Nursing Competencies Needed for Electronic Advance Care Planning in Community

Advance care planning implementation occurs acrossthe world using different legislative frameworks, differentlanguage to describe both the process and the outcome, anddifferent models to develop these plans. Many countries are inthe process of developing personally controlled electronic healthrecords. Including advance care plans as part of this record isproposed in Australia. The Electronic Advance Care Plan(eACP) in Community project aimed to develop a model that willengage community dwelling older adults with chronic lifelimitingillnesses in the process of advance care planning that isperson-centred, evidence-based and has a focus of dignity of life.A systematic review was conducted to identify models of advancecare planning information sharing and to examine the nurses’role. A realist review comprising a metasynthesis of 8 qualitativestudies and 9 quantitative studies was conducted. Nursingcompetencies need to be developed to include the medico-legalframework around advance care plan development, as well asinformation technology competencies and communicationcompetencies so that nurses around the world are betterinformed for end-of-life care planning and practice in a digitalworl

Formative interventions and practice-development: A methodological perspective on teacher rounds

Highlights • We examine Rounds in education from a methodological perspective. • In doing so, we class Rounds as a formative intervention and compare it to another means of formative intervention—Developmental Work Research. • We raise three methodological issues about both types of formative intervention: the role of theory; the relationship between the individual and the collective; and the meaning of collaboration

Oregon home economics teachers' knowledge and use of content area reading strategies

The major purpose of this study was to determine the extent to which home economics teachers know and use content area reading strategies in the classroom. The study looked at a variety of personal and school variables to determine their relationship to the teachers' knowledge and use of content area reading strategies. The study was designed to determine what role the home economics teacher plays in reading instruction. Finally, the study examined reading training and needs. The sample used in this study included thirty-four Oregon home economics teachers. Seventeen had participated in a content area reading, writing and mathematics strategies workshop in the summer of 1984. The remaining seventeen Oregon home economics teachers were randomly selected from a list secured from the state specialist. Data for the purpose of this study were collected by means of a structured questionnaire. The questionnaire was developed by the researcher and validated by a panel of experts. The questionnaire include sections on: content area reading strategies knowledge and use, teachers' role in reading instruction, and personal and school data. This study revealed that workshop training could have a significant impact on teachers' knowledge and use of content area reading strategies. Training is an issue with home economics, many feeling inadequately trained. Teachers support the contention that there is room in the home economics curriculum to integrate and teach reading. The time consuming nature of developing reading strategies was reported

Joubert Syndrome Presenting with Motor Delay and Oculomotor Apraxia

We describe two sisters who presented in early childhood with motor delay and unusual eye movements. Both demonstrated hypotonia and poor visual attention. The older girl at 14 weeks of age showed fine pendular horizontal nystagmus more pronounced on lateral gaze, but despite investigation with cranial MRI no diagnosis was reached. The birth of her younger sister four years later with a similar presentation triggered review of the sisters' visual behaviour. Each had developed an unusual but similar form of oculomotor apraxia (OMA) with head thrusts to maintain fixation rather than to change fixation. MRI of the older sibling demonstrated the characteristic “molar tooth sign” (MTS) of Joubert syndrome which was subsequently confirmed on MRI in the younger sibling. We discuss the genetically heterogeneous ciliopathies now grouped as Joubert syndrome and Related Disorders. Clinicians need to consider this group of disorders when faced with unusual eye movements in the developmentally delayed child

Prospectus, April 18, 1979

SPRING AT PARKLAND! IS IT REALLY HERE?; Kelly wins UPI award; PC students discuss Canteen; Stu-go discusses many subjects at last meeting; The Looking Glass: Spiritual awakening of women; Equine Club to host horse show at PC; Soap operas--A way of life for millions of Americans; Classified Advertising; Parkland student body to vote May 2 and 3; Trout steps down as coach; Walkathon to be April 28; Reader\u27s theatre to perform at PC; Cobras split double-header; Girl\u27s softball has slow start; Two Cobra tracksters place secondhttps://spark.parkland.edu/prospectus_1979/1019/thumbnail.jp

Evaluation of ‘Eyelander’: a video game designed to engage children and young people with homonymous visual field loss in compensatory training

