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Intergenerational practice, where children and older adults come together for shared activities, has grown in popularity in many Western countries. However, research about intergenerational practice, particularly in the UK, is limited. This paper reports on the findings from an exploratory case study about a small intergenerational project between a maintained nursery school and a residential care home for older adults with dementia in the South-East of England. The methodology was informed by a narrative dialogic approach drawing on the work of Bakhtin. Data was collected using naturalistic observations of children's weekly visits to the care home and qualitative interviews with nursery school practitioners. The analysis explores how meaningful interactions were created between the children, the older adults, and the nursery school practitioners. Our findings suggest that singing, unstructured moments, continuity, context (open spaces/flexible sessions), and objects contribute to meaningful interactions between young children and older adults. The ability to be flexible and "go with the moment" were identified as key skills for practitioners supporting children and older adults. We conclude that intergenerational projects afford benefits not just for children and older adults, but also for practitioners in the form of "emotional rewards". The importance of re-establishing intergenerational practice is recognised, as well as the ways in which barriers created by social distancing might safely be addressed through the use of outdoor spaces and digital technologies. Supplementary Information: The online version contains supplementary material available at 10.1007/s10643-022-01330-5.
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BACKGROUND: Consumer-driven homecare models support aging and disabled individuals to live independently through the services of homecare workers. Although these models have benefits, including autonomy and control over services, little evidence exists about challenges homecare workers may face when providing services, including workplace violence and the negative outcomes associated with workplace violence. This study investigates the prevalence of workplace violence among homecare workers and examines the relationship between these experiences and homecare worker stress, burnout, depression, and sleep. METHODS: We recruited female homecare workers in Oregon, the first US state to implement a consumer driven homecare model, to complete an on-line or telephone survey with peer interviewers. The survey asked about demographics and included measures to assess workplace violence, fear, stress, burnout, depression and sleep problems. RESULTS: Homecare workers (n = 1,214) reported past-year incidents of verbal aggression (50.3% of respondents), workplace aggression (26.9%), workplace violence (23.6%), sexual harassment (25.7%), and sexual aggression (12.8%). Exposure was associated with greater stress (p < .001), depression (p < .001), sleep problems (p < .001), and burnout (p < .001). Confidence in addressing workplace aggression buffered homecare workers against negative work and health outcomes. CONCLUSIONS: To ensure homecare worker safety and positive health outcomes in the provision of services, it is critical to develop and implement preventive safety training programs with policies and procedures that support homecare workers who experience harassment and violence.
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Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Auxiliares de Salud a Domicilio/estadística & datos numéricos , Salud Laboral/estadística & datos numéricos , Violencia Laboral/estadística & datos numéricos , Adulto , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oregon/epidemiología , Prevalencia , Investigación Cualitativa , Acoso Sexual , Lugar de Trabajo/estadística & datos numéricosRESUMEN
Recent research has indicated that processing different kinds of action verbs, such as those related to arm or leg movements (e.g. grab, kick), engages regions along the motor strip responsible for the execution of the corresponding actions. It has been proposed that this activation reflects action-related meaning and that these regions are automatically triggered whenever action words are encountered. However, this view is not universally shared by cognitive studies that have shown that the representation of verbs is highly dependent on the interactions with the semantic context. We investigated these views in a set of fMRI studies, in which participants performed a movement localiser task and listened to arm- and leg-related verbs that were presented in isolation (e.g. kick), in literal sentences (as in kick the ball) and idiomatic sentences (as in kick the bucket). We found significant activation in motor regions when action verbs were presented in isolation, and, to a lesser extent, in literal sentential contexts. When the same verbs were presented in idiomatic contexts, activation was found in fronto-temporal regions, associated with language processing, but not in motor and premotor cortices. These results suggest that motor responses were context-dependent, rather than automatic and invariable. These findings lend support to cognitive theories of semantic flexibility, by showing that the nature of the semantic context determines the degree to which alternative senses and particularly relevant features are processed when a word is heard.
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Vías Eferentes/fisiología , Corteza Motora/fisiología , Estimulación Acústica , Lateralidad Funcional/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Movimiento/fisiología , Psicolingüística , Adulto JovenRESUMEN
Both herpes simplex virus encephalitis (HSVE) and semantic dementia (SD) typically affect anterior temporal lobe structures. Using voxel-based morphometry (VBM), this study compared the structural damage in four HSVE patients having a semantic deficit particularly affecting knowledge of living things and six SD patients with semantic impairment across all categories tested. Each patient was assessed relative to a group of control subjects. In both patient groups, left anterior temporal damage extended into the amygdala. In patients with HSVE, extensive grey matter loss was observed predominantly in the medial parts of the anterior temporal cortices bilaterally in SD patients the abnormalities extended more laterally and posteriorly in either the left, right or both temporal lobes. Based on a lesion deficit rationale and converging results from several other sources of evidence, we suggest that (i) antero-medial temporal cortex may be important for processing and differentiating between concepts that are 'tightly packed' in semantic space, such as living things, whereas (ii) inferolateral temporal cortex may play a more general role within the semantic system.
