Reactions of Persons with Dementia to Caregivers Singing in Morning Care Situations

Music therapeutic caregiving', when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with'Music therapeutic caregiving'. Through a qualitative content analysis two themes emerged.'Being in a different reality' was based on'usual' morning care situations. The caregivers' experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,'Being present', was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that'Music therapeutic caregiving' might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving.  

Recruiting in public places : A strategy to increase diversity in qualitative research samples

For some research projects, recruiting in public places is an invaluable addition to sampling strategies. It complements the more traditional recruitment strategies by providing researchers with' opportunities to include people in the research who would otherwise be excluded. One of the limitations of selective and snowball sampling is that participants often come from the same social group. Participants from these social groups often share similar experiences and ways of thinking about those experiences. The aim of recruiting in public places is to move beyond this 'in group' to ensure a wider perspective. This paper illustrates how recruiting in public places can provide greater sample diversity for theoretical strength. The paper begins with a brief overview of recruiting in public places. It then describes the theoretical considerations associated with this recruiting strategy. The paper demonstrates how recruiting in public places facilitates grounded theory by providing comparisons that are informed by diverse experiences. Using examples and a case study, we illustrate how recruiting in public places can complement selective, snowball and theoretical sampling to ensure a more comprehensive sample.

The influence of collectivism in society and its implications for research on information systems and national culture

This paper argues that the nature of IS research that deals with indigenous culture must be informed as much by context as it is by culture models, which has been the focus of such research in the past. This is considered important because it better reflects the meaning of the data collected for the researcher. To appreciate the importance of context this papers also argues that research subjects from designated individualist societies will inform the researcher in different ways from those subjects located in collectivist societies. To illustrate the practical implications of this argument the paper reports three separate case studies in IS research where the researchers reflect on the impact that a collectivist view has had on the research findings. The paper suggests that (1) similar ethnicity and appearance are significant in gaining the trust of subjects in a collectivist society; that is the researcher is part of the in-group as they belong to the same culture or ethnic group; that (2) who introduced the researcher to the subject is significant in that trust is best reflected when a member of the group/collective plays an important role in the research process itself; and that (3) an ability to (a) communicate in the natural language and (b) understand the implicit body language and (c) cultural codes is important in gaining significant and more meaningful research outcomes. This is enabled via the implicit meanings embedded in members of the collectivist society.

Preliminary study of the effect of low-intensity home-based physical therapy in chronic stroke patients

This study was a preliminary examination of the effect of low-intensity home-based physical therapy on the performance of activities of daily living (ADL) and motor function in patients more than 1 year after stroke. Twenty patients were recruited from a community stroke register in Nan-Tou County, Taiwan, to a randomized, crossover trial comparing intervention by a physical therapist immediately after entry into the trial (Group I) or after a delay of 10 weeks (Group II). The intervention consisted of home-based physical therapy once a week for 10 weeks. The Barthel Index (BI) and Stroke Rehabilitation Assessment of Movement (STREAM) were used as standard measures for ADL and motor function. At the first follow-up assessment at 11 weeks, Group I showed greater improvement in lower limb motor function than Group II. At the second follow-up assessment at 22 weeks, Group II showed improvement while Group I had declined. At 22 weeks, the motor function of upper limbs, mobility, and ADL performance in Group II had improved slightly more than in Group I, but the between-group differences were not significant. It appears that low-intensity home-based physical therapy can improve lower limb motor function in chronic stroke survivors. Further studies will be needed to confirm these findings.

Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis

Postoperative cholangitis is a frequent and unpredictable complication of unknown etiology following bile duct reconstruction (BDR), particularly for biliary atresia. This study was undertaken to correlate the growth of bacteria in the hepaticojejunostomy with that in the liver after BDR. Quantitative bacterial culture was done on the specimens taken from the liver and from the hepaticojejunostomy at 1 week (group 1, n = 7), 1 month (group 2, n = 7), and 2 months (group 3, n = 7) following BDR with Roux-en-Y hepaticojejunostomy in piglets after 2 weeks of common bile duct ligation. The histological examination of the liver and the hepaticojejunostomy, as well as serial monitoring of hemogram and liver function tests, were performed to correlate the findings with the bacterial concentration of the liver and the hepaticojejunostomy following BDR. The bacterial concentration of the hepaticojejunostomy, expressed as log10 colony-forming units per gram (log10 CFU/g) of the hepaticojejunostomy, showed a progressive decrease from 8.38 ± 1.36 in group 1, 7.07 ± 2.54 in group 2, to 3.56 ± 1.31 in group 3 (p = 0.001). The log10 CFU/g of the liver also showed a progressive decrease from 5.02 ± 1.59 in group 1, 3.16 ± 1.56 in group 2, to 2.19 ± 1.09 in group 3 (p = 0.006). There was a significant positive correlation of the log10 CFU/g of the liver (n = 21) with that of the hepaticojejunostomy (n = 21) following BDR (r = 0.600, p = 0.004). Most of the infectious pathogens isolated from the liver were also isolated from the hepaticojejunostomy. The changes in hemoglobin, bilirubin, albumin, and ammonia significantly correlated with the changes of the bacterial concentration of the liver. The results of the study suggests that hepatic bacterial proliferation after BDR is significantly affected by microbial overgrowth in the bilioenteric anastomosis and is associated with deteriorated liver function and hemogram.

