The invisible nature of learning: Patient education in nursing

BackgroundLearning for patients and their families within nurses’ patient- and family-education practice is an important part of person- and family-centred care. Patients and their families must master health promotional or management strategies to optimise their health outcomes. Support is often provided by nurses, but how nurses facilitate each patient’s and their family’s learning, using cognitive learning principles, seems invisible in the nursing literature.AimThis discussion paper examines the important role of cognitive learning within nurses’ patient- and family-education practice. How learning is enabled, the differences between teaching and learning and the role of learning principles are discussed. Shortcomings are identified and possible ways to address these within nurses’ practice are considered.MethodsThe discussion draws on the limited current literature surrounding cognitive learning principles in nurses’ practice and nurses’ awareness of learning principles. Readers are encouraged to question their current conceptualisation of learning and their perceptions and use of learning principles in their practice.Findings and discussionThe learning process within nursing is overshadowed by explanations of teaching strategies, determinants of learning and the learning principles of one specific theorist. The principles of cognitive learning and their role in patient- and family-education are poorly described and possibly poorly understood. This creates a fundamental knowledge gap in nursing practice.ConclusionA significant rethink about the role of learning principles within nurses’ patient- and family-education practice is overdue. These principles need to be explored further by involving nurses, patients and their families to identify how nurses are perceiving and using learning principles in their practice.     

护理教学评价方法的应用现状

从教育评价发展的历史来看,教育评价的发展趋势是从无到有,从单一到多样,评价过程也由封闭逐渐转为开放.西方发达国家护理教育事业起步早,护理教学评价方法较为成熟;而国内护理教育事业起步晚,尽管取得了一定成绩,但在教学评价方面还有待进一步完善和规范.笔者通过文献调研的方法从学校和临床护理教学两个方面综述了护理教学评价方法的应用现状.     

From the Cover: Ecosystem responses in the southern Caribbean Sea to global climate change

Over the last few decades, rising greenhouse gas emissions have promoted poleward expansion of the large-scale atmospheric Hadley circulation that dominates the Tropics, thereby affecting behavior of the Intertropical Convergence Zone (ITCZ) and North Atlantic Oscillation (NAO). Expression of these changes in tropical marine ecosystems is poorly understood because of sparse observational datasets. We link contemporary ecological changes in the southern Caribbean Sea to global climate change indices. Monthly observations from the CARIACO Ocean Time-Series between 1996 and 2010 document significant decadal scale trends, including a net sea surface temperature (SST) rise of ∼1.0 ± 0.14 °C (±SE), intensified stratification, reduced delivery of upwelled nutrients to surface waters, and diminished phytoplankton bloom intensities evident as overall declines in chlorophyll a concentrations (ΔChla = −2.8 ± 0.5%⋅y⁻¹) and net primary production (ΔNPP = −1.5 ± 0.3%⋅y⁻¹). Additionally, phytoplankton taxon dominance shifted from diatoms, dinoflagellates, and coccolithophorids to smaller taxa after 2004, whereas mesozooplankton biomass increased and commercial landings of planktivorous sardines collapsed. Collectively, our results reveal an ecological state change in this planktonic system. The weakening trend in Trade Winds (−1.9 ± 0.3%⋅y⁻¹) and dependent local variables are largely explained by trends in two climatic indices, namely the northward migration of the Azores High pressure center (descending branch of Hadley cell) by 1.12 ± 0.42°N latitude and the northeasterly progression of the ITCZ Atlantic centroid (ascending branch of Hadley cell), the March position of which shifted by about 800 km between 1996 and 2009.     

Panik i Norden

Supplement No. 9 of this journal was devoted to the biology of anxiety and inter alia described the classification of anxiety disorders in DSM-IH and the effect of antidepressant drugs in «panic disorder» (PD). This has incited Professor Thorkil Vanggaard to discuss critically DSM-III in relation to the classical diagnose «anxiety neurosis» (AN) and the use of antidepressant drugs in anxiety that is not part of a depressive syndrome

In this reply the scientific support for separating anxiety states with and without panic attacks, as in DSM-III, is reviewed (mainly studies on outcome of drug therapy and genetic influence). The evidence showing that PD is discriminated from typical and atypical and hence that antidepressant drugs have true antipanic effects is also discussed (mainly that biological markers for depression are not found in PD and that depressive symptoms are by definition excluded in PD)

Finally it is underlined that a thorough discussion of facts, experiences and theories related to PD and AN is urgent. □ Panic disorder, anxiety neuroses, antidepressant treatment.     

Early attachment and maternal insightfulness predict educational placement of children with autism

We examined whether mothers’ insightfulness – their capacity to “see things from the child's point of view” – and children's attachment, both assessed during the preschool years, are associated with the educational placement of children with ASD in middle childhood and early adolescence beyond the prediction offered by children's IQ and interactive competence. 39 boys with autism and their mothers participated. We assessed mothers’ insightfulness, and children's attachment to their mothers, their intelligence and their interactional competencies. The results supported our hypothesis. The emotional quality of the relationship between the children and their mothers during the preschool age, as reflected in the mothers’ insightfulness and the children's attachment security, predicted children's educational placement in inclusive programs 4.5 and 8.5 years later, over and above the prediction offered by children's IQ and their interactive competence.     

不同教学方法对大学生课堂学业情绪的影响

目的 了解教学方法对大学生学业情绪的影响情况.方法 对湖南某高校大一4个教学班168名被试,采用教育实验法探讨了活动教学法、讲授教学法和讨论教学法对大学生课堂学业情绪的影响情况.结果 大学生课堂学业情绪的得分在3种不同教学方法下存在显著差异(F=3.12～27.38,P＜0.05),学生在活动课体验到了更多的积极情绪和更少的消极情绪.结论 活动教学法有利于促进大学生课堂学业情绪的发展.     

Marine biodiversity,ecosystem functioning,and carbon cycles

Although recent studies suggest that climate change may substantially accelerate the rate of species loss in the biosphere, only a few studies have focused on the potential consequences of a spatial reorganization of biodiversity with global warming. Here, we show a pronounced latitudinal increase in phytoplanktonic and zooplanktonic biodiversity in the extratropical North Atlantic Ocean in recent decades. We also show that this rise in biodiversity paralleled a decrease in the mean size of zooplanktonic copepods and that the reorganization of the planktonic ecosystem toward dominance by smaller organisms may influence the networks in which carbon flows, with negative effects on the downward biological carbon pump and demersal Atlantic cod (Gadus morhua). Our study suggests that, contrary to the usual interpretation of increasing biodiversity being a positive emergent property promoting the stability/resilience of ecosystems, the parallel decrease in sizes of planktonic organisms could be viewed in the North Atlantic as reducing some of the services provided by marine ecosystems to humans.