An examination of the needs of parents of hospitalized children: comparing parents' and staff's perceptions

The needs of parents of hospitalized children have received some attention in the health literature, but few studies have compared parents' perceptions of needs with staff's ideas about parents' needs. The aim of this Study was to examine differences between the perceptions of the needs of parents of hospitalized children held by staff - nurses, doctors and allied health staff, and parents in a 150-bed paediatric hospital in Sweden. The convenience sample comprised 132 staff - nurses, doctors and allied health stall and 115 parents of children admitted to all the wards except intensive care. Kristjansdottir's needs of parents of hospitalized children questionnaire (NPQ) was the instrument of choice and was modified slightly for use with staff. Results indicated significant differences in perceptions of the importance of different needs of parents, of how well they were being met in the hospital arid how much help the parents needed to have them filled. Differences between parents' and staff's perceptions of the importance of parental needs were found in areas relating to psychosocial needs, but in general, in that hospital, the needs were being adequately met. The main differences between staff's and parents' results were in the degree of independence shown by parents in requiring hell) to have their needs met. This demonstrates either that parents are much more independent than appraised by staff, or, that parents are sometimes unaware of the level of assistance available.

The late effects of poliomyelitis in Queensland

This paper reports an investigation of new health problems reported by Queensland residents with a prior history of poliomyelitis. 126 people with a past history of paralytic poliomyelitis were recruited from the waiting list for the trial Post Polio Clinic at Queen Elizabeth II Hospital, Brisbane. A self-administered postal questionnaire was used to examine a number of variables including acute poliomyelitis histories; presence, duration and severity of new symptoms consistent with the late effects of poliomyelitis; changes in functional status between the maximal recovery period and the time of the survey and the impact of post-polio symptoms on lifestyle and employment. The most frequent new symptoms reported were muscle weakness (87 per cent), unusual tiredness (79 per cent), joint pain (79 per cent), muscle pain (61 per cent) and muscle cramps (71 per cent). Subjects reported an increased reliance on assistive devices and a decreased level of independence with activities of daily living, particularly with mobility-related tasks. Eight three per cent of subjects had made lifestyle changes as a result of post-polio symptoms and 67 per cent of those subjects in the workforce reported making changes to their employment, such as reduced hours of work. (author abstract)

The state of history and the empire of metaphysics [Review]

One of the curious things about this challenging book is that its ostensible subject— the Saxon medical and political scientist Hermann Conring (1606–1681)— is not mentioned in the title. Constantin Fasolt argues that we cannot know what Conring really thought or meant in his writings, which means that his topic cannot be Conring as such and must instead be that which occludes our knowledge of him, the titular limits of history. Given that we do in fact learn a good deal about Conring from Fasolt’s book, we can only hope that the decapitation of its subject will be rectified in a subsequent edition, or perhaps by the restorative work of librarians putting together subject headings. And yet Fasolt’s decision is understandable, for Conring is indeed a stalking-horse for a much bigger quarry: historiography and the historical consciousness. By “history” Fasolt understands a way of imposing intelligibility on the world, which is founded on the twin assumptions that the past is gone and unchangeable, and that the meaning of texts can be determined by placing them in their historical contexts (ix). In challenging this mode of intelligibility, Fasolt is not attempting to improve professiona history—it’s already as good as it can be—but to displace it. He regards his work as a declaration of “independence from historical consciousness” (32). At the same time, Fasolt insists that he is not simply jumping from historiography to philosophy, or attempting to preempt history with ontology (37-39). That has been tried by Nietzsche and Heidegger, who have been tainted by Nazism (Fasolt thinks unfairly). It has also been attempted by modern philosophers from Gadamer to Foucault and Charles Taylor who, in failing to address the “violence” that its mode of intelligibility does to the world, have not succeeded in outflanking history. Perhaps, Fasolt wonders, it is only the personal experience of those who have been subject to this violence—the experience of those who have been subject to historical examination—that can break the spell of history. Fasolt’s disclaimer notwithstanding, in the course of these remarks I shall argue that he is indeed jumping from history to philosophy, or attempting to outflank history by subjecting it to a particular metaphysical understanding. I shall do so in part by sketching the recent intellectual history of this move—a historical examination that I hope inflicts as little violence as possible on Fasolt’s argument.

Socioeconomic position, cognitive function, and clustering of cardiovascular risk factors in adolescence: Findings from the Mater University Study of Pregnancy and its outcomes

Objectives: The objectives of this study were to examine the extent of clustering of smoking, high levels of television watching, overweight, and high blood pressure among adolescents and whether this clustering varies by socioeconomic position and Cognitive function. Methods: This study was a cross-sectional analysis of 3613 (1742 females) participants of an Australian birth cohort who were examined at age 14. Results: Three hundred fifty-three (9.8%) of the participants had co-occurrence of three or four risk factors. Risk factors clustered in these adolescents with a greater number of participants than would be predicted by assumptions of independence having no risk factors and three or four risk factors. The extent of clustering tended to be greater in those from lower-income families and among those with lower cognitive function. The age-adjusted ratio of observed to expected cooccurrence of three or four risk factors was 2.70 (95% confidence interval [Cl], 1.80-4.06) among those from low-income families and 1.70 (95% Cl, 1.34-2.16) among those from more affluent families. The ratio among those with low Raven's scores (nonverbal reasoning) was 2.36 (95% Cl, 1.69-3.30) and among those with higher scores was 1.51 (95% Cl, 1.19-1.92); similar results for the WRAT 3 score (reading ability) were 2.69 (95% Cl, 1.85-3.94) and 1.68 (95% Cl, 1.34-2.11). Clustering did not differ by sex. Conclusion: Among adolescents, coronary heart disease risk factors cluster, and there is some evidence that this clustering is greater among those from families with low income and those who have lower cognitive function.