Building research capacity in General Practice : Incorporating research as a component of GP vocational training

Aims & rationale/Objectives : Australian research shows that most GP registrar supervisors lack confidence to support registrar research projects and themselves have little or no research experience. Assisting registrars to develop critical thinking skills and an understanding of research methods sufficient to enable active use of these tools in general practice is one of the curriculum statements in the RACGP Training Program Curriculum. A University Department of Rural Health (UDRH) and a General Practice Education and Training (GPET) organisation formed a partnership to: Engage basic term registrars in group research and concurrent research skills training program; Improve research skills, confidence, and knowledge; and Contribute research findings relevant to general practice.

Methods : Registrars' initial research knowledge and confidence was measured by a questionnaire. In addition to a final focus group, feedback via evaluation forms was sought from the 11 registrars and two GPET supervisors at the conclusion of each research training session.

Principal findings : Approaches

Implications : Research skills development training and involvement in research can be successfully integrated into a GP vocational training program.

Magnitude and meaningfulness of change in SF-36 scores in four types of orthopedic surgery

Background: The Medical Outcomes General Health Survey (SF-36) is a widely used health status measure; however, limited evidence is available for its performance in orthopedic settings. The aim of this study was to examine the magnitude and meaningfulness of change and sensitivity of SF-36 subscales following orthopedic surgery.

Methods: Longitudinal data on outcomes of total hip replacement (THR, n = 255), total knee replacement (TKR, n = 103), arthroscopic partial meniscectomy (APM, n = 74) and anterior cruciate ligament reconstruction (ACL, n = 62) were used to estimate the effect sizes (ES, magnitude of change) and minimal detectable change (sensitivity) at the group and individual level. To provide context for interpreting the magnitude of changes in SF-36 scores, we also compared patients' scores with age and sex-matched population norms. The studies were conducted in Sweden. Follow-up was five years in THR and TKR studies, two years in ACL, and three months in APM.

Results: On average, large effect sizes (ES≥0.80) were found after orthopedic surgery in SF-36 subscales measuring physical aspects (physical functioning, role physical, and bodily pain). Small (0.20–0.49) to moderate (0.50–0.79) effect sizes were found in subscales measuring mental and social aspects (role emotional, vitality, social functioning, and mental health). General health scores remained relatively unchanged during the follow-up. Despite improvements, post-surgery mean scores of patients were still below the age and sex matched population norms on physical subscales. Patients' scores on mental and social subscales approached population norms following the surgery. At the individual level, scores of a large proportion of patients were affected by floor or ceiling effects on several subscales and the sensitivity to individual change was very low.

Conclusion: Large to moderate meaningful changes in group scores were observed in all SF-36 subscales except General Health across the intervention groups. Therefore, in orthopedic settings, the SF-36 can be used to show changes for groups in physical, mental, and social dimensions and in comparison with population norms. However, SF-36 subscales have low sensitivity to individual change and so we caution against using SF-36 to monitor the health status of individual patients undergoing orthopedic surgery.

Innovative model for clinical education in dietetics

Aim: Professional practice placement programs in dietetics face a number of challenges in respect of quantity, quality and sustainability. The aim of the present study is to report on the development of an innovative placement model based on a variety of training and supervision approaches to address these aforementioned challenges.

Methods: The model was developed following an investigation of existing practice and the literature with approaches that were identified as important to the requirements and constraints of dietetics clinical training incorporated into the model.

Results: Although one-on-one supervision is the predominant approach in Australian dietetic education, the educational literature and the authors' experience showed that a variety of approaches are represented in some form. The model developed involves the pairing of two students with one supervisor with students changing peer partners and supervisors every three weeks during the nine-week placement to diversify exposure to working and learning styles. The model integrates four customised approaches: incremental exposure to tasks; use of a clinical reasoning framework to help structure student understanding of the methods and judgements involved in patient care; structured enquiry in group discussions; and peer observation and feedback.

