Patient participation in postoperative care activities in patients undergoing total knee replacement surgery: multimedia intervention for managing patient experience (MIME). Study protocol for a cluster randomised crossover trial

BACKGROUND: Patient participation is an important indicator of quality care. Currently, there is little evidence to support the belief that participation in care is possible for patients during the acute postoperative period. Previous work indicates that there is very little opportunity for patients to participate in care in the acute context. Patients require both capability, in terms of having the required knowledge and understanding of how they can be involved in their care, and the opportunity, facilitated by clinicians, to engage in their acute postoperative care. This cluster randomised crossover trial aims to test whether a multimedia intervention improves patient participation in the acute postoperative context, as determined by pain intensity and recovery outcomes.

METHODS/DESIGN: A total of 240 patients admitted for primary total knee replacement surgery will be invited to participate in a cluster randomised, crossover trial and concurrent process evaluation in at least two wards at a major non-profit private hospital in Melbourne, Australia. Patients admitted to the intervention ward will receive the multimedia intervention daily from Day 1 to Day 5 (or day of discharge, if prior). The intervention will be delivered by nurses via an iPad™, comprising information on the goals of care for each day following surgery. Patients admitted to the control ward will receive usual care as determined by care pathways currently in use across the organization. The primary endpoint is the "worst pain experienced in the past 24 h" on Day 3 following TKR surgery. Pain intensity will be measured using the numerical rating scale. Secondary outcomes are interference of pain on activities of daily living, length of stay in hospital, function and pain following TKR surgery, overall satisfaction with hospitalisation, postoperative complications and hospital readmission.

DISCUSSION: The results of this study will contribute to our understanding of the effectiveness of interventions that provide knowledge and opportunity for patient participation during postoperative in-hospital care in actually increasing participation, and the impact of participation on patient outcomes. The results of this study will also provide data about the barriers and enablers to participation in the acute care context.

Student participation in professional organisations: the need for innovation

Professional organisations in construction management and builtenvironment list many benefits of membership, including professionaldevelopment and engagement with fellow professionals. However,despite free membership for students, their membership and retention isgenerally low and it is important for the future of professionalorganisations to determine reasons for this disinterest. Do currentstudents understand the benefits of professional organisations and placeany value on membership? This paper presents the findings of a researchproject to better understand why recruitment of students and their activeparticipation in professional organisations is low. A questionnaire surveywas conducted across the students of the degrees of constructionmanagement in Deakin University to obtain the evaluations of themembership, while interviews were undertaken with representatives ofprofessional organisations to determine the alignment between theparties. Student expectations of membership were shown to be amismatch with the stated benefits offered by the professionalorganisations, or at least with how these benefits are communicated.Possible improvements are suggested to ensure that, in this era of instantcommunications and access to information, professional organisationsinnovate to remain relevant to the future leaders of their industry.

Do cognitive, language, or physical impairments affect participation in a trial of self-management programs for stroke?

BACKGROUND: Research studies may have limited generalizability when survivors of stroke with physical, language, or cognitive impairments are excluded. AIMS: To assess whether presence of cognitive, language, or global impairments affects participation in self-management programs.

METHODS: Stroke survivors were recruited in South Australia from seven hospitals or via advertisements into a randomized controlled trial (1:1:1 ratio) of a Stroke Self-Management Program, the Stanford chronic condition self-management program, or standard care. Impairment status was measured using: Cognistat (cognition), Frenchay Aphasia assessment (language), modified Rankin Score (mRS; where score 3-5 = global disability).

PRIMARY OUTCOMES: participation (i.e. booked, accessed, and completed a program (defined as attending&thinsp;≥&thinsp;50% of sessions)) and safety (i.e. adverse events). Outcomes were compared by impairment status. RESULTS: Among 315 people screened 143/149 eligible were randomized (median age 71 years; 41% male; with impairments: 62% cognitive, 34% language, 64% global disability). Participation did not differ by cognitive or language impairment status (cognitive 75%, no cognitive 68%, p&thinsp;=&thinsp;0.54; language 78%, no language 69%, p&thinsp;=&thinsp;0.42). However, participation did vary by global impairment status (global disability 61%, no disability 96%, p&thinsp;<&thinsp;0.001). Participants with cognitive impairment experienced more adverse events (severe n&thinsp;=&thinsp;9 versus no cognitive impairment n&thinsp;=&thinsp;1).

