The challenge of patients’ unmet palliative care needs in the final stages of chronic illness.

Background: There is consensus in the literature that the end of life care for patients with chronic illness is suboptimal, but research on the specific needs of this population is limited. Aim: This study aimed to use a mixed methodology and case study approach to explore the palliative care needs of patients with a non-cancer diagnosis from the perspectives of the patient, their significant other and the clinical team responsible for their care. Patients (n 18) had a diagnosis of either end-stage heart failure, renal failure or respiratory disease. Methods: The Short Form 36 and Hospital and Anxiety and Depression Questionnaire were completed by all patients. Unstructured interviews were (n 35) were conducted separately with each patient and then their significant other. These were followed by a focus group discussion (n 18) with the multiprofessional clinical team. Quantitative data were analysed using simple descriptive statistics and simple descriptive statistics. All qualitative data were taped, transcribed and analysed using Colaizzi’s approach to qualitative analysis. Findings: Deteriorating health status was the central theme derived from this analysis. It led to decreased independence, social isolation and family burden. These problems were mitigated by the limited resources at the individual’s disposal and the availability of support from hospital and community services. Generally resources and support were perceived as lacking. All participants in this study expressed concerns regarding the patients’ future and some patients described feelings of depression or acceptance of the inevitability of imminent death. Conclusion: Patients dying from chronic illness in this study had many concerns and unmet clinical needs. Care teams were frustrated by the lack of resources available to them and admitted they were ill-equipped to provide for the individual’s holistic needs. Some clinicians described difficulty in talking openly with the patient and family regarding the palliative nature of their treatment. An earlier and more effective implementation of the palliative care approach is necessary if the needs of patients in the final stages of chronic illness are to be adequately addressed. Pa

Predictors of attitudes toward inclusion of students with special educational needs in future education professionals

One of the main pillars in the development of inclusive schools is the initial teacher training. Before determining if it is necessary to make changes (and of what type) in training programs or curriculum guides related to the attention to diversity and inclusive education, the attitudes of future education professionals in this area should be analyzed. This includes the identification of the relevant predictors of inclusive attitudes. The research reported in this article pursued this objective, doing so with a quantitative survey methodology based on the use of cross-sectional structured data collection and statistical analyses related to the quality of the attitude questionnaire (factor analysis and Cronbach's alpha), descriptive statistics, correlations, hypothesis tests for difference of means, and regression analysis in order to predict attitudes towards inclusion in education. Firstly, the results show that the participants held very positive attitudes toward the inclusion of students with special educational needs. Particularly, older respondents, those with a longer training and, to a lesser extent, women and those who had been in touch with disabled people stood out within this attitude. Secondly, it is evidenced that self-transcendence values ​and, more weakly, contact, function as robust predictors of attitudes of future practitioners towards the inclusion of students with special needs. Some applications for the initial professionalization of educators are suggested in the discussion.

Actionable Nuggets: Knowledge Translation Tool for the Needs of Patients with Spinal Cord Injury

OBJECTIVE: To present the results of a pilot study of an innovative methodology for translating best evidence about spinal cord injury (SCI) for family practice.

Meeting the Needs of Adult Learners in a Faculty of Education Careers Curriculum

Adult learners are a discrete population with specific needs and characteristics. The context of this project is a Career Services office in a Faculty of Education at a Local University [pseudonym]. The office serves a population of students from various programs within the Faculty, with the majority of students enrolled in the Bachelor of Education program. As a result of the current job market for teachers in Ontario and Canada, it is important to be able to communicate effectively with students to support them in their job searches. The purpose of this project was to identify the needs and characteristics of adult learners, and to identify ways that the current Career Services curriculum could be improved to better support adult learners. In order to engage this population of students, it is important to ensure that the content of the course addresses and meets their needs. To provide a more personalized learning environment, online resources were considered to allow students to participate more, providing a more convenient and suitable method of delivery for our intended audience, and a sample website was created to host the online resources. In addition, the entire Career Services curriculum was formalized by producing a curriculum document to outline the goals and outcomes of the program to ensure that the content will facilitate the achievement of those goals. What resulted is a hybrid, online and in-person program for Career Services, and a more robust curriculum that considers the needs of our adult learners.

Inter-professional working in child protection with families with long-term and complex needs

Within the United Kingdom there is growing awareness of the need to identify and support the small number of children who are living in families experiencing multiple problems. Research indicates that adverse experiences in childhood can result in poor outcomes in adulthood in terms of lack of employment, poorer physical and mental health and increases in social problems experienced. It is acknowledged that most of these children are known to child welfare professionals and that some are referred to social services, subsequently entering the child protection system. This paper reports research conducted with twenty-eight experienced child welfare professionals. It explores their views about families known to the child protection system with long-term and complex needs in relation to the characteristics of children and their families; the process of intervention with families; and the effects of organisational arrangements on practice. The research indicates that these families are characterised by the range and depth of the problems experienced by the adults, such as domestic violence, mental health difficulties and substance misuse problems, and the need for professionals to have good inter-personal skills and access to specialist therapeutic services if families are to be supported to address their problems.

Chronic child abuse and domestic violence: Children and families with long-term and complex needs

It is estimated that up to one million children may have been exposed to domestic violence in the UK, with significant consequences for their social and emotional development in childhood and later life. At a time when the central and devolved administrations in the UK have developed strategies to tackle domestic violence, this paper reports the findings from a study conducted on children in the child protection system with long-term and complex needs as a result of experiencing domestic violence. The research identifies the characteristics of the children and their families and tracks their careers through the child protection system. The findings indicate that professionals have an awareness of domestic violence, and that younger children with younger parents are most likely to experience prolonged periods in the child protection system. Domestic violence in this context typically co-exists in families experiencing other difficulties such as substance misuse and socio-economic deprivation. In conclusion, the paper argues that Government policy and professional practice should primarily be concerned with assessing the risk that men present, rather than the risk that children are at. By reframing professional interventions, men are more likely to be challenged to accept responsibility for their behaviour and the consequences for their families.

The L Pack: Addressing the Sexual Health Needs of Young Lesbians

Concerns about the sexual health of women who identify as other than heterosexual have been highlighted in numerous research reports, yet access to information, advice and services remains limited within Northern Ireland. In response to this, a group of young women have produced a sexual health resource (‘‘The L Pack’’) specifically for those who identify as lesbian or bisexual. This article discusses the issue of lesbian sexual health and the rationale for the production of The L Pack. Drawing upon discussions with the young women involved and the various partners, it outlines the participatory process of producing information for young women by young women, the meaning and value of this and the nature of learning for all involved. Illustrating feminist and related principles through practice examples, the article outlines how the project moved from a focus on individual learning to one where the young women involved gained the knowledge, skills and confidence to take their learning to their peers and others.