The impact on employees of providing informal caregiving for someone with dementia.

Objective: To determine if employees who are concurrently providing informal caregiving for a person with dementia (DCG) experience greater challenges than employees providing informal caregiving to older adults without dementia (ND CG).

Method: From a sample of employee respondents to a national Canadian survey three groups were studied: ND CG, and two subgroups of DCGs defined by the level of demand posed by the care recipient (CR) - low dementia demand (LDD) and moderate/high dementia demand (HDD). The dependent variables were CGs' job profile, health/well-being, nature of caregiving and work-caregiving balance and CRs' health demands.

Evaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: a pre-post intervention study.

Objectives: While family caregivers (CGs) of persons with dementia are cost-effective for the health system, this form of caregiving leads to disproportionate vulnerability to physical, mental, and social adverse health consequences among CGs. The study goal was to determine the effect of the Reitman Centre CARERS program on key outcomes in family CGs of people with dementia. The Reitman Centre CARERS program is an innovative, group psychotherapeutic skills training intervention based on integrated problem-solving techniques (PST), simulation learning, and group psychotherapy designed to address each CGs' unique situation.

A Canadian national survey of informal employed caregivers of older adults with and without dementia: Work and employee outcomes.

Background: The majority of family caregivers (CG) caring for older adults, many of whom have dementia, are employees concurrently contending with the work demands and the stress and conflicts of caregiving. Both employers and CG employees are challenged by the need to address this problem.

Method: A cross-sectional Canadian survey was distributed nationally to working informal CGs of older adults in 2015 to 2016.

Is shared decision-making to blame for the provision of ethically inappropriate treatment? Results of a multi-site study exploring physician understanding of the "shared" model of decision making.

Support for the concept of respect for first-person informed consent and patient autonomy, including the negative right of patients to refuse unwanted interventions has grown, but does not generally include a positive right of patients to receive whatever treatment they request or demand without constraint. Despite this, health-care providers in both Canada and the United States are guilty of providing, in their own opinions, futile or probably futile treatments at the request of patients or their substitute decision-makers. The purpose of this study was to examine whether physicians' understanding of the shared model of medical decision-making - shared decision-making, (SDM) - may be among the reasons why some patients receive treatment understood as ethically inappropriate, including those deemed futile, treatments that are not medically indicated, or those that are not in the patient's best interests to receive.

Education and training for preventing and minimizing workplace aggression directed toward healthcare workers.

Background: Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression.

The Effect of Peer Support on Knowledge and Self-Efficacy in Weight Management: A Prospective Clinical Trial in a Mental Health Setting.

Metabolic disturbances commonly occur with serious mental illness (SMI). Strategies for weight management include group education, peer support, and follow up. This study evaluated the effects of group peer support on body weight, Confidence and Conviction (C&C), diet quality and health-related quality of life in a mental health setting.

A hermeneutic phenomenological exploration of 'last resort' in the use of restraint.

Restraining patients is a practice that dates back at least three centuries. In recent years, there has been a mandate and advocacy in various countries for organizations to shift towards the minimization of restraint, whereby its use is only as a 'last resort'. There is growing evidence internationally indicating the negative impact of the use of restraint.

A grounded theory study to identify caregiving phases and support needs across the Alzheimer's disease trajectory.

Purpose: Caregivers of individuals with Alzheimer's disease require support across the full disease trajectory. The aim of this study was to develop a conceptual framework of caregiving phases across the Alzheimer's disease and caregiving trajectories and the corresponding caregiver support needs.

Materials And Methods: Constructivist grounded theory informed data collection and analysis.

A pay for performance scheme in primary care: Meta-synthesis of qualitative studies on the provider experiences of the quality and outcomes framework in the UK.

Background: The Quality and Outcomes Framework (QOF) is an incentive scheme for general practice, which was introduced across the UK in 2004. The Quality and Outcomes Framework is one of the biggest pay for performance (P4P) scheme in the world, worth £691 million in 2016/17. We now know that P4P is good at driving some kinds of improvement but not others.

An analysis of documentation language and word choice among forensic mental health nurses.

Documenting patient care is an important part of mental health services. The documentation is expected to be accurate, relevant, and informative for all future readers as it provides details about patients and the care they are receiving. Language can produce positive or negative emotions in individuals, and these emotions can influence their thoughts and actions.

How forensic mental health nurses' perspectives of their patients can bias healthcare: A qualitative review of nursing documentation.

Aims And Objectives: Our aim was to examine the notes produced by nurses, paying specific attention to the style in which these notes are written and observing whether there are concerns of distortions and biases.

Background: Clinicians are responsible to document and record accurately. However, nurses' attitudes towards their patients can influence the quality of care they provide their patients and this inevitably impacts their perceptions and judgments, with implications to patients' care, treatment, and recovery.

Mending the Cracks: A Case Study in Using Technology to Assist with Transitional Care for Persons with Dementia.

Transitions between hospital and community are particularly challenging for vulnerable adults experiencing behavioural and psychological symptoms (BPSD) of dementia. Too often, miscommunication results in triggering a recurrence of disruptive behaviours leading to frustration of staff and families. As part of the implementation of Health Quality Ontario (HQO) Quality Standards, this project involved improving transitions using an electronic-based care plan on a 23-bed geriatric dementia unit in a mental health hospital.

