Supporting family caregivers with palliative symptom management: A qualitative analysis of the provision of an emergency medication kit in the home setting

Purpose The purpose of this qualitative analysis was to examine the experiences of family caregivers supporting a dying person in the home setting. In particular, it explores caregivers’ perceptions of receiving palliative care at home when supplied with an emergency medication kit (EMK). Results Most family caregivers described preexisting medication management strategies that were unable to provide timely intervention in symptoms. The EMK was largely viewed as an effective strategy in providing timely symptom control and preventing readmission to inpatient care. Caregivers reported varying levels of confidence in the administration of medication. Conclusion The provision of an EMK is an effective strategy for improving symptom control and preventing inpatient admissions of home-dwelling palliative care patients.

"The red dress or the blue?" How do staff perceive that they support decision making for people with dementia living in residential aged care facilities?

Respect for a person's right to make choices and participate in decision making is generally seen as central to quality of life and well-being. When a person moves into a residential aged care facility (RACF), however, decision making becomes more complicated, particularly if the person has a diagnosis of dementia. Little is known about how staff in RACFs perceive that they support decision making for people with dementia within their everyday practice, and this article seeks to address this knowledge gap. The article reports on the findings of a qualitative study conducted in the states of Victoria and Queensland, Australia with 80 direct care staff members. Findings revealed that the participants utilized a number of strategies in their intention to support decision making for people with dementia, and had an overall perception that "a little effort goes a long way."

Principles of goal-directed spatial robot navigation in biomimetic models

Mobile robots and animals alike must effectively navigate their environments in order to achieve their goals. For animals goal-directed navigation facilitates finding food, seeking shelter or migration; similarly robots perform goal-directed navigation to find a charging station, get out of the rain or guide a person to a destination. This similarity in tasks extends to the environment as well; increasingly, mobile robots are operating in the same underwater, ground and aerial environments that animals do. Yet despite these similarities, goal-directed navigation research in robotics and biology has proceeded largely in parallel, linked only by a small amount of interdisciplinary research spanning both areas. Most state-of-the-art robotic navigation systems employ a range of sensors, world representations and navigation algorithms that seem far removed from what we know of how animals navigate; their navigation systems are shaped by key principles of navigation in ‘real-world’ environments including dealing with uncertainty in sensing, landmark observation and world modelling. By contrast, biomimetic animal navigation models produce plausible animal navigation behaviour in a range of laboratory experimental navigation paradigms, typically without addressing many of these robotic navigation principles. In this paper, we attempt to link robotics and biology by reviewing the current state of the art in conventional and biomimetic goal-directed navigation models, focusing on the key principles of goal-oriented robotic navigation and the extent to which these principles have been adapted by biomimetic navigation models and why.

Fourier active appearance models

Gaining invariance to camera and illumination variations has been a well investigated topic in Active Appearance Model (AAM) fitting literature. The major problem lies in the inability of the appearance parameters of the AAM to generalize to unseen conditions. An attractive approach for gaining invariance is to fit an AAM to a multiple filter response (e.g. Gabor) representation of the input image. Naively applying this concept with a traditional AAM is computationally prohibitive, especially as the number of filter responses increase. In this paper, we present a computationally efficient AAM fitting algorithm based on the Lucas-Kanade (LK) algorithm posed in the Fourier domain that affords invariance to both expression and illumination. We refer to this as a Fourier AAM (FAAM), and show that this method gives substantial improvement in person specific AAM fitting performance over traditional AAM fitting methods.

A pilot trial of mobile, patient-performed teledermoscopy

BACKGROUND Early detection by skin self-examination (SSE) could improve outcomes from melanoma. Mobile teledermoscopy may aid this process. OBJECTIVES To establish clinical accuracy of SSE plus mobile teledermoscopy compared to clinical skin examination (CSE) and test whether providing people with detailed SSE instructions improves accuracy. METHODS Men and women 50-64 years (n=58) performed SSE plus mobile teledermoscopy in their homes between May and November 2013 and were given technical instructions plus detailed SSE instructions (intervention) or technical instructions only (control). Within three months, they underwent a CSE. Outcome measures included: a) body sites examined, lesions photographed, and missed; b) sensitivityof SSE plus mobile teledermoscopy compared to in-person CSE using either patients or lesions as denominator, and; c) concordance of telediagnosis with CSE. RESULTS: 49 of 58 randomised participants completed the study, and submitted 309 lesions to the teledermatologist (156 intervention; 153 control group). Intervention group participants were more likely to submit lesions from their legs compared to control (p=0.03), no other differences between groups in number or site of missed lesions.11 participants (22%) did not photograph 14 pigmented lesions the dermatologist considered worthwhile photographing or requiring clinical monitoring. Sensitivity of SSE plus mobile teledermoscopy was 81.8% (95% confidence interval 64.5-93.0) using the patient as the denominator and 41.9 (27.6-56.2) using the lesion as denominator.-There was substantial agreement between telediagnosis and CSE (Kappa =0.90) accounting for differential diagnoses. CONCLUSIONS SSE plus mobile teledermoscopy is promising for surveillance of particular lesions even without provision of detailed SSE instructions, but in the format tested in this study, consumers may overlook lesions and send many non-pigmented lesions. This investigation demonstrates that high quality dermoscopic images can be taken by patients at home and for those sent, telediagnosis is highly accurate.

