749 resultados para Community healthcare agent


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A community history project must be relevant to each person within it so that they see themselves as part of the socio-cultural fabric of the area and feel a sense of ownership of their environment. The Mill Albion community history project is a diverse, multi-layered public history/art program that captures the social heritage of The Mill Albion and allows the community to contribute to their ongoing history. The Albion Flour Mill was built in 1930 at a time when Australia was feeling the effects of its worst economic depression and continued operations for more than 72 years. After ceasing operation in 2005 the site was left to deteriorate. The FKP Property Group purchased the land to undertake a new urban redevelopment project, drawing on the design principles of a traditional ‘village’, while valuing the importance of remembering the community that once included the Flour Mill. This paper reflects on the this project and showcases some of the culturally creative ways this community’s history was told, using methods such as digital stories, contemporary and historical photography and oral history.

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Purpose Samoan communities in Australia exhibit a disproportionate rate of kidney disease compared with other Australians. This article describes a research project that used a culturally sensitive framework, Fa’afaletui, to help reduce the barriers of language and culture and increase our understanding of the factors contributing to kidney disease, in one Samoan community in Australia. Design Semistructured group interviews were undertaken with Samoan community families and groups. The interviews were analyzed according to key concepts embedded in the Fa’afaletui framework. Findings Four factors associated with health risks in this Samoan community emerged—diet and exercise; issues related to the collective (incorporating the village, church, and family); tapu or cultural protocols; and the importance of language. Conclusions The findings suggest that future kidney health promotion initiatives within this Samoan community will be more effective if they are sensitive to Samoan cultural norms, language, and context.

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Open access reforms to railway regulations allow multiple train operators to provide rail services on a common infrastructure. As railway operations are now independently managed by different stakeholders, conflicts in operations may arise, and there have been attempts to derive an effective access charge regime so that these conflicts may be resolved. One approach is by direct negotiation between the infrastructure manager and the train service providers. Despite the substantial literature on the topic, few consider the benefits of employing computer simulation as an evaluation tool for railway operational activities such as access pricing. This article proposes a multi-agent system (MAS) framework for the railway open market and demonstrates its feasibility by modelling the negotiation between an infrastructure provider and a train service operator. Empirical results show that the model is capable of resolving operational conflicts according to market demand.

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Many infrastructure and necessity systems such as electricity and telecommunication in Europe and the Northern America were used to be operated as monopolies, if not state-owned. However, they have now been disintegrated into a group of smaller companies managed by different stakeholders. Railways are no exceptions. Since the early 1980s, there have been reforms in the shape of restructuring of the national railways in different parts of the world. Continuous refinements are still conducted to allow better utilisation of railway resources and quality of service. There has been a growing interest for the industry to understand the impacts of these reforms on the operation efficiency and constraints. A number of post-evaluations have been conducted by analysing the performance of the stakeholders on their profits (Crompton and Jupe 2003), quality of train service (Shaw 2001) and engineering operations (Watson 2001). Results from these studies are valuable for future improvement in the system, followed by a new cycle of post-evaluations. However, direct implementation of these changes is often costly and the consequences take a long period of time (e.g. years) to surface. With the advance of fast computing technologies, computer simulation is a cost-effective means to evaluate a hypothetical change in a system prior to actual implementation. For example, simulation suites have been developed to study a variety of traffic control strategies according to sophisticated models of train dynamics, traction and power systems (Goodman, Siu and Ho 1998, Ho and Yeung 2001). Unfortunately, under the restructured railway environment, it is by no means easy to model the complex behaviour of the stakeholders and the interactions between them. Multi-agent system (MAS) is a recently developed modelling technique which may be useful in assisting the railway industry to conduct simulations on the restructured railway system. In MAS, a real-world entity is modelled as a software agent that is autonomous, reactive to changes, able to initiate proactive actions and social communicative acts. It has been applied in the areas of supply-chain management processes (García-Flores, Wang and Goltz 2000, Jennings et al. 2000a, b) and e-commerce activities (Au, Ngai and Parameswaran 2003, Liu and You 2003), in which the objectives and behaviour of the buyers and sellers are captured by software agents. It is therefore beneficial to investigate the suitability or feasibility of applying agent modelling in railways and the extent to which it might help in developing better resource management strategies. This paper sets out to examine the benefits of using MAS to model the resource management process in railways. Section 2 first describes the business environment after the railway 2 Modelling issues on the railway resource management process using MAS reforms. Then the problems emerge from the restructuring process are identified in section 3. Section 4 describes the realisation of a MAS for railway resource management under the restructured scheme and the feasible studies expected from the model.