Conclusions: The model has potential to achieve efficiencies in supervisors' involvement by coordinating the skill development activities of students as a group and promoting peer-assisted learning.

Strategic concealment of sexual identity in an estrildid finch

One explanation for the evolution of sexual monomorphism is the sexual indistinguishability hypothesis, which argues that in group-living species individuals might benefit by concealing their sex to reduce sexual competition. We tested this hypothesis in long-tailed finches Poephila acuticauda. Males and females could not be reliably distinguished morphologically or by analysis of the reflectance spectra (300-700 nm) from the plumage and bill. Males seemed unable to distinguish the sex of an unfamiliar individual in the absence of behavioural cues; they were equally likely to court and copulate with unfamiliar males and females but rarely courted familiar males. Here we report the first experimental evidence that sexual monomorphism enables strategic concealment of sex. Males were more likely to reveal their sex when faced with a solitary unfamiliar individual than a group of unfamiliar individuals. When encountering an unfamiliar male that revealed his sex, subordinate males were more likely to conceal their sex than dominant males.

Influence of an adventure learning program, using group adventure initiative tasks, on participant self-esteem

The purpose of this study was to assess the influence of an adventure learning program, based on participation in group adventure initiative tasks (GAITs), on participant self-esteem and, further, to examine any associated gender differences in the dependent variable. The study took place within the framework of the 'Group Dynamics in Action' unit offered at the University of South Australia, Underdale Campus, in semester 2, 1994. The course included participation in group adventure initiative tasks, the identification and examination of group dynamic processes, the investigation of individual roles within the small group and the review of these processes in the group setting. The program also included an experience on a high ropes course. Both quantitative and qualitative data was gathered to gain insight into gender differences and their relationship to the dependent variable and also to provide insight into any discrepancy in outcomes between males and females with regard to participation in group adventure initiative tasks. The sample set of participants was drawn from undergraduate students studying at the University of South Australia in the Bachelor of Teaching (Primary), Bachelor of Education (Secondary Physical Education Teaching) and Bachelor of Applied Science (Exercise and Sport Science) courses. Subjects were assigned to either experimental or control conditions and the experimental group were then randomly assigned to one of three treatment groups. Sixty one (N = 61) male and female subjects were tested pre and post-treatment period. Psychological tests included the Coopersmith Self Esteem Inventory (Coopersmith 1981) and an adaptation of Coopersmith's Behaviour Rating Form (Coopersmith 1967). Qualitative data was gathered using Kuhn's Twenty Statements Test (Kuhn and McPartland 1954), a self-esteem questionnaire, observations made by the researcher and other staff about subjects interactions and from weekly journals kept by subjects throughout the treatment. The duration of the treatment period was 14 weeks consisting of 14, 2 hour seminars.

Promoting group participation : a conscious approach to collaboration

Collaborative group work has increasingly been adopted as a learning and assessment tool at tertiary level, yet despite the prevalence of group
activities within the language classroom, feedback from university faculties is that international students struggle in this area. While the problem is
one of communication, language proficiency is only part of the picture. Diverse cultural expectations and students’ individual personalities play a significant role. In light of this, Deakin University English Language Institute (DUELI) decided to focus on successful participation in group work as a specific learning outcome in the EAP stream. Beginning with the recognition that having students work in groups was not, by itself, sufficient to equip them with the necessary skills for successful
collaboration, it was decided to develop a program designed to instill in students a more conscious awareness of group dynamics and of their own adopted roles and behaviours within groups. Our central aim was to encourage students to take responsibility for fostering a group dynamic
that benefited from the diversity of the student population and to raise students’ confidence in tackling academic group work.

Using large group methods to develop effective quality cultures

It has become evident that higher education institutions in the Sultanate of Oman are currently experiencing change, in particular when it involves implementing quality management systems. The underlying principles of quality management are participatory decision making. Our methods for conducting improvements in quality management, strategic planning and other topics model this principle. Large group methods or interventions involve gathering an entire organization to talk about, influence or invent needed changes (Bunker & Alban, 2002). Change is a result of purposeful social construction by organizational members. It involves a goal (approach/plan), implementation (deployment/act/so), evaluation (results/check) and modification (improvement). This paper explores the different large group methods being used in the field today and it proposes that large group methods allow a forum to overcome some of the hurdles and challenges that are being faced in Oman such as; How do you encourage sharing information in a fiercely competitive environment? And how do you establish an informal network of peers? We were witness to some of these challenges being over come when we used large group methods during various strategic planning workshops with members of staff from the different colleges in Oman. Results from the evaluations of the workshops highlighted that participants enjoyed the opportunity to network and share ideas with their peers as well as being involved in group discussions and brainstorming ideas. The paper will also propose that large group methods can be used effectively in Omani culture strengthening goals towards Omanisation.

