Perceptions of evidence-based practice: A survey of Australian occupational therapists

Evidence-based practice (EBP) requires clinicians to access, appraise and integrate research literature with clinical experience and clients' perspectives. Currently, little is known about occupational therapists' attitudes to EBP, their perception of implementation barriers or their educational needs. A questionnaire reflecting these issues was sent to a proportionate random sample of 1491 members of the national professional occupational therapy association, OT AUSTRALIA. The questionnaire was completed by 649 (44%) participants. Occupational therapists were positive about EBP with most (96%) agreeing that EBP is important to occupational therapy. Although 56% used research to make clinical decisions, more relied on clinical experience (96%), information from continuing education (82%) and colleagues (80%). Lack of time, evidence and skills were identified as the main barriers to the implementation of EBP. Over half (52%) expressed strong interest in EBP skills training, and most (80%) indicated an interest in the availability of brief summaries of evidence. Targeted educational initiatives, resources and systems are needed to support EBP in occupational therapy.

Motor and functional skills of children with developmental coordination disorder: A pilot investigation of measurement issues

This paper reports on the motor and functional outcomes of 20 children with developmental coordination disorder (DCD) aged 4-8 years consecutively referred to a pediatric physiotherapy service. Children with a Movement ABC (M-ABC) score less than the 15th percentile, and with no concurrent medical, sensory, physical, intellectual or neurological impairments, were recruited. The Motor Assessment Outcomes Model (MAOM) [Coster and Haley, Infants and Young Children 4 (1992) 11] provided the theoretical base for measurement selection, and preliminary findings at the activities and participation levels of the model are reported in this article. Children with DCD performed at the lower end of the normal range on the Pea-body Developmental Motor Scales (fine motor total score) (M = 85.65, SD = 12.23). Performance on the Visual Motor Integration Test (VMI) standard scores was within the average range (M = 96.15, SD = 10.69). Videotaped observations of the children's writing and cutting indicated that 29% were left-handed and that a large proportion of all children (31%) utilized unusual pencil grasp patterns and immature prehension of scissors. Measurement at the participation level involved use of the Pictorial Scale of Perceived Competence and Social Acceptance (PCSA) and Pediatric Evaluation of Disability Inventory (PEDI). Overall, these young children rated themselves towards the more competent and accepted end of the PCSA over the dimensions of physical and cognitive competence and peer and maternal acceptance. The PEDI revealed generally average performance on social (M = 49.98, SD = 16.62) and mobility function (M = 54.71, SD = 3.99), however, self-care function was below the average range for age (M = 38.01, SD = 12.19). The utility of the MAOM as a framework for comprehensive measurement of functional and motor outcomes of DCD in young children is discussed. (C) 2003 Elsevier B.V. All rights reserved.

Is emotional intelligence training for leaders justified?

In this paper, we present the results of a qualitative study of subordinate perceptions of leaders. The study represents a preliminary test of a model based on Affective Events Theory, which posits that leaders who are seen to be effective shape the affective events that determine employees' attitudes and behaviours in the workplace. Within this framework, we argue that effective leaders ameliorate employees' hassles by providing frequent, small emotional uplifts. The resulting positive affective states are then proposed to lead to more positive employee attitudes and behaviours, and more positive regard for the leader. Importantly, leaders who demonstrate these ameliorating behaviours are likely to require high levels of emotional intelligence, defined in terms of the ability to recognise, understand, and manage emotions in self and others. To investigate this model, we conducted interviews and focus groups with 10 leaders and 24 employees. Results confirmed that these processes do indeed exist in the workplace. In particular, leaders who were seen by employees to provide continuous small emotional uplifts were consistently held to be the most effective. Study participants were especially affected by negative events (or hassles). Leaders who failed to deal with hassles or, worse still, were the source of hassles, were consistently seen to be less effective. We conclude with a discussion of implications for practicing managers, and suggest that our exploratory findings provide justification for emotional intelligence training as a means to improve leader perceptions and effectiveness. [Abstract from author]

A practical guide to exercise training for heart failure patients

Background: Exercise training has been shown to improve exercise capacity in patients with heart failure. We sought to examine the optimal strategy of exercise training for patients with heart failure. Methods: Review of the published data on the characteristics of the training program, with comparison of physiologic markers of exercise capacity in heart failure patients and healthy individuals and comparison of the change in these characteristics after all exercise training program. Results: Many factors, including the duration, supervision, and venue of exercise training; the volume of working muscle; the delivery mode (eg, continuous vs. intermittent exercise), training intensity; and the concurrent effects of medical treatments may influence the results of exercise training in heart failure. Starting in an individually prescribed and safely monitored hospital-based program, followed by progression to an ongoing and progressive home program of exercise appears to be the best solution to the barriers of anxiety, adherence, and ease of access encountered by the heart failure patient. Conclusions: Various exercise training programs have been shown to improve exercise capacity and symptom status in heart failure, but these improvements may only be preserved with an ongoing maintenance program.