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Afasia/patología , Lesiones Encefálicas/patología , Demencia/patología , Encefalitis por Herpes Simple/patología , Lóbulo Temporal/patología , Adulto , Anciano , Amígdala del Cerebelo/patología , Afasia/psicología , Lesiones Encefálicas/psicología , Mapeo Encefálico/métodos , Demencia/psicología , Encefalitis por Herpes Simple/psicología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Recuerdo Mental , Persona de Mediana Edad , Pruebas Neuropsicológicas , Reconocimiento en Psicología , SemánticaRESUMEN
The conceptual structure account of semantic memory (CSA; L. K. Tyler & H. E. Moss, 2001) claims that feature correlation (the degree to which features co-occur) and feature distinctiveness (the number of concepts in which a feature occurs) interact with domains of knowledge (e.g., living vs. nonliving) such that the distinctive features of nonliving things are more highly correlated than the distinctive features of living things. Evidence for (B. Randall, H. E. Moss, J. M. Rodd, M. Greer, & L. K. Tyler, 2004) and against this claim (G. S. Cree, C. McNorgan, & K. McRae, 2006) has been reported. This comment outlines the CSA, discusses Cree et al.'s (2006) critiques of the Randall et al. (2004) experiments and the CSA, and reports new analyses of property norm and behavioral data, which replicate the results reported by Randall et al. (2004).
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Formación de Concepto , Recuerdo Mental , Reconocimiento Visual de Modelos , Semántica , Aprendizaje Discriminativo , Humanos , Psicolingüística , Tiempo de Reacción , Disposición en PsicologíaRESUMEN
Patients with semantic impairments sometimes demonstrate category-specific deficits suggesting that the anatomical substrates of semantic memory may reflect categorical organisation, however, neuroimaging studies have failed to provide consistent data in support of a category-based account. We conducted three functional neuroimaging experiments to investigate the neural correlates of semantic processing, two with positron emission tomography (PET) and a third with functional magnetic resonance imaging (fMRI). The first experiment used a lexical decision task to search for brain regions selectively activated by concepts from four different categories--animals, fruit, tools, and vehicles. The second experiment used a semantic categorisation task to increase the demands on the semantic system and to look for evidence of consistent activations for the domains of natural kinds or man-made items. The final experiment was a replication of the semantic categorisation task using fMRI to increase the spatial resolution and statistical sensitivity of the experiment. The results of these experiments reliably identified a distributed neural system common to both natural kinds and artifacts but failed to find robust evidence of functional segregation by domain or categories. Category effects were neither reliable nor consistently present across experiments although some were consistent with previous studies. We discuss the implications of these findings, arguing that they are most consistent with a semantic system undifferentiated by category at the neural level.
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Imagen por Resonancia Magnética , Trastornos de la Memoria/diagnóstico por imagen , Trastornos de la Memoria/patología , Tomografía Computarizada de Emisión , Adulto , Análisis de Varianza , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Humanos , Masculino , Trastornos de la Memoria/fisiopatología , Persona de Mediana Edad , Tiempo de Reacción , Sensibilidad y Especificidad , Análisis y Desempeño de TareasRESUMEN
Patients with category-specific deficits have motivated a range of hypotheses about the structure of the conceptual system. One class of models claims that apparent category dissociations emerge from the internal structure of concepts rather than fractionation of the system into separate substores. This account claims that distinctive properties of concepts in the living domain are vulnerable because of their weak correlation with other features. Given the assumption that mutual activation among correlated properties produces faster activation in the normal system, the authors predicted a disadvantage for the distinctive features of living things for unimpaired adults. Results of a speeded feature verification study supported this prediction, as did a computational simulation in which networks mapped from orthography to semantics.
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Atención , Formación de Concepto , Aprendizaje por Asociación de Pares , Tiempo de Reacción , Adolescente , Adulto , Aprendizaje Discriminativo , Femenino , Humanos , Masculino , Modelos Estadísticos , Redes Neurales de la Computación , Psicolingüística , Psicometría/estadística & datos numéricos , Lectura , Análisis de Regresión , Semántica , Disposición en Psicología , Estadística como AsuntoRESUMEN
Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed.
