Mediation and Joke Design: Resolving the Incongruities

The purposes of this Article are: (1) to highlight some of these new discoveries; (2) to discuss their implications for mediators generally, particularly toward achieving super-optimum resolutions of conflict; (3) to explore the relationship of these discoveries to the brain\u27s bilateral functions, creativity, and the process of humor and joke design; (4) to suggest techniques, based on joke design, for altering conflict frames of disputants; and (5) to suggest directions for further experimentation and research. Although the interrelationships among the separate topics presented here may not be immediately discernible, the seeming incongruities will be resolved in Part VII

Designing for dementia: personas to aid communication between professionals developing built environments for people with dementia

Dementia is expected to become increasingly prevalent, with some estimates suggesting that the number of people with dementia (PWDem) will reach 115.4 million by 2050 (Prince et al., 2013). Due to the diverse and complex needs of PWDem, this poses significant challenges in providing appropriate built environments for this group. A Human Factors and Ergonomics (HFE) approach may be useful in designing built environments for PWDem, including care environments, as it focuses on the needs, limitations and abilities of users. Personas represent the needs of archetypal users and may therefore be useful in supporting this approach to design.The results of a systematic literature review indicated that HFE did not appear to have been widely used in this area previously, but that such an approach was likely to be useful in designing dementia care homes. Evidence-based dementia personas were therefore developed, with the intention of these being used as a discussion tool to encourage stakeholders to consider the needs, limitations and abilities of PWDem when designing new dementia care environments. [Continues.]</div

An investigation into the impact of computer therapy on people with aphasia.

Use of computers by the general population continues to increase and computers are now an integral part of communication, leisure activities and work. The majority of research into use of computers by people with aphasia has focussed narrowly on evaluating effects of computer therapy on specific language impairments. Little is known about the broader impacts of computer use by people with aphasia, in terms of levels of social activity and social participation and little is known of the views of people with aphasia on using computers. The research in this thesis investigates the outcome of computer therapy from the perspective of people living with aphasia. Outcome was evaluated using the framework of the World Health Organisation International Classification of Functioning, Disability and Health (WHO ICF 2001) to investigate impact not just in terms of impairment but on activity and participation as well. The ICF also provided a framework for investigating contextual factors (environmental and personal) which might effect outcome. The investigation took the form of two complementary but contrasting case series studies: an investigation into the outcome of using computers to target word finding abilities (treatment targeting impairment only); and an investigation into the outcome of training to use voice recognition software as a writing aid (treatment aiming to overcome activity limitations but not targeting impairment itself). Both studies comprised a qualitative investigation of the views of participants on the outcome and process of therapy. Both studies supplemented this qualitative data with complementary quantitative evaluations seeking to quantify key aspects of outcome. Study one findings indicated that all six participants perceived benefits to levels of activity, participation and confidence in addition to benefits to language impairment. Although some of this benefit was attributed to improved language skill, benefits were also attributed to increased confidence associated with acquiring skills. Study two found benefits to levels of activity and participation and confidence for all participants. Benefits were perceived even where there was no measured change to language impairment or quality or quantity of language used. Computer use by people with aphasia can therefore bring much broader benefits than just to language impairment. Benefits include increases in leisure and social activity, social participation and confidence. Previous computer experience is not necessary and benefits can be shown many years post stroke. These broader benefits should be borne in mind when selecting who may be appropriate for computer therapy

Wordfinding problems and how to overcome them ultimately with the help of a computer.

International audienceno abstrac

New techniques for neuro-rehabilitation: Transcranial Electric Stimulation and Virtual Reality

