Palliative care challenges : implications for nurses' practice in renal settings

The very act of withdrawing dialysis places renal nurses in a unique practice setting requiring a sudden shift in care delivery from one of providing Ife-sustaining, active treatment to that of palliation. The impact of this act on the renal nurse remains largely invisible. Minimal research has been conducted that explores the significant issues and challenges that exist for renal nurses in the delivery of palliation following withdrawal of dialysis treatment. This paper attempts to highlight the issues and challenges that do exist for renal nurses in providing palliation and the subsequent lack of available research knowledge to inform practice in the renal setting. It recommends further research be conducted into the renal setting so as to inform the development of appropriate education to support renal nurses practice in the future.

PCR bias Toward the wild-type k-ras and p53 sequences: Implications for PCR detection of mutations and cancer diagnosis

PCR-based cancer diagnosis requires detection of rare mutations in k- ras, p53 or other genes. The assumption has been that mutant and wild-type sequences amplify with near equal efficiency, so that they are eventually present in proportions representative of the starting material. Work on factor IX suggests that this assumption is invalid for one case of near- sequence identity. To test the generality of this phenomenon and its relevance to cancer diagnosis, primers distant from point mutations in p53 and k-ras were used to amplify wild-type and mutant sequences from these genes. A substantial bias against PCR amplification of mutants was observed for two regions of the p53 gene and one region of k-ras. For k-ras and p53, bias was observed when the wild-type and mutant sequences were amplified separately or when mixed in equal proportions before PCR. Bias was present with proofreading and non-proofreading polymerase. Mutant and wild-type segments of the factor V, cystic fibrosis transmembrane conductance regulator and prothrombin genes were amplified and did not exhibit PCR bias. Therefore, the assumption of equal PCR efficiency for point mutant and wild-type sequences is invalid in several systems. Quantitative or diagnostic PCR will require validation for each locus, and enrichment strategies may be needed to optimize detection of mutants.

The constraints-based approach to motor learning : Implications for a non-linear pedagogy in sport and physical education

Recently, a constraints- led approach has been promoted as a framework for understanding how children and adults acquire movement skills for sport and exercise (see Davids, Button & Bennett, 2008; Araújo et al., 2004). The aim of a constraints- led approach is to identify the nature of interacting constraints that influence skill acquisition in learners. In this chapter the main theoretical ideas behind a constraints- led approach are outlined to assist practical applications by sports practitioners and physical educators in a non- linear pedagogy (see Chow et al., 2006, 2007). To achieve this goal, this chapter examines implications for some of the typical challenges facing sport pedagogists and physical educators in the design of learning programmes.

Identifying constraints on children with movement difficulties : implications for pedagogues and clinicians

A constraints- based framework for understanding processes of movement coordination and control is predicated on a range of theoretical ideas including the work of Bernstein (1967), Gibson (1979), Newell (1986) and Kugler, Kelso & Turvey (1982). Contrary to a normative perspective that focuses on the production of idealized movement patterns to be acquired by children during development and learning (see Alain & Brisson, 1986), this approach formulates the emergence of movement co- ordination as a function of the constraints imposed upon each individual. In this framework, cognitive, perceptual and movement difficulties and disorders are considered to be constraints on the perceptual- motor system, and children’s movements are viewed as emergent functional adaptations to these constraints (Davids et al., 2008; Rosengren, Savelsbergh & van der Kamp, 2003). From this perspective, variability of movement behaviour is not viewed as noise or error to be eradicated during development, but rather, as essentially functional in facilitating the child to satisfy the unique constraints which impinge on his/her developing perceptual- motor and cognitive systems in everyday life (Davids et al., 2008). Recently, it has been reported that functional neurobiological variability is predicated on system degeneracy, an inherent feature of neurobiological systems which facilitates the achievement of task performance goals in a variety of different ways (Glazier & Davids, 2009). Degeneracy refers to the capacity of structurally different components of complex movement systems to achieve different performance outcomes in varying contexts (Tononi et al., 1999; Edelman & Gally, 2001). System degeneracy allows individuals with and without movement disorders to achieve their movement goals by harnessing movement variability during performance. Based on this idea, perceptual- motor disorders can be simply viewed as unique structural and functional system constraints which individuals have to satisfy in interactions with their environments. The aim of this chapter is to elucidate how the interaction of structural and functional organismic, and environmental constraints can be harnessed in a nonlinear pedagogy by individuals with movement disorders.

Fitness and fatness in childhood obesity : implications of physical activity

Overweight and obesity are a significant cause of poor health worldwide, particularly in conjunction with low levels of physical activity (PA). PA is health-protective and essential for the physical growth and development of children, promoting physical and psychological health while simultaneously increasing the probability of remaining active as an adult. However, many obese children and adolescents have a unique set of physiological, biomechanical, and neuromuscular barriers to PA that they must overcome. It is essential to understand the influence of these barriers on an obese child's motivation in order to exercise and tailor exercise programs to the special needs of this population. Chapter Outline • Introduction • Defining Physical Activity, Exercise, and Physical Fitness • Physical Activity, Physical Fitness, And Motor Competence In Obese Children • Physical Activity and Obesity in Children • Physical Fitness in Obese Children • Balance and Gait in Obese Children • Motor Competence in Obese Children • Physical Activity Guidelines for Obese Children • Clinical Assessment of the Obese Child • Physical Activity Characteristics: Mode • Physical Activity Characteristics: Intensity • Physical Activity Characteristics: Frequency • Physical Activity Characteristics: Duration • Conclusion

The concept of creative industries and its implications for the MFEH

An account of the creative industries as a discourse and the challenges it presents for smaller cities such as Gwanju in terms of culture-led regeneration.