Assessing group work

When effective group management processes are employed, clear assessment guidelines developed and communicated and valid and fair grading processes employed, the likelihood of positive learning outcomes and student satisfaction with group activities is significantly increased. Alternatively, if students cannot see the objective of group work, are unsure of what is expected of them, or believe the assessment methods are invalid or simply unfair, the educational benefits are reduced and tensions can emerge. The conditions under which group work is conducted are crucial to its success:

Group work, under proper conditions, encourages peer learning and peer support and many studies validate the efficacy of peer learning. Under less than ideal conditions, group work can become the vehicle for acrimony, conflict and freeloading. It may also impose a host of unexpected stresses on, for example, students with overcrowded schedules living long distances from the University.
(University of Wollongong assessment policy, 2002).

The educational benefits of students working cooperatively in groups are well recognised. Among other things,
• studying collaboratively has been shown to directly enhance learning;
• employers value the teamwork and other generic skills that group work may help develop; and
• group activities may help academic staff to effectively utilise their own time.

The design of assessment is central to capturing the benefits of group work and avoiding its pitfalls. Assessment defines the character and quality of group work. In fact, the way in which students approach group work is largely determined by the way in which they are to be assessed.

To maximise student learning in group activities, this section offers advice on how academic staff can:
• establish explicit guidelines for group work to ensure that learning objectives are met and to ensure that they are transparent and equitable; and
• manage the planning, development and implementation of processes and procedures for learning through group work and group assessment.

From rural beginnings to statewide roll-out : evaluation of facilitator training for a group-based diabetes prevention program

Objective: To evaluate the approach used to train facilitators for a large-scale group-based diabetes prevention program developed from a rural implementation research project.

Participants: Orientation day was attended by 224 health professionals; 188 submitted the self-learning task; 175 achieved the satisfactory standard for the self-learning task and attended the workshop; 156 completed the pre- and post-training questionnaires.

Main outcome measures: Two pre- and post-training scales were developed to assess knowledge and confidence in group-based diabetes prevention program facilitation. Principal component analysis found four factors for measuring training effectiveness: knowledge of diabetes prevention, knowledge of group facilitation, confidence to facilitate a group to improve health literacy and confidence in diabetes prevention program facilitation. Self-learning task scores, training discontinuation rates and satisfaction scores were also assessed.

Results: There was significant improvement in all four knowledge and confidence factors from pre- to post-training (P < 0.001). The self-learning task mean test score was 88.7/100 (SD = 7.7), and mean assignment score was 72.8/100 (SD = 16.1). Satisfaction with training scores were positive and 'previous training' interacted with 'change in knowledge of diabetes prevention program facilitation' but not with change in 'confidence to facilitate.'

Conclusions: The training program was effective when analysed by change in facilitator knowledge and confidence and the positive mean satisfaction score. Learning task scores suggest tasks were manageable and the requirement contributed to facilitator self-selection. Improvement in confidence scores in facilitating a group-based diabetes prevention program, irrespective of previous training and experience, show that program-specific skill development activities are necessary in curriculum design.

Language and learning preferences : a study of university students in Australia

This study sought to investigate the preferences for language use and modes of learning of university students who were completing undergraduate degrees in Australia. Of the sixty students surveyed, forty percent were international students. For seventy five percent of all students sampled, either they or their parents (or both) were bi- or multilingual. Questions which this research sought to answer were: Do the preferences for learning of university students differ according to the culture and / or language backgrounds of the students? Does an individual student’s preferred learning style influence the student’s preferences for learning in a group situation? For students whose first language is not English, do their preferences for language use vary in group learning? General findings resulting from a statistical analysis of responses to the questionnaire indicated in many, but not all, cases that the preferences for learning of university students differed according to the cultural and / or language backgrounds of the students, that an individual student’s preferred learning style influenced the student’s preferences for learning in a group situation, and that the preferences for language use of students whose first language was not English varied in group learning. Reid’s (1984 in Richards, J.C. & Lockhart, C., 1994) “Perceptual learning style preference questionnaire” comprised one section of the questionnaire for this study. This replication made possible a comparison of the findings which related to students’ learning styles from this study with findings from similar studies in which Reid’s survey instrument had been used. Findings of the present study indicate a number of differences from Reid’s findings. This study found, for example, that most language groups showed a minor preference for group learning using this survey instrument whereas Reid had found that group learning was a negligible preference for most of the language groups in her study. This study may give tertiary educators a greater understanding of their students’ preferences for group and other learning styles. It may also inform them of the likely preferences for language use of those of their students who have first languages other than English. Future students may benefit from this.