Pilot study assessing the possible benefits of a higher level of implementation of biosecurity measures on farm productivity and health status in Belgian cattle farms

Over the last few years, the interest of decision‐makers and control agencies in biosecurity (BS), aiming at preventing and controlling the introduction and spread of infectious diseases, has considerably increased. Nevertheless, previous studies highlighted a low implementation level of biosecurity measures (BSM), especially in cattle farms; different reasons were identified such as perceived costs, utility, importance, increased workload and lack of knowledge. In order to convince cattle farmers to adopt BSM, it is necessary to gather more information and evidence on their cost‐effectiveness and their importance or utility in terms of disease prevention and control. The objectives of this study were to determine whether the farm or farmers’ profile correlated with the implementation level of BSM and if there was a positive correlation between the BSM implementation and the farm production and health parameters. Data were collected through face‐to‐face interviews conducted in 100 Belgian farms as part of a stratified and randomized survey. The Regional Animal Health Services provided the farm health status and production data. A general BS score and five sub‐scores related to the five BS compartments (bio‐exclusion, bio‐compartmentation, bio‐containment, bio‐prevention and bio‐preservation) were calculated for each farm based on the implementation level of different BSM grouped in 16 domains. The study highlighted a significant and negative correlation between the mortality rates in adult cattle (over 24 months of age) and young calves (aged 0–7 days) and different BS compartment scores. The study also demonstrated that the farms having a higher general BS score were indeed more likely to have a BVD‐free status. These evidence‐based findings are encouraging as they demonstrate the benefits of implementing BSM and could promote their adoption by farmers.     

Study protocol Implementation of the Veder contact method (VCM) in daily nursing home care for people with dementia: an evaluation based on the RE-AIM framework

Objectives: People with dementia in nursing homes benefit from person-centred care methods. Studies examining the effect of these methods often fail to report about the implementation of these methods. The present study aims to describe the implementation of the Veder contact method (VCM) in daily nursing home care.

Method: A process analysis will be conducted based on qualitative data from focus groups with caregivers and interviews with key figures. To investigate whether the implementation of VCM is reflected in the attitude and behaviour of caregivers and in the behaviour and quality of life of people with dementia, a controlled observational cohort study will be conducted. Six nursing home wards implementing VCM will be compared with six control wards providing Care As Usual. Quantitative data from caregivers and residents will be collected before (T0), and 9–12 months after the implementation (T1). Qualitative analysis and multilevel analyses will be carried out on the collected data and structured based on the constructs of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance).

Conclusion: By using the RE-AIM framework this study introduces a structured and comprehensive way of investigating the implementation process and implementation effectiveness of person-centred care methods in daily dementia care.     

PDCA循环管理法在抗菌药物管理中的应用

目的：评价PDCA循环法在改善医院抗菌药物临床应用中的效果。方法：采用PDCA循环管理法,通过计划-执行-检查-改进环节对武汉大学中南医院抗菌药物的临床应用进行专项整治,并对整治活动前后（2012~2016年）的抗菌药物使用强度、住院患者抗菌药物使用率以及抗菌药物使用前病原微生物送检率的效果进行分析、评价。结果：经过PDCA循环干预,我院抗菌药物的临床应用有了显著改善,抗菌药物使用率由73.37%降至38.64%,抗菌药物使用强度由68.43降至29.02,限制级和特殊使用级抗菌药物的病原微生物送检率由21.59%和57.34%分别上升至88.42%和99.07%,I类切口预防使用抗菌药物比例由84.5%降至28.6%。结论：PDCA循环法用于医院抗菌药物的管理可促进抗菌药物的合理使用,提高医院合理用药水平。     

Structured Risk Assessment Instruments: A Systematic Review of Implementation Determinants

Research-based structured risk assessment instruments (SRAIs) can improve violence risk assessment and clinical judgements in mental health and correctional services. Practical challenges of implementing SRAIs have led to calls for more research to understand the determinants influencing this process. Studies describing determinants for SRAI implementation in psychiatric, correctional, or community in-patient settings were systematically reviewed. Findings were analysed according to the Consolidated Framework for Implementation Research. A total of 11 studies were included. Four types of main implementation determinants were found: characteristics of the SRAI; users of the SRAI; inner setting; and process. Findings underscore the importance of applying a multifactorial approach to the implementation of SRAIs to address many different barriers and facilitators. More stringent research is needed to obtain more solid evidence of factors that impede or enable SRAI implementation, especially regarding patient perspectives and outer setting determinants. Constructing shared concepts of determinants across research fields could further aid information transferences.     

Teaching caregivers to implement an augmentative and alternative communication intervention to an adult with ASD

Many researchers have investigated the effectiveness of augmentative and alternative communication (AAC) systems on improving communication skills of children with autism spectrum disorder (ASD) and communication complex needs (CCN); however, few studies included adults with ASD. Also, there is a lack of research on primary caregiver implemented interventions with high treatment fidelity although primary caregiver-implemented interventions have been used effectively with adults with ASD and their families. This study investigated the accuracy of primary caregivers’ implementation of a tablet-computer based AAC system while they were providing instruction to an adult with ASD. Also, independent use of AAC system of the participant was examined. We implemented a multiple probe design across three instructional coaching steps to examine the accuracy of the caregivers’ AAC implementation. One adult with autism and CCN and his four primary caregivers participated in this study, twice a week for seven weeks. Both visual and statistical analyses were utilized. Results indicated that, with instructional coaching, all of the caregivers were able to implement the procedures of the AAC mode with the participant accurately, as demonstrated via visual inspection and statistical analyses. Nevertheless, there was little improvement in the participant's independent use of the AAC mode. Limitations and suggestions for future researchers are discussed.     

Implementation of active support in Victoria,Australia: An exploratory study

Abstract

Background Active support is an effective intervention to support engagement of residents with intellectual disability in group homes. This survey explored resident characteristics of the people supported by organisations implementing active support, the provision of active support, its procedures and systems, and resident engagement in meaningful activity and relationships.

Method Information was collected through questionnaires and direct observation of 33 group homes from 6 organisations in Victoria, Australia, with a 5–10-year history of implementing active support.

Results Residents with lower support needs were engaged with little staff contact or assistance. Use of active support systems and structures was mixed. Only one organisation consistently provided good active support.

Conclusions Administrative systems and structures are not sufficient to change staff interaction and thus resident experience. Shared supported accommodation services may represent an inefficient use of resources for more able residents, as staff resources are not maximised to support for resident engagement.