1000 resultados para OUTCOMES


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Anger management interventions with offenders, particularly violent offenders, are a common form of rehabilitative activity. The rationale for addressing anger problems is clear-cut and there is good evidence that anger management can be effective with some client populations. Information relating to effectiveness with serious offenders, however, is sparse. An intervention study is reported in which offenders receiving anger management were compared with waiting list controls on a range of dependent measures. In general, the degree of pre-treatment/post-treatment change was small and experimental versus control differences were not statistically significant. The degree of improvement was found to be predictable from pre-treatment measures of anger and treatment readiness. Explanations of the low impact of anger management on violent offenders are discussed and recommendations made for improving outcomes.

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Purpose: To examine the predictive capability of the demand-control-support (DCS) model, augmented by organizational justice variables, on attitudinal- and health-related outcomes for nurses caring for elderly patients.

Design: The study is based on a cross-sectional survey design and involved 168 nurses working with elderly patients in facilities of a medium to large Australian organization.

Method: Participants were asked to complete a questionnaire consisting of scales designed for measuring independent (e.g., demand, control, support, organizational justice) and dependent (e.g., job satisfaction, organizational commitment, wellbeing and psychological distress) variables. Multiple regression analyses were undertaken to identify significant predictors of the outcome variables.

Findings: The DCS model explains the largest amount of variance across both the attitudinal and health outcomes with 27% of job satisfaction and 49% of organizational commitment, and 33% of psychological distress and 35% of wellbeing, respectively. Additional variance was explained by the justice variables for job satisfaction (5%), organizational commitment (4%), and psychological distress (23%).

Conclusions: Using organizational justice variables to augment the DCS model was valuable in better understanding the work conditions experienced by nurses caring for elderly patients. Inclusion of curvilinear effects added clarity to the potentially artifactual nature of certain interaction variables.

Clinical Relevance: The results indicated practical implications for managers of nurses caring for elderly patients in terms of developing and maintaining levels of job control, support, and fairness, as well as monitoring levels of job demands. The results particularly show the importance of nurses' immediate supervisors.

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The high baseline prevalence of overweight highlighted the pressing need for interventions like Be Active Eat Well (BAEW). The mid-intervention survey found that change was underway. The impact on weight status, behaviours and environments is presented.

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Analyzing GEM 2005 data, we confirm that entrepreneurship and economic development form a U-shaped curve. We seek to understand New Zealand’s large deviation from the modeled curve by analyzing all countries’ deviations from the curve. We make recommendations that would move New Zealand toward the trend line and thus aid in increasing its level of economic development. Our findings more generally suggest how entrepreneurial policies should be designed differently, depending on the current level of economic development and a region’s short and long-term economic goals.

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Analyzing GEM 2005 data, we confirm that entrepreneurship and economic development form a U-shaped curve. We seek to understand New Zealand’s large deviation from the modeled curve by analyzing all countries’ deviations from the curve. We make recommendations that would move New Zealand toward the trend line and thus aid in increasing its level of economic development. Our findings more generally suggest how entrepreneurial policies should be designed differently, depending on the current level of economic development and a region’s short and long-term economic goals.

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Background: Identification of psychosocial issues in pregnant women by screening is difficult because of the lack of accuracy of screening tools, women's reluctance to disclose sensitive issues, and health care practitioner's reluctance to ask. This paper evaluates if a health professional education program, a new (ANEW) approach, improves pregnant women's ratings of care and practitioner's listening skills and comfort to disclose psychosocial issues.

Methods
: Midwives and doctors from Mercy Hospital for Women, Melbourne, Australia, were trained from August to December 2002. English-speaking women (< 20 wks' gestation) were recruited at their first visit and mailed a survey at 30 weeks (early 2002) before and after (2003) the ANEW educational intervention. Follow-up was by postal reminder at 2 weeks and telephone reminder 2 weeks later.

Results: Twenty-one midwives and 5 doctors were trained. Of the eligible women, 78.2 percent (584/747) participated in a pre-ANEW survey and 73.3 percent (481/657) in a post-ANEW survey. After ANEW, women were more likely to report that midwives asked questions that helped them to talk about psychosocial problems (OR 1.45, CI 1.09–1.98) and that they would feel comfortable to discuss a range of psychosocial issues if they were experiencing them (coping after birth for midwives [OR 1.51, CI 1.10–2.08] and feeling depressed [OR 1.49, 1.16–1.93]; and concerns relating to sex [OR 1.35, CI 1.03–1.77] or their relationships [OR 1.36, CI 1.00–1.85] for doctors).

Conclusions: The ANEW program evaluation suggests trends of better communication by health professionals for pregnant women and should be evaluated using rigorous methods in other settings.

