311 resultados para Surgical approaches
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The UN Convention on the Rights of Persons with Disability (CRPD) promotes equal and full participation by children in education. Equity of educational access for all students, including students with disability, free from discrimination, is the first stated national goal of Australian education (MCEETYA 2008). Australian federal disability discrimination law, the Disability Discrimination Act 1992 (DDA), follows the Convention, with the federal Disability Standards for Education 2005 (DSE) enacting specific requirements for education. This article discusses equity of processes for inclusion of students with disability in Australian educational accountability testing, including international tests in which many countries participate. The conclusion drawn is that equitable inclusion of students with disability in current Australian educational accountability testing in not occurring from a social perspective and is not in principle compliant with law. However, given the reluctance of courts to intervene in education matters and the uncertainty of an outcome in any court consideration, the discussion shows that equitable inclusion in accountability systems is available through policy change rather than expensive, and possibly unsuccessful, legal challenges.
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In this article, we report on the findings of an exploratory study into the experience of undergraduate students as they learn new mathematical models. Qualitative and quanti- tative data based around the students’ approaches to learning new mathematical models were collected. The data revealed that students actively adopt three approaches to under- standing a new mathematical model: gathering information for the task of understanding the model, practising with and using the model, and finding interrelationships between elements of the model. We found that the students appreciate mathematical models that have a real world application and that this can be used to engage students in higher level learning approaches.
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Objective: A literature review to examine the incorporation of respiratory assessment into everyday surgical nursing practice; possible barriers to this; and the relationship to patient outcomes. Primary argument: Escalating demands on intensive care beds have led to highly dependent patients being cared for in general surgical ward areas. This change in patient demographics has meant the knowledge and skills required of registered nurses in these areas has expanded exponentially. The literature supported the notion that postoperative monitoring of vital signs should include the fundamental assessment of respiratory rate; depth and rhythm; work of breathing; use of accessory muscles and symmetrical chest movement; as well as auscultation of lung fields using a stethoscope. Early intervention in response to changes in a patient's respiratory health status impacts positively on patient health outcomes. Substantial support exists for the contention that technologically adept nurses who also possess competent respiratory assessment skills make a difference to respiratory care. Conclusions: Sub-clinical respiratory problems have been demonstrated to contribute to adverse events. There is a paucity of research knowledge as to whether respiratory education programs and associated inservice make a difference to nursing clinical practice. Similarly, the implications for associated respiratory educational needs are not well documented, nor has a research base been sufficiently developed to guide nursing practice. Further research has the potential to influence the future role and function of the registered nurse by determining the importance of respiratory education programs on post-operative patient outcomes.
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Post-discharge surgical wound infection surveillance is an important part of many infection control programs. It is frequently undertaken by patient self-assessment, prompted either by a telephone or postal questionnaire. To assess the reliability of this method, 290 patients were followed for six weeks postoperatively. Their wounds were photographed and also covertly assessed for signs of infection by two experienced infection control nurses (ICNs). Patients also responded to a postal questionnaire seeking evidence of infection at both week four and week six post-surgery. Correlation between the patient's assessment of their wound and the ICNs diagnosis was poor (r=0.37) with a low positive predictive value (28.7%), although negative predictive value was high (98.2%). Assessment of photos for signs of infection by two experienced clinicians also correlated poorly with the ICNs diagnosis of infection (r=0.54). The patient's recall of prescription of an antibiotic by their general practitioner (GP) for wound infection during the postoperative period correlated best with the ICNs diagnosis (r=0.76). This latter measure, particularly when confirmed by the GP in those patients reporting an infection, appears to provide the most valid and resource efficient marker of post-discharge surgical wound infection.
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Background Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults. Methods Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives. Results Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively. Conclusions The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach.
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Aim This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Background Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. Methods A quasi experimental pre test, post test non–equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. Findings The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. Conclusion The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians.