CPR training in households of patients with chest pain

The objectives of this study are to (1) quantify prior cardiopulmonary resuscitation (CPR) training in households of patients presenting to the Emergency Department (ED) with or without chest pain or ischaemic heart disease (IHD); (2) evaluate the willingness of household members to undertake CPR training; and (3) identify potential barriers to the learning and provision of bystander CPR. A cross-sectional study was conducted by surveying patients presenting to the ED of a metropolitan teaching hospital over a 6-month period. Two in five households of patients presenting with chest pain or IHD had prior training in CPR. This was no higher than for households of patients presenting without chest pain or IHD. Just under two in three households of patients presenting with chest pain or IHD were willing to participate in future CPR classes. Potential barriers to learning CPR included lack of information on CPR classes, perceived lack of intellectual and/or physical capability to learn CPR and concern about causing anxiety in the person at risk of cardiac arrest. Potential barriers to CPR provision included an unknown cardiac arrest victim and fear of infection. The ED provides an opportunity for increasing family and community capacity for bystander intervention through referral to appropriate training. (C) 2003 Published by Elsevier Science Ireland Ltd.

Optimising high-intensity treadmill training using the running speed at maximal O-2 uptake and the time for which this can be maintained

The aim of this study was to compare the effects of two high-intensity, treadmill interval-training programs on 3000-m and 5000-m running performance. Maximal oxygen uptake ((V) over dot O-2max), the running speed associated with (V) over dot O-2max (nu (V) over dot O-2max), the time for which nu (V) over dot O-2max can be maintained (T-max), running economy (RE), ventilatory threshold (VT) and 3000-m and 5000-m running times were determined in 27 well-trained runners. Subjects were then randomly assigned to three groups; (1) 60% T-max (2) 70% T-max and (3) control. Subjects in the control group continued their normal training and subjects in the two T-max groups undertook a 4-week treadmill interval-training program with the intensity set at nu (V) over dot O-2max and the interval duration at the assigned T-max. These subjects completed two interval-training sessions per week (60% T-max = six intervals/session, 70% T-max group = five intervals/session). Subjects were re-tested on all parameters at the completion of the training program. There was a significant improvement between pre- and post-training values in 3000-m time trial (TT) performance in the 60% T-max group compared to the 70% T,,a, and control groups [mean (SE); 60% T-max = 17.6 (3.5) s, 70% T-max = 6.3 (4.2) s, control = 0.5 (7.7) s]. There was no significant effect of the training program on 5000-m TT performance [60% T-max = 25.8 (13.8) s, 70% T-max = 3.7 (11.6) s, control = 9.9 (13.1) s]. Although there were no significant improvements in (V) over dot O-2max, nu (V) over dot (2max) and RE between groups, changes in (V) over dot O-2max and RE were significantly correlated with the improvement in the 3000-m TT. Furthermore, VT and T-max were significantly higher in the 60% Tmax group post-compared to pre-training. In conclusion, 3000-m running performance can be significantly improved in a group of well-trained runners, using a 4-week treadmill interval training program at nu (V) over dot O-2max with interval durations of 60% T-max.

Mechanisms of exercise training in patients with heart failure

Background The reduction of exercise capacity because of fatigue and dyspnea in patients with heart failure can be improved with exercise training. We sought to examine the mechanisms of exercise training, as an adjunctive treatment strategy for patients with heart failure. Methods a reviewed the published data on the possible mechanisms of effect of exercise training in heart failure. Results Symptoms of heart failure may be explained on the basis of abnormal skeletal muscle perfusion and structure and endothelial function. Exercise training has been shown to engender changes in muscle structure and biochemistry and vascular function, although effects on cardiac function have not been detected uniformly and may require longer training periods. Conclusions A suitable, long-term program of exercise training may reverse unfavorable interactions among the heart, vessels, and skeletal muscles. These improvements may be preserved with an ongoing maintenance program.

