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No / The correlation between 'disengagement' and illness in people with dementia living in long-term care settings is becoming more widely recognised, and developing and adapting front-line staff responses to the changing needs of individuals is a crucial factor in addressing this problem. This book presents a complete practical framework for whole person assessment, care planning and review of persons with dementia or signs of dementia (including those with learning disabilities) who are in need of, or already receiving, health and/or social support. The book provides photocopiable assessment forms, guidelines for carrying out the assessment, and suggestions for tailored interventions based on the profile that emerges from the assessment process. The authors also include a clear explanation of the five theoretical components of dementia that are considered in the assessment: health, biography, personality, neurological impairment and social psychology. This good practice guide will provide a step up to the challenge of providing person centred care as a minimum standard rather than just an ideal.

Yes / perinatal palliative care services are increasingly available globally, offering a range of clinical and psychological support services to families during pregnancy, in the neonatal period and following the death of a baby with a life-limiting or life-threatening condition. Little is understood about the role of children’s hospice care and how it contributes to effective perinatal palliative care. Design: The study aims to answer the question ‘what is the role of children’s hospices in the provision of perinatal palliative care and advance care planning in the United Kingdom?’ Methods: An electronic survey was sent to all 54 children’s hospices in the United Kingdom between May and June 2022. Results: 30 hospices responded, representing 54% of the sector. All regions of all four counties are represented. Numbers of referrals to hospices for perinatal palliative care have increased significantly over the last five years. Hospices provide a range of services for families and babies, usually from the point of diagnosis or recognition of a life-limiting or life-threatening condition, underpinned with counselling and emotional support. Hospices worked with a range of professionals and services, most commonly fetal medicine and neonatal services. Advance care plans were an important element of effective perinatal palliative care, strengthening parent-professional and interprofessional relationships. Conclusion: Children’s hospice services play an important and growing role in the perinatal care of babies and families following the diagnosis or recognition of a life limiting or life-threatening condition. The family centred approach to care, from a broad, biopsychosocial perspective means that hospices make a unique and meaningful contribution to both the clinical and psychological needs of families. / University of Bradford. Grant Number: DA5151. SURE Research Project

The course of endstage renal disease (ESRD) and receiving hemodialysis (HD) treatment is complex and filled with uncertainty. Part of this illness experience includes making end-of-life (EOL) care decisions. Many families are unprepared to make such decisions. Advance care planning (ACP) creates an excellent context for laying the groundwork for these emotionally charged conversations. Hemodialysis patients, their families and healthcare providers (HCPs) are in a unique position to begin the ACP process early in the illness trajectory, revisiting it when the patient’s health status, prognosis and treatment modality changes. To date, little research has focused directly on how families experience ACP conversations in the context of ESRD or HD. The purpose of this study was to explore family members’ experiences of participating in a facilitated ACP conversation with the HD patient. This approach recognizes and privileges the family’s role in the illness trajectory of ESRD and validates that they too are HCPs’ clients. Five families, consisting of the HD patient and one family member, who went through the ACP process were interviewed along with an ACP facilitator from the nephrology program. This focused ethnographic study applied the theoretical perspective of postmodernist critical theory to derive and analyze data from in-depth semi-structured interviews. Findings revealed a detailed description of the ACP process that included timing, readiness to acknowledge the potentiality of death, facing mortality, and finding meaning in the illness experience. As families started to deconstruct their experiences, they shared stories of communication breakdown, highlighting the complexities of their relationships with HCPs. Understanding the factors that potentially contribute to HD patients’, their families’ and the renal staff’s discomfort with death were analyzed. The study findings provide important direction for HCPs about how families make ACP decisions, how they perceive the ACP process, and what they identify as their EOL care needs and wishes. Failure to implement ACP as part of an EOL care program means that death will continue to be denied and clients’ EOL care needs will remain un-addressed. In order for ACP to be effective on HD units, sustainable resources are essential for patients, their families and HCPs.

The course of endstage renal disease (ESRD) and receiving hemodialysis (HD) treatment is complex and filled with uncertainty. Part of this illness experience includes making end-of-life (EOL) care decisions. Many families are unprepared to make such decisions. Advance care planning (ACP) creates an excellent context for laying the groundwork for these emotionally charged conversations. Hemodialysis patients, their families and healthcare providers (HCPs) are in a unique position to begin the ACP process early in the illness trajectory, revisiting it when the patient’s health status, prognosis and treatment modality changes. To date, little research has focused directly on how families experience ACP conversations in the context of ESRD or HD. The purpose of this study was to explore family members’ experiences of participating in a facilitated ACP conversation with the HD patient. This approach recognizes and privileges the family’s role in the illness trajectory of ESRD and validates that they too are HCPs’ clients. Five families, consisting of the HD patient and one family member, who went through the ACP process were interviewed along with an ACP facilitator from the nephrology program. This focused ethnographic study applied the theoretical perspective of postmodernist critical theory to derive and analyze data from in-depth semi-structured interviews. Findings revealed a detailed description of the ACP process that included timing, readiness to acknowledge the potentiality of death, facing mortality, and finding meaning in the illness experience. As families started to deconstruct their experiences, they shared stories of communication breakdown, highlighting the complexities of their relationships with HCPs. Understanding the factors that potentially contribute to HD patients’, their families’ and the renal staff’s discomfort with death were analyzed. The study findings provide important direction for HCPs about how families make ACP decisions, how they perceive the ACP process, and what they identify as their EOL care needs and wishes. Failure to implement ACP as part of an EOL care program means that death will continue to be denied and clients’ EOL care needs will remain un-addressed. In order for ACP to be effective on HD units, sustainable resources are essential for patients, their families and HCPs.