CONCLUSION: Survivors of stroke with cognitive, language, or global impairments are able to participate in self-management programs and should be included in these types of research studies or programs. Reduced participation by those with global disability and the possibility of more adverse events in people with cognitive impairments needs to be considered.

Mathematical pedagogical content knowledge in early childhood education: A study in initial teacher education in Portugal

The study aims to explore the specificity of mathematics Pedagogical Content Knowledge in Early Childhood Education Pedagogy. The pedagogy of ECE (Siraj-Blatchford, 2010) and the didactics of ECE (Pramling & Pramling-Samuelsson, 2011) suggest dimensions of knowledge that require strong content and PC knowledge of teachers. Recent studies about PCK of ECE teachers highlight similar specific dimensions: organization of educational environment and interactions with children (Lee, 2010, McCray, 2008, Rojas, 2008). The current framework for ECE Teacher Education in Portugal (since 2007) focuses both content knowledge and subject didactics. PCK has been labelled the 'great unknown' in ECE (Rojas, 2008) in traditions where the child's development is considered as the main knowledge base for ECE (Chen & McNamee, 2006, Cullen, 2005, Hedges & Cullen, 2005). We studied the perspectives of 27 initial teacher education students about knowledge for teaching and about ECE Pedagogy. We used one open-ended questionnaire and students' analysis of episodes focusing children's answers or discourse relevant for mathematics (about high numbers and square root). The questionnaire was anonymous and students’ permission to use the answers was obtained. In the questionnaire, interactions with children (62%) and organization of the educational environment (38%) are highlighted as the most important focus for the teacher. Students suggested tasks that were adult planned and oriented to further the situations presented in the episodes. Very few references to children's exploratory actions (Bonawitz et al., 2011) were made. The specificity of ECE (child initiated activities, e.g.) needs to be further developed in initial teacher education.

Digging Deeper than Platinum: South Africa's Participation in an Emergent Fuel Cell Industry

Thesis (Master, Environmental Studies) -- Queen's University, 2016-09-09 11:52:31.446

The role of area-level deprivation and gender in participation in population-based faecal immunochemical test (FIT) colorectal cancer screening

This study aimed to investigate the effects of sex and deprivation on participation in a population-based faecal immunochemical test (FIT) colorectal cancer screening programme. The study population included 9785 individuals invited to participate in two rounds of a population-based biennial FIT-based screening programme, in a relatively deprived area of Dublin, Ireland. Explanatory variables included in the analysis were sex, deprivation category of area of residence and age (at end of screening). The primary outcome variable modelled was participation status in both rounds combined (with “participation” defined as having taken part in either or both rounds of screening). Poisson regression with a log link and robust error variance was used to estimate relative risks (RR) for participation. As a sensitivity analysis, data were stratified by screening round. In both the univariable and multivariable models deprivation was strongly associated with participation. Increasing affluence was associated with higher participation; participation was 26% higher in people resident in the most affluent compared to the most deprived areas (multivariable RR = 1.26: 95% CI 1.21–1.30). Participation was significantly lower in males (multivariable RR = 0.96: 95%CI 0.95–0.97) and generally increased with increasing age (trend per age group, multivariable RR = 1.02: 95%CI, 1.01–1.02). No significant interactions between the explanatory variables were found. The effects of deprivation and sex were similar by screening round. Deprivation and male gender are independently associated with lower uptake of population-based FIT colorectal cancer screening, even in a relatively deprived setting. Development of evidence-based interventions to increase uptake in these disadvantaged groups is urgently required.

