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Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]). Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. State Health Research Advisory Council, Department of Health, Government of Western Australia.

\"Mindshift reveals how we can overcome stereotypes and preconceived ideas about what is possible for us to learn and become. At a time when we are constantly being asked to retrain and reinvent ourselves to adapt to new technologies and changing industries, this book shows us how we can uncover and develop talents we didn't realize we had--no matter what our age or background. We're often told to \"follow our passions.\" But in Mindshift, Dr. Barbara Oakley shows us how we can broaden our passions. Drawing on the latest neuroscientific insights, Dr. Oakley shepherds us past simplistic ideas of \"aptitude\" and \"ability,\" which provide only a snapshot of who we are now--with little consideration about how we can change. Even seemingly \"bad\" traits, such as a poor memory, come with hidden advantages--like increased creativity. Profiling people from around the world who have overcome learning limitations of all kinds, Dr. Oakley shows us how we can turn perceived weaknesses, such as impostor syndrome and advancing age, into strengths. People may feel like they're at a disadvantage if they pursue a new field later in life; yet those who change careers can be fertile cross-pollinators: They bring valuable insights from one discipline to another. Dr. Oakley teaches us strategies for learning that are backed by neuroscience so that we can realize the joy and benefits of a learning lifestyle. Mindshift takes us deep inside the world of how people change and grow. Our biggest stumbling blocks can be our own preconceptions, but with the right mental insights, we can tap into hidden potential and create new opportunities\"-- Provided by publisher.

Agitation is a common, challenging symptom affecting large numbers of people with dementia and impacting on quality of life (QoL). There is an urgent need for evidence-based, cost-effective psychosocial interventions to improve these outcomes, particularly in the absence of safe, effective pharmacological therapies. This study aimed to evaluate the efficacy of a person-centred care and psychosocial intervention incorporating an antipsychotic review, WHELD, on QoL, agitation, and antipsychotic use in people with dementia living in nursing homes, and to determine its cost. This was a randomised controlled cluster trial conducted between 1 January 2013 and 30 September 2015 that compared the WHELD intervention with treatment as usual (TAU) in people with dementia living in 69 UK nursing homes, using an intention to treat analysis. All nursing homes allocated to the intervention received staff training in person-centred care and social interaction and education regarding antipsychotic medications (antipsychotic review), followed by ongoing delivery through a care staff champion model. The primary outcome measure was QoL (DEMQOL-Proxy). Secondary outcomes were agitation (Cohen-Mansfield Agitation Inventory [CMAI]), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version [NPI-NH]), antipsychotic use, global deterioration (Clinical Dementia Rating), mood (Cornell Scale for Depression in Dementia), unmet needs (Camberwell Assessment of Need for the Elderly), mortality, quality of interactions (Quality of Interactions Scale [QUIS]), pain (Abbey Pain Scale), and cost. Costs were calculated using cost function figures compared with usual costs. In all, 847 people were randomised to WHELD or TAU, of whom 553 completed the 9-month randomised controlled trial. The intervention conferred a statistically significant improvement in QoL (DEMQOL-Proxy Z score 2.82, p = 0.0042; mean difference 2.54, SEM 0.88; 95% CI 0.81, 4.28; Cohen's D effect size 0.24). There were also statistically significant benefits in agitation (CMAI Z score 2.68, p = 0.0076; mean difference 4.27, SEM 1.59; 95% CI -7.39, -1.15; Cohen's D 0.23) and overall neuropsychiatric symptoms (NPI-NH Z score 3.52, p < 0.001; mean difference 4.55, SEM 1.28; 95% CI -7.07,-2.02; Cohen's D 0.30). Benefits were greatest in people with moderately severe dementia. There was a statistically significant benefit in positive care interactions as measured by QUIS (19.7% increase, SEM 8.94; 95% CI 2.12, 37.16, p = 0.03; Cohen's D 0.55). There were no statistically significant differences between WHELD and TAU for the other outcomes. A sensitivity analysis using a pre-specified imputation model confirmed statistically significant benefits in DEMQOL-Proxy, CMAI, and NPI-NH outcomes with the WHELD intervention. Antipsychotic drug use was at a low stable level in both treatment groups, and the intervention did not reduce use. The WHELD intervention reduced cost compared to TAU, and the benefits achieved were therefore associated with a cost saving. The main limitation was that antipsychotic review was based on augmenting processes within care homes to trigger medical review and did not in this study involve proactive primary care education. An additional limitation was the inherent challenge of assessing QoL in this patient group. These findings suggest that the WHELD intervention confers benefits in terms of QoL, agitation, and neuropsychiatric symptoms, albeit with relatively small effect sizes, as well as cost saving in a model that can readily be implemented in nursing homes. Future work should consider how to facilitate sustainability of the intervention in this setting. ISRCTN Registry ISRCTN62237498.