Vitamin C: Effects of exercise and requirements with training

Ascorbic acid or vitamin C is involved in a number of biochemical pathways that are important to exercise metabolism and the health of exercising individuals. This review reports the results of studies investigating the requirement for vitamin C with exercise on the basis of dietary vitamin C intakes, the response to supplementation and alterations in plasma, serum, and leukocyte ascorbic acid concentration following both acute exercise and regular training. The possible physiological significance of changes in ascorbic acid with exercise is also addressed. Exercise generally causes a transient increase in circulating ascorbic acid in the hours following exercise, but a decline below pre-exercise levels occurs in the days after prolonged exercise. These changes could be associated with increased exercise-induced oxidative stress. On the basis of alterations in the concentration of ascorbic acid within the blood, it remains unclear if regular exercise increases the metabolism of vitamin C. However, the similar dietary intakes and responses to supplementation between athletes and nonathletes suggest that regular exercise does not increase the requirement for vitamin C in athletes. Two novel hypotheses are put forward to explain recent findings of attenuated levels of cortisol postexercise following supplementation with high doses of vitamin C.

Plasma zinc and immune markers in runners in response to a moderate increase in training volume

Changes in plasma zinc concentration and markers of immune function were examined in a group of 10 male runners (n = 10) following a moderate increase in training over four weeks. Seven sedentary males acted as controls. Fasting blood samples were taken at rest, before (T0) and after T4) four weeks of increased (+ 16 %) training and after two weeks of reduced (- 31 %) training (W. Blood was analysed for plasma zinc concentration, differential leucocyte counts, lymphocyte subpopulations and lymphocyte proliferation using incorporation of H-3-thymidine. The runners increased their training volume by 16 % over the four weeks. When compared with the nonathletes, the runners had lower concentrations of plasma zinc (p = 0.012), CD3(+) (p = 0.042) and CD19(+) lymphocytes (p = 0.010) over the four weeks. Lymphocyte proliferation in response to Concanavalin A stimulation was greater in the runners (p = 0.0090). Plasma zinc concentration and immune markers remained constant during the study. Plasma zinc concentration correlated with total leucocyte counts in the athletes at T6 (r = -0.72, p < 0.05) and with Pokeweed mitogen stimulation in the nonathletes at T6 (r = -0.92, p < 0.05). Therefore, athletes are unlikely to benefit from zinc supplementation during periods of moderately increased training volume.

Matriz de capacita????o modelada por compet??ncias para atuar em programas de educa????o a dist??ncia: uma proposta para as escolas de governo

This study discusses distance learning (DL) as a corporate education strategy in the scope of National Policy on Staff Development. The purpose was to identify, along with managers and specialists of National Network of Schools of Government in Brazil (RNEG), demanded competencies for DL professionals acting in continued education to service public. Part of the research is based in official documents and in related capacity-building initiatives of Schools of Government in the last three years. Through questionnaire sent to managers of institutions of RNEG, we identified existing infrastructure, teams profile, actions developed in DL and training needs. The research allowed to map the critical competencies to work in DL programs and to create a proposal from a Competency-Based Training Matrix for school teams in order to leverage continuing education programs to public servants in three spheres of government. The results revealed the key technological, pedagogical, management and communication skills, as well as the critical activities and content to be included in the training plans. It was found that 88% of institutions have already implemented or are in the process of implementing DL, and the other 12% are deficient in qualified staff to make regulations on hiring personnel or in technology fluency. This corroborates the importance and the contribution of Competency-Based Training Matrix for RNEG

Plano de implementa????o do projeto de desenvolvimento de capacidade de governan??a