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The focus of this doctoral research study is making the most what a person knows and can do, as an outcome from their lifelong learning, so as to better contribute to organisational achievement. This has been motivated by a perceived gap in the extensive literature linking knowledge with organisational achievement. Whereas there is a rich body of literature addressing the meta-philosophies giving rise to the emergence of learning organisations there is, as yet, scant attention paid to the detail of planning and implementing action which would reveal individual/organisational opportunities of mutual advantage and motivate, and sustain, participation at the day-to-day level of the individual. It is in this space that this dissertation seeks to contribute by offering a mechanism for bringing the, hindsight informed, response “but that’s obvious” into the abiding explicit realm at the level of the individual. In moving beyond the obvious which is prone to be overlooked, the emphasis on “better” in the introductory sentence, is very deliberately made and has a link to awakening latent individual, and hence organisational, capabilities that would otherwise languish. The evolved LCM Model – a purposeful integration valuing the outcomes from lifelong learning (the L) with nurturing a culture supporting this outcome (the C) and with responsiveness to potentially diverse motivations (the M) – is a reflective device for bringing otherwise tacit, and latent, logic into the explicit realm of action. In the course of the development of the model, a number of supplementary models included in this dissertation have evolved from the research. They form a suite of devices which inform action and lead to making the most of what an individual knows and can do within the formal requirements of a job and within the informal influences of a frequently invisible community of practice. The initial inquiry drew upon the views and experiences of water industry engineering personnel and training facilitators associated with the contract cleaning and waste management industries. However, the major research occurred as an Emergency Management Australia (EMA) project with the Country Fire Authority (CFA) as the host organisation. This EMA/CFA research project explored the influence of making the most of what a CFA volunteer knows and can do upon retention of that volunteer. In its aggregate, across the CFA volunteer body, retention is a critical community safety objective. A qualitative research, ethnographic in character, approach was adopted. Data was collected through interviews, workshops and outcomes from attempts at action research projects. Following an initial thirteen month scoping study including respondents other than from the CFA, the research study moved into an exploration of the efficacy of an indicative model with four contextual foci – i.e. the manner of welcoming new members to the CFA, embracing training, strengthening brigade sustainability and leadership. Interestingly, the research environment which forced a truncated implementation of action research projects was, in itself, an informing experience indicative of inhibitors to making the most of what people know and can do. Competition for interest, time and commitment were factors governing the manner in which CFA respondents could be called upon to explore the efficacy of the model, and were a harbinger of the influences shaping the more general environment of drawing upon what CFA volunteers know and can do. Subsequent to the development of the indicative model, a further 16 month period was utilised in the ethnographic exploration of the relevance of the model within the CFA as the host organisation. As a consequence, the model is a more fully developed tool (framework) to aid reflection, planning and action. Importantly, the later phase of the research study has, through application of the model to specific goals within the CFA, yielded operational insight into its effective use, and in which activity systems have an important place. The model – now confidently styled as the LCM Model – has three elements that when enmeshed strengthen the likelihood of organisational achievement ; and the degree of this meshing, as relevant to the target outcome, determines the strength of outcome. i.e. - • Valuing outcomes from learning: When a person recognises and values (appropriately to achievement by the organisation) what they know and can do, and associated others recognise and value what this person knows and can do, then there is increased likelihood of these outcomes from learning being applied to organisational achievement. • Valuing a culture that is conducive to learning: When a person, and associated others, are further developing and drawing upon what they know and can do within the context of a culture that is conducive to learning, then there is increased likelihood that outcomes from learning will be applied to organisational achievement. • Valuing motivation of the individual: When a person’s motivation to apply what they know and can do is valued by them, and associated others, as appropriate to organisational achievement then there is increased likelihood that appropriately drawing upon outcomes from learning will occur. Activity theory was employed as a device to scope and explore understanding of the issues as they emerged in the course of the research study. Viewing the data through the prism of activity theory led not only to the development of the LCM Model but also to an enhanced understanding of the role of leadership as a foundation for acting upon the model. Both formal and informal leadership were found to be germane in asserting influence on empowering engagement with learning and drawing upon its outcomes. It is apparent that a “leaderful organisation”, as postulated by Raelin (2003), is an environment which supports drawing upon the LCM model; and it may be the case that the act of drawing upon the model will move a narrowly leadership focused organisation toward leaderful attributes. As foreshadowed at the beginning of this synopsis, nurturing individual and organisational capability is the guiding mantra for this dissertation - “Capability embraces competence but is also forward-looking, concerned with the realisation of potential” (Stephenson 1998, p. 3). Although the inquiry focussed upon a need for CFA volunteer retention, it began with a broader investigation as part of the scoping foundation and the expanded usefulness of the LCM Model invites further investigation. The dissertation concludes with the encapsulating sentiment that “You have really got to want to”. With this predisposition in mind, this dissertation contributes to knowledge through the development and discussion of the LCM model as a reflective device informing transformative learning (Mezirow and Associates 1990). A leaderful environment (Raelin 2003) aids transformative learning – accruing to the individual and the organisation - through engendering and maintaining making the most of knowledge and skill – motivating and sustaining “the will”. The outcomes from this research study are a strong assertion that wanting to make the most of what is known and can be done is a hallmark of capability. Accordingly, this dissertation is a contribution to the “how” of strengthening the capability, and the commitment to applying that capability, of an individual and an organisation.