Loyalty without Conformity: Tailoring Self-perception as a Means of Balancing Belonging and Differentiation

We argue that members of individualist cultures balance their desire to belong with their desire to be different by maintaining a self-image as being loyal but relatively immune to group influence. Consistent with this, in Study 1 there was a strong tendency for people to rate themselves as being more independent (i.e., less conformist) than other people in their college. College students also rated themselves as being highly loyal to the group, however no self - other discrepancies were found on this dimension. This is despite the fact that traits of loyalty were rated more positively than were traits of independence. Study 2 provided evidence that culture influences the pattern of self - other discrepancies. Whereas people from individualist countries self-enhance on independence dimensions, people from collectivist countries self-enhance on loyalty dimensions. Again, these effects could not be explained as being a function of how positive these traits were seen to be, suggesting a cultural explanation rather than a straight forward superiority bias explanation for the observed discrepancies in self - other ratings. Results are discussed in relation to the SCENT model.

Multi-level zero-inflated Poisson regression modelling of correlated count data with excess zeros

Count data with excess zeros relative to a Poisson distribution are common in many biomedical applications. A popular approach to the analysis of such data is to use a zero-inflated Poisson (ZIP) regression model. Often, because of the hierarchical Study design or the data collection procedure, zero-inflation and lack of independence may occur simultaneously, which tender the standard ZIP model inadequate. To account for the preponderance of zero counts and the inherent correlation of observations, a class of multi-level ZIP regression model with random effects is presented. Model fitting is facilitated using an expectation-maximization algorithm, whereas variance components are estimated via residual maximum likelihood estimating equations. A score test for zero-inflation is also presented. The multi-level ZIP model is then generalized to cope with a more complex correlation structure. Application to the analysis of correlated count data from a longitudinal infant feeding study illustrates the usefulness of the approach.

Corporate governance codes in Australia and New Zealand: Propriety and prosperity

Overview of the central features of corporate governance codes, 'Principles of Good Corporate Governance and Best Practice Recommendations' (released by the ASX Corporate Governance Council) and 'Corporate Governance in New Zealand, Principles and Guidelines' (released by New Zealand Securities Commission) - whether the codes address the right problem - are the solutions of independence and disclosure conceptually and practically viable - whether codes pay sufficient attention to wealth creation.

Accessible Internet training package helps people with aphasia cross the digital divide

Background : The Internet is a source of information, communication, and leisure opportunities for people with aphasia. However, accessible training is one of several barriers for people with aphasia in using the Internet. Aims : This study developed and trialled special aphasia-friendly Internet training materials for people with aphasia. Methods & Procedures : A total of 20 people with aphasia were matched with volunteer tutors. The tutor-student pairs met for six lessons. Pre- and post-test Internet skills assessments were conducted and attitudinal questionnaires were completed. The training materials were based on Microsoft Internet Explorer 5.5 and consisted of a tutor's manual and a manual for the Internet student with aphasia. These materials are available as a free download from: http://www.shrs.uq.edu.au/cdaru/aphasiagroups/ Outcomes & Results : Significant differences between pre and post scores were found and participants reached a range of levels of independence following the training. The majority reported favourable outcomes. Conclusions. Results indicated that it was possible for people with aphasia to learn to use the Internet when they were taught in a one-to-one teaching situation with the use of accessible training manuals.

Addressing internet training issues for people with Parkinson's disease

The Internet enables access to information, services, support and participation in leisure opportunities. Some populations, including people with disabilities, lack access to these opportunities through the Internet. Barriers may include finances, physical access, lack of resources and inaccessible websites. Limited access to Internet training is an additional barrier for people with communication impairments. People with Parkinson's disease (PD) may have difficulty accessing usual Internet training due to high-level language, cognitive and physical limitations. Aphasia-friendly Internet training materials were trialed with this population to investigate if participants could learn to use the Internet and would benefit from Internet training. The tutors' experience was also investigated using qualitative measures. Seven people with PD were matched with volunteer tutors. These pairs met for six Internet training lessons using training materials available as a free download from: http://dexter.shrs.uq.edu.au/cdaru/aphasiagroups/. Pre and post-test Internet skills assessments and attitudinal questionnaires were conducted. Significant differences between pre and post-test scores were found. Participants reached varying levels of independence on Internet tasks. Favorable outcomes were reported by participants, and tutors reported a positive experience. Further investigation is recommended to determine the efficacy of this approach compared with other training avenues and with other communication-impaired populations. Practical and theoretical implications for speech pathology practice are discussed.

An Internet training intervention for people with traumatic brain injury: Barriers and outcomes

Primary objective: To test whether people with cognitive-linguistic impairments following traumatic brain injury could learn to use the Internet using specialized training materials. Research design: Pre-post test design. Methods and procedures: Seven participants were each matched with a volunteer tutor. Basic Internet skills were taught over six lessons using a tutor's manual and a student manual. Instructions used simple text and graphics based on Microsoft Internet Explorer 5.5. Students underwent Internet skills assessments and interviews pre- and post-training. Tutors completed a post-training questionnaire. Main outcomes and results: Six of seven participants reached moderate-to-high degrees of independence. Literacy impairment was an expected training barrier; however, cognitive impairments affecting concentration, memory and motivation were more significant. Conclusions: Findings suggest that people with cognitive-linguistic impairments can learn Internet skills using specialized training materials. Participants and their carers also reported positive outcomes beyond the acquisition of Internet skills.