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With the recent regulatory reforms in a number of countries, railways resources are no longer managed by a single party but are distributed among different stakeholders. To facilitate the operation of train services, a train service provider (SP) has to negotiate with the infrastructure provider (IP) for a train schedule and the associated track access charge. This paper models the SP and IP as software agents and the negotiation as a prioritized fuzzy constraint satisfaction (PFCS) problem. Computer simulations have been conducted to demonstrate the effects on the train schedule when the SP has different optimization criteria. The results show that by assigning different priorities on the fuzzy constraints, agents can represent SPs with different operational objectives.

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Background: Early and persistent exposure to socioeconomic disadvantage impairs children’s health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0-1, 2-3, 4-5 and 6-7 years. Methods: 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Results: Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. Conclusions: From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

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This paper explores the idea of virtual participation through the historical example of the republic of letters in early modern Europe (circa 1500-1800). By reflecting on the construction of virtuality in a historical context, and more specifically in a pre-digital environment, this paper calls attention to accusations of technological determinism in ongoing research concerning the affordances of the Internet and related media of communication. It argues that ‘the virtual’ is not synonymous with ‘the digital’ and suggests that, in order to articulate what is novel about modern technologies, we must first understand the social interactions underpinning the relationships which are facilitated through those technologies. By analysing the construction of virtuality in a pre-digital environment, this paper thus offers a baseline from which scholars might consider what is different about the modes of interaction and communication being engaged in via modern media.

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This chapter outlines: a brief history of Australian Aboriginal health and health policy and then moves on to demonstrate how the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) undertakes its work and is an example of 'decolonizing policy in action'. Moreover, it highlights how Aboriginal participation in the development of policy and in the planning, delivery, management and evaluation of health programs enables policies and programs to respond effectively to the needs of Aboriginal people and to change future health outcomes for them. It showcases how Aboriginal decision-making has gone some way to decolonizing policymaking and has addressed the power imbalance - both of which have been critical in the improvement in Aboriginal health outcomes.

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This article focuses on how teachers worked to build a meaningful curriculum around changes to a neighborhood and school grounds in a precinct listed for urban renewal. Drawing on a long-term relationship with the principal and one teacher, the researchers planned and designed a collaborative project to involve children as active participants in the redevelopment process, negotiating and redesigning an area between the preschool and the school. The research investigated spatial literacies, that is, ways of thinking about and representing the production of spaces, and critical literacies, in this instance how young people might have a say in remaking part of their school grounds. Data included videotapes of key events, interviews, and an archive of the elementary students' artifacts experimenting with spatial literacies. The project builds on the insights of community members and researchers working for social justice in high-poverty areas internationally that indicate the importance of education, local action, family, and youth involvement in building sustainable and equitable communities.

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Introduction The Australian Nurse Practitioner Project (AUSPRAC) was initiated to examine the introduction of nurse practitioners into the Australian health service environment. The nurse practitioner concept was introduced to Australia over two decades ago and has been evolving since. Today, however, the scope of practice, role and educational preparation of nurse practitioners is well defined (Gardner et al, 2006). Amendments to specific pre-existing legislation at a State level have permitted nurse practitioners to perform additional activities including some once in the domain of the medical profession. In the Australian Capital Territory, for example 13 diverse Acts and Regulations required amendments and three new Acts were established (ACT Health, 2006). Nurse practitioners are now legally authorized to diagnose, treat, refer and prescribe medications in all Australian states and territories. These extended practices differentiate nurse practitioners from other advanced practice roles in nursing (Gardner, Chang & Duffield, 2007). There are, however, obstacles for nurse practitioners wishing to use these extended practices. Restrictive access to Medicare funding via the Medicare Benefit Scheme (MBS) and the Pharmaceutical Benefit Scheme (PBS) limit the scope of nurse practitioner service in the private health sector and community settings. A recent survey of Australian nurse practitioners (n=202) found that two-thirds of respondents (66%) stated that lack of legislative support limited their practice. Specifically, 78% stated that lack of a Medicare provider number was ‘extremely limiting’ to their practice and 71% stated that no access to the PBS was ‘extremely limiting’ to their practice (Gardner et al, in press). Changes to Commonwealth legislation is needed to enable nurse practitioners to prescribe medication so that patients have access to PBS subsidies where they exist; currently patients with scripts which originated from nurse practitioners must pay in full for these prescriptions filled outside public hospitals. This report presents findings from a sub-study of Phase Two of AUSPRAC. Phase Two was designed to enable investigation of the process and activities of nurse practitioner service. Process measurements of nurse practitioner services are valuable to healthcare organisations and service providers (Middleton, 2007). Processes of practice can be evaluated through clinical audit, however as Middleton cautions, no direct relationship between these processes and patient outcomes can be assumed.

