Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data.

Background: Presentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood.

Aims: To examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter.

The effects of the Green House nursing home model on ADL function trajectory: A retrospective longitudinal study.

Background: Growing attention in the past few decades has focused on improving care quality and quality of life for nursing home residents. Many traditional nursing homes have attempted to transform themselves to become more homelike emphasizing individualized care. This trend is referred to as nursing home culture change in the U.

Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.

Background: The 'Supporting Teachers And childRen in Schools' (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8-12 teachers. The STARS trial will investigate whether TCM can improve children's behaviour, attainment and wellbeing, reduce teachers' stress and improve their self-efficacy.

Longitudinal psychological outcomes of the small-scale nursing home model: a latent growth curve zero-inflated Poisson model.

Background: This study aims to examine the longitudinal effects of a small-scale nursing home model on the change rates of psychological outcomes by comparing green house (GH) and traditional nursing home residents.

Methods: A total of 242 residents (93 GH and 149 traditional home residents) who resided at the home least 6 months from admission. Four minimum dataset assessments every six months from admission were included.

Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study.

Background: Communication is a fundamental part of health care, but can be more difficult with disabled children. Disabled children are more frequently admitted to hospital than other children.

Aims: To explore experiences of ward staff and families to identify barriers and facilitators to effective communication with disabled children whilst inpatients.

Creating and supporting a mixed methods health services research team.

Objective: To use the experience from a health services research evaluation to provide guidance in team development for mixed methods research.

Methods: The Research Initiative Valuing Eldercare (THRIVE) team was organized by the Robert Wood Johnson Foundation to evaluate The Green House nursing home culture change program. This article describes the development of the research team and provides insights into how funders might engage with mixed methods research teams to maximize the value of the team.

Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.

Objectives: To determine those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level.

Design: Observational study with quantitative analysis of nursing home characteristics, team participation levels, and implementation milestones collected as part of a QI program.

Setting: Fourteen nursing homes in Washington, District of Columbia, participating in the On-Time Pressure Ulcer Prevention program.

Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study.

Background: Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa.

Aim: We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice.

Integrating the transitional relationship model into clinical practice.

Background: The challenge of facilitating knowledge translation in clinical practice includes enabling practitioners and agencies to implement a common set of best practices, such as the Transitional Relationship Model (TRM). In 1992, a participatory action project implemented the TRM on a long-term psychiatric hospital ward in Ontario, Canada. All participants were successfully "bridged" to the community.

Supporting teachers and children in schools: the effectiveness and cost-effectiveness of the Incredible Years teacher classroom management programme in primary school children: a cluster randomised controlled trial, with parallel economic and process evaluations.

Background: Childhood antisocial behaviour has high immediate and long-term costs for society and the individual, particularly in relation to mental health and behaviours that jeopardise health. Managing challenging behaviour is a commonly reported source of stress and burn out among teachers, ultimately resulting in a substantial number leaving the profession. Interventions to improve parenting do not transfer easily to classroom-based problems and the most vulnerable parents may not be easily able to access them.

Incorporating INTERACT II Clinical Decision Support Tools into Nursing Home Health Information Technology.

A substantial reduction in hospitalization rates has been associated with the implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement intervention using the accompanying paper-based clinical practice tools (INTERACT II). There is significant potential to further increase the impact of INTERACT by integrating INTERACT II tools into nursing home (NH) health information technology (HIT) via standalone or integrated clinical decision support (CDS) systems. This article highlights the process of translating INTERACT II tools from paper to NH HIT.

Supportive interchanges and face-work as 'protective talk' in an online self-harm support forum.

Within a context of concern about inappropriate advice-giving online, we examined how young people who self-harm behave online, and how professionals might engage with them. We use Discourse Analysis to focus on participant interactions (posts)from a forum's crisis/support rooms, and highlight the prevalence of disclaimers, hedges, questions and tags in the young people's online interactions. We use the concept of face-work as a framework to help understand interactions in the forum SharpTalk.

Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these.

Membership and boundary maintenance on an online self-harm forum.