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Servicios de Atención de Salud a Domicilio , Violencia Laboral/estadística & datos numéricos , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Salud Laboral , OregonRESUMEN
Spreading odontogenic infections are a common source of hospital admissions to Oral and Maxillofacial Surgery (OMFS) units. This report describes an unusual reaction to routine treatment for a spreading odontogenic infection in a healthy male with no known allergies, requiring the patient to be managed supportively in the resuscitation room. The patient deteriorated rapidly after the administration of paracetamol, intravenous fluids, steroids and antibiotics, demonstrating delusional behaviour, fever, rigors, tachycardia and hypoxia. Fever associated with sepsis can lead to confusional states, but similar symptoms have been described in the literature as a reaction to antibiotic therapy known as Jarisch-Herxheimer (J-H) reaction. This is potentially the first time a J-H like reaction has been described in the context of dental sepsis. The authors feel that the OMFS team should be aware of possible sequelae of medical therapy in patients with acute dental sepsis and be confident in their management of these complications.
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Deluciones/inducido químicamente , Tercer Molar , Sepsis/tratamiento farmacológico , Diente Impactado/complicaciones , Antibacterianos/efectos adversos , Deluciones/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Radiografía Panorámica , Sepsis/diagnóstico , Sepsis/etiología , Diente Impactado/diagnóstico , Adulto JovenRESUMEN
Fracture healing is a complex physiological process. Local vascularity at the site of the fracture has been established as one of the most important factors influencing the healing process, and lack of vascularity has been implicated in atrophic non unions. Existing research has primarily involved utilising Mesenchymal Stem Cells (MSCs) to augment bone healing but there remains much scope to explore the role of stem cells in the vascularisation process. Endothelial Progenitor Cells (EPCs) and other Endothelial Cellular populations (ECs) could constitute a valid alternative to MSCs. This systematic review is examining the importance of co-implantation of MSCs and EPCs/ECs for bone healing. A literature search was performed using the Cochrane Library, OVID Medline, OVID EMBASE and Google Scholar, searching for combinations of the terms EPCs, Endothelial progenitor cells, angiogenesis, fracture, bone and healing. Finally 18 articles that fulfilled our criteria were included in this review. ECs could be of value for the treatment of critical size bone defects as they are known to be capable of forming ectopic, vascularised bone. The co-implantation of ECs with MSCs is more intriguing when we take into account the vast array of complex reciprocal interactions between ECs and MSCs.
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Regeneración Ósea , Células Endoteliales/trasplante , Endotelio/citología , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/fisiología , Animales , Células Endoteliales/fisiología , Curación de Fractura , Regeneración Tisular Dirigida , Humanos , Neovascularización Fisiológica , Ingeniería de Tejidos , Andamios del TejidoRESUMEN
OBJECTIVES: Intimate partner violence (IPV) is a significant global public health concern, affecting 5.3 million US individuals annually. An estimated 1 in 3 women globally are abused by an intimate partner in their lifetime, and the effects carry over into the workplace. This article examines employers' perceptions of IPV in the workplace, targeting supervisors of Latina employees. METHODS: Fourteen employers and supervisors of small service-sector companies in Oregon were interviewed using semi-structured interviews. Interpretive description was used to identify themes. These qualitative interviews preceded and helped to formulate a larger workplace intervention study. RESULTS: THE FOLLOWING THEMES WERE FOUND AND ARE DETAILED: (1) factors associated with recognizing IPV in the workplace, (2) effects of IPV on the work environment and (3) supervisors' responses to IPV-active vs. passive involvement. Also, supervisors' suggestions for addressing IPV in the workplace are summarized. CONCLUSION: These findings demonstrate the need for more IPV-related resources in the workplace to be available to supervisors as well as survivors and their coworkers. The needs of supervisors and workplaces vary by site, demonstrating the need for tailored interventions, and culturally appropriate workplace interventions are needed for Latinas and other racially and ethnically diverse populations.
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AIM: This paper describes how an acute teaching trust established the role of Senior Nurses (Modern Matrons) and an audit that was undertaken 12 months after they were appointed to evaluate the role. BACKGROUND: The concept of the Modern Matron was introduced in 2000 and all trusts had to implement the role by April 2002. METHODS: The audit comprised: measurement of progress against agreed corporate objectives and questionnaires to all senior nurses and a range of trust staff staff. RESULTS: The following themes were identified: Senior Nurse post, patient care, infection control and leadership. Senior nurses were found to be satisfied with their role and the preparation for and understanding of their role seemed to be successful. There were many improvements such as a reduction in drug errors, complaints and MRSA bacteriaemias. CONCLUSIONS: Implementation of the Modern Matron role has been successful and made improvements in patient care.
