The Effect of False Positive Feedback on Learning an Inhibitory-Action Task in Older Adults.

Background/Study Context: Older adults show a greater response to feedback whilst learning than younger adults. To date this has only been shown for receiving veridical feedback, but there is evidence that suggests that receiving false positive feedback may further enhance learning. We tested the hypothesis that receiving false positive feedback, being told you are preforming better than expected, would be more advantageous for older than younger adults when learning an inhibitory-action task. Methods: 42 younger and 34 older adults trained to improve their inhibition and response times on the Simon task. They completed 18 training blocks and a retention test two weeks after training. Participants received either false positive feedback or veridical feedback on their performance at the end of each training session and the start of the next session. Those in the false positive feedback group were told they were performing faster than expected. Results: Both older and younger adults improved their inhibition and response times but receiving false positive feedback did not significantly change their rate of learning on these outcomes. However, false positive feedback did impact on accuracy levels with those receiving this type of feedback making fewer errors. Older adults were slower but more accurate than younger adults, but contrary to our hypothesis they did not benefit more from false positive feedback than younger adults. Conclusion: This first direct comparison of the effects of false positive feedback on older and younger adults showed that the positive impact of false positive feedback does not decline with age. We also demonstrated that feedback given about one aspect of a skill (in this case speed) may in fact influence another aspect of the skill (in this case accuracy). This suggests that false positive feedback could be used as a motivational tool to enhance cognitive-motor learning in older adults, but care needs to be taken when using this, as the feedback may not affect the element of the skill at which it is targeted.

Positive PsychoTherapy in ABI Rehab (PoPsTAR): A pilot randomised controlled trial.

Psychological distress is common following acquired brain injury (ABI), but the evidence base for psychotherapeutic interventions is small and equivocal. Positive psychotherapy aims to foster well-being by increasing experiences of pleasure, engagement and meaning. In this pilot trial, we investigated the feasibility and acceptability of brief positive psychotherapy in adults with ABI and emotional distress. Participants were randomised to brief positive psychotherapy plus usual treatment, or usual treatment only. Brief positive psychotherapy was delivered over eight individual out-patient sessions, by one research psychologist. A blinded assessor administered the Depression Anxiety Stress Scales (DASS-21) and the Authentic Happiness Inventory (AHI) at 5, 9 and 20 weeks post-baseline. Of 27 participants randomised (median age 57; 63% male; 82% ischaemic stroke survivors; median 5.7 months post-injury), 14 were assigned to positive psychotherapy, of whom 8 completed treatment. The intervention was feasible to deliver with excellent fidelity, and was acceptable to participants. Retention at 20 weeks was 63% overall. A full-scale trial would need to retain n = 39 per group to end-point, to detect a significant difference in change scores on the DASS-21 Depression scale of 7 points (two-tailed alpha = .05, power = .80). Trials including an active control arm would require larger sample sizes. We conclude that a full-scale trial to investigate efficacy is warranted.

Transcriptionist saturation: knowing too much about sensitive health and social data.

AIM: The paper describes and interprets the experiences of transcriptionists employed to translate recorded auditory research, medical, court data into text and specifically when the research is sensitive and the audio source material may be traumatic to hear. BACKGROUND: This study highlights the ongoing need for transcriptionists to be recognized in the ethics process as a potentially vulnerable group who need greater support and debriefing when transcribing sensitive health and social data. DESIGN: Qualitative research. METHODS: Telephone interviews were conducted with 12 transcriptionists in Australia and New Zealand during 2012, who had transcribed sensitive material and reported issues with transcribing certain topics. Accuracy and confidentiality were paramount in this work. FINDINGS: Seven participants reported negative emotional and physical effects from transcribing sensitive material On the other hand six participants found the work enjoyable. CONCLUSION: The majority of the transcriptionists did not receive any debriefing after transcribing sensitive material. The participants developed their own strategies to deal with the effects of transcribing sensitive materials such as online support groups, relaxation activities and unofficial debriefing with friends and family.

Clients with chronic conditions: community nurse role in a multidisciplinary team.

AIMS AND OBJECTIVES: To define and validate the role of the community nurse in a multidisciplinary team caring for clients with chronic and complex needs. BACKGROUND: A key factor in optimising care for clients with chronic and complex conditions in the community is the use of multidisciplinary teams. A team approach is more effective as it enables better integration of services. The role of the community nurse in the multidisciplinary team has as yet not been delineated. DESIGN: A modified Delphi technique was used in this study. METHODS: A group of 17 volunteer registered nurses who were experienced in the care of clients with chronic conditions and complex care needs in the community formed a panel of experts. Experts were emailed a series of three questionnaires. RESULTS: Main findings show that the role of the community nurse in a multidisciplinary team for clients with chronic conditions has six main domains - advocate, supporter, coordinator, educator, team member and assessor. CONCLUSION: A consensus on the role of the community nurse in the multidisciplinary team is described. The six key role domains reaffirm the generic role of the nurse and the validation of the role clarifies and reinforces the centrality of the community nurse in the team. Further refinement of the community nurse role is indicated to increase comprehensiveness of role descriptors particularly for the role domain, advocate. RELEVANCE TO CLINICAL PRACTICE: Community nurses working in multidisciplinary teams caring for clients with chronic conditions can define their role as a team member. The working relationship of the community nurse with other health professionals in the multidisciplinary team as a key approach to more integrated care for clients and carers enables the use of this approach to be better understood by all team members. With this increased understanding, community nurses are in a position to build stronger and more effective care teams.