Self-reflection as an intervention to influence achievement goal orientations and intrinsic motivation

In the context of physical activity, intrinsic motivation refers to the inherent satisfaction associated with participation in the activity. Interest-enjoyment, perceived competence, and effort have been identified as three underlying components of intrinsic motivation. Achievement goal theory stipulates that achievement goals guide our beliefs and behavior. The two main achievement goal orientations identified in the sport and physical activity literature are task and ego orientations. A person with a strong task orientation defines success in self-referenced terms, as improving one’s own performance or mastering new skills. Someone with a strong ego orientation defines success normatively, as being better than others. The majority of research suggests that having a strong task orientation is a good thing, whether with regard to motivationally adaptive responses, sources of sport confidence, students’ satisfaction with learning, or the use of cognitive and self-regulatory strategies. Although the literature supporting the potential benefits of having a strong task orientation is vast, considerably less research has tested interventions designed to strengthen task orientations and intrinsic motivation. A climate that emphasises individual mastery has resulted in increased interest-enjoyment and perceived competence, whereas an emphasis on competition and comparison with others has resulted in a decrease in interest-enjoyment and an increase in tension-pressure. One possible intervention is the use of structured self-reflection. Using self-reflection sheets that cause respondents to focus on specific elements of technique or skills, and rate one’s own performance, should theoretically promote a task focus. Hanrahan suggested that engaging in self-reflection may enhance intrinsic motivation. Perceived competence could be positively affected, as self-analysis and self-monitoring have been found to positively influence the acquisition of physical skills. The purpose of this study was to determine if the use of structured self-reflection in community dance classes would influence achievement goal orientations or levels of intrinsic motivation.

Rupturing otherness : becoming Estonian in the context of contemporary Britain

While identity construction continues to be a widely discussed and researched area in contemporary social sciences, the existing theories have overlooked the importance of understanding why and how identities as semiotic constructions emerge in individuals' consciousness in the flow of their everyday functioning. This article seeks to address this limitation in the theorizing by proposing an alternative conceptualization of identity, according to which identity construction is triggered by rupturing life-experience, which surfaces another perspective and makes the person aware of a possibility to be otherwise or of the reality of being different. Theoretical claims put forward in the paper are drawn from data gathered in a recent study, which explored lived-through experiences of young Estonians, who made study-visits to the United Kingdom. The discussed data will also highlight some interesting aspects in Estonians' self-definition as it is constructed in relation to Eastern-European identity in the context of contemporary Britain.

Teacher education for high-poverty schools : keeping the bar high

For some time now, there has been a focus, both in Australia and internationally, on quality teaching as a fundamental component that affects the educational outcomes of all students. The question of how teacher education programs in Australia prepare effective teachers to work across all school settings-including low-SES schools-has been elevated to national prominence by data from the 20 12 Programme for International Student Assessment (PIS A), which revealed a fall in Australian students' world ranking across Mathematics, Reading and Science. Education is commonly acknowledged as a "foundation capability" that improves a person's life chances, including employment prospects, and it is widely understood to be a "route out of disadvantage" (McLachlan, Gilfillan, and Gordon 20 13). The Australian Bureau of Statistics 201 1- 12 data suggest that around 2.6 million (11.8%) Australians currently live under the poverty line (Phillips et a!. 2012, 8). According to the Organisation for Economic Cooperation and Development (OECD), despite the significant effects teachers have on student performance, disadvantaged schools are not always staffed with the highest quality teachers (see Darling-Hammond, 2006).

Can’t we all just get along? A qualitative investigation of the cognitive processes motivating driver aggression.

