioners (DSPs) facilitating it. Within this pragmatic randomised trial, DSPs gave memory aids, training and support to people with mild to moderate dementia and their carers at home. Data were collected across seven NHS Trusts in England and Wales (2016-2018) and abstracted from intervention records and semi-structured interviews with DSPs delivering the intervention, supplemented by a subset of the trial dataset. Measures were created to permit quantification and descriptive analysis and interview data thematically analysed. A GAS measure for this intervention in this client group was derived. Engagement was high across the 117 participants and 293 goals were identified. These reflected individual circumstances and needs and enabled classification and assessment of their attainment. Seventeen goal types were identified across six domains: self-care, household tasks, daily occupation, orientation, communication, and well-being and safety. On average participants achieved nominally significant improvement regarding the specified goals of 1.4 with standard deviation of 0.6. Five interviews suggested that DSPs' experiences of goal setting were also positive. GAS is useful for assessing psychosocial interventions for people with early-stage dementia. It has a utility in identifying goals, promoting self-management and providing a personalised outcome measure. There is a strong case for exploring whether these clear benefits translate to other interventions in other populations in other places.

‘Being in’and ‘Being of’: Reflections on Being a Rural WorkingClass Student, and Academic Support Practitioner, in Higher Education

‘Being in’and ‘Being of’: Reflections on Being a Rural WorkingClass Student, and Academic Support Practitioner, in Higher Education

Implementation Support Skills: Findings From a Systematic Integrative Review

Purpose: Skills in selecting and designing strategies for implementing research-supported interventions (RSIs) within specific local contexts are important for progressing a wider RSI adoption and application in human and social services. This also applies to a particular role in implementation, the implementation support practitioner (ISP). This study examines which strategies have been reported as being used by ISPs across multiple bodies of research on implementation support and how these strategies were applied in concrete practice settings. Methods: A systematic integrative review was conducted. Data analysis utilized the Expert Recommendations for Implementing Change compilation of implementation strategies. Results: Studies reported on 18 implementation strategies commonly used by different ISPs, who require mastery in selecting, operationalizing, and detailing these. Two further strategies not included in the ERIC compilation could be identified. Discussion: Given the use of primarily more feasible implementation support strategies among ISPs, their potential as agents of change may be underutilized.

342 - The Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: Goal Attainment Scaling

The DESCANT (Dementia Early Stage Cognitive Aids New Trial) intervention provided a personalised care package to improve the cognitive abilities, function and well -being of people with early-stage dementia and their carers by providing a range of memory aids, with training and support for use. This presentation will explore findings from a goal attainment scaling exercise undertaken within a multi-site pragmatic randomised trial, part of a NIHR-funded research programme ‘Effective Home Support in Dementia Care: Components, Impacts and Costs of Tertiary Prevention.’The aim was to describe the Goal Attainment Scaling (GAS) approach developed; investigate the types of goals identified by people with dementia and their carers and subsequent attainment; and explore the role of Dementia Support Practitioners (DSPs) in the process. This GAS exercise was designed by researchers, a clinical psychologist, a clinician and a DSP. Goal setting and attainment were conducted with the person with dementia and their carer and recorded by DSPs. Data were obtained from 117 intervention records and semi-structured interviews with five DSPs delivering the intervention across seven NHS Trusts in England and Wales. The GAS exercise was conducted as planned with goals and extent of involvement in the exercise tailored to individual participants and engagement was high. Demographic characteristics from the trial baseline dataset were analysed. Measures were created from intervention records to permit quantification and descriptive analysis. Interviews were professionally transcribed and subject to thematic analysis to identify salient themes.A total of 293 goals were identified across the 117 participants. From these 17 goal types were distinguished across six domains: self -care; household tasks; daily occupation; orientation; communication; and well-being and safety. A measure of goal attainment appropriate to both the client group and a modest intervention was obtained. On average participants had evidenced some improvement regarding goals set. Qualitative findings suggested overall DSPs were positive about their experience of goal setting. Although several challenges were identified, if these were overcome, measuring goal attainment was generally viewed as straightforward. GAS can be used in the context of a psychosocial intervention for people with early-stage dementia to identify and measure attainment of personalised care goals.

Changing considerations of matching foster carers and children: A scoping review of the research and evidence

Abstract Background and objectives The ‘fit’ or ‘match’ between foster or adoptive children and their carers may be instrumental in determining the outcomes for children and the sustainability of their placement. Understanding components most likely to produce a successful match will assist professionals to support carer families and place children optimally. This Scoping Review investigated research relating to matching children needing care and adult carers. It sought to understand the extent of previous research, note key areas of matching interest and theoretical trends and identify gaps. Method Four databases, ASSIA, CINAHL, PsychInfo, and SocIndex, were searched for references in March 2020. Eligible studies included those that reported explicit or implicit matching elements, children in need of care and systematic data collection and recording. Research quality was not included in eligibility criteria. Results The systematic search returned 2802 results. After removing duplicates, eligibility screening and a close reading, only 31 studies published over a period of 81 years were deemed eligible. These studies demonstrate limited scholarly engagement with the concept of matching and changing foci on matching elements that shift from objective features to subjective features, and then to inter-subjective. Conclusions The area of matching carers and children is under-researched, fragmented and lacks consistent or rigorous theoretical frameworks. An increased understanding of matching would assist practitioners in child placement and support for adoptive and foster parents. This would contribute to the broader issue of placement sustainability and improved outcomes for children.

Child development assessment: Practitioner input in the revision for Griffiths III.

