The structure of depressive symptom patterns was investigated in a community sample of 344 women between the ages of 51 and 92 who were administered the SCL-90-R Depression and Additional Symptoms Scales. Confirmatory factor analysis was used to test alternative measurement hypotheses implied by clinical formulations of depressive symptom patterns among elderly persons. The findings show support for the hypothesis that 2 somewhat different depressive syndromes, along with 4 more delimited forms of distress, underlie symptom-reporting patterns. Implications of these findings for future research on the relation between aging and depression are discussed.

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This article presents playfulness as an emerging approach to learning in higher education that emphasises the arts and humanities across disciplines. The article is based on a qualitative, hermeneutical literature review in light of educational culture in higher education. The literature review indicates that playful approaches to learning stand in opposition to educational cultures that focus on rapidness and student performance. However, an educational culture of play is about to establish itself, and this culture of play emphasises creativity in learning and human flourishing in education, perspectives that are connected to arts and humanities. The main findings cultures of time, performance and play lead to several questions about societal, institutional, and organisational educational culture, and regarding approaches to teaching, learning, humanity and society. The main contribution of this article is that a focus on playfulness offer the field of arts and humanities new possibilities in future education.

We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation–dwelling adult American Indian men and women with type 2 diabetes who are at high risk for CVD. Enrollment on a rolling basis of 180 planned participants began during 2009; an average 18-month follow-up was completed by June 2011. The primary outcome variable is change in glycosylated hemoglobin level after an average 18-month follow-up period. Secondary outcome variables include changes in low-density lipoprotein cholesterol, systolic blood pressure, body mass index, and smoking status, as well as an evaluation of intervention cost-effectiveness. If effective, the LOWPK trial may serve as a guide for future chronic disease intervention trials in remote, technologically challenged settings.

Based on action research as a practitioner‐involving approach, this article communicates the findings of a two‐year study on implementing patient participation as an empowering learning process for both patients and rehabilitation nurses. At a rehabilitation facility for patients who have sustained spinal cord injuries, eight nurses were engaged throughout the process aiming at improving patient participation. The current practice was explored to understand possibilities and obstacles to patient participation. Observations, interviews and logbooks, creative workshops and reflective meetings led to the development and testing of four new rehabilitation initiatives aimed at enhancing patient participation. This study suggests that skills of critical reflection from action research toolbox shed light on both the notion of patient participation and caring in nursing rehabilitation. By actively involving nurses in research, the knowledge development stems from practice and the solutions therefore became practice‐oriented. In addition, the personal and professional development experienced by the involved nurses points to a secondary gain in the form of an analytical and reflective approach to complex issues in relation to patient participation, rehabilitation in general and the individual nurses' sense of professional pride.