\"I highly appreciate the quality of Fejes' and Dahlstedt's research and writing. They manage to present in a comprehensible way some essential concepts of Foucault that help us to understand better what practices of lifelong learning, in a broad sense, are emerging nowadays in advanced liberal societies. In doing so, they contribute to the renewal of critical thinking in education. They convince me that such renewal is important and necessary... and I think both theoreticians and practitioners of lifelong learning will equally recognize and value this analysis, particularly also, because they present a good mix of theory and practice.\" -Professor Danny Wildemeersch Today, people are constantly encouraged to verbalise and disclose their \"true\" inner self to others, whether on TV shows, in newspapers, in family life or together with friends. Such encouragement to disclose the self has proliferated through discourses on lifelong learning through which each citizen is encouraged to become a constant learner. The Confessing Society takes a critical stance towards the modern relentless will to disclose the self and argues that society has become a confessing society. Drawing on Foucault's later work on confession and governmentality, this book carefully analyses how confession operates within practices of lifelong learning as a way to shape activated and responsible citizens and provides examples of how it might be possible to traverse the confessional truth of the present time. Chapters include: Reflection and Reflective Practices Deliberation and Therapeutic Intervention Lifelong Guidance Medialised Parenting This controversial book is international in its scope and pursues current debates regarding trans-national policy and to research discussions on education, lifelong learning and governance, and it will provoke lively debate a

Today in the United States, the professional health workforce is not consistently prepared to provide high quality health care and assure patient safety, even as the nation spends more per capita on health care than any other country. The absence of a comprehensive and well-integrated system of continuing education (CE) in the health professions is an important contributing factor to knowledge and performance deficiencies at the individual and system levels. To be most effective, health professionals at every stage of their careers must continue learning about advances in research and treatment in their fields (and related fields) in order to obtain and maintain up-to-date knowledge and skills in caring for their patients. Many health professionals regularly undertake a variety of efforts to stay up to date, but on a larger scale, the nation's approach to CE for health professionals fails to support the professions in their efforts to achieve and maintain proficiency. Redesigning Continuing Education in the Health Professions illustrates a vision for a better system through a comprehensive approach of continuing professional development, and posits a framework upon which to develop a new, more effective system. The book also offers principles to guide the creation of a national continuing education institute.

We present results from a large (n = 3,016) field experiment at a global organization testing whether a brief science-based online diversity training can change attitudes and behaviors toward women in the workplace. Our preregistered field experiment included an active placebo control and measured participants’ attitudes and real workplace decisions up to 20 weeks postintervention. Among groups whose average untreated attitudes—whereas still supportive of women—were relatively less supportive of women than other groups, our diversity training successfully produced attitude change but not behavior change. On the other hand, our diversity training successfully generated some behavior change among groups whose average untreated attitudes were already strongly supportive of women before training. This paper extends our knowledge about the pathways to attitude and behavior change in the context of bias reduction. However, the results suggest that the one-off diversity trainings that are commonplace in organizations are unlikely to be stand-alone solutions for promoting equality in the workplace, particularly given their limited efficacy among those groups whose behaviors policymakers are most eager to influence.