The impact of advance care planning on end of life care in elderly patients: randomised controlled trial

Objective To investigate the impact of advance care planning on end of life care in elderly patients

Praxiologia Motriz e as dimensões de conhecimento da BNCC

Objetivo: Este artigo tem como objetivo apresentar a Praxiologia Motriz como conhecimento científico capaz de contribuir para estimular o desenvolvimento das dimensões de conhecimento da EF contidas na BNCC. Procedimentos metodológicos: O estudo caracteriza-se como qualitativo e foi realizado a partir de uma pesquisa teórica, considerando conceitos da Praxiologia Motriz como instrumentos para análise. Resultados e discussão: A BNCC aponta oito dimensões de conhecimento que devem ser garantidas aos educandos ao longo do percurso escolar, visando desenvolver uma formação integral do indivíduo. Para tanto, sistematizou-se uma relação entre as dimensões de conhecimento, trazidas na BNCC, com os elementos da Praxiologia Motriz, mais precisamente inerentes à lógica interna. Assim, apresentou-se possibilidades de apreensão dos conhecimentos praxiológicos como forma de embasar a prática pedagógica do professor, de modo que ele tenha maiores ferramentas para alcançar as dimensões de conhecimento que deseja desenvolver. Os conceitos da Praxiologia Motriz possibilitaram que as seguintes dimensões do conhecimento fossem aprofundadas: experimentação, uso e apropriação, fruição, reflexão sobre a ação e análise. Considerações Finais: Conclui-se que os conhecimentos elaborados pela Praxiologia Motriz possibilitam uma concreta organização e sistematização didática para o ensino e aprendizagem das práticas corporais

Advance care planning in chronic kidney disease: a survey of current practice in Australia

Aim: Advance care planning (ACP) in nephrology is widely advocated but not always implemented. The aims of this study were to describe current ACP practice and identify barriers/facilitators and perceived need for health professional education and chronic kidney disease (CKD)-specific approaches. Methods: An anonymous cross-sectional survey was administered online. Nephrology health professionals in Australia and New Zealandwere recruited via professional societies, email lists and nephrology conferences. Multiple regression explored the influence of respondents’ attributes on extent of involvement in ACP and willingness to engage in future. Results: A total of 375 respondents included nephrologists (23%), nurses (65%), social workers (4%) and others (8%) with 54% indicated that ACP at their workplace was performed ad hoc and 61% poorly. Perceived barriers included patient/family discomfort (84%), difficulty engaging families (83%), lack of clinician expertise (83%) and time (82%), health professional discomfort (72%), cultural/language barriers (65%), lack of private space (61%) and lack of formal policy/procedures (60%). Respondents overwhelmingly endorsed the need for more dialysis-specific ACP programs (96%) and education (95%). Whilst 85% thought ACP would be optimally performed by specially trained staff, comments emphasized that all clinicians should have a working proficiency. Respondents who were more willing to engage in future ACP tended to be non-physicians (odds ratio (OR) 4.96, 95% confidence intervals (CI) 1.74–14.07) and reported a greater need for CKD-specific ACP materials (OR 10.88, 95% CI 2.38–49.79). Conclusion: Advance care planning in nephrology needs support through education and CKD-specific resources. Endorsement by nephrologists is important. A multidisciplinary approach with a gradient of ACP expertise is also recommended

Prevalence and predictors of advance directives in Australia

Background Advance care planning is regarded as integral to better patient outcomes yet little is known about the prevalence of advance directives in Australia. Aims To determine the prevalence of advance directives (ADs) in the Australian population. Methods A national telephone survey about estate and advance planning. Sample was stratified by age (18-45 and >45 years) and quota sampling occurred based on population size in each State and Territory. Results Fourteen percent of the Australian population has an AD. There is State variation with people from South Australia and Queensland more likely to have an AD than people from other states. Will making and particularly completion of a financial enduring power of attorney are associated with higher rates of AD completion. Standard demographic variables were of limited use in predicting whether a person would have an AD. Conclusions Despite efforts to improve uptake of advance care planning (including ADs), barriers remain. One likely trigger for completing an AD and advance care planning is undertaking a wider future planning process (e.g. making a will or financial enduring power of attorney). This presents opportunities to increase advance care planning but steps are needed to ensure that planning which occurs outside the health system is sufficiently informed and supported by health information so that it is useful in the clinical setting. Variations by State could also suggest that redesign of regulatory frameworks (such as a user-friendly and well publicised form backed by statute) may help improve uptake of ADs

Archive of Darkness:William Kentridge's Black Box/Chambre Noire

Situating itself in histories of cinema and installation art, William Kentridge's Black Box/Chambre Noire (2005) raises questions about screens, exhibition space, site-specificity and spectatorship. Through his timely intervention in a debate on Germany’s colonial past, Kentridge’s postcolonial art has contributed to the recognition and remembrance of a forgotten, colonial genocide. This article argues that, by transposing his signature technique of drawings for projection onto a new set of media, Kentridge explores how and what we can know through cinematic projection in the white cube. In particular, his metaphor of the illuminated shadow enables him to animate archival fragments as shadows and silhouettes. By creating a multi-directional archive, Black Box enables an affective engagement with the spectres of colonialism and provides a forum for the calibration of moral questions around reparation, reconciliation and forgiveness

Potential for organ donation in Victoria: an audit of hospital deaths

Australia has one of the highest transplantation success rates but a relatively low organ donation rate compared with other developed countries. In 2004, there were 218 deceased donors, from whom 789 people received a transplant. Many of the 1663 people on the transplant waiting list will have died awaiting a transplant. It is unclear why organ donation rates in Victoria and the rest of Australia are relatively low, and whether there is potential to increase these rates. Possible reasons for the low rate include a small donor pool, a low consent rate, and a high incidence of potential organ donors for whom organ donation is not requested

Financial advice, wealth and gender: risk tolerance, knowledge and confidence

We examine gender differences in investment risk tolerance, knowledge, confidence, and portfolio cash allocations among a sample of advised and self-directed wealthy individuals. Our results demonstrate that gender effects are more complicated than previously assumed. First, while even wealthy women consider themselves more conservative and hold more cash than men, previous findings of lower confidence and knowledge do not extend to our sample wealthy women. Second, having an advisor matters. Advised investors perceive themselves to have a higher risk tolerance and hold 15% points less cash than self-directed investors. Finally, the investor-advisor gender combination matters, but only for female investors. Women with male advisors are more risk averse, and feel less knowledgeable and less confident about investments. They also hold 11% more cash than women with female advisors. Indeed, female investors advised by women report the highest risk tolerance and make the lowest portfolio allocation to risk-free assets across the full sample, including men.<br