Navigating Interprofessional Spaces: Experiences of Clients Living with Parkinson's Disease, Students and Clinical Educators.

When students in interprofessional education and practice programmes partner with clients living with a long-term condition, the potential for a better client and educational experience is enhanced when the focus is on client self-management and empowerment. This paper reports the findings from a phenomenological study into the experiences of five clients, six speech language therapy students, eight physiotherapy students, and two clinical educators participating in a university clinic-based interprofessional programme for clients living in the community with Parkinson's Disease. Collaborative hermeneutic analysis was conducted to interpret the texts from client interviews and student and clinical educator focus groups held immediately after the programme. The overarching narratives emerging from the texts were: "client-centredness"; "who am I/why am I here?"; "understanding interprofessional collaboration and development"; "personal and professional development, awareness of self and others"; "the environment - safety and support". These narratives and the meanings within them were drawn together to develop a tentative metaphor-based framework of "navigating interprofessional spaces" showing how the narratives and meanings are connected. The framework identifies a temporal journey toward interprofessional collaboration impacted by diverse identities and understandings of self and others, varying expectations and interpretations of the programme, intra- and interpersonal, cultural and contextual spaces, and uncertainty. Shifts in being and doing and uncertainty appear to characterise client-driven, self-management focused interprofessional teamwork for all participants. These findings indicate that students need ongoing opportunities to share explicit understandings of interprofessional teamwork and dispel assumptions, since isolated interprofessional experiences may only begin to address these temporal processes.

Auditory selective attention in young and elderly adults: the selection of single versus conjoint features.

The effects of aging on the behavioral and neurophysiological correlates of auditory selective attention were investigated when selection was between either unidimensional or multidimensional stimuli. Attentional processes were studied by recording event-related brain potentials (ERPs) from 16 young (M = 22 years) and 16 elderly adults (M = 74 years) while they detected target tones based on a single location cue or a conjunction of location and pitch cues. Performance declined from the single- to the conjoint-cue task for both age groups but more so for the elderly. The ERP data showed that both age groups used a hierarchical processing strategy to perform the conjoint-cue task, but processing of the pitch dimension took longer for the elderly than for the young. The ERP data also showed that the scalp distribution of a late aspect of the waveform was more restricted in both anterior and posterior directions for the elderly. This suggests that frontal-lobe dependent attentional processes may be less efficacious with aging.

Stimulus characteristics and task category dissociate the anterior and posterior aspects of the novelty P3.

The novelty P3 is an event-related potential component that is most often elicited by environmental sounds within the "novelty oddball" paradigm. Within the context of this paradigm, it is not clear if the novelty P3 can be elicited by deviant stimuli regardless of whether they serve as target or nontarget deviants, or to what extent the physical characteristics of the stimulus contributes to the amplitude of the novelty P3. The current study examines this issue by systematically switching target and nontarget deviants between environmental sounds and tonal stimuli. Participants were 36 young adults. Auditory stimuli were 48 unique tones and 48 unique environmental sounds presented under three experimental conditions. The results showed that target and nontarget deviants elicited novelty P3s with anterior and posterior aspects. The major determinant of the extent of the anterior aspect was the degree of difference between the physical characteristics of the deviant stimuli and the standards. By contrast, the major determinant of the posterior aspect was the task relevance of the deviant stimuli.

Age-related changes in neural trace generation of rule-based auditory features.

Young (M = 22) and elderly volunteers (M = 74) participated in an ERP study that examined rule-based feature ion in the auditory modality. Stimuli were either a frequent ascending tone pair or an infrequent descending tone pair. Tone-pairs were presented under three conditions. Physical feature monaural (1 tone pair), feature monaural (10 tone pairs), and feature binaural (10 tone pairs). Volunteers watched a silent movie during ERP recordings. After completion of the ERP session all volunteers participated in a behavioral discrimination task. MMNs were elicited under all three conditions for the young. For the elderly, MMNs were elicited under both monaural conditions but not under binaural conditions. Behavioral discrimination was high under the physical feature condition but fell to near chance under the two rule-based feature conditions for both age groups. Thus rule-based neural representations were generated for both age groups under monaural conditions, but only for the young under binaural conditions, suggesting that there is an age-related decline in the efficacy of integrating multiple sources into a single auditory stream.