Recovery of motor and cognitive performances after a neurological illness remains a significant challenge for rehabilitation specialists. The traditional rehabilitative interventions are usually delivered using a multidisciplinary approach, whose results are not always satisfactory. These limitations in functional recovery have led researchers to consider alternative approaches. The hypothesis of providing new therapeutic possibilities in the different patients treated is, as a rehabilitator, very rewarding and represents a challenge for the future. The application of simple and low-cost techniques, defined by the literature as "unconventional" or “novel”, can provide new ideas not only in the field of research but above all of application in clinical reality.A suitable approach to improve the rehabilitation outcome is to utilize these novel rehabilitation techniques that act as a substitute or an addition to the traditional ones. In this context, some recent approaches have been proposed that might increase the effectiveness of a traditional treatment. Among them, two techniques have been demonstrated to be very promising, namely non-invasive brain stimulation (NIBS) and Virtual Reality (VR).In light of the foregoing, my thesis has been divided into two main lines of research, namely: a) the study of the effects of transcranial direct current stimulation (tDCS) in different neurological conditions; b) the application of VR (used alone or combined with tDCS) in the treatment of some neurocognitive disorders. A semi-immersive VR tool (ReMOVES system) has been used as a user-friendly platform providing activities based on exergames

Testing and refinement of an integrated, ethically-driven environmental model of clinical decision-making in emergency settings

Thesis advisor: Dorothy A. JonesThesis advisor: Pamela J. GraceThe purpose of the study was to explore the relationship between multiple variables within a model of critical thinking and moral reasoning that support and refine the elements that significantly correlate with accuracy and clinical decision-making. Background: Research to date has identified multiple factors that are integral to clinical decision-making. The interplay among suggested elements within the decision making process particular to the nurse, the patient, and the environment remain unknown. Determining the clinical usefulness and predictive capacity of an integrated ethically driven environmental model of decision making (IEDEM-CD) in emergency settings in facilitating accuracy in problem identification is critical to initial interventions and safe, cost effective, quality patient care outcomes. Extending the literature of accuracy and clinical decision making can inform utilization, determination of staffing ratios, and the development of evidence driven care models. Methodology: The study used a quantitative descriptive correlational design to examine the relationships between multiple variables within the IEDEM-CD model. A purposive sample of emergency nurses was recruited to participate in the study resulting in a sample size of 200, calculated to yield a power of 0.80, significance of .05, and a moderate effect size. The dependent variable, accuracy in clinical decision-making, was measured by scores on clinical vignettes. The independent variables of moral reasoning, perceived environment of care, age, gender, certification in emergency nursing, educational level, and years of experience in emergency nursing, were measures by the Defining Issues Test, version 2, the Revised Professional Practice Environment scale, and a demographic survey. These instruments were identified to test and refine the elements within the IEDEM-CD model. Data collection occurred via internet survey over a one month period. Rest's Defining Issues Test, version 2 (DIT-2), the Revised Professional Practice Environment tool (RPPE), clinical vignettes as well as a demographic survey were made available as an internet survey package using Qualtrics TM. Data from each participant was scored and entered into a PASW database. The analysis plan included bivariate correlation analysis using Pearson's product-moment correlation coefficients followed by chi square and multiple linear regression analysis. Findings: The elements as identified in the IEDEM-CD model supported moral reasoning and environment of care as factors significantly affecting accuracy in decision-making. Findings reported that in complex clinical situations, higher levels of moral reasoning significantly affected accuracy in problem identification. Attributes of the environment of care including teamwork, communication about patients, and control over practice also significantly affected nurses' critical cue recognition and selection of appropriate interventions. Study results supported the conceptualization of the IEDEM-CD model and its usefulness as a framework for predicting clinical decision making accuracy for emergency nurses in practice, with further implications in education, research and policyThesis (PhD) — Boston College, 2011.Submitted to: Boston College. Connell School of Nursing.Discipline: Nursing

Psychological Aspects of Children and Adolescents With Duchenne Muscular Dystrophy (DMD) and Research Portfolio

This paper reviews the extant literature on the psychological aspects of Duchenne Muscular Dystrophy (DMD) and discusses the clinical implications of its impact on children and their families. DIVID is the commonest form of muscular dystrophy and the most severe, following a progressive and fatal course of muscular weakness and deterioration. Research on psychological aspects of DMD is rather old and restricted to a small number of studies of varying methodological quality. However, the clinical presentation of DMD, the developmental stage of the child, social/environmental restrictions and family interactions have all been implicated in psychological difficulties within this group. Seminal work and directly relevant research from other areas is discussed and suggestions are made to guide both research and service provision