349 resultados para Expertise médicale
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This article investigates the ethnographic methodological question of how the researcher observes objectively while being part of the problem they are observing. It uses a case study of ABC Pool to argue a cooperative approach that combines the roles of the ethnographer with that of a community manager who assists in constructing a true representation of the researched environment. By using reflexivity as a research tool, the ethnographer engages in a process to self-check their personal presumptions and prejudices, and to strengthen the constructed representation of the researched environment. This article also suggests combining management and expertise research from the social sciences with ethnography, to understand and engage with the research field participants more intimately - which, ultimately, assists in gathering and analysing richer qualitative data.
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The official need for content teachers to teach the language features of their fields has never been greater in Australia than now. In 2012, the recently formed national curriculum board announced that all teachers are responsible for the English language development of students whose first language or dialect is not Standard Australian English (SAE). This formal endorsement is an important juncture regarding the way expertise might be developed, perceived and exchanged between content and language teachers through collaboration, in order for the goals of English language learners in content areas to be realised. To that end, we conducted an action research project to explore and extend the reading strategies pedagogy of one English language teacher who teaches English language learners in a parallel junior high school Geography program. Such pedagogy will be valuable for all teachers as they seek to contribute to English language development goals as outlined in national curricula.
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Nurses are the primary care providers of consumers admitted to the High Dependency Ward (HDU) or Psychiatric Intensive Care Unit (PICU). They are the largest professional group providing care to the acutely unwell, managing crisis and complex clinical psychiatric scenarios. It is timely to review the skills and expertise of this nursing specialty for further definition and acknowledgement.
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This article explores the role a writing group played in influencing the scholarly identities of a group of doctoral students by fostering their writing expertise. While the interest in writing groups usually centres on their potential to support doctoral students to publish, few studies have been conducted and written by the students themselves. Using a situated learning perspective on identity, we explore the connection that emerged between our perceptions of ourselves as developing expertise as scholarly writers and the function of the writing group as a dynamic space for transforming our identities. Findings show that our writing group served as a flexible and interactive Community of Practice (CoP) that shaped critical and durable shifts in identity amongst members.
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This paper begins by identifying the key attributes for future STEM teachers. Then based on a review of the literature, a framework for informing reforms to pre-service teacher education programs to facilitate the development of these attributes in future STEM teachers is presented and discussed. This framework consists of a set of three principles together with eight strategies for the operationalization of these principles. During the discussion, the implications for the structure and implementation of future pre-service STEM teacher education programs are explored.
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A profile of the roles performed by Australian health professionals working in international health was constructed to identify the core competencies they require, and the implications for education and training of international health practitioners. The methods used included: literature review and document analysis of available training and education; an analysis of competencies required in job descriptions for international health positions; and consultations with key informants. The international health roles identified were classified in four main groups: Program Directors, Program Managers, Team Leaders and Health Specialists. Thirteen 'core' competencies were identified from the job analysis and key informant/group interviews. Contributing to international health development in resource poor countries requires high level cultural, interpersonal and team-work competencies. Technical expertise in health disciplines is required, with flexibility to adapt to new situations. International health professionals need to combine public health competencies with high level personal maturity to respond to emerging challenges.
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An Expert Panel of the Royal Society of Canada and a Select Committee of the Québec National Assembly both recently recommended the issuance of permissive guidelines for the exercise of prosecutorial discretion on voluntary euthanasia and assisted suicide and “medical aid in dying” respectively. It seems timely, therefore, to propose a set of offence-specific guidelines for how prosecutorial discretion should be exercised in cases of voluntary euthanasia and assisted suicide in Canadian provinces and territories. We take as our starting point the only existing guidelines of this sort currently in force in the world (i.e. the British Columbia Guidelines, and the England and Wales Guidelines). In light of certain concerns we have with these guidelines, we outline an approach to constructing guidelines for Canadian jurisdictions that begins with identifying three guiding principles we argue are appropriate for this purpose (respect for autonomy, the need for high-quality prosecutorial decision making, and the importance of public confidence in that decision making), and ends with a concrete and detailed set of proposed guidelines. The paper is consistent with, but also extends, the work of the Royal Society of Canada Expert Panel on End of Life Decision Making. Un panel d’expert de la Société Royale du Canada et une Commission spéciale de l’Assemblée nationale du Québec ont tous les deux récemment recommandé que soit émises des directives permettant exercice d’un pouvoir de poursuite discrétionnaire concernant l’euthanasie et le suicide assisté et « l’assistance médicale pour mourir », respectivement. Il semble donc à propos de proposer une série de directives spécifiques aux offenses sur la façon dont le pouvoir de poursuite discrétionnaire dans les territoires et provinces canadiennes serait appliqué dans les cas d’euthanasie et de suicide assisté. Nous avons pris comme point de départ les seules directives de la sorte existant déjà (c’est-à-dire celle de la Colombie-Britannique et de l’Angleterre et du Pays de Galles). Par contre, compte tenu de certaines de nos réserves concernant ces directives, nous avons ensuite établi les grandes lignes d’une approche permettant de mettre sur pied des directives pour les juridictions canadiennes, qui débute par l’identification de trois principes de base qui sont selon nous appropriées à cette fin (respect de l’autonomie, besoin pour une grande qualité de prise de prise de décision du poursuivant et la confiance du public envers cette prise de décision) pour se terminer par une série de directives concrètes et détaillées. Le présent document est compatible avec le travail de la Société royale du Canada tout en en augmentant la portée.