Although driver aggression has been identified as contributing to crashes, current understanding of the fundamental causes of the behaviour is poor. Two key reasons for this are evident. Firstly, existing research has been largely atheoretical, with no unifying conceptual framework guiding investigation. Secondly, emphasis on observable behaviours has resulted in limited knowledge of the underlying thought processes that motivate behaviour. Since driving is fundamentally a social situation, requiring drivers to interpret on-road events, insight regarding these perception and appraisal processes is paramount in advancing understanding of the underlying causes. Thus, the current study aimed to explore the cognitive appraisal processes involved in driver aggression, using a conceptual model founded on the General Aggression Model (Anderson & Bushman, 2002). The present results reflect the first of several studies testing this model. Participants completed 3 structured driving diaries to explore perceptions and cognitions. Thematic analysis of diaries identified several cognitive themes. The first, ‘driving etiquette’ concerned an implied code of awareness and consideration for other motorists, breaches of which were strongly associated with reports of anger and frustration. Such breaches were considered intentional; attributed to dispositional traits of another driver, and precipitated the second theme, ‘justified retaliation’. This theme showed that drivers view their aggressive behaviour as warranted, to convey criticism towards another motorist’s etiquette violation. However, the third theme, ‘superiority’ suggested that those refraining from an aggressive response were motivated by a desire to perceive themselves as ‘better’ than the offending motorists. Collectively, the themes indicate deep-seated and complex thought patterns underlying driver aggression, and suggest the behaviour will be challenging to modify. Implications of these themes in relation to the proposed model will be discussed, and continued research will explore these cognitive processes further, to examine their interaction with person-related factors.

Emotional experiences of preservice science teachers in online learning : the formation, disruption and maintenance of social bonds

The enactment of learning to become a science teacher in online mode is an emotionally charged experience. We attend to the formation, maintenance and disruption of social bonds experienced by online preservice science teachers as they shared their emotional online learning experiences through blogs, or e-motion diaries, in reaction to videos of face-to-face lessons. A multi-theoretic framework drawing on microsociological perspectives of emotion informed our hermeneutic interpretations of students’ first-person accounts reported through an e-motion diary. These accounts were analyzed through our own database of emotion labels constructed from the synthesis of existing literature on emotion across a range of fields of inquiry. Preservice science teachers felt included in the face-to-face group as they watched videos of classroom transactions. The strength of these feelings of social solidarity were dependent on the quality of the video recording. E-motion diaries provided a resource for interactions focused on shared emotional experiences leading to formation of social bonds and the alleviation of feelings of fear, trepidation and anxiety about becoming science teachers. We offer implications to inform practitioners who wish to improve feelings of inclusion amongst their online learners in science education.

The potentiality of the embryo and the somatic cell

Recent arguments on the ethics of stem cell research have taken a novel approach to the question of the moral status of the embryo. One influential argument focuses on a property that the embryo is said to posses—namely, the property of being an entity with a rational nature or, less controversially, an entity that has the potential to acquire a rational nature—and claims that this property is also possessed by a somatic cell. Since nobody seriously thinks that we have a duty to preserve the countless such cells we wash off our body every day in the shower, the argument is intended as a reductio ad absurdum of the claim that the embryo should be afforded the same moral status as a fully developed human being. This article argues that this argument is not successful and that it consequently plays into the hands of those who oppose embryonic stem cell research. It is therefore better to abandon this argument and focus instead on the different argument that potentiality, as such, is not a sufficient ground for the creation of moral obligations towards the embryo.

Compensation sought for an improper caveat

Re Brooks’ Caveat [2014] QSC 76 is a decision of Henry J delivered on 24 April 2014. The decision considers the operation of s 130 of the Land Title Act 1994 (Qld). That section provides that a person who lodges or continues a caveat without reasonable cause must compensate anyone else who suffers loss or damage as a result...

The UAV Challenge

The UAV challenge takes place every year. Teams of compteitors compete to use an Unmanned Airborne Vehicle to locate a simulated lost person and deliver water.

What keeps nurses busy in the mental health setting?

The foundation of mental health nursing has historically been grounded in an interpersonal, person-centred process of health care, yet recent evidence suggests that the interactional work of mental health nursing is being eroded. Literature emphasizes the importance of person-centred care on consumer outcomes, a model reliant upon the intimate engagement of nurses and consumers. Yet, the arrival of medical interventions in psychiatry has diverted nursing work from the therapeutic nursing role to task-based roles delegated by medicine, distancing nurses from consumers. This study used work sampling methodology to observe the proportion of time nurses working in an inpatient mental health setting spend in the activities of direct care, indirect care and service-related activities. Nurses spent 32 of their time in direct care, 52% in indirect care and 17% in service-related activities. Mental health nurses need to re-establish their therapeutic availability to maximize consumer experiences and outcomes.