How well do general practitioners deliver palliative care? A systematic review

General practitioners (GPs) deliver the majority of palliative care to patients in the last year of life. This article seeks to examine the nature of GP care, perceptions of the GPs themselves and others of that care, the adequacy of palliative care training, issues relating to accessibility of GPs to palliative care patients, and strategies that may be of use in encouraging more effective delivery of palliative care by GPs. Medline and PubMed databases from 1966 to 2000 were searched, and 135 references identified. Sixty-six of these described studies relevant to GP palliative care. GPs value this part of their work. Most of the time, patients appreciate the contribution the GP makes to palliative care particularly if the GP is accessible, takes time to listen, allows patient and carer to ventilate their feelings, and is seen to be making efforts made regarding symptom relief. However, reports from bereaved relatives suggest that palliative care is performed less well in the community than in other settings. GPs express discomfort about their competence to perform palliative care adequately. They tend to miss symptoms which are not treatable by them, or which are less common. However, with appropriate specialist support and facilities, GPs have been shown to deliver sound and effective care. GP comfort working with specialist teams increases with exposure to this form of patient management, as does the understanding of the potential other team members have in contributing to the care of the patient. Formal arrangements engaging GPs to work with specialist teams have been shown to improve functional outcomes, patient satisfaction, improve effective use of resources and improve effective physician behaviour in other areas of medicine. Efforts by specialist services to develop formal involvement of GPs in the care of individual patients, may be an effective method of improving GP palliative care skills and appreciation of the roles specialist services can play.

Teacher Use of Learners' Native Language in the Foreign Language Classroom

This article reports on an exploratory study into the use of students' native language (NL) by teachers in the foreign language (FL) classroom. The project was undertaken by four teachers of beginner French at the University of Queensland. The teachers' aim was to investigate the use of NL in a context which actively promotes an immersion approach to FL teaching. The audio recordings of the teachers' speech were transcribed to provide data for estimating the amount of NL, and for analyzing the various instances of NL use. The study indicates that the activity type is a significant variable affecting NL amount. It also isolates two strategic uses of NL, translating FL words into NL, and contrasting NL and FL forms, both of which involve intrasentential code switching with NL words embedded in an FL sentence. The study suggests that these strategies may facilitate acquisition during immersion in FL, but experimental research is needed to test the hypothesis that translation and contrast facilitate learning of FL vocabulary and grammar.

Implications of missed opportunities for learning and assessment in design and technology education

Supporting student learning can be difficult, especially within open-ended or loosely structured activities, often seen as valuable for promoting student autonomy in many curriculum areas and contexts. This paper reports an investigation into the experiences of three teachers who implemented design and technology education ideas in their primary school classrooms for the first time. The teachers did not capitalise upon many of the opportunities for scaffolding their students' learning within the open-ended activities they implemented. Limitations of the teachers' conceptual and procedural knowledge of design and technology were elements that influenced their early experiences. The study has implications for professional developers planning programs in newly introduced areas of the curriculum to support teachers in supporting learning within open-ended and loosely structured problem solving activities. (C) 2001 Elsevier Science Ltd. All rights reserved.

Research utilization among pediatric health professionals

The present study investigated research use and attitudes toward research among pediatric health professionals. All nurses and allied health professionals in a pediatric teaching hospital were surveyed using previously tested and published measures. Over half of the participants had some formal education in research but, for some participants, that education was many years ago. Most participants reported poor or very poor understanding of research design. Two variables were independently associated with a positive attitude towards research: (i) better understanding of how to conduct a literature search; and (ii) higher level of education. Five variables were independently associated with research use: better understanding of research design; having presented at a conference in the past two years; sense of calling to the profession; better understanding of how to conduct a literature search; and attending rounds. A small proportion of variance in both research use and a positive attitude towards research was explained by the independent predicator variables. Further research is required to identify characteristics of the workplace environment that support research use.

The suitability of written education materials for stroke survivors and their carers

This study evaluated the suitability of written materials for stroke survivors and their carers. Twenty stroke survivors and 14 carers were interviewed about the stroke information they had received and their perceptions of the content and presentation of materials of increasing reading difficulty. The mean readability level of materials (grade 9) was higher than participants’ mean reading ability (grade 7–8). Satisfaction with materials decreased as the content became more difficult to read. Seventy-five percent reported that their information needs were not met in hospital. More stroke survivors with aphasia wanted support from health professionals to read and understand written information, and identified simple language, large font size, color, and diagrams to complement the text as being important features of written materials. Simple materials that meet clients’ information needs and design preferences may optimally inform them about stroke.

On-line writing: a link to learning in a teacher education program

This paper examines the use of on-line discussion as a medium for learning in a pre-service teacher education program. As part of an Education Studies course student teachers engaged in a discussion of issues related to technology and equity in schools. The design of the task and the subsequent analysis of the on-line text were part of a research project investigating whether and how communications technology can be used to integrate and extend the learning of teacher education students. The main argument developed in the paper is that through the on-line activity distinctive sets of writing practices were created. These practices enabled students to make connections between the often disparate parts of teacher education programs-theory and practice, campus and school, research and experience. (C) 2002 Elsevier Science Ltd. All rights reserved.