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Orthopaedics and Trauma Queensland, a Centre for Research and Education in Musculoskeletal Disorders, is an internationally recognised research group that is developing into an international leader in research and education. It provides a stimulus for research, education and clinical application within the international orthopaedic and trauma communities. Orthopaedics and Trauma Queensland develops and promotes the innovative use of engineering and technology, in collaboration with surgeons, to provide new techniques, materials, procedures and medical devices. Its integration with clinical practice and strong links with hospitals ensure that the research will be translated into practical outcomes for patients. The group undertakes clinical practice in orthopaedics and trauma and applies core engineering skills to challenges in medicine. The research is built on a strong foundation of knowledge in biomedical engineering, and incorporates expertise in cell biology, mathematical modelling, human anatomy and physiology and clinical medicine in orthopaedics and trauma. New knowledge is being developed and applied to the full range of orthopaedic diseases and injuries, such as knee and hip replacements, fractures and spinal deformities.
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There has been a recent surge of interest in cooking skills in a diverse range of fields, such as health, education and public policy. There appears to be an assumption that cooking skills are in decline and that this is having an adverse impact on individual health and well-being, and family wholesomeness. The problematisation of cooking skills is not new, and can be seen in a number of historical developments that have specified particular pedagogies about food and eating. The purpose of this paper is to examine pedagogies on cooking skills and the importance accorded them. The paper draws on Foucault’s work on governmentality. By using examples from the USA, UK and Australia, the paper demonstrates the ways that authoritative discourses on the know how and the know what about food and cooking – called here ‘savoir fare’ – are developed and promulgated. These discourses, and the moral panics in which they are embedded, require individuals to make choices about what to cook and how to cook, and in doing so establish moral pedagogies concerning good and bad cooking. The development of food literacy programmes, which see cooking skills as life skills, further extends the obligations to ‘cook properly’ to wider populations. The emphasis on cooking knowledge and skills has ushered in new forms of government, firstly, through a relationship between expertise and politics which is readily visible through the authority that underpins the need to develop skills in food provisioning and preparation; secondly, through a new pluralisation of ‘social’ technologies which invites a range of private-public interest through, for example, television cooking programmes featuring cooking skills, albeit it set in a particular milieu of entertainment; and lastly, through a new specification of the subject can be seen in the formation of a choosing subject, one which has to problematise food choice in relation to expert advice and guidance. A governmentality focus shows that as discourses develop about what is the correct level of ‘savoir fare’, new discursive subject positions are opened up. Armed with the understanding of what is considered expert-endorsed acceptable food knowledge, subjects judge themselves through self-surveillance. The result is a powerful food and family morality that is both disciplined and disciplinary.
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One aspect of quality education in the 21st century is the availability of digital resources in schools. Many developing countries need to build this capability – not just in terms of technology but teacher capability as well. One of the ways to achieve such capacity is through knowledge sharing between teachers and educators in developed and developing countries. Over time such collaboration can have a lasting impact on all participants on both sides of the digital divide. This paper reports on how such collaboration can occur. It focuses on the initial stages of a long-term initiative where our primary objective is to develop models, which demonstrate how we (in developed countries) can engage productively and meaningfully with schools in developing countries to build their ICT capacity. As part of this initiative, we introduced laptops and LEGO robotics tool kits to a rural primary school in Fiji. We developed ICT activities that aligned with the curriculum in a number of subjects. In addition, we worked with the teachers over two weeks to build their expertise.
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Background: Chronic leg ulcers cause long term ill-health for older adults and the condition places a significant burden on health service resources. Although evidence on effective management of the condition is available, a significant evidence-practice gap is known to exist, with many suggested reasons e.g. multiple care providers, costs of care and treatments. This study aimed to identify effective health service pathways of care which facilitated evidence-based management of chronic leg ulcers. Methods: A sample of 70 patients presenting with a lower limb leg or foot ulcer at specialist wound clinics in Queensland, Australia were recruited for an observational study and survey. Retrospective data were collected on demographics, health, medical history, treatments, costs and health service pathways in the previous 12 months. Prospective data were collected on health service pathways, pain, functional ability, quality of life, treatments, wound healing and recurrence outcomes for 24 weeks from admission. Results: Retrospective data indicated that evidence based guidelines were poorly implemented prior to admission to the study, e.g. only 31% of participants with a lower limb ulcer had an ABPI or duplex assessment in the previous 12 months. On average, participants accessed care 2–3 times/week for 17 weeks from multiple health service providers in the twelve months before admission to the study clinics. Following admission to specialist wound clinics, participants accessed care on average once per week for 12 weeks from a smaller range of providers. The median ulcer duration on admission to the study was 22 weeks (range 2–728 weeks). Following admission to wound clinics, implementation of key indicators of evidence based care increased (p<0.001) and Kaplan-Meier survival analysis found the median time to healing was 12 weeks (95% CI 9.3–14.7). Implementation of evidence based care was significantly related to improved healing outcomes (p<0.001). Conclusions: This study highlights the complexities involved in accessing expertise and evidence based wound care for adults with chronic leg or foot ulcers. Results demonstrate that access to wound management expertise can promote streamlined health services and evidence based wound care, leading to efficient use of health resources and improved health.
