The Effect of Community-Based Specialist Palliative Care Teams on Place of Care

BACKGROUND: Prior research on community-based specialist palliative care teams used outcome measures of place of death and/or dichotomous outcome measures of acute care use in the last two weeks of life. However, existing research seldom measured the diverse places of care used and their timing prior to death.

OBJECTIVE: The study objective was to examine the place of care in the last 30 days of life.

METHODS: In this retrospective cohort study, patients who received care from a specialist palliative care team (exposed) were matched by propensity score to patients who received usual care in the community (unexposed) in Ontario, Canada. Measured was the percentage of patients in each place of care in the last month of life as a proportion of the total cohort.

RESULTS: After matching, 3109 patients were identified in each group, where 79% had cancer and 77% received end-of-life home care. At 30 days compared to 7 days before death, the exposed group's proportions rose from 33% to 41% receiving home care and 14% to 15% in hospital, whereas the unexposed group's proportions rose from 28% to 32% receiving home care and 16% to 22% in hospital. Linear trend analysis (proportion over time) showed that the exposed group used significantly more home care services and fewer hospital days (p < 0.001) than the unexposed group. On the last day of life (place of death), the exposed group had 18% die in an in-patient hospital bed compared to 29% in usual care.

CONCLUSION: Examining place of care in the last month can effectively illustrate the service use trajectory over time.

Les effets de la mise en place d'une adaptation didactique en rédaction sur les productions écrites des élèves à risque intégrés

Dans cet article, l'objectif poursuivi consiste à évaluer les effets de la mise en place d'une adaptation didactique sur l'écriture narrative d'élèves à risque intégrés. L'originalité de l'étude repose sur le choix de la situation d'apprentissage et de l'adaptation didactique afin de permettre aux élèves à risque d'une classe de 4e année du primaire d'une école québécoise de produire des récits structurés et cohérents. L'apport de l'adaptation didactique «texte modèle» réside dans la présentation d'un texte fini répondant aux attentes finales afin de guider le processus d'écriture. L'analyse quantitative des résultats montre des effets significatifs produits par le dispositif didactique sur la compétence à structurer un texte de type narratif et sur celle à le rendre cohérent.

Exploring the micro-politics of place: lifestyle migrants, collective identities and modes of belonging

Taking up Hopkins and Dixon’s (2006) call to attend to the micro-politics of everyday constructions of space and place, which necessarily involves psychological concepts such as identity, belonging and attachment, this paper aims to show how a critical socio-cognitive approach to discourse analysis is an effective means of unpacking the ways in which versions of place are (re)produced and negotiated through discursive practices, and in particular the ways in which ‘legitimate’ collective identities are constructed in relation to place. I focus on the contemporary social phenomenon of lifestyle migration. Within Europe, this typically involves relatively affluent northern Europeans moving to destinations in southern Europe that are strongly linked to tourism. Although lifestyle migrants are generally viewed by their hosts as ‘desirable’ migrants due to their perceived economic and socio-cultural capital, their integration into destination communities is often minimal. The question arises as to how these migrants construct modes of belonging in relation to their adopted home-place and how they relate to the other social groups with whom they share it. Using texts from a variety of sources, including in-depth interviews with British migrants in Portugal, I explore not only how migrants position themselves (and others) discursively in relation to places, but also how they are already positioned by discursive practices in the public sphere. I also examine to what extent the construction of a ‘legitimate’ mode of belonging involves the construction of intergroup cooperation within that place.

The discursive construction of place-identity: british lifestyle migrants in the Algarve

Tese dout., Philosophy, Lancaster University, 2011

Les représentations sociales d'une discipline scolaire - l'activité scientifique - et de sa place au sein des autres disciplines formant le curriculum chez des instituteurs marocains

Cette thèse s'inscrit dans les préoccupations récentes du système scolaire marocain à l'égard de la qualité de l'éducation. Ces préoccupations consistent à considérer l'enseignement fondamental (le primaire) non seulement comme un lieu pour apprendre à lire, à écrire et à compter pour se préparer aux études ultérieures, mais aussi, et surtout, comme un lieu de formation de qualité pour tous. La recherche s'intéresse particulièrement à la contribution d'une matière scolaire, l'activité scientifique, à cette formation. L'auteur dégage de la problématique que l'exploitation de l'activité scientifique à la formation des élèves nécessite une analyse à trois niveaux. Le premier est celui des enjeux qu'elle véhicule. Le deuxième niveau est celui du statut qu'occupe cette discipline au sein des autres disciplines. Le troisième est celui de l'implication de cette discipline dans des activités d'enseignement-apprentissage qui s'assurent la cohérence du curriculum . Pour explorer les dimensions retenues, l'auteur s'est intéressé aux représentations sociales que les principaux acteurs scolaires, les instituteurs, détiennent à l'égard de chacune d'elles. L'étude menée s'est basée sur des entrevues réalisées auprès de 32 instituteurs marocains.

"Picture yourself in my place": Fitzgerald em Hollywood

Esta dissertação estuda a intertextualidade entre as obras literárias de F. Scott Fitzgerald e a escrita para cinema nos anos formativos de Hollywood das décadas de 1920 e 30, assim como a influência da sétima arte não só nos romances de Fitzgerald, como em alguma literatura norte-americana da época. Por outro lado, considerando o trabalho de Fitzgerald como argumentista em Hollywood, analisa-se alguns dos guiões em que colaborou, comparando a linguagem cinematográfica da sua prosa com a literária do seu cinema. Na experiência e obra de Fitzgerald está representada uma questão paradigmática sobre a eterna relação de amor e ódio, influência e angústia, ou “angústia da influência” (para tomar emprestado o conceito de Harold Bloom), entre a literatura e o cinema, ao mesmo tempo que nos leva a parafrasear a pergunta de Michel Foucault: o que é um autor no cinema?

Going for god : mobility, place and temporality among evangelical guineans in Lisbon

Tese de doutoramento, Antropologia (Antropologia da Religião e do Simbólico), Universidade de Lisboa, Instituto de Ciências Sociais, 2014

Something to show for it: the place of mementoes in women’s oral histories of work

Workplace memorabilia, regarded here as artifacts and mementoes kept from workplaces and stored in homes, is varied, including; tools of a trade, ephemeral leaflets and pamphlets, union mementoes, uniforms and badges, long service awards, gifts from colleagues, and photographs both formal and informal. These objects can symbolize many years of work-life history and the corollary of this, their absence, perhaps the need to forget the drudgery of ‘the daily grind’. The materiality of an object saved or taken from the workplace often prompts reminiscence (Bornat, 2001) but can also, in itself and its method of display, represent and express key identities, work processes and traditions. Using examples from a three year ESRC funded project on work and identity this paper focuses on the women who participated in the study and investigates what is kept or not, whether the ways in which work memorabilia is displayed or stored is gendered, and how this might illuminate gendered social relations in the workplace and gendered work identities.