939 resultados para training of carers


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A new algorithm for training of nonlinear optimal neuro-controllers (in the form of the model-free, action-dependent, adaptive critic paradigm). Overcomes problems with existing stochastic backpropagation training: need for data storage, parameter shadowing and poor convergence, offering significant benefits for online applications.

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This paper seeks to analyse some key issues related to initial training models for secondary education teachers from an international perspective with more specific references to the Spanish model. First, we briefly mention secondary education and its training needs: purpose, organization, structure, character, duration, etc.. Secondly, the most typical models of initial training of these teachers: consecutive and simultaneous, academic and professional, are adressed. Thirdly, we analyse the structure of initial training containing more general scientific and professional knowledge, (its theoretical and practical components). Lastly, the relationship between initial training and access to the teaching profession will be established, as well as the possibility of academic and / or professional qualifications is analyzed. We then highlight the issue of "professional identity", which is closely linked to the initial training of future teachers and final conclusions are discussed.

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This article presents an educational experiment carried out in the Primary School Teaching Degree at the University of Barcelona. Specifically, the article analyses the application of the “Work Corners” approach in a core subject. In a three-year action research process, trainers put into practice an innovation which enabled them to boost cooperative work and reflexive learning among trainees. Firstly, the theoretical model underpinning the project and guiding many of the actions carried out by the training team is presented. After providing detailed information on the practical development of the experiment, the data-gathering process and its results are shown. Various information-gathering strategies were used in assessing the project, such as a questionnaire, participant observation, and teachers’ diaries. The results demonstrate, amongst other things, that “work corners” offer viable and appropriate educational conditions for the articulation of theoretical and practical knowledge, for building professional knowledge, and therefore, the beginnings of a reflexive teaching practice.

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Background and Purpose—Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of a new nonrobotic training device, the Sensorimotor Active Rehabilitation Training (SMART) Arm, that was used with or without electromyography-triggered electrical stimulation of triceps brachii to augment elbow extension, permitting stroke survivors with severe paresis to practice a constrained reaching task.

Methods—A single-blind, randomized clinical trial was conducted with 42 stroke survivors with severe and chronic paresis. Thirty-three participants completed the study, of whom 10 received training using the SMART Arm with electromyography-triggered electrical stimulation, 13 received training using the SMART Arm alone, and 10 received no intervention (control). Training consisted of 12 1-hour sessions over 4 weeks. The primary outcome measure was “upper arm function,” item 6 of the Motor Assessment Scale. Secondary outcome measures included impairment measures; triceps muscle strength, reaching force, modified Ashworth scale; and activity measures: reaching distance and Motor Assessment Scale. Assessments were administered before (0 weeks) and after training (4 weeks) and at 2 months follow-up (12 weeks).

Results—Both SMART Arm groups demonstrated significant improvements in all impairment and activity measures after training and at follow-up. There was no significant difference between these 2 groups. There was no change in the control group.

Conclusions—Our findings indicate that training of reaching using the SMART Arm can reduce impairment and improve activity in stroke survivors with severe and chronic upper limb paresis, highlighting the benefits of intensive task-oriented practice, even in the context of severe paresis.

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In young adults, improvements in the rate of force development as a result of resistance training are accompanied by increases in neural drive in the very initial phase of muscle activation. The purpose of this experiment was to determine if older adults also exhibit similar adaptations in response to rate of force development (RFD) training. Eight young (21-35 years) and eight older (60-79 years) adults were assessed during the production of maximum rapid contractions, before and after four weeks of progressive resistance training for the elbow flexors. Young and older adults exhibited significant increases (P<0.01) in peak RFD, of 25.6% and 28.6% respectively. For both groups the increase in RFD was accompanied by an increase in the root mean square (RMS) amplitude and in the rate of rise (RER) in the electromyogram (EMG) throughout the initial 100 ms of activation. For older adults, however, this training response was only apparent in the brachialis and brachioradialis muscles. This response was not observed in surface EMG recorded from the biceps brachii muscle during either RFD testing or throughout training, nor was it observed in the pronator teres muscle. The minimal adaptations observed for older adults in the bifunctional muscles biceps brachii and pronator teres are considered to indicate a compromise of the neural adaptations older adults might experience in response to resistance training.

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Krysia M. Yardley-Matwiejczuk has addressed the clinical and psychological implications of role-play (Role Play: Theory and Practice, Sage Publications, 1997) and Judith Ackroyd has thoroughly reassessed the place of roleplay in education (Role Reconsidered, Trentham Books, 2004). But there has been no systematic analysis of the implications for actor training of this growing area of employment. This paper interrogates some of the implications of role-play for actor trainers, particularly in relation to the need for a clear ethical framework governing spontaneous performance in non-theatrical environments. The paper also suggests guidelines on ‘distancing’ and ‘presencing’ techniques to equip actors to cope with the unpredictability of role play-based performance.

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Aim: To explore the impact of being a family carer to patients with stage 5 chronic kidney disease managed without dialysis.
Background: Increasing numbers of patients with renal disease worldwide are making the decision not to embark on dialysis. This group has significant physical and psychological symptom burdens similar to or greater than those in advanced cancer patients. Little is known about the impact on family carers.
Design: Exploratory, qualitative design.
Methods: The study was undertaken with 19 carers caring for patients managed in a Renal Supportive Care Service in the UK between 2006–2008. Sixty-one semi-structured interviews and detailed field notes inform the analysis.
Findings: ‘Caring from diagnosis to death’ was the overarching theme illustrated by three sub-themes: (i) Caregiver's plight – making sense of the disease and potential deterioration; (ii) Having to care indefinitely; and (iii) Avoiding talk of death. ‘Caring from diagnosis to death’ coincides with an original concept analysis of renal supportive care, which is considered an adjunct to the management of patients with renal disease at all stages of their illness.
Conclusion: There is a clear need for further research internationally and theory-based nursing interventions to support carers of patients managed without dialysis. The development of a holistic, integrated care pathway based on carer perspectives, which includes identification of information needs related to original diagnosis, associated comorbidities, treatment options, prognosis, and assistance in developing strategies to manage communication with patients as the end of life approaches, is required.

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Although most people with Parkinson's disease are cared for in the community, little is known about family members' lived experiences of palliative or end-of-life care. The aim of this study was to explore former carers' lived experiences of palliative and end-of-life care. In total, 15 former family caregivers of patients who had died with Parkinson's disease were interviewed using a semi-structured topic list. Findings indicated that some palliative and end-of-life care needs had not been fully addressed. Lack of communication, knowledge and coordination of services resulted in many people caring for someone with Parkinson's disease not accessing specialist palliative care services. Participants also reflected upon the physical and psychological impact of caring in the advanced stage of Parkinson's. A multi-disciplinary team-based approach was advocated by participants. These findings provide important insights into the experience of caregiving to patients with Parkinson's disease in the home at the end-of-life stage. According to palliative care standards, patients and their carers are the unit of care; in reality, however, this standard is not being met.