Why Physical Geography? An analysis of justifications in teacher magazines in Germany

School geography is often quite different from academic geography and there are good reasons for that, as school is preparing young people to be able to lead the life they value instead of just training them to learn specific subject contents. In some countries school geography is understood as being mainly a social science. Nonetheless physical geography often plays an important part in textbooks and in everyday teaching in these countries. This presentation will examine how physical geography topics are justified in specialist teacher magazines in Germany. Are they justified by simply pointing at the value of the academic knowledge itself? Are they justified by claiming students’ special interest in these topics? Or are they justified by showing the value of physical geography in promoting social aims such as sustainable development, freedom or equality?

Widening participation in Australia: lessons on equity, standards, and institutional leadership

Widening participation movements inevitably give rise to discussions of the false dichotomy between equity and standards. The assumption is that by allowing differently prepared students into university and thereby improving equity, standards are somehow compromised. A recent national Australian study examined effective teaching and support of university students from low socio-economic status (LSES) backgrounds from the conceptual framework of bridging sociocultural incongruity rather than from a deficit perspective that assumes lower standards are operating. This chapter outlines the findings from that study of relevance to institutional leaders and policy makers. It draws on the rich qualitative data to show that, contrary to claims of lowered standards, students from low socio-economic backgrounds are high achievers who both expect and want high academic standards. It argues that the dichotomy between equity and standards is premised on an assumption of deficit in, and fundamental lack of respect for, students from diverse backgrounds which undermines the widening participation agenda. Where the false dichotomy exists in institutions, a situation is created which mitigates against LSES students feeling empowered to achieve high academic standards and overall success. It presents the key factors for empowering students from low socio-economic backgrounds to achieve academic success of the highest standard.

Educating for designing in and planning for country: Empowering built environment students with Indigenous protocols and knowledge

Increasingly, built environment professionals in Australia, including architect, landscape architect and planner practitioners, are becoming involved in planning and design of projects for, and in direct consultation with Indigenous communities and their proponents. Critically, built environment professionals must be able to plan and design, and demonstrate respect for Indigenous protocols, cultural issues and their community values. Yet many students graduate with little or no comprehension of Indigenous knowledge systems or the protocols for engagement with Australian or international Indigenous communities in which they are required to work. This paper reports on a recently completed Office of Learning & Teaching funded project that was designed to improve the knowledge and skills of tertiary students in the built environment professions including proposing strategies and processes to expose students in the built environment professions to Australian Indigenous knowledge systems. This is a positive beginning in a long-term decolonising project.

Intimate partner violence in pregnancy: planning and pregnancy monitoring

The intimate partner violence (IPV) in pregnancy results in risk factors with an impact on maternal and fetal health. There is a tendency to unwanted pregnancies, unplanned and poor adherence to health services, increasing the risk of complications during pregnancy. The aim is describe the prevalence rates of IPV during pregnancy in the Central Region of Portugal and analyse their association with pregnancy planning and frequency of prenatal consultations. There was prevalence of IPV during pregnancy with a significant association to pregnancy planning. Although most women have attended prenatal consultations in the last pregnancy, the late start is associated with the probability of frequency of some type of IPV.

Intimate partner violence in pregnancy: planning and pregnancy monitoring.

The aim is describe the prevalence rates of IPV during pregnancy in the Central Region of Portugal and analyse their association with pregnancy planning and frequency of prenatal consultations.

Rural Participation in the Territorial Development Processes

This paper discusses the urgency of creating a bridge between social participation and civic capacity building.  The permanent dialogue between expert and local knowledge should sustain significant, relevant learning processes from/to the rural areas of the Central American region.  Consistency and persistence of these processes will enhance human welfare based on the changes experienced in the rural areas.  Numerous Central American initiatives require effective social and institutional participation to be implemented.  Education, in its different forms and through its different resources, has the crucial responsibility of helping citizens to take advantage of those initiatives.