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Actitud del Personal de Salud , Enfermeras Administradoras/organización & administración , Rol de la Enfermera , Supervisión de Enfermería/organización & administración , Competencia Clínica , Inglaterra , Necesidades y Demandas de Servicios de Salud , Hospitales de Enseñanza , Humanos , Relaciones Interprofesionales , Perfil Laboral , Satisfacción en el Trabajo , Liderazgo , Enfermeras Administradoras/educación , Enfermeras Administradoras/psicología , Rol de la Enfermera/psicología , Auditoría de Enfermería , Investigación en Evaluación de Enfermería , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/psicología , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Calidad de la Atención de Salud/normas , Apoyo Social , Encuestas y Cuestionarios , Estudios de Tiempo y Movimiento , Gestión de la Calidad Total/organización & administraciónRESUMEN
Recent research has indicated that anteromedial temporal cortex (including the perirhinal cortex) may function as the endpoint of a hierarchically organized visual object-processing network providing the basis for fine-grained discrimination among objects. The present study examines whether the same system is involved in processing conceptual information when concepts, and their properties, are denoted by words. A lesion-behavior correlational study was conducted in which cortical damage in 21 brain-damaged patients was correlated with behavioral scores in a verbally presented property verification task. Results indicated that the neural correlates of conceptual processing depend on the dynamic interaction between the content of a conceptual representation and the specific demands of the task and that the role of anteromedial temporal cortex in this process is not limited to the visual input modality. The results are consistent with the claim that anteromedial temporal cortex provides the neural structure necessary for the emergence of fine-grained conceptual knowledge about objects, although the region is strongly weighted toward processing of visually based object features.
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Aprendizaje por Asociación , Trastornos del Conocimiento/fisiopatología , Cognición , Tiempo de Reacción , Reconocimiento en Psicología , Percepción del Habla/fisiología , Lóbulo Temporal/fisiopatología , Adaptación Fisiológica/fisiología , Adulto , Anciano , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Análisis y Desempeño de TareasRESUMEN
Knowledge of objects in the world is stored in our brains as rich, multimodal representations. Because the neural pathways that process this diverse sensory information are largely anatomically distinct, a fundamental challenge to cognitive neuroscience is to explain how the brain binds the different sensory features that comprise an object to form meaningful, multimodal object representations. Studies with nonhuman primates suggest that a structure at the culmination of the object recognition system (the perirhinal cortex) performs this critical function. In contrast, human neuroimaging studies implicate the posterior superior temporal sulcus (pSTS). The results of the functional MRI study reported here resolve this apparent discrepancy by demonstrating that both pSTS and the perirhinal cortex contribute to crossmodal binding in humans, but in different ways. Significantly, only perirhinal cortex activity is modulated by meaning variables (e.g., semantic congruency and semantic category), suggesting that these two regions play complementary functional roles, with pSTS acting as a presemantic, heteromodal region for crossmodal perceptual features, and perirhinal cortex integrating these features into higher-level conceptual representations. This interpretation is supported by the results of our behavioral study: Patients with lesions, including the perirhinal cortex, but not patients with damage restricted to frontal cortex, were impaired on the same crossmodal integration task, and their performance was significantly influenced by the same semantic factors, mirroring the functional MRI findings. These results integrate nonhuman and human primate research by providing converging evidence that human perirhinal cortex is also critically involved in processing meaningful aspects of multimodal object representations.
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Mapeo Encefálico/métodos , Encéfalo/patología , Corteza Cerebral/patología , Procesos Mentales , Adolescente , Adulto , Anciano , Conducta , Encéfalo/anatomía & histología , Corteza Cerebral/anatomía & histología , Aprendizaje Discriminativo , Femenino , Humanos , Conocimiento , Imagen por Resonancia Magnética , Masculino , Memoria , Persona de Mediana Edad , Reconocimiento Visual de ModelosRESUMEN
How objects are represented and processed in the brain remains a key issue in cognitive neuroscience. We have developed a conceptual structure account in which category-specific semantic deficits emerge due to differences in the structure and content of concepts rather than from explicit divisions of conceptual knowledge in separate stores. The primary claim is that concepts associated with particular categories (e.g., animals, tools) differ in the number and type of properties and the extent to which these properties are correlated with each other. In this review, we describe recent neuropsychological and neuroimaging studies in which we have extended our theoretical account by incorporating recent claims about the neuroanatomical basis of feature integration and differentiation that arise from research into hierarchical object processing streams in nonhuman primates and humans. A clear picture has emerged in which the human perirhinal cortex and neighbouring anteromedial temporal structures appear to provide the neural infrastructure for making fine-grained discriminations among objects, suggesting that damage within the perirhinal cortex may underlie the emergence of category-specific semantic deficits in brain-damaged patients.
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Mapeo Encefálico , Procesos Mentales/fisiología , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/fisiología , Animales , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Oxígeno/sangre , Lóbulo Temporal/irrigación sanguíneaRESUMEN
The Symposium entitled 'Conceptual Knowledge: Developmental, Biological, Functional and Computational Accounts' was held at the British Academy, London, UK on 24-26 June 2002. It was funded by the British Academy with support from the Novartis Foundation, and organized by Lorraine Tyler (University of Cambridge, UK) and Tim Shallice (University College London, UK).