Specialist Palliative Care and Dementia: Staff Challenges and Learning Needs.

Objective: This study explored the perspectives of specialist palliative care (SPC) teams in Ireland, in relation to personal learning needs and education regarding dementia care. Methods: This mixed-methods study involved a survey and focus group. SPC staff were recruited through a professional palliative care society and via hospices in 4 regions. Survey items included challenges in clinical care, personal learning needs, and preferred modes of educational delivery. Quantitative data analysis was descriptive; open-answer survey questions and the focus group transcript underwent thematic analysis. Results: In total, 76 staff completed surveys and rated the following as most challenging: timely access to community agency and specialist support; and managing the needs of people with dementia (PwD). Respondents volunteered additional challenges around the timing/duration of SPC involvement, prognostication, and inadequate knowledge of local services. Staff ranked learning needs as highest in: nonpharmacological management of noncognitive and cognitive symptoms; differentiation of dementia subtypes; and pharmacological management of cognitive symptoms. The focus group (n = 4) gave deeper perspectives on these topics. Overall, 79.2% of staff preferred formal presentations by dementia-care specialists and 76.6% preferred e-learning. Conclusion: Several dementia-care challenges and learning needs are identified by SPC staff, as above. These can inform the design and delivery of tailored education programs for SPC staff. There is also a need for closer working between dementia services and SPC services to provide integrated, holistic care for PwD. One aspect of achieving this is greater awareness of local dementia-care services among SPC staff, and vice versa.

Aquatic exercise programs for children and adolescents with cerebral palsy: what do we know and where do we go?

Aquatic exercise programs may be a beneficial form of therapy for children and adolescents with cerebral palsy (CP), particularly for those with significant movement limitations where land-based physical activity is difficult. The most recently published systematic review (2005) on aquatic interventions in children with CP found supportive but insufficient evidence on its effectiveness. The aim of this paper is to review recently published literature since 2005 with a focus on aquatic exercise for children with CP. In total, six new studies were published with a main focus on aerobic aquatic interventions in higher functioning children and adolescents with CP. Swimming is one of the most frequently reported physical activities in children and adolescents with CP. Therefore, information on its safety and benefits is highly needed, for those with more severe CP in particular. Research design issues are discussed to help guide future research and practice.