Approaches to the longstanding challenges of 'integrating' subject-based and work-based knowledge have typically focused on questions of how learning can be 'transferred' from one setting to another, relating the assumed 'abstract' nature of theory to the assumed 'real' nature of practice. This is often seen as a single movement as encapsulated in the term 'from theory to practice'. The authors have developed a fresh approach that concentrates on different forms of knowledge and the ways in which these are contextualised and 're-contextualised' in movements between different sites of learning in colleges and workplaces. While the research has been carried out in a range of professional fields outside nursing, the arguments put forward by the authors are relevant to continuing debates within nursing around the theory-practice gap. The aim has been to explore how the subject-based and work-based aspects of a curriculum or learning programme can articulate with one another more effectively. The potential of the 're-contextualisation' approach for nurse education is outlined, with a view to further research. The original research was sponsored by the London Chamber of Commerce and Industry Commercial Education Trust and the Economic and Social Research Council Teaching and Learning Research Programme.

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Abstract-We explored the buildup and decay of threshold elevation during and after adaptation to sinewave gratings in a series of experiments investigating the effects of adapting time, adapting contrast, spatial frequency and retinal eccentricity. Contrast thresholds for vertical sinewave gratings truncated in space by a one-dimensional Gaussian envelope were measured before and after adaptation to a full-field suprathreshold grating of the same spatial frequency and orientation. Thresholds were measured intermittently after adaptation in a "seen/not-seen" single presentation procedure until these thresholds returned to baseline values. The first test grating was presented 300 msec after the offset of the adapting stimulus, and thereafter at regular intervals. At different times after adaptation, contrast thresholds were estimated by off-line analysis of the data using the QUEST algorithm. Adapting time was either 1, 10, 108 or 1000 set and adapting contrast was either 9, 19, 29 or 39 dB (re. 1%). The test gratings were presented centered either at the fixation point or at 5 and 10 deg eccentricity along the horizontal meridian. The results suggest that up to the saturation level the buildup and the decay of adaptation to contrast is well described by a power function of time. The slope of the best fitting line on log-log axes is fairly constant for the adaptation times tested. As reported earlier, thresholds increased with adapting contrast and these contrast-dependent differences were evident 3OOmsec after the termination of adaptation. Adaptation at 10 deg eccentricity yielded slightly higher threshold elevations than for central vision. Based on these results, a description is given of the dynamic response of the underlying neural mechanisms.

The purpose of this study was to determine the reliability and validity of selected pain intensity scales such as the Faces Pain Scale (FPS), the Verbal Descriptor Scale (VDS), the Numeric Rating Scale (NRS), and the Iowa Pain Thermometer (IPT) to assess pain in cognitively impaired older adults. A descriptive correlational design was used, and a convenience sample of 66 volunteers age 60 and older residing in assisted living facilities in the South was recruited for this study. The sample included 22 (33%) men and 44 (67%) women, with a mean age of 76. Ninety-eight percent (65) of the sample comprised Caucasian participants, with the exception of 1 African-American man. Seventy percent (47) completed high school and/or college. The mean Mini Mental State Exam (MMSE) score was 16, with a range of 1 to 29. Eighty-five percent scored 24 or lower, indicating some degree of cognitive impairment. The remaining 15% were cognitively intact. All but one participant could use each scale to rate their pain. Concurrent validity of the VDS, NRS, and IPT was supported with Spearman rank correlation coefficients ranging from .78 to .86 in the cognitively impaired group. The FPS, however, demonstrated weak correlations with other scales when used with the impaired group, ranging from .48 to .53. In the cognitively intact group, strong correlations ranging from .96 to .97 were found among all of the scales. Test-retest reliability at a 2-week interval was acceptable in the cognitively intact group (Spearman rank correlations ranged from .67 to .85) and unacceptable for most scales in the cognitively impaired group (correlations ranged from .26 to .67). When asked about scale preference, both the cognitively impaired and the intact groups preferred the IPT and the VDS. This study revealed that cognitive impairment did not inhibit participants' ability to use a variety of pain intensity scales, but the stability issue must be considered.

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A two interval forced choice constant stimuli method was used to determine: (i) the point of subjective equality (PSE); and (ii) the just-noticeable-difference (JND) in contrast for two luminance gratings, one held in short-term visual memory. Psychometric functions for delayed contrast discrimination were determined as a function of spatial frequency from 1 to 8 c/deg, reference contrast from 5 to 60% and inter-stimulus interval from 1 to 10 sec. The PSE for remembered contrast was invariant with spatial frequency and inter-stimulus interval for the three reference contrast levels tested. The JND contrast plotted against spatial frequency followed a U-shaped function with lowest thresholds at around 4 c/deg. The threshold function translates parallel to the sensitivity axis with an increase in either the reference contrast or the inter-stimulus interval. However, the bandpass shape of the threshold function is invariant with both reference contrast and inter-stimulus interval. At 1, 3 and 10 sec inter-stimulus intervals, contrast JNDs increase with reference contrast according to a power law with an average exponent of 0.70. Contrast JNDs also increase as a power function of the inter-stimulus interval with an average exponent of 0.38 for the three reference contrasts tested.

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