The course of endstage renal disease (ESRD) and receiving hemodialysis (HD) treatment is complex and filled with uncertainty. Part of this illness experience includes making end-of-life (EOL) care decisions. Many families are unprepared to make such decisions. Advance care planning (ACP) creates an excellent context for laying the groundwork for these emotionally charged conversations. Hemodialysis patients, their families and healthcare providers (HCPs) are in a unique position to begin the ACP process early in the illness trajectory, revisiting it when the patient’s health status, prognosis and treatment modality changes. To date, little research has focused directly on how families experience ACP conversations in the context of ESRD or HD. The purpose of this study was to explore family members’ experiences of participating in a facilitated ACP conversation with the HD patient. This approach recognizes and privileges the family’s role in the illness trajectory of ESRD and validates that they too are HCPs’ clients. Five families, consisting of the HD patient and one family member, who went through the ACP process were interviewed along with an ACP facilitator from the nephrology program. This focused ethnographic study applied the theoretical perspective of postmodernist critical theory to derive and analyze data from in-depth semi-structured interviews. Findings revealed a detailed description of the ACP process that included timing, readiness to acknowledge the potentiality of death, facing mortality, and finding meaning in the illness experience. As families started to deconstruct their experiences, they shared stories of communication breakdown, highlighting the complexities of their relationships with HCPs. Understanding the factors that potentially contribute to HD patients’, their families’ and the renal staff’s discomfort with death were analyzed. The study findings provide important direction for HCPs about how families make ACP decisions, how they perceive the ACP process, and what they identify as their EOL care needs and wishes. Failure to implement ACP as part of an EOL care program means that death will continue to be denied and clients’ EOL care needs will remain un-addressed. In order for ACP to be effective on HD units, sustainable resources are essential for patients, their families and HCPs. / Applied Science, Faculty of / Nursing, School of / Graduate

A cirurgia ortognática moderna utiliza-se de medidas do perfil tegumentar para estabelecer uma relação direta com as bases ósseas. Sabe-se, entretanto, que métodos digitais vêm sendo empregados para auxiliar na precisão e predição do planejamento cirúrgico. O presente estudo comparou as medidas, obtidas da análise cefalométrica dos tecidos moles de brasileiros da região nordeste com as obtidas por SantAna et al. (2009). O trabalho foi realizado utilizando telerradiografias em norma lateral, digitalizadas e medidas pelo programa Dolphin Imaging, versão 11.0. Vinte e seis indivíduos (5 homens e 21 mulheres) satisfizeram os critérios de inclusão e constituíram a amostra do trabalho. Os resultados obtidos foram inseridos em uma planilha do programa Microsoft Excel e foram submetidos à análise estatística com o teste t paramétrico não pareado. Os resultados mostraram que os brasileiros da região nordeste apresentam terço médio menos proeminente, lábio inferior mais espesso, ângulo nasolabial mais obtuso, ângulo do lábio superior menor e o incisivo superior menos protruído em relação aos brasileiros da região sudeste. A conclusão do trabalho foi a existência de diferenças estatisticamente significantes no perfil mole quando comparou-se os brasileiros do nordeste com os do sudeste. / Orthognathics surgery modern uses the measure of soft tissue profile to stablish a relation with osseous basis. However, digital methods have been used to aid the prediction and accuracy of surgical planning. The present study compared the measures obtained from the cephalometric analysis of the soft tissues from brazilian northeast with the ones obtained by Sant´Ana et al. (2009). The work was performed by using cephalometric radiograph and measured by the Dolphin Imaging 11.0 version. Twenty-six individuals (5 male and 21 female) were the sample of this study. The results were inserted in an Excel program and were analyzed with the non paired parametric t test. The results showed that the brazilian northeast have the medium third less prominent, thicker lower lip, more obtuse nasolabial angle, smallest angle of the upper lip and less protruding upper incisor in relation to the brazillian southeast. The conclusion of this study was the existence of statistically significant differences in the soft tissue profile compared to the brazilian northeast to the southeast.

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism was associated with more planning. High optimism may be a barrier to future planning in certain social and cultural contexts.

<p>The purpose of this paper is to provide an overview of how cooperation functions between the health services and social services within Sollentuna County Municipal area regarding clients and simultaneous or double diagnoses. Focusing more specifically; the paper also aims to provide additionally, an inquiry as to how the implementation of the Gemensam Individuell Vårdplan (GIVP) (The Integrated Individual Service Care Programme or (GIVP) functions within the Sollentuna Municipal County Area. The questions asked in the paper are: How do the Municipal and County Council personnel experience how the (GIVP) system functions in Sollentuna? How do the Municipal Council and County Council personnel respectively describe their own and their cooperative sister services rolls in terms of the implementation of the GIVP system in practice? The projection activates a hypothesis and tries to explain how the cooperation functions and provides an assessment as to how it functions or not as may be the case in practise. The authors attempt to achieve this using a combination of methodologies. Partly through data based collection and collation through the use of a vignette-focus-study and partly through the use of a questionnaire. A combination of methods has been used to collate both quantitative and qualitative data. The analysis and interpretation of the data is managed through the use of Bengt Berggren’s (1982) cooperative model, incorporating both cognitive theory as well as meta-cognitive theory. The purpose and application of the theories is designed both to individually and collectively nuance interpretations of the relevant data. The investigations primary results show the existence of a strong willingness to cooperate. It shows that cooperation is widely regarded as being important, and that in addition, GIVP is regarded as a useful system for an improved integrated service. It additionally suggests that cooperation can be improved amongst the relevant services to an even greater extent.</p>