Suhteessa kohteeseen ja suhteessa toisiin : Oppiminen ja vuorovaikutus opettajaopiskelijoiden suunnittelutapaamisessa

Objectives. In this research I analyzed the learning process of teacher students in a planning meeting using the expansive learning cycle and types of interaction approaches. In activity theory framework the expansive learning cycle has been applied widely in analyzing learning processes taking several years. However, few studies exist utilizing expansive cycles in analyzing short single meetings. In the activity theory framework talk and interaction have been analyzed using following types of interaction: coordination, cooperation and communication. In these studies single interaction situations have been analyzed, in which the status and power positions of participants has been very different. Interactions of self-directed teams, in which the participants are equal, have been examined very little. I am not aware of any studies, in which both learning actions of the expansive cycle and types of interaction by analyzing the same data would have been utilized. The aim of my study was to describe the process of collaborative innovative learning in a situation where the student group tries to accomplish a broad and ill-defined learning task. I aim to describe, how this planning process proceeds through different phases of learning actions of the expansive cycle. My goal is to understand and describe the transformations in the quality of interaction and transitions which are related to it. Another goal of this study is to specify the possible similarities and differences between expansive learning and types of interactions. Methods. Data of this study consisted of videotaped meetings, which were part of the study module for class teacher degree. The first meeting of the study module was chosen to be the primary research material. Five students were present in the group meeting. Transcription of the conversation was analyzed by classifying the turns of conversation following phases of the expansive cycle. After that the material was categorized again by using types of interaction. Results and conclusions. As a result of this study I was able to trace all the phases of the expansive cycle except one. Also, I was able to identify all interaction types. When I compared the two modes of analysis side by side I was able to find connecting main phases. Thus I was able to identify the interdependence between the two ways of analysis on a higher level, although I was not able to notice correlation on the level of individual phases. Based on this, I conclude that learning of the group was simultaneously specification and formulation of the object at the different phases of expansive learning and transformation of the quality of the interaction while searching for the common object.

Asukkaan Helsinki? : Tapaustutkimus vuorovaikutteisuudesta kaupunkisuunnittelussa

This study examines the interaction between inhabitants and urban planning. In addition to traditional methods of participation there can be seen an increasing need to find new channels and means to influence on one´s environment. Hearing of inhabitants during planning is hoped to decrease the amount of claims and this way to speed up the planning process. Discussion that emphasizes competitiveness and innovativeness in planning has brought out the role of inhabitants as selective consumers and end users. This extension of civil perspective completes the thought of participation in city planning and adds the pressure on developing the interaction and user orientation. The aim of the study is to point out the present situation of inhabitant´s participation and influencing in Helsinki. Helsinki City Planning Department opened a new information and exhibiotion hall called Laituri in 2008. Laituri provides the latest information about planning projects in Helsinki and temporary exhibitions as well as it operates as communication channel and information point for the department. In this study Laituri is examined as a case study of interaction between citizen and planner. The study is divided into two principal themes. The aim is to research action and interactivity at Laituri from the inhabitants´and planners´point of view. The qualitative study has inquiries, interview surveys and observation as research methods. Empiricial data of the study consists of three parts which complement each other: Laituri operational reseach, inquiry directed to the members of Laituri team and interviews of three experts. The aim is to find answers to questions like, does Laituri reach the citizens and will the opportunities to participate improve along Laituri. The study examines also how the local knowledge of inhabitants will come across to planners and further to planning. The study combines discussions of inhabitants´ influencing in Finnish society and science community. Cornerstones of the study are inhabitant participation, interaction and local knowledge in urban planning. The theory behind the study is communicative planning theory. In addition the theory consists of key concepts. The study introduces a concept of Inhabitant´s Helsinki, which reflects the inhabitant as customer-citizen who is an active product developer in participative urban planning. According to the research results the experts of Laituri and majority of inhabitants in Helsinki experience that the inhabitant´s possibilities to participate will improve along Laituri. However half of the citizens in Helsinki believe that local knowledge and ideas will only have minor impact on the final plan. According to city dwellers the present practise used by Helsinki City Planning Department supports only partially adequate interaction. The experts of Laituri experience that the role of Laituri is first of all forum of communication and discussion channel instead of effective local data collector. Based on the results the study introduces a model of inhabitant´s participation field. According to the model Laituri can be seen as phenomenom in Helsinki urban planning which has the elements of network municipality. The planner is more like diplomatic trend-setter and visionary. The inhabitant of Helsinki is an expert in city living and participative producer of local knowledge. Participation methods are increasingly segmented and tailored in every plan and project. The study argues that Inhabitant´s Helsinki is a pluralistic milieu in constant pressure for change. Therefore reaching the everyday life experiencies of inhabintants should be at higher degree in Helsinki City Planning Department´s operations.

