Background: There is scope to improve the quality of life (QOL) of people with dementia living in residential care facilities (RCF). The DIRECT study will determine if delivery of education to General Practitioners (GPs) and care staff improves the quality of life of residential care recipients with cognitive impairment.
Methods/design: A prospective randomised controlled trial conducted in residential aged care facilities in the metropolitan area of Perth, Western Australia. Participants are care facility residents, aged 65 years and older and with mini-mental state examination scores less than 25. GPs and care facility staff have been independently randomised to intervention or control groups. An education programme, designed to meet the perceived needs of learners, will be delivered to GPs and care staff in the intervention groups. The primary outcome of the study will be quality of life of the people with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) and Alzheimer Disease Related QOL Scale (ADRQL), 4 weeks and 6 months after the conclusion of the education intervention.
Results: Recruitment of 351 people with dementia, cared for by staff in 39 residential facilities and 55 GPs, was undertaken between May 2007 and July 2008. Collection of baseline data is complete. Education has been delivered to GPs and Care staff between September 2008 and July 2009. Follow-up data collection is underway.
Discussion: The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.
Trial Registration: These trial methods have been prospectively registered (ACTRN12607000417482).
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http://dx.doi.org/10.1186/1745-6215-11-63 | DOI Listing |
Ann Fam Med
January 2025
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
The impact of the Supreme Court of the United States ruling against race-conscious admissions extends beyond college admissions to professional schools. Based partially on the idea that enough time had elapsed for achievement of the stated goals of affirmative action, the court ruled race-conscious admissions are unconstitutional under the 14th Amendment's Equal Protection Clause. The ruling left a crack in the door to higher education, however, allowing students to write an essay showing how race or ethnicity affected their lives.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Background: The avoidable causes of infant mortality should be identified, and interventions should be made to improve the infant mortality rate. The cause of infant deaths should be assessed in both medical and social contexts.
Objectives: We aimed to determine the medical causes of infant mortality by verbal autopsy and its determinants in two rural blocks of the Khordha district of Odisha and assess the pathway of care and delay in seeking care for the illness preceding infant death using the three-delay model.
Australas J Ageing
March 2025
Department of Geriatric Medicine, Austin Health, Heidelberg, Victoria, Australia.
Objectives: Residential aged care respite clients are vulnerable and prone to poor health-care outcomes. Improvements in the quality of care for this cohort are urgently needed. However, before proposing changes in care models, a nuanced understanding of relevant issues affecting respite care consumers and professionals is required.
View Article and Find Full Text PDFJ Med Humanit
January 2025
The University of North Carolina School of Medicine, 321 Columbia St, Chapel Hill, NC, 27514, USA.
A growing body of literature explores the intersection of eating disorders and identity formation-an entanglement that makes eating disorders particularly challenging to treat. Narrative medicine is a discipline of the health humanities that is interested in bearing witness to patients' stories with a closeness and rigor that enhances clinical care. The pedagogy of the field is the narrative medicine workshop, which mobilizes close-reading of works of art and reflective writing to improve our understanding of Self and Other.
View Article and Find Full Text PDFJ Multidiscip Healthc
January 2025
Department of Nursing, The Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, People's Republic of China.
Objective: This study aimed to assess the determinants of demoralization syndrome among patients with breast cancer (BC) in the southwestern region of China.
Methods: This investigation constituted a single-center cross-sectional study in which 176 patients with BC were surveyed through a questionnaire covering the current status of demoralization syndrome and social support.
Results: Majority of patients with BC developed moderate-to-severe levels of demoralization.
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