307 resultados para Comparative Effectiveness Research


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This thesis is about a comparative study of early childhood education (ECE) curriculum documents focused on education for sustainability (EfS) in South Korea and Australia. It examined how the national ECE curriculum documents in two culturally different contexts align with contemporary concepts of sustainability and activist early childhood education for sustainability (ECEfS) principles. Drawing on systems theory, Korean and Australian ECE curriculum documents were used as the primary sources for this study within the framework of critical document analysis (CDA). This study offers a step forward in developing culturally inclusive/holistic understandings of sustainability and more contextualised/localised approaches to ECEfS.

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There has been substantial growth in the provision of, and importance attached to, coach education in many Western countries in particular, but there is also an emerging interest in the developing world (Gilbert & Trudel, 1999; Lyle, 2002). Yet this growth in interest has not resulted in a corresponding increase in research activity. Much of the focus of the existing coach education literature has been on coach development and learning (Cushion, Armour,& Jones, 2003; Malete et al, 2000; Sage, 1989; Weiss et al, 1991), coaching behavior and coach effectiveness training in the context of youth sports (Smith & Smoll, 1990; Smith, Smoll, & Barnett, 1995; Smoll et al.,1993) and the problems associated with the privileging of technical, tactical, and bio-scientific knowledges that have been characteristic features of much coach education provision (Abraham & Collins, 1998; Campbell, 1993; Potrac et al, 2000; Schempp, 2000). While this scholarship has provided valuable insights into some aspects of coach education, it underlines the absence of research addressing a range of topics such as the development of coach education curricula, the structures for coach learning, coaches’ learning processes and coach certification (Gilbert & Trudel, 2000). In this paper we discuss a new theoretical frame for coach education research centered on the idea of communities of practice.

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This article highlights the importance of systematic reviews for research synthesis, with the strength of this approach demonstrated through the authors’ recent Cochrane review into the effectiveness of school-based programs for the prevention of child sexual abuse. It describes the features of evaluation studies and the differences between systematic reviews and more traditional literature reviews, before summarising the findings of their recent Cochrane review.

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Background Advances in cancer diagnosis and treatment have significantly improved survival rates, through their subsequent health needs are often not adequately addressed by current health services. National Health and Medical Research Council (NHMRC) Partnerships Project awarded a national collaborative project to develop, trial and evaluate clinical benefits and cost effectiveness of an e-health enabled structured health promotion intervention - The Women’s Wellness after Cancer Program (WWACP). The aim of this e-health enabled multimodal intervention is to improve health related quality of life in women previously treated for target cancers. Aim The WWACP is a 12-week web based, interactive, holistic program. Primary outcomes for this project are to promote a positive change in health-related quality of life (HRQoL) and reduction in Body Mass Index (BMI) in the women undertaking WWACP compared to women who receive usual care. Secondary outcomes include managing other side effects of cancer treatment through evidence-based nutrition and exercise practices, dealing with stress, sleep, menopause and sexuality issues. Methods The single-blinded multi-center randomized controlled trial recruited a toatl of 330 women within 24 months of completion of chemotherapy and /or radiotherapy. Women were randomly assigned to either a usual care or intervention group. Women provided with the intervention were provided with an interactive iBook and journal, web interface, and three virtual consultations by experienced cancer nurses. A variety of methods were utilized, to enable positive self- efficacy and lifestyle changes. These include online coaching with a registered nurse trained in the intervention, plus written educational and health promotional information. The program has been delivered through the e-health enabled interfaces, which enables virtual delivery via desktop and mobile computing devices. Importantly this enables accessibility for rural and regional women in Australia who are frequently geographically disadvantaged in terms of health care provision. Results Research focusing on alternative methods of delivering post treatment / or survivorship care in cancer utilizing web based interfaces is limited, but emerging evidence suggests that Internet interventions can increase psychological and physical wellbeing in cancer patients. The WWACP trial aims to establish the effectiveness of delivery of the program in terms of positive patient outcomes and cost effective, flexibility. The trial will be completed in September and results will be presented at the conference. Conclusions Women after acute hematological, breast and gynecological cancer treatments demonstrate good cancer survival rates and face residual health problems which are amenable to behavioral interventions. The conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change can be achieved if patients receive education and psychological support which targets key treatment related health problems and known chronic disease risk factors.