Desde a d??cada de 1990, o Governo Federal brasileiro vem implementando uma agenda ambiciosa de reformas do Estado, centradas na redu????o da pobreza e na melhoria da efici??ncia dos servi??os p??blicos. As principais prioridades, conforme previstas no Plano Plurianual (PPA) para o per??odo 2003-2007, s??o as seguintes: inclus??o social e redu????o da desigualdade; crescimento econ??mico com gera????o de emprego; distribui????o de renda e respeito ao meio ambiente; promo????o e amplia????o dos direitos de cidadania; e fortalecimento da democracia. No in??cio de 2006, o Governo criou a Pol??tica Nacional de Desenvolvimento de Pessoal (Decreto 5.707), com o objetivo de melhorar e aumentar a efici??ncia e a efic??cia na presta????o de servi??os p??blicos. No marco dessa pol??tica recente, as escolas de administra????o p??blica desempenham um papel fundamental na identifica????o das compet??ncias que precisam ser desenvolvidas nas institui????es do governo, bem como na implementa????o de pol??ticas de capacita????o para os servidores p??blicos, diretamente e/ou em parceria com escolas de governo nos n??veis federal, estadual ou local. O Canad?? tamb??m est?? criando uma estrutura para levantar as compet??ncias necess??rias para os servidores p??blicos e desenvolv??-las como um componente da Renova????o do Servi??o P??blico em todo o governo. Como institui????es l??deres no desenvolvimento de compet??ncias de servidores p??blicos, a Canada School of Public Service (CSPS) e a Escola Nacional de Administra????o P??blica (ENAP) firmaram uma parceria para implementar o Projeto de Desenvolvimento de Capacidade de Governan??a no Brasil. A finalidade do Projeto ?? melhorar a capacidade de servidores p??blicos federais, estaduais e municipais do Brasil para desenvolver e implementar programas de capacita????o e gerenciar pol??ticas p??blicas descentralizadas. Espera-se que essa parceria e o resultante compartilhamento de experi??ncias em capacita????o para governan??a efetiva contribuam para a redu????o da pobreza e das desigualdades no Brasil, por meio do desenvolvimento de compet??ncias de servidores na presta????o de servi??os p??blicos eficazes e eficientes, voltados para o cidad??o. O Projeto re??ne, al??m das duas principais Escolas de Governo no Canad?? e no Brasil, seis Escolas Brasileiras de Administra????o P??blica regionais e duas renomadas Institui????es Acad??micas Canadenses ??? a Queen???s University e a Western Ontario University. O Minist??rio do Desenvolvimento Social e Combate ?? Fome (MDS) e tr??s Secretarias Especiais do Governo Federal ??? Ra??a (SEPPIR), Direitos Humanos (SEDH) e Pol??ticas para as Mulheres (SPM) ??? tamb??m se envolver??o nas atividades de compartilhamento de conhecimentos com o Human Resources and Skills Development Canada (HRSDC) e a Canada Public Service Agency (CPSA). A CIDA fornecer?? CND$1.700.000 por meio do Programa Brasil-Canad?? de Interc??mbio de Conhecimentos para a Promo????o da Equidade (PIPE). A contribui????o da ENAP ser?? de CND$1.069.707 em esp??cie. A CSPS contribuir?? com cursos, al??m de conhecimentos e suporte t??cnicos, avaliados em CND$1.000.000. Aproveitando a parceria entre a CSPS e a ENAP, que resultou na transfer??ncia e na adapta????o bem sucedidas de cursos e metodologias canadenses, o novo projeto extrapola o n??cleo do servi??o p??blico em Bras??lia, alcan??ando escolas de governo em regi??es brasileiras em situa????o de desvantagem. ?? semelhan??a do papel da CSPS no primeiro projeto, a ENAP fortalecer?? a capacidade das escolas parceiras regionais para capacitar servidores p??blicos envolvidos na presta????o de servi??os aos brasileiros. O interc??mbio estruturado entre Minist??rios dos Governos canadense e brasileiro tamb??m aplicar?? a aprendizagem mais diretamente a quest??es de pol??ticas e programas sociais do Brasil. O desafio assumido neste Projeto ?? a adapta????o de conhecimentos e aprendizagem, com vistas a melhorar a implementa????o de pol??ticas e programas sociais. Para tanto, a CSPS e a ENAP introduzir??o novos cursos nos curr??culos das escolas parceiras e incorporar??o novos m??todos e tecnologias de aprendizagem como, por exemplo, comunidades de pr??tica virtuais e um componente de tutoria (mentoring) envolvendo o Human Resources and Skills Development Canada e o Minist??rio do Desenvolvimento Social e Combate ?? Fome do Brasil. Seis institui????es da Rede Nacional de Escolas de Governo do Brasil e do Programa de Parceria da ENAP foram selecionadas e convidadas a se unir ?? CSPS e ?? ENAP nesse novo Projeto: a Universidade Federal do Par?? (UFPA), de Bel??m (estado do Par?? ??? regi??o Norte); a Funda????o Joaquim Nabuco (FUNDAJ), de Recife (Pernambuco ??? Nordeste); a Universidade Corporativa do Servi??o P??blico / Secretaria de Administra????o do Estado da Bahia (UCS/SAEB), Salvador (Bahia ??? Nordeste); a Escola de Governo do Mato Grosso do Sul (ESCOLAGOV), Campo Grande (estado do Mato Grosso do Sul ??? Centro-Oeste); a Escola Nacional de Ci??ncias Estat??sticas / Instituto Brasileiro de Geografia e Estat??stica (ENCE/IBGE), Rio de Janeiro (estado do Rio de Janeiro ??? Sudeste); e o Instituto Municipal de Administra????o P??blica (IMAP) de Curitiba (Paran?? ??? Sul). Essas escolas de refer??ncia foram escolhidas segundo sua capacidade de trabalhar como p??los de pr??ticas inovadoras em pol??ticas p??blicas e disseminar os benef??cios do Projeto para outras escolas em suas regi??es, por meio da Rede Nacional coordenada pela ENAP. O objetivo dessa parceria ?? fortalecer as escolas de governo locais, para que estas desenvolvam, por meio de eventos de aprendizagem, compet??ncias em servidores p??blicos, a fim de aumentar a capacidade do governo na implementa????o e gest??o de pol??ticas p??blicas. O Plano de Implementa????o do Projeto (PIP) descreve o trabalho a ser realizado por essas institui????es nos pr??ximos 30 meses, ao tempo em que serve de guia para os Parceiros do Projeto no que se refere ??s a????es e aos recursos necess??rios para a obten????o dos resultados acordados. Na medida em que o Projeto estiver em andamento e os parceiros iniciarem um interc??mbio produtivo de conhecimentos, o Plano de Trabalho Anual ser?? atualizado e revisto por meio de reuni??es anuais de avalia????o e encontros do Comit?? Diretor do Projeto, com vistas a assegurar que os resultados descritos no PIP sejam alcan??ados com sucesso