The input from practitioners in developmental assessment test revision is a crucial and leading component of the project. This paper highlights six key phases of the Griffiths III revision process and the value of having a guiding plan that includes test practitioner input. The revision of the Griffiths III consisted of six separate phases that were supported by practitioner and user input and feedback. These six phases and practitioner views ensured that the necessary core constructs and new areas for item development were included in the revised version. These processes also underscored the construct development and task review, item design, piloting and standardization of the revised version, as well as its production, release and subsequent training methods. The six guiding phases provided a methodologically robust frame to the revision process. Practitioners valued an overall developmental measure with discrete data about and within the 'avenues of learning' allowing them to analyse a child's strengths and weaknesses. Communication with practitioners across the world demonstrated the wide disparity of culture and environments that the Griffiths Scales are deployed in. It is not possible to design a revised scale that is appropriate for all areas of use, so in this revision process, it was decided to design the scales as culturally fair as possible and support practitioners in other countries to translate and validate the scales for use. The revision of the Griffiths III found test users to be valuable sources of information on the basis of their experiences with the test and professional knowledge. Creating a continuous feedback mechanism within a phased process provided opportunities for the revision team to engage meaningfully with the data being obtained as well as test users to advance the scope and quality of the test. Revision teams are encouraged to consider the process and engagement methods explored in this study during their projects.

Assessing and Supporting Late Career Practitioners: Four Key Questions

Assessing and Supporting Late Career Practitioners: Four Key Questions

Defining Creativity: How Far Have We Come Since Plucker, Beghetto, and Dow?

ABSTRACT Defining creativity remains an Achilles heel of creativity research. In 2004, Plucker, Beghetto, and Dow placed a call to action for more consistent, clearer conceptions of creativity to move research forward and support practitioners across fields. The present study replicated and expanded on their study by surveying articles from business, education, psychology, and creativity journals (n = 600). Results suggested small but notable improvements in the reporting of explicit definitions and field-specific trends addressing creativity in contexts. There were also strong suggestions from the data that elements present in creativity conceptions are strongly field-specific. Although these findings were encouraging, issues regarding congruence across and within fields persist even on core elements such as novelty and usefulness. At a time when academic research is becoming more integrative, the degree of and implications of this lack of coherence and transparency are discussed.

Identifying and de-implementing low-value care in primary care: the GP's perspective-a cross-sectional survey.

ObjectiveGeneral practitioners have an important role in reducing low-value care as gatekeepers of the health system. The aim of this study was to assess the experiences of Dutch general practitioners regarding low-value care and to identify their needs to decrease low-value primary care.DesignWe performed a cross-sectional study.ParticipantsWe sent a survey to 500 general practitioners.SettingPrimary care in the Netherlands.Primary and secondary outcomesThe survey contained questions about the provision of low-value care and on clinical cases about lumbosacral spine X-rays in patients with low back pain and vitamin B12 laboratory tests without an evidence-based indication. We also asked general practitioners what they needed to reduce low-value care.ResultsA total of 182 general practitioners (37%) responded. 67% indicated that low-value care practices are regularly provided in general practice. 57% of the general practitioners have seen negative consequences of low-value care, in particular side effects of medication. The most provided low-value care practices are medication prescriptions such as antibiotics and laboratory tests such as vitamin B12 tests. The most reported drivers are patient-related. General practitioners want to maintain a good relationship with their patients by offering their patients an intervention instead of watchful waiting. Lack of time also plays a major role. In order to reduce low-value care, general practitioners suggested that educating patients on the value of tests and treatments might help. Supporting general practitioners and other healthcare professionals with clear guidelines as well as having more time for consultation were also mentioned by general practitioners.ConclusionGeneral practitioners are aware of providing unnecessary care despite their role as gatekeepers and have reasons for this. They need support in order to change their practice. This support might consist of better education of healthcare professionals and providing more time for consultation. Local and national media, such as websites and television, could be used to educate patients while guidelines could support professionals in reducing low-value care.

Prehospital acute traumatic pain assessment and management practices in the Western Cape, South Africa: a retrospective review

BackgroundTrauma is a common aetiology of acute pain in the emergency setting, and traumatic injuries have been recognised as a global public health crisis leading to numerous deaths and disabilities. This study aimed to identify the prevalence of acute pain among high acuity trauma patients presenting to a public sector emergency medical service and to describe prehospital acute traumatic pain assessment and management practices amongst emergency care providers in the Western Cape Province, South Africa.MethodsA retrospective review of electronic patient care reports of trauma patients treated by the South African Western Cape Emergency Medical Services between January 1 and December 31, 2017 was conducted. Stratified random sampling was utilised to select 2401 trauma patients out of 24,575 that met the inclusion criteria.ResultsOf the 2401 patients reviewed, 435 (18.1%) had a pain score recorded, of which 423 (97.2%) were experiencing pain. An additional 8.1% (n = 194) of patients had pain or tenderness mentioned in the working diagnosis but no pain score noted. Eighty-one (18.6%) patients experienced mild pain, 175 (40.2%) moderate pain and 167 (38.2%) severe pain. No association was found between a pain score recorded and age group (≤ 14 versus > 14 years) (p = 0.649) or gender (p = 0.139). Only 7.6% of patients with moderate-to-severe pain and 2.8% of all trauma patients received any form of analgesic medication. No association was found between the administration of analgesia and age group (≤ 14 versus > 14 years) (p = 0.151) or gender (p = 0.054). Patients were more likely to receive analgesia if they had a pain score recorded (p < 0.001), were managed by advanced life support practitioners (p < 0.001) or had severe pain (p = 0.001).ConclusionAcute trauma pain assessment and management practices in this prehospital cohort are less well established than reported elsewhere and whether this reflects emergency care training, institutional culture, scopes of practice or analgesic resources, requires further research. Emergency medical services need to monitor and promote quality pain care, enhance pain education and ensure that all levels of emergency care providers have access to analgesic medication approved for prehospital use. Clear and rational guidelines would enable better pain management by all cadres of providers, for all levels of pain.