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The knowledge economy of the 21st century requires skills such as creativity, critical thinking, problem solving, communication and collaboration (Partnership for 21st century skills, 2011) – skills that cannot easily be learnt from books, but rather through learning-by-doing and social interaction. Big ideas and disruptive innovation often result from collaboration between individuals from diverse backgrounds and areas of expertise. Public libraries, as facilitators of education and knowledge, have been actively seeking responses to such changing needs of the general public...
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This book examines the influence of emerging economies on international legal rules, institutions and processes. It describes recent and predicted changes in economic, political and cultural powers, flowing from the growth of emerging economies such as China, India, Brazil, South Africa and Russia, and analyses the influence of these changes on various legal frameworks and norms. Its contributors come from a variety of fields of expertise, including international law, politics, environmental law, human rights, economics and finance. The book begins by providing a broad analysis of the nature of the shifting global dynamic in its historical and contemporary contexts, including analysis of the rise of China as a major economic and political power and the end of the period of United States domination in international affairs. It illustrates the impact of these changes on states’ domestic policies and priorities, as they adapt to a new international dynamic. The authors then offer a range of perspectives on the impact of these changes as they relate to specific regimes and issues, including climate change regulation, collective security, indigenous rights, the rights of women and girls, environmental protection and foreign aid and development. The book provides a fresh and comprehensive analysis of an issue with extensive implications for international law and politics.
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The chapters in this book explore the impact of recent shifts in global and regional power and the subsequent development and enforcement of international refugee protection standards in the Asia Pacific region. Drawing on their expertise across a number of jurisdictions, the contributors assess the challenges confronting the implementation of international law in the region, as well as new opportunities for extending protection norms into national and regional dialogues. The case studies span key jurisdictions across the region and include a comparative analysis with China, Indonesia, Thailand, Myanmar, Malaysia, Bangladesh and Australia. This topical and important book raises critical questions for the Asia Pacific region and sheds light on the challenges confronting the protection of refugees and displaced persons in this area. Interdisciplinary in its approach, it will be of interest to academics, researchers, students and policy-makers concerned with the rights and protection of refugees.
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Introduction: Evaluating the effectiveness of interventions designed to increase the physical activity in communities is often a difficult and complex task, requiring considerable expertise and investment, and often constrained by methodological limitations. These limitations, in turn, create additional challenges when these studies are used in systematic reviews as they hinder the confidence, precision and interpretation of results. The objective of this paper is to summarise the methodological challenges posed in conducting a systematic review of community-wide physical activity interventions to help inform those conducting future primary research and systematic reviews. Methods: We conducted a Cochrane systematic review of community-wide interventions to increase physical activity. We assessed the methodological quality of the included studies. We will investigate these in greater detail, particularly in relation to the potential impact on measures of effect, confidence in results, generalizability of results and general interpretation. Results: The systematic review was conducted and has been published in the Cochrane Library. A logic model was helpful in defining and interpreting the studies. Many studies of unsuitable study design were excluded; however several important methodological limitations of the primary studies evaluating community-wide physical activity interventions emerged. These included: - the failure to use validated tools to measure physical activity; - issues associated with pre and post test designs; - inadequate sampling of populations; - poor control groups; and - intervention and measurement protocols of inadequate duration. Although it is challenging to undertake rigorous evaluations of complex interventions, these issues result in significant uncertainty over the effectiveness of these interventions, and the possible factors required for a community-wide intervention to be successful. In particular, the combination of several of these limitations (e.g. un-validated tools, inadequate sampling, and short duration) is that studies may lack the sensitivity to detect any meaningful change. Multiple publications of findings for the same study also made interpretation difficult; however, interventions with parallel qualitative publications were helpful. Discussion: Evaluating community wide interventions to increase physical activity in a rigorous way is incredibly challenging. These findings reflect these challenges but have important ramifications for researchers conducting primary studies to determine the efficacy of such interventions, as well as for researchers conducting systematic reviews. This new review shows that the inadequacies of design and evaluation are continuing. It is hoped that the adoption of such suggestions may aid in the development of systematic reviews, but more importantly, in enabling translation of such findings into policy and practice.