Forma????o de carreiras para a gest??o p??blica contempor??nea: o caso dos especialistas em pol??ticas p??blicas e gest??o governamental

O artigo analisa o curso de forma????o inicial para a carreira de Especialista em Pol??ticas P??blicas e Gest??o Governamental (EPPGG), recentemente reformulado. Conclui-se que as mudan??as realizadas no curso, tendo em vista os problemas enfrentados em edi????es anteriores, os desafios contempor??neos da administra????o p??blica, a crescente complexidade dos problemas e as demandas da sociedade, proporcionaram respostas bastante adequadas. No entanto, persistem in??meros desafios, dentre os quais se destacam o aprimoramento do ensino de aplica????o e novas tecnologias. Ao longo das nove edi????es do curso, percebe-se que os principais objetivos do projeto inicial da carreira permaneceram, mesmo com todas as descontinuidades administrativas. Preservaram-se o perfil generalista e as policompet??ncias na forma????o do EPPGG, a fim de permitir ao profissional uma vis??o abrangente e integrada dos complexos problemas da administra????o p??blica e desenvolver a capacidade de analisar, decidir e buscar os melhores resultados em prol do cidad??o, conduzindo as rela????es e as atividades profissionais de acordo com os princ??pios da ??tica p??blica.

Ensino primário e matemática dos imigrantes e descendentes germânicos em Santa Leopoldina (1857-1907)

O objetivo da pesquisa é descrever o cenário da imigração germânica no século XIX, tratando também, de trilhar o caminho da educação por meio de educadores e das comunidades na Colônia de Santa Leopoldina, criada em 1857, na Província do Espírito Santo, considerando 50 anos a partir do início da imigração (1857-1907). A pesquisa histórica ancorou-se em consultas a documentos oficiais do Império, documentos e relatórios oficiais dos Presidentes da Província do Espírito Santo, jornais de circulação da época, fotografias, mapas geográficos, mapas estatísticos, livros didáticos antigos e livros de autores que abordaram o processo imigratório do Espírito Santo. O diálogo com Marc Bloch ajudou a entender essa multiplicidade de documentos, na complexa relação entre o passado e o presente da educação do Espírito Santo. O trabalho apresenta uma trajetória do imigrante germânico vindo da Europa até a ex-colônia e como a administração da província tratou a imigração e a educação. O ensino primário iniciou-se a partir de iniciativas públicas e particulares. Foram identificados as primeiras escolas e os nomes de muitos professores que atuaram no período estudado. Os livros utilizados nas escolas das comunidades teuto-brasileiras eram oriundos da Alemanha e posteriormente foram produzidos no sul do Brasil. Entre os livros escritos em alemão encontrados destacam-se o livro texto de alfabetização „Lese – Schule I für Deutsche Kinder in Brasilien‟, editado na Alemanha no final do século XIX, de autoria do diretor de uma escola particular em Santa Leopoldina, Albert Richard Dietze, e o primeiro volume do livro de matemática „Rechenbuch für Deutsch-Brasilianische Volksschulen‟, de Ferdinand Hackbart, Konrad Glaus e Hermann Lange. Foi feita uma análise sob os aspectos físicos e formais, o processo de ensino e os conteúdos do livro de matemática. A análise evidenciou que a proposta de ensino apoia-se no “cálculo mental” e o escrito, com a repetição dos conteúdos, envolvendo o treino intensivo. Os conceitos de matemática são apresentados partindo de problemas com situações concretas do aluno para a aquisição de competências necessárias para inserir o aluno em sua comunidade. Levando-se em conta que o livro foi editado em 1906, conclui-se que se trata de uma obra relevante com uma proposta de ensino que se manteve presente nos livros didáticos de matemática até os dias atuais.