Challenging the SD benefits attributed to sport Mega-Events hosting

Sport Mega-event hosting faces opposition that is manifested with different intensity during the different phases of the event, from its inception as an idea to its delivery and legacy. Some Social Movements Organisations (SMOs) have acted as indefatigable monitors of the Sustainable Development (SD) dimension of sporting events in general and, in some of the most recent sport mega-events, in particular the Olympics, they have served as important advisors and facilitators. Nevertheless, in many cases we see enthusiastic supporters turning to vehemently challenging whatever positives have been associated with hosting the event. In addition, there is opposition to sport Mega-events in their entirety. That type of opposition tends to employ a holistic prism that manages to identify multiple interconnected negative aspects of hosting a sport mega-event and incorporate them into an anti-systemic discourse. It is important to bear in mind that irrespective of many proclamations to the opposite as far as megas are concerned (projects and/or events), a number of studies have demonstrated that citizen participation and democratic accountability in decision-making have been notoriously absent. After all, the idea of citizen participation in the planning of sport mega-event is essentially the public response to a plan conceived by others. There were, of course, some notable cases of democratic consultation at the early stages of bidding to host a sport mega-event but these more democratic approaches resulted in the failure of the bid (for e.g. Toronto 1996). The knowledge of this by the groups that initiated the hosting idea and the bidding process has led to discouraging in depth public consultation that may fit perfectly to the democratic process but not to the tight schedules of associated projects completion. That produces ‘autocracy against which opposition may arise’ (Hiller, 2000, p. 198). It is this democratic deficit that has led to important instances of social contestation and protest mobilizations by citizen groups as well as the more regular corps of social activists. From a perspective borrowed from the sociology of protest and social movements, sport mega-events hosting can operate as an issue that stimulates protest activities by an existing protest milieu and new actors as well as an important mobilizing resource. In fact, some scholars have also argued that the Olympic Games were an important frame for the transnational activism that was marked by anti-globalization protest in Seattle in 1999 (Cottrell & Nelson, 201; Lenskyj, 2008). In addition, it’s important not to lose sight of other acts dissent that take place in relatively close proximity, about a year before the event when most infrastructural and societal changes brought by hosting the event and impact start to become apparent by the host communities, like the rioting of August 2011 in the London Olympic Boroughs and the 2012 riots of June 2013 in Sao Paulo and other Brazilian cities. This paper starts by outlining the SD claims made in the bidding to host the summer Olympic Games by five prospective hosts (Sydney; Athens; Beijing; London and Rio) proceeds towards examining the opposition and challenges that was manifested in relation to these claims. In Particular it provides an assessment of protest-events over the aforementioned different phases of sport mega-events hosting. A different picture emerges for each of the host nation that is partly explained by local, national and global configuration of protest politics. Whereas the post-event legacy of the first two hosts of the Games can be assessed and that way see the validity of claims made by challengers in the other phases, in the other three cases, the implementation of Olympic Games Impact (OGI) studies offers the tool for discussing the post-event phase for Beijing and London and engage in a speculative exercise for the case of Rio. Judging by available findings, the paper concludes that the SD aspiration made in the bid documents are unlikely to be met and social contestation based on the same issues is likely to increase due to the current global economic crisis and BRICS, like China and Brazil, having entered the process of becoming global economic hegemons.