In this article we explore how young adults became members and sustained membership in an online self-harm support forum, SharpTalk. We take a discursive approach to consider resources young people used to establish themselves, how others responded to their attempts, and how membership categories were developed and applied. Participants displayed expectations about appropriate ways of discussing self-harm, and about responses and advice.

Leveraging certified nursing assistant documentation and knowledge to improve clinical decision making: the on-time quality improvement program to prevent pressure ulcers.

The goal of this article was to enhance understanding of the On-Time Quality Improvement for Long-term Care Program, a practical approach to embed health information technology into quality improvement in nursing homes that leverages certified nursing assistant documentation and knowledge, supports frontline clinical decision making, and establishes proactive intervention for pressure ulcer prevention.

Using metrics to describe the participative stances of members within discussion forums.

Background: Researchers using forums and online focus groups need to ensure they are safe and need tools to make best use of the data. We explored the use of metrics that would allow better forum management and more effective analysis of participant contributions.

Objective: To report retrospectively calculated metrics from self-harm discussion forums and to assess whether metrics add to other methods such as discourse analysis.

Frontline caregiver daily practices: a comparison study of traditional nursing homes and the Green House project sites.

Objectives: To describe differences in frontline caregiver daily practice in two types of skilled nursing facility (SNF) settings, Green House (GH) homes and traditional SNF units, related to overall staffing (nursing and nonnursing departments), direct care and indirect care time per resident day, and staff time interacting with residents.

Design: Observational, interview, and survey study comparing frontline caregiver daily practice in GH homes and traditional SNFs.

Setting: Twenty-seven sites (GH homes and traditional SNF units).

Beyond CMS quality measure adjustments: identifying key resident and nursing home facility factors associated with quality measures.

Objective: This quality improvement (QI) project was initiated to understand what differentiates nursing homes (NHs) that perform well on publicly reported Centers for Medicare and Medicaid Services (CMS) Quality Measures (QMs). The intent was to assist NH staff to direct QI efforts to positively impact QM rates. A key step was to determine if any resident or facility characteristics might account for some of the variability in QMs of high-risk pressure ulcers (HRPrUs), low-risk incontinence (LRI), and Activities of Daily Living (ADL) decline, beyond those already adjusted for by CMS.

Pressure ulcer prevention in long-term-care facilities: a pilot study implementing standardized nurse aide documentation and feedback reports.

Objective: To design and facilitate implementation of practice-based evidence changes associated with decreases in pressure ulcer (PrU) development in long-term-care (LTC) facilities and promote these practices as part of routine care.

Design: Pre/post observational study.

Settings And Participants: Frail older adult residents in 11 US LTC facilities.

A case study of transfer of learning in a family health nursing course for students in remote and rural areas.

This paper describes a case study detailing one approach to tackling the problems of knowledge transfer in an undergraduate course on Research, Decision-Making and Evaluation in Family Health Nursing. Transfer is the ability to access and utilise ones intellectual resources in situations where these may be needed [Nursing Diagnosis 3(4) (1992) 148-154]. The discussion will explore the related issues of transfer of learning, casuistry, and teaching and learning on a course for experienced community practitioners.

The Transitional Discharge Model: comparing implementation in Canada and Scotland.

Effective discharge planning is needed to facilitate clients' transition from psychiatric hospital wards to community care. Previous studies have shown that client outcomes can be improved by using a Transitional Discharge Model (TDM) that includes peer support and an extension of inpatient-practitioner relationships that are introduced prior to discharge. However, countries vary in many ways that may affect implementation of the model.

Transitional discharge based on therapeutic relationships: state of the art.

The Transitional Discharge Model (TDM) has been used to facilitate effective discharge from psychiatric hospital to community. A summary of the research to date on TDM is given. The model is based on the provision of therapeutic relationships to provide a safety net throughout the discharge and community reintegration processes.

Social capital, age and religiosity in people who are lonely.

Aims And Objectives: The aims of the study were to (i) investigate age and loneliness, (ii) investigate the association between religiosity and loneliness, and (iii) and explore the relationship between social capital and loneliness.

Background: Loneliness is the subjective experience of social isolation and is a risk factor for a wide range of health problems including heart disease and depression. Poor self-rated health, domestic violence and poor economic conditions are associated with greater loneliness.