This study examined activities related to the provision of psychosocial care by counsellors in the hospice/palliative care setting. A qualitative design using written reports was used in an urban Canadian hospice/palliative care program. A convenient sample of 13 counsellors indicated the activities they typically performed in their work with patients and families. Thematic analysis of the activities directly related to patient and family care was performed and then validated by presenting these activities back to the counsellors in a group setting. Seven themes resulted: 1) companioning; 2) psychosocial assessment, planning, and evaluation; 3) counselling interventions; 4) facilitation and advocacy; 5) patient and family education; 6) consultation and reporting; and 7) team support. These thematic findings confirmed those of previous studies and also highlighted two additional findings. Team support was seen as an activity that directly affected client care, and there was a strong emphasis on the activity of companioning the dying and their families. Also discussed are implications of these results, as well as suggestions for further research.
The aims of the present study were (1) to analyse the physical demands of top-class referees and (2) to compare their official FIFA fitness test results with physical performance during a match. The work rate profiles of 11 international referees were assessed during 12 competitive matches at the 2003 FIFA Under-17 World Cup and then analysed using a bi-dimensional photogrammetric video analysis system based on direct lineal transformation (DLT) algorithms. In the first 15 min of matches, the referees were more active, performing more high-intensity exercise (P
Cultural-historical activity theory is a new framework aimed at transcending the dichotomies of micro- and macro-, mental and material, observation and intervention in analysis and redesign of work. The approach distinguishes between short-lived goal-directed actions and durable, object-oriented activity systems. A historically evolving collective activity system, seen in its network relations to other activity systems, is taken as the prime unit of analysis against which scripted strings of goal-directed actions and automatic operations are interpreted. Activity systems are driven by communal motives that are often difficult to articulate for individual participants. Activity systems are in constant movement and internally contradictory. Their systemic contradictions, manifested in disturbances and mundane innovations, offer possibilities for expansive developmental transformations. Such transformations proceed through stepwise cycles of expansive learning which begin with actions of questioning the existing standard practice, then proceed to actions of analyzing its contradictions and modelling a vision for its zone of proximal development, then to actions of examining and implementing the new model in practice. New forms of work organization increasingly require negotiated 'knotworking' across boundaries. Correspondingly, expansive learning increasingly involves horizontal widening of collective expertise by means of debating, negotiating and hybridizing different perspectives and conceptualizations. Findings from a longitudinal intervention study of children's medical care illuminate the theoretical arguments.
In spite of the long history of nurse practitioner practice in primary healthcare, less is known about nurse practitioners in hospital-based environments because until very recently, they have not been included in the extended class registration (nurse practitioner equivalent) with the College of Nurses of Ontario. Recent changes in the regulation of nurse practitioners in Ontario to include adult, paediatric and anaesthesia, indicates that a workforce review of practice profiles is needed to fully understand the depth and breadth of the role within hospital settings. Here, we present information obtained through a descriptive, self-reported survey of all nurse practitioners working in acute care settings who are not currently regulated in the extended class in Ontario. Results suggest wide acceptance of the role is concentrated around academic teaching hospitals. Continued barriers exist related to legislation and regulation as well as understanding and support for the multiple aspects of this role beyond clinical practice. This information may be used by nurse practitioners, nursing leaders and other administrators to position the role in hospital settings for greater impact on patient care. As well, understanding the need for regulatory and legislative changes to support the hospital-based Nurse Practitioner role will enable greater impact on health human resources and healthcare transformation.
To examine acupuncture's effect on cycling performance.
This was a prospective, single-blind, patient as own control (repeated measures), crossover design. Subjects underwent 3 tests a week, riding a stationary bike for 20-km as fast as able. Before each test, they received acupuncture (test A), "sham" acupuncture (test B), and no intervention (control, test C) once each in a random order.
University of Alberta, Faculty of Rehabilitation Medicine.
20 male cyclists (age, 18 to 30 years) were recruited via convenience sampling of students and general public. Athletic ability was assessed through a questionnaire and modified Par-Q.
Acupuncture, sham acupuncture, and no intervention in random order with each subject before each test. Acupuncture points were chosen on the basis of Traditional Chinese Medicine and administered immediately before cycling. Sham was shallow needling of known acupoints.
The outcome measures of each of the tests were time to completion, VAS for lower extremity/exercise-induced pain, Borg rating of perceived exertion (RPE), and blood lactate concentrations, recorded immediately following each test.
Mean times to Test A, B, and C completion were 36.19 +/- 5.23, 37.03 +/- 5.66, and 37.48 +/- 6.00 minutes, respectively, P = 0.76. Mean RPE scores after tests A, B, and C were 17.65 +/- 0.67, 16.95 +/- 0.99, and 16.85 +/- 0.88, respectively, P = 0.0088. Mean VAS scores after tests A, B, and C were 7.72 +/- 0.86, 7.94 +/- 0.78, and 8.08 +/- 0.69, respectively, P = 0.76.
The only statistically significant finding was that acupuncture gave higher RPE scores compared to the other tests. The clinical significance was that the higher RPE scores gave lower time and VAS scores.
We present a Finland-Swedish adaptation of the Sweden-Swedish group screening test for dyslexia for adults and young adults DUVAN (Lundberg & Wolff, 2003) together with normative data from 143 Finland-Swedish university students. The test is based on the widely held phonological deficit hypothesis of dyslexia and consists of a self-report and five subtests tapping phonological working memory, phonological representation, phonological awareness, and orthographic skill. We describe the test adaptation procedure and show that the internal reliability of the new test version is comparable to the original one. Our results indicate that the language background (Swedish, Finnish, early simultaneous Swedish-Finnish bilingualism) should be taken into account when interpreting the results on the Finland-Swedish DUVAN test. We show that the FS-DUVAN differentiates a group of students with dyslexia diagnosis from normals, and that a low performance on the FS-DUVAN correlates with a positive self-report on familial dyslexia and with a history of special education in school. Finally, we analyze the sensitivity and specificity of the FS-DUVAN for dyslexia among university students.
Wast of working time and distraction from basic duties over a period of one year in different age and professional groups of the paramedical personnel were studied in 2 regions and 1 territory of the RSFSR. The investigation showed that on all occasions and on account of all causes the waste of productive time and distraction from primary duties occurred among the personnel of young age. In senior age groups this figures were noted to be on decline. Essential age-specific features common to the frequency and duration of lost working time and distraction from basic duties were found to be associated with temporary incapacitation, leaves of absence due to pregnancy and confinement, care of children, etc. The existence of a definite connection of the factors under study and posts occupied by paramedical workers was established.
Performance of reaction time (RT) tasks was investigated in young children and adults to test the hypothesis that age-related differences in processing speed supersede a "global" mechanism and are a function of specific differences in task demands and processing requirements. The sample consisted of 54 4-year-olds, 53 5-year-olds, 59 6-year-olds, and 35 adults from Russia. Using the regression approach pioneered by Brinley and the transformation method proposed by Madden and colleagues and Ridderinkhoff and van der Molen, age-related differences in processing speed differed among RT tasks with varying demands. In particular, RTs differed between children and adults on tasks that required response suppression, discrimination of color or spatial orientation, reversal of contingencies of previously learned stimulus-response rules, and greater stimulus-response complexity. Relative costs of these RT task differences were larger than predicted by the global difference hypothesis except for response suppression. Among young children, age-related differences larger than predicted by the global difference hypothesis were evident when tasks required color or spatial orientation discrimination and stimulus-response rule complexity, but not for response suppression or reversal of stimulus-response contingencies. Process-specific, age-related differences in processing speed that support heterochronicity of brain development during childhood were revealed.