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During the last four decades, educators have created a range of critical literacy approaches for different contexts, including compulsory schooling (Luke & Woods, 2009) and second language education (Luke & Dooley, 2011). Despite inspirational examples of critical work with young students (e.g., O’Brien, 1994; Vasquez, 1994), Comber (2012) laments the persistent myth that critical literacy is not viable in the early years. Assumptions about childhood innocence and the priorities of the back-to-basics movement seem to limit the possibilities for early years literacy teaching and learning. Yet, teachers of young students need not face an either/or choice between the basic and critical dimensions of literacy. Systematic ways of treating literacy in all its complexity exist. We argue that the integrative imperative is especially important in schools that are under pressure to improve technical literacy outcomes. In this chapter, we document how critical literacy was addressed in a fairytales unit taught to 4.5 - 5.5 year olds in a high diversity, high poverty Australian school. We analyze the affordances and challenges of different approaches to critical literacy, concluding they are complementary rather than competing sources of possibility. Furthermore, we make the case for turning familiar classroom activities to critical ends.
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Responding to the individual needs of the person affected by cancer is a fundamental tenet of nursing care. The evidence base to enable highly personalized approaches to the way we provide care has grown enormously in recent years. Today, we have a much better understanding of the mechanisms underpinning health needs of people with cancer, as well as the wide range of environmental, sociocultural, psychological, and biological influences on these needs. This growing evidence base enables us to better target and tailor interventions in increasingly sophisticated ways.
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This study makes out the case for the use of the Conversational Analytic method as a research approach that might both extricate and chronicle the features of the journalism interview. It seeks to encourage such research to help inform understanding of this form and to provide further lessons as to the nature of journalism practice. Such studies might follow many paths but this paper focuses more particularly on the outcomes for the debate as to the continued relevance of "objectivity" in informing journalism professional practice. To make out the case for the veracity of CA as a means through which the conduct of journalism practice might be explored the paper examines: the theories of the interaction order that gave rise to the CA method; outlines the key features of the journalism interview as explicated through the CA approach; outlines the implications of such research for the establishment of the standing of "objectivity". It concludes as to the wider relevance of such studies of journalism practice for a fracturing journalism field, which suffers from a lack of benchmarks to measure the public benefit of the range of forms that now proliferate on the internet.
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This discussion has outlined a theoretical and pragmatic framework to demonstrate that future research involving the analysis of human performance in surgical should encourage the use of phenomenology to enhance the knowledge base of this area of study. Merging experiential (first-person) and experimental (third-person) methods may possibly help improve research designs and analyses in the investigation of robotics in surgical performance. By relying solely on third-person techniques, the current methodology and interpretation used to analyze human performance in surgical robotics is limited. Recent advances in cognitive science and psychology have also recognized this limitation and have now begun to shift to neurophenomenology. Finally, discussion on recent robotics research presented here demonstrates the potential phenomenology holds for augmenting the methodological and analysis techniques currently used by researchers of human performance in surgical robotics.
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Model-based testing (MBT) relies on models of a system under test and/or its environment to derive test cases for the system. This paper discusses the process of MBT and defines a taxonomy that covers the key aspects of MBT approaches. It is intended to help with understanding the characteristics, similarities and differences of those approaches, and with classifying the approach used in a particular MBT tool. To illustrate the taxonomy, a description of how three different examples of MBT tools fit into the taxonomy is provided.
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The role of the judiciary in common law systems is to create law, interpret law and uphold the law. As such decisions by courts on matters related to ecologically sustainable development, natural resource use and management and climate change make an important contribution to earth jurisprudence. There are examples where judicial decisions further the goals of earth jurisprudence and examples where decisions go against the principles of earth jurisprudence. This presentation will explore judicial approaches to standing in Australia and America. The paper will explore two trends in each jurisdiction. Approaches by American courts to standing will be examined in reference to climate change and environmental justice litigation. While Australian approaches to standing will be examined in the context of public interest litigation and environmental criminal negligence cases. The presentation will draw some conclusions about the role of standing in each of these cases and implications of this for earth jurisprudence.