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Exercise that targets ankle joint mobility may lead to improvement in calf muscle pump function and subsequent healing. The objectives of this research were to assess the impact of an exercise intervention in addition to routine evidence-based care on the healing rates, functional ability and health-related quality of life for adults with venous leg ulcers (VLUs). This study included 63 patients with VLUs. Patients were randomised to receive either a 12-week exercise intervention with a telephone coaching component or usual care plus telephone calls at the same timepoints. The primary outcome evaluated the effectiveness of the intervention in relation to wound healing. The secondary outcomes evaluated physical activity, functional ability and health-related quality of life measures between groups at the end of the 12 weeks. A per protocol analysis complemented the effectiveness (intention-to-treat) analysis to highlight the importance of adherence to an exercise intervention. Intention-to-treat analyses for the primary outcome showed 77% of those in the intervention group healed by 12 weeks compared to 53% of those in the usual care group. Although this difference was not statistically significant due to a smaller than expected sample size, a 24% difference in healing rates could be considered clinically significant. The per protocol analysis for wound healing, however, showed that those in the intervention group who adhered to the exercise protocol 75% or more of the time were significantly more likely to heal and showed higher rates for wound healing than the control group (P = 0·01), that is, 95% of those who adhered in the intervention group healed in 12 weeks. The secondary outcomes of physical activity, functional ability and health-related quality of life were not significantly altered by the intervention. Among the secondary outcomes (physical activity, functional ability and health-related quality of life), intention-to-treat analyses did not support the effectiveness of the intervention. However, per protocol analyses revealed encouraging results with those participants who adhered more than 75% of the time (n = 19) showing significantly improved Range of Ankle Motion from the self-management exercise programme (P = 0·045). This study has shown that those participants who adhere to the exercise programme as an adjunctive treatment to standard care are more likely to heal and have better functional outcomes than those who do not adhere to the exercises in conjunction with usual care.

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Twitter’s hashtag functionality is now used for a very wide variety of purposes, from covering crises and other breaking news events through gathering an instant community around shared media texts (such as sporting events and TV broadcasts) to signalling emotive states from amusement to despair. These divergent uses of the hashtag are increasingly recognised in the literature, with attention paid especially to the ability for hashtags to facilitate the creation of ad hoc or hashtag publics. A more comprehensive understanding of these different uses of hashtags has yet to be developed, however. Previous research has explored the potential for a systematic analysis of the quantitative metrics that could be generated from processing a series of hashtag datasets. Such research found, for example, that crisis-related hashtags exhibited a significantly larger incidence of retweets and tweets containing URLs than hashtags relating to televised events, and on this basis hypothesised that the information-seeking and -sharing behaviours of Twitter users in such different contexts were substantially divergent. This article updates such study and their methodology by examining the communicative metrics of a considerably larger and more diverse number of hashtag datasets, compiled over the past five years. This provides an opportunity both to confirm earlier findings, as well as to explore whether hashtag use practices may have shifted subsequently as Twitter’s userbase has developed further; it also enables the identification of further hashtag types beyond the “crisis” and “mainstream media event” types outlined to date. The article also explores the presence of such patterns beyond recognised hashtags, by incorporating an analysis of a number of keyword-based datasets. This large-scale, comparative approach contributes towards the establishment of a more comprehensive typology of hashtags and their publics, and the metrics it describes will also be able to be used to classify new hashtags emerging in the future. In turn, this may enable researchers to develop systems for automatically distinguishing newly trending topics into a number of event types, which may be useful for example for the automatic detection of acute crises and other breaking news events.

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This doctoral thesis aims to demonstrate the importance of incentives to technology-based firms as a strategy to promote knowledge-based economic development (KBED). To remain competitive, technology-based firms must innovate and seek new markets; therefore, this study aims to propose an incentive model to technology-based firms as a strategy to promote knowledge-based urban development, according to framework described by Yigitcanlar (2011). This is an exploratory and descriptive research with a qualitative approach. Surveys were carried out with national trade associations that represented technology-based firms both in Brazil and Australia. After analysing the surveys, structured interviews were conducted with government representatives, trade associations and businessmen who had used financial support by the federal government. When comparing both countries, the study found the importance of direct incentives through tax incentives, for it is a less bureaucratic, quicker and more direct process for firms. We suggest to include the terms incentives in the framework of knowledge-based urban development, as one of the pillars that contribute to knowledge-based economic development.