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In this paper we discuss an advanced, 3D groundwater visualisation and animation system that allows scientists, government agencies and community groups to better understand the groundwater processes that effect community planning and decision-making. The system is unique in that it has been designed to optimise community engagement. Although it incorporates a powerful visualisation engine, this open-source system can be freely distributed and boasts a simple user interface allowing individuals to run and investigate the models on their own PCs and gain intimate knowledge of the groundwater systems. The initial version of the Groundwater Visualisation System (GVS v1.0), was developed from a coastal delta setting (Bundaberg, QLD), and then applied to a basalt catchment area (Obi Obi Creek, Maleny, QLD). Several major enhancements have been developed to produce higher quality visualisations, including display of more types of data, support for larger models and improved user interaction. The graphics and animation capabilities have also been enhanced, notably the display of boreholes, depth logs and time-series water level surfaces. The GVS software remains under continual development and improvement

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The Tamborine Mt area is a popular residential and tourist area in the Gold Coast hinterland, SE Qld. The 15km2 area occurs on elevated remnant Tertiary Basalts of the Beechmont Group, which comprise a number of mappable flow units originally derived from the Tweed volcanic centre to the south. The older Albert Basalt (Tertiary), which underlies the Beechmont Basalt at the southern end of the investigation area, is thought to be derived from the Focal Peak volcanic centre to the south west. The Basalts contain a locally significant ‘un-declared’ groundwater resource, which is utilised by the Tamborine Mt community for: • domestic purposes to supplement rainwater tank supplies, • commercial scale horticulture and • commercial export off-Mountain for bottled water. There is no reticulated water supply, and all waste water is treated on-site through domestic scale WTPs. Rainforest and other riparian ecosystems that attract residents and tourist dollars to the area, are also reliant on the groundwater that discharges to springs and surface streams on and around the plateau. Issues regarding a lack of compiled groundwater information, groundwater contamination, and groundwater sustainability are being investigated by QUT, utilising funding provided by the Federal Government’s ‘Caring for our Country’ programme through SEQ Catchments Ltd. The objectives of the two year project, which started in April 2009, are to: • Characterise the nature and condition of groundwater / surface water systems in the Tamborine Mountain area in terms of the issues being raised; • Engage and build capacity within the community to source local knowledge, encourage participation, raise awareness and improve understanding of the impacts of land and water use; • Develop a stand-alone 3D Visualisation model for dissemination into the community and use as a communication tool.

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In the knowledge era the importance of making space and place for knowledge production is clearly understood worldwide by many city administrations that are keen on restructuring their cities as highly competitive and creative places. Consequently, knowledge-based urban development and socio-spatial development of knowledge community precincts have taken their places among the emerging agendas of the urban planning and development practice. This chapter explores these emerging issues and scrutinizes the development of knowledge community precincts that have important economic, social and cultural dimensions on the formation of competitive and creative urban regions. The chapter also sheds light on the new challenges for planning discipline, and discusses the need for and some specifics of a new planning paradigm suitable for dealing with 21st Century’s socio-economic development and urbanization problems.

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Background and Aim: To investigate participation in a second round of colorectal cancer screening using a fecal occult blood test (FOBT) in an Australian rural community, and to assess the demographic characteristics and individual perspectives associated with repeat screening. ---------- Methods: Potential participants from round 1 (50–74 years of age) were sent an intervention package and asked to return a completed FOBT (n = 3406). Doctors of participants testing positive referred to colonoscopy as appropriate. Following screening, 119 participants completed qualitative telephone interviews. Multivariable logistic regression models evaluated the association between round-2 participation and other variables.---------- Results: Round-2 participation was 34.7%; the strongest predictor was participation in round 1. Repeat participants were more likely to be female; inconsistent screeners were more likely to be younger (aged 50–59 years). The proportion of positive FOBT was 12.7%, that of colonoscopy compliance was 98.6%, and the positive predictive value for cancer or adenoma of advanced pathology was 23.9%. Reasons for participation included testing as a precautionary measure or having family history/friends with colorectal cancer; reasons for non-participation included apathy or doctors’ advice against screening.---------- Conclusion: Participation was relatively low and consistent across rounds. Unless suitable strategies are identified to overcome behavioral trends and/or to screen out ineligible participants, little change in overall participation rates can be expected across rounds.

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Introduction: Nurse Practitioners (NPs) have an emerging role in the Australian healthcare system. However, there remains a dearth of available data about public understanding of the NP role. ---------- Aim: To evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. ---------- Method: All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales (NSW) were invited to recruit five consecutive clients to complete the self-administered survey. ---------- Results: Thirty two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (p=0.005), and where applicable would to prefer to see a NP rather than a doctor (p=0.022). ---------- Discussion: Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction more awareness of the scope of the NP role is required.