Kinect Project: People with dementia or mild cognitive impairment learning to play group motion-based games.

Introduction: Motion-based technologies (MBTs) could provide nonpharmacologic interventions for people with cognitive impairment (PCI; e.g., dementia or mild cognitive impairment).

Motivational Influences and Trajectories to Violence in the Context of Major Mental Illness.

Developmental trajectories regarding the age onset of violence and offending have not routinely considered the role of major mental illness (MMI). In parallel, despite several studies investigating the relationship between MMI, violence and offending, fewer have identified motivational processes that may link illness to these outcomes in a more direct and proximal manner. This study investigates whether subtypes of forensic psychiatric patients deemed Not Criminally Responsible on account of Mental Disorder ( = 91) can be identified based on the age onset of mental illness and offending behavior, and whether information on motivational influences for offending-elicited both from the patient directly and detailed collateral information-contributes to the clinical utility of this typology.

Therapist adherence to family-based treatment for adolescents with anorexia nervosa: A multi-site exploratory study.

Objective: This exploratory study is the first to examine family-based treatment (FBT) adherence and association to treatment outcome in the context of a large-scale, multi-centre study for the treatment of adolescents with anorexia nervosa.

Method: One hundred and ninety recorded FBT sessions from 68 adolescents with anorexia nervosa and their families were recruited across multiple sites (N = 6). Each site provided 1-4 tapes per family over four treatment time points, and each was independently rated for therapist adherence.

Psychiatric and Behavioral Complications of GPi DBS in an Adolescent with Myoclonus Dystonia.

Myoclonus dystonia is a rare movement disorder that often causes significant disability. Deep brain stimulation of the internal pallidum (GPi DBS) is a recommended treatment for those who do not respond to pharmacotherapy or who have intolerable side effects. This paper reports on the case of a 17-year-old male who was admitted to a tertiary level mental healthcare facility for treatment of psychiatric and behavioral symptoms thought to be related to GPi DBS.

The Best of Both Models: Key Components of a Successful Hybrid Project Management Office Model in a Health Care Organization.

Project management (PM) is considered an important competency for improving organizational efficiencies, and its practice is evolving in health care organizations. As a medium-sized health care organization, Ontario Shores Centre for Mental Health Sciences used a hybrid PM office model and created a PM network to connect the small, centralized PM office to the decentralized project leaders. The key components to create the PM network were (1) skilled leader, (2) organizational support, (3) infrastructure, and (4) session content.

Needs and preferences for technology among Chinese family caregivers of persons with dementia: A pilot study.

Background: Dementia is a major public health concern associated with significant caregiver demands and there are technologies available to assist with caregiving. However, there is a paucity of information on caregiver needs and preferences for these technologies, especially among Chinese family caregivers of persons with dementia in Canada.

Objective: The purpose of this study was to examine the technology needs and preferences of Chinese family caregivers of persons with dementia with a sex and gender lens in Canada.

'It makes you someone who changes with the times': health worker and client perspectives on a smartphone-based counselling application deployed in rural Tanzania.

Mobile health (mHealth) applications have been developed for community health workers (CHW) to help simplify tasks, enhance service delivery and promote healthy behaviours. These strategies hold promise, particularly for support of pregnancy and childbirth in low-income countries (LIC), but their design and implementation must incorporate CHW clients' perspectives to be effective and sustainable. Few studies examine how mHealth influences client and supervisor perceptions of CHW performance and quality of care in LIC.

How can engagement of adolescents in antenatal care be enhanced? Learning from the perspectives of young mothers in Ghana and Tanzania.

Background: Adolescents are especially vulnerable due to increased biological, social and economic risks associated with early pregnancy and childbirth, yet most pregnancy and childbirth-related complications are preventable through a combination of proven, cost-effective clinical interventions including timely antenatal care (ANC). The voices and specific needs of adolescents are currently underrepresented in the literature on antenatal and maternity care. Objectives were to a) increase our understanding of adolescents' experiences with, and perceptions of, ANC and b) explore how these perspectives might be applied towards future initiatives to enhance adolescent care-seeking behaviour.

Ethical failings of CPSO policy and the health care consent act: case review.

End-of-life disputes in Ontario are currently overwhelmingly assessed through the singular lens of patient autonomy. The current dispute resolution mechanism(s) does not adequately consider evidence-based medical guidelines, standards of care, the patient's best interests, expert opinion, or distributive justice. We discuss two cases adjudicated by the Consent and Capacity board of Ontario that demonstrate the over emphasis on patient autonomy.

Perceptions on the sexual harassment of female nurses in a state hospital in Sri Lanka: a qualitative study.

Background: Sexual harassment occurs within the nursing profession globally, challenging the health and safety of nurses and the quality and efficiency of health systems. In Sri Lanka, no studies have explored this issue in the health sector; however, female employees face sexual harassment in other workplace settings.

Objective: To explore female nurses' perceptions of workplace sexual harassment in a large state hospital in Sri Lanka.

Extraversion modulates cortisol responses to acute social stress in chronic major depression.

Background: Chronic Major Depressive Disorder (CMDD) is a common, disabling illness that is often complicated by high reactivity to social stress. To further elucidate the nature of this reactivity, the current study evaluated whether the personality dimensions of neuroticism and extraversion influenced cortisol responses to a social challenge in CMDD patients vs. controls.