Dementia-related work activities of home care nurses and aides: Frequency,perceived competence,and continuing education priorities

ABSTRACT

An understanding of the specific dementia learning needs of home care staff is needed to plan relevant continuing education (CE) programs and supports. The study’s objective was to examine frequency and perceived competence in performing 20 dementia-related work activities, and identify CE priorities among home care staff. A cross-sectional survey of all home care staff in a primarily rural health region was used to gather data. Of 111 eligible staff, 82 participated (41 nursing aides, 41 nurses/case managers). To explore the relationship between activity frequency (F) and competence (C), the proportion of nurses and aides in four quadrants for each activity was examined: (1) low F-low C, (2) low F-high C, (3) high F-low C, and (4) high F-high C. Nurses/case managers were significantly more likely than aides to regularly perform 11 activities and to report high competence in 9 activities (p < .05); aides were more likely to assist with two activities (personal care and daily living activities). Thus, nurses/case managers performed a broader range of activities and reported higher competence overall. The top CE topic for both groups was recognizing differences between dementia subtypes, but rankings for most activities varied by group. Aides’ CE priorities indicated a desire to develop competence in low frequency-low competence activities, suggesting an expanded role in supporting dementia patients and their families. Nurses’ CE priority topics were in the high F-high C quadrant, indicating a need to further develop competence in these activities. Findings have implications for planning CE programming for home care providers.     

Evaluating the Efficiency of Research in Academic Departments: an Empirical Analysis in an Italian Region

This paper investigates the efficiency of university departments in science, technology and medicine in an Italian Region (Lombardy). The aim of the paper is twofold: (i) to analyse the changes in productivity in recent years (from 2004 and 2007); and (ii) to detect factors that are potentially affecting efficiency. The research benefited from a new and unique dataset (called QuESTIO) developed by the Lombardy Regional Government. Using facilities and academic staff as inputs and research grants and publications as outputs, the research activity of academic departments was modelled. The methodological approach for computing efficiency scores is (DEA) Data Envelopment Analysis; Malmquist indexes have been used to measure changes in productivity, while Kruskal‐Wallis tests were employed to study the potential determinants of efficiency. Two main results were obtained. First, the academic departments improved their efficiency but, at the same time, the efficiency frontier worsened. Second, external and measurable factors (such as scientific sector, proportion of tenured staff, location, etc.) have a limited impact in explaining efficiency differentials. The policy implications of both results are discussed.     

An investigation into the representation of geological maps by 15–16 year‐old Turkish students

This paper explores secondary school students’ representations of a geological map. Ninety‐two high school students (ninth graders – 15‐ to 16‐years‐old) participated in the survey in Turkey. The findings indicate that students have only a vague idea of how a geological map is constructed, and how the map is affected by the topography. The students’ poor understandings are based on insufficient information supplied to them during their learning process, and on their need to see things clearly in order to describe or understand them. Since research shows that developing an understanding of how to make and use geological maps fosters the development of cognitive skills in general, the implication of these research findings is that all pupils would benefit from education in how to make and use geological maps. Thus national curricula should require training in geological map work, teachers should be trained in teaching the necessary skills and textbooks should include good coverage of this topic.     

Reforming the university sector: effects on teaching efficiency—evidence from Italy

In this article, we analyse the effects of teaching reforms in Italy. These were introduced in 1999, and changed the entire organization of university courses, where the Bachelor–Master (BA–MA) structure was adopted. The first step is to define the production process of higher education (HE). This process consists of several inputs (professors, facilities and students) which combine to produce outputs (graduates). We define efficiency in this context. Data Envelopment Analysis (DEA) is used for the empirical analysis. This method allows us to build a frontier of efficient units, comparing universities with each other. The changes introduced by the reforms are modelled within this framework: the effects of teaching reforms are investigated as determinants of efficiency improvements. Our results, also supported by a Malmquist index analysis, suggest that efficiency of the HE sector as a whole improved in the period 1998/1999 to 2003/2004. Despite the fact that teaching reforms led to worse performance in the first year, in the following years productivity improved more rapidly than before. Our analyses will require further advancements, both for (1) analysing quality issues (improving the production process modelling) and for (2) testing our findings on longer periods. In fact, even if the results clearly evidenced an improvement in performances, better analyses on unobservable factors (e.g. quality) and on longer periods will give stability to our preliminary results.

Evolution of muscular fatigue in periscapular and rotator cuff muscles during isokinetic shoulder rotations

To this day, how shoulder muscles react to a strong fatigue stimulus during dynamic shoulder rotations remains unknown. The aims of this study were to assess the effect of repeated maximal internal-external isokinetic shoulder rotations on shoulder strength and muscle activity. Twenty-four individuals completed a 50-repetition fatiguing isokinetic protocol while electromyography was recorded on eleven muscles of the shoulder girdle. Time-frequency transformation and an ANOVA model using statistical parametric mapping methods were used to analyze shifts in instantaneous median frequency (MDF) between each 10-repetition Blocks. Peak torques decreased in both internal and external rotation (P < 0.01) by 24.8% on average which indicated the presence of fatigue. Significant decrease in MDF (P < 0.01) was observed for pectoralis, middle deltoid, upper, middle and lower trapezius, infraspinatus and subscapularis muscles. The observed fatigue to the periscapular and rotator cuff muscles suggests that shoulder stability could be compromised during repeated shoulder rotations, which could underlie the increased risk of scapular dyskinesis and shoulder impingement during fatiguing tasks. The present study provides a deeper understanding on the manifestations of fatigue within muscles of the shoulder girdle and the results could be applied toward improvements in athlete shoulder injury prevention and rehabilitation programs.