Multidisciplinary teams caring for clients with chronic conditions: experiences of community nurses and allied health professionals.

In Western societies the community prevalence of chronic conditions is increasing rapidly. Evidence has shown the benefits of care given to these clients by multidisciplinary teams. However, the experience of diverse health professionals working in these teams is not well understood. This study presents the experiences of members in multidisciplinary teams caring for clients with chronic conditions in the community. A qualitative descriptive study was used with a purposive sample of 34 multidisciplinary team members who participated in focus groups that were audio-taped, transcribed and analysed. Team members' experiences of working in multidisciplinary teams are described within three categories: shared purpose, working in the team, and tensions within the team. The findings provide direction for addressing team effectiveness, including issues of team leadership and evaluation of team performance.

Community cycling exercise for stroke survivors is feasible and acceptable.

Background: Physical activity is recommended after stroke but levels for stroke survivors are typically low. The use of indoor recumbent cycling, delivered through local government leisure facilities, may increase access to exercise among stroke survivors. Objective: This study aimed to evaluate the acceptability and feasibility of an indoor cycling program delivered through existing local government services. Methods: Participants were recruited through stroke liaison nurses and public advertising. After a home visit to assess eligibility and conduct psychological and general health assessments, participants attended their local leisure center for an initial fitness test and short battery of physical tests. Then, an 8 week training program was designed with weekly goals. Following the program the assessments were retaken along with an evaluation questionnaire. In-depth, semi-structured, interviews were conducted with 15 participants and five fitness coaches. Results: One hundred fifteen individuals volunteered to participate during a 10-month recruitment period, 77 met the inclusion criteria and consented, 66/77 (86%) completed the program including all nine non-ambulatory participants. The program and procedures (recruitment and outcome measures) were feasible and acceptable to participants (81% reported following the program). Participants were generally very positive about the experience. Significant improvements in sit-to-stand capacity (Mpre = 25.2 s, Mpost = 19.0 s, p = .002), activities of daily living (NEADL, Mpre = 12.2, Mpost = 13.2, p = .002), psychosocial functioning (SAQOL, Mpre = 3.82, Mpost = 4.15, p = .001), energy (SAQOL, Mpre = 3.75, Mpost = 4.02, p = .018) and depression (GHQ, Mpre = .97, Mpost = .55, p = .009) were observed. Conclusion: A cycling-based exercise program delivered through local leisure center staff and facilities was shown to be feasible and acceptable for people living with stroke.

Supportive expressive therapy--Parent child version: An exploratory study.

Currently, there are no empirically supported psychodynamic treatments for disruptive behavior in young children. Supportive Expressive Therapy--Parent Child (SET-PC) is a newly developed brief psychodynamic psychotherapy that focuses on a parent's internal representations of self and others, particularly as they manifest in problematic parent-child relationships. It is a manualized dyadic therapy that uses videotaped parent-child play sessions followed by parent-therapist discussions. This exploratory study is the first randomized controlled study of SETPC. SET-PC was compared with the Incredible Years Parenting Program (IYPP; Webster-Stratton, 2001), an empirically supported group parent training intervention for child disruptive behavior. Treatment completers were 37 consecutive referrals of parent- child dyads (children ages 30-72 months) to an outpatient psychiatry clinic. SET-PC produced treatment outcomes that were equivalent to IYPP. Both treatments were associated with large effect sizes for decreases in externalizing behavior and for the positive quality of observed parent- child interactions and small effect sizes for improvements in parents' psychological functioning. Treatment gains were maintained at 1-year follow-up regardless of treatment condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Developing a culture to facilitate research capacity building for clinical nurse consultants in generalist paediatric practice.

This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW), Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT) was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge.

Physical activity in pregnancy: women's perceptions, practices, and influencing factors.

INTRODUCTION: Evidence shows that physical activity during and after pregnancy results in health gains for women. There is no clear understanding apparent in the literature of women's experiences with physical activity during their pregnancy. The aim of this study was to describe women's perceptions and participation in physical activity during pregnancy and identify factors influencing participation. METHODS: In this qualitative descriptive study, face-to-face interviews were conducted with 19 women, all at different stages of pregnancy, who were asked about their experiences with physical activity. RESULTS: Data analysis resulted in four categories describing "meaning of physical activity," "perceived benefits of physical activity in pregnancy," "barriers to and motives for participation in physical activity," and "process of engagement in physical activity." The process of engagement in physical activity by women was shown to have three marked phases: "uncertainty," "engaging," and "compromise." DISCUSSION: To facilitate women's self-management across these phases, support is needed that focuses on providing strategies to strengthen individual approaches by women. Such support might promote activities of daily living as a specific entity of physical activity, expose myths about activity during pregnancy, and endorse the benefits of weight management arising from physical activity, not just during pregnancy, but across the lifespan.