Introduction: Rehabilitation can improve visual outcomes for adults with acquired homonymous visual field loss. However, it is unclear whether (re)habilitation improves visual outcomes for children because previous training schedules have been tiresome, uninteresting, and failed to keep them engaged. In this study we assessed whether children and young people with homonymous visual field loss would adhere to six weeks of unsupervised compensatory training using a specialised video game. Methods: Participants aged between 7 and 25 with homonymous visual field loss completed table-top assessments of visual search across four site visits. Two baseline assessments separated by four weeks evaluated spontaneous improvements before training began. Participants were then given a copy of the video game to use unsupervised at home for six weeks. Two follow-up assessments separated by four weeks were then conducted to evaluate immediate and acutely maintained effects of training. Results. 15 candidates met the inclusion-exclusion criteria, 9 participated, and 8 completed the study. Participants completed an average of 5.6 hours training unsupervised over the six weeks. Improvements on in-game metrics plateaued during week 3 of training. The time taken to find objects during table-top activities improved by an average of 24% (95% CI [2%, 46%]) after training. Discussion: The findings demonstrate that children and young people with homonymous visual field loss will engage with gamified compensatory training, and can improve visual outcomes with less time commitment than adults have required with non-gamified training in previous studies. Appropriately powered, randomised controlled trials are required to evaluate the validity and generalisability of observed training effects. Implications for practitioners: We conclude that (re)habilitation specialists can use specialist video games and gamification to engage children and young people with homonymous visual field loss in long-term unsupervised training schedules

Relative preservation of triceps over biceps strength in upper limb-onset ALS: the 'split elbow'

OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the motor system. The split hand sign in ALS refers to observed preferential weakness of the lateral hand muscles, which is unexplained. One possibility is larger cortical representation of the lateral hand compared with the medial. Biceps strength is usually preserved relative to triceps in neurological conditions, but biceps has a larger cortical representation and might be expected to show preferential weakness in ALS. METHODS Using the South-East England Register for Amyotrophic Lateral Sclerosis, we performed a retrospective longitudinal cohort study and extracted the modified Medical Research Council (MRC) muscle strength score for biceps and triceps in patients with a diagnosis of upper limb-onset ALS in the 19-year period 1996-2015. A Wilcoxon signed-rank test was used to assess the relative strength of the muscles within the total sum of the upper limbs involved in the study. RESULTS There were 659 people with upper limb onset of weakness. In 215 there were insufficient data to perform the analysis, and a further 33 were excluded for other reasons, leaving 411 for analysis. Biceps was stronger than triceps in 87 limbs, and triceps was stronger than biceps in 258 limbs, with no difference seen in the remaining 477. Triceps strength scores (mean rank=186.1) were higher than ipsilateral biceps strength scores (mean rank=134.2), Z=-10.1, p<0.001 (two-tailed). CONCLUSION Triceps strength is relatively preserved compared with biceps in ALS. This is consistent with a broadly corticofugal hypothesis of selective vulnerability, in which susceptibility might be associated with larger cortical representation

A simulation interface designed for improved user interaction and learning in water quality modelling software

Traditional simulation software that supports management decisions is configured and run by experienced scientists. However, it is often criticised for its lack of interactivity, not only in the application of decisions but also in the display of results. This paper presents the simulation interface of software with management strategy evaluation capabilities and its capacity to enable resource managers to learn about water quality management as evaluated in a workshop setting. The software ‘MSE Tool’ is not intended to produce definitive real-world advice but provides a test-bed for managers to interactively design strategies and explore the complexities inherent to water quality management using a simple, yet effective, user interface. MSE Tool has been used in a pilot application that simulated the effects of management strategies applied in catchments and their effects on riverine, estuarine and marine water quality in South East Queensland, Australia. The approach and the software are suitable for reuse in other management strategy evaluation projects

Flight Crew Workload, Acceptability, and Performance When Using Data Comm in a High-Density Terminal Area Simulation

This document describes a collaborative FAA/NASA experiment using 22 commercial airline pilots to determine the effect of using Data Comm to issue messages during busy, terminal area operations. Four conditions were defined that span current day to future flight deck equipage: Voice communication only, Data Comm only, Data Comm with Moving Map Display, and Data Comm with Moving Map displaying taxi route. Each condition was used in an arrival and a departure scenario at Boston Logan Airport. Of particular interest was the flight crew response to D-TAXI, the use of Data Comm by Air Traffic Control (ATC) to send taxi instructions. Quantitative data was collected on subject reaction time, flight technical error, operational errors, and eye tracking information. Questionnaires collected subjective feedback on workload, situation awareness, and acceptability to the flight crew for using Data Comm in a busy terminal area. Results showed that 95% of the Data Comm messages were responded to by the flight crew within one minute and 97% of the messages within two minutes. However, post experiment debrief comments revealed almost unanimous consensus that two minutes was a reasonable expectation for crew response. Flight crews reported that Expected D-TAXI messages were useful, and employment of these messages acceptable at all altitude bands evaluated during arrival scenarios. Results also indicate that the use of Data Comm for all evaluated message types in the terminal area was acceptable during surface operations, and during arrivals at any altitude above the Final Approach Fix, in terms of response time, workload, situation awareness, and flight technical performance. The flight crew reported the use of Data Comm as implemented in this experiment as unacceptable in two instances: in clearances to cross an active runway, and D-TAXI messages between the Final Approach Fix and 80 knots during landing roll. Critical cockpit tasks and the urgency of out-the window scan made the additional head down time to respond to Data Comm messages undesirable during these events. However, most crews also stated that Data Comm messages without an accompanying audio chime and no expectation of an immediate response could be acceptable even during these events