762 resultados para Healthcare community agent
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Purpose: This study provides insight into the histories and current statuses of queer community archives in California and explores what the archives profession can learn from the queer community archives and archivists. Through the construction of histories of three community archives (GLBT Historical Society; Lavender Library, Archives, and Cultural Exchange of Sacramento, Inc.; and ONE National Gay & Lesbian Archives), the study discovered why these independent, community-based archives were created, the issues that influenced their evolution, and the similarities and differences among them. Additionally, it compared the community archives to institutional archives which collect queer materials to explore the similarities and differences among the archives and determine possible implications for the archives profession. Significance: The study contributes to the literature in several significant ways: it is the first in-depth comparative history of the queer community archives; it adds to the cross-disciplinary research in archives and history; it contributes to the current debates on the nature of the archives and the role of the professional archivist; and it has implications for changing archival practice. Methodology: This study used social constructionism for epistemological positioning and new social history theory for theoretical framework. Information was gathered through seven oral history interviews with community archivists and volunteers and from materials in the archives’ collections. This evidence was used to construct the histories of the archives and determine their current statuses. The institutional archives used in the comparisons are the: University of California, Berkeley’s Bancroft Library; University of California, Santa Cruz’s Special Collections and University Archives; and San Francisco Public Library’s James C. Hormel Gay and Lesbian Center. The collection policies, finding aids, and archival collections related to the queer communities at the institutional and community archives were compared to determine commonalities and differences among the archives. Findings: The findings revealed striking similarities in the histories of the community archives and important implications for the archives’ survival and their relevancy to the archives profession. Each archives was started by an individual or small group collecting materials to preserve history that would otherwise have been lost as institutional archives were not collecting queer materials. These private collections grew and became the basis for the community archives. The community archives differ in their staffing models, circulation policies, and descriptive practices. The community archives have grown to incorporate more public programming functions than most institutional archives. While in the past, the community archives had little connection to institutional archives, today they have varying degrees of partnerships. However, the historical lack of collecting queer materials by institutional archives makes some members of the communities reluctant to donate materials to institutional archives or collaborate with them. All three queer community archives are currently managed by professionally trained and educated archivists and face financial issues impacting their continued survival. The similarities and differences between the community and institutional archives include differences in collection policies, language differences in the finding aids, and differing levels of relationships between the archives. However, they share similar sensitivity in the use of language in describing the queer communities and overlap in the types of materials collected. Implications: This study supports previous research on community archives showing that communities take the preservation of history into their own hands when ignored by mainstream archives (Flinn, 2007; Flinn & Stevens, 2009; Nestle, 1990). Based on the study’s findings, institutional archivists could learn from their community archivist counterparts better ways to become involved in and relevant to the communities whose records they possess. This study also expands the understanding of history of the queer communities to include in-depth research into the archives which preserve and make available material for constructing history. Furthermore, this study supports reflective practice for archivists, especially in terms of descriptions used in finding aids. It also supports changes in graduate education for archives students to enable archivists in the United States to be more fully cognizant of community archives and able to engage in collaborative, international projects. Through this more activist role of the archivists, partnerships between the community and institutional archives would be built to establish more collaborative, respectful relationships with the communities in this post-custodial age of the archives (Stevens, Flinn, & Shepherd, 2010). Including community archives in discussions of archival practice and theory is one way of ensuring archives represent and serve a diversity of voices.
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Australia requires decisive action on climate change and issues of sustainability. The Urban Informatics Research Lab has been funded by the Queensland State Government to conduct a three year study (2009 – 2011) exploring ways to support Queensland residents in making more sustainable consumer and lifestyle choices. We conduct user-centred design research that inform the development of real-time, mobile, locational, networked information interfaces, feedback mechanisms and persuasive and motivational approaches that in turn assist in-situ decision making and environmental awareness in everyday settings. The study aims to deliver usable and useful prototypes offering individual and collective visualisations of ecological impact and opportunities for engagement and collaboration in order to foster a participatory and sustainable culture of life in Australia. Raising people’s awareness with environmental data and educational information does not necessarily trigger sufficient motivation to change their habits towards a more environmentally friendly and sustainable lifestyle. Our research seeks to develop a better understanding how to go beyond just informing and into motivating and encouraging action and change. Drawing on participatory culture, ubiquitous computing, and real-time information, the study delivers research that leads to viable new design approaches and information interfaces which will strengthen Australia’s position to meet the targets of the Clean Energy Future strategy, and contribute to the sustainability of a low-carbon future in Australia. As part of this program of research, the Urban Informatics Research Lab has been invited to partner with GV Community Energy Pty Ltd on a project funded by the Victorian Government Sustainability Fund. This feasibility report specifically looks at the challenges and opportunities of energy monitoring in households in Victoria that include a PV solar installation. The report is structured into two parts: In Part 1, we first review a range of energy monitoring solutions, both stand-alone and internet-enabled. This section primarily focusses on the technical capacilities. However, in order to understand this information and make an informed decision, it is crucial to understand the basic principles and limitations of energy monitoring as well as the opportunities and challenges of a networked approach towards energy monitoring which are discussed in Section 2.
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It was rugby league State of Origin night 2008 and a group of adults had descended upon a house in Eagleby, Brisbane to have some drinks and to celebrate the game. At 11pm that evening, Shane Thomas Davidson entered the bedroom of the homeowner’s 10-year-old son, TC. Davidson approached the bed and began to massage the boy’s penis under his clothing, which caused TC to wake. Davidson stated, ‘Show me how big your willy is and I’ll show you how big mine is’. TC refused the request and after a small period of time, left the bedroom and told his father what had happened...
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Background Emergency department (ED) crowding caused by access block is an increasing public health issue and has been associated with impaired healthcare delivery, negative patient outcomes and increased staff workload. Aim To investigate the impact of opening a new ED on patient and healthcare service outcomes. Methods A 24-month time series analysis was employed using deterministically linked data from the ambulance service and three ED and hospital admission databases in Queensland, Australia. Results Total volume of ED presentations increased 18%, while local population growth increased by 3%. Healthcare service and patient outcomes at the two pre-existing hospitals did not improve. These outcomes included ambulance offload time: (Hospital A PRE: 10 min, POST: 10 min, P < 0.001; Hospital B PRE: 10 min, POST: 15 min, P < 0.001); ED length of stay: (Hospital A PRE: 242 min, POST: 246 min, P < 0.001; Hospital B PRE: 182 min, POST: 210 min, P < 0.001); and access block: (Hospital A PRE: 41%, POST: 46%, P < 0.001; Hospital B PRE: 23%, POST: 40%, P < 0.001). Time series modelling indicated that the effect was worst at the hospital furthest away from the new ED. Conclusions An additional ED within the region saw an increase in the total volume of presentations at a rate far greater than local population growth, suggesting it either provided an unmet need or a shifting of activity from one sector to another. Future studies should examine patient decision making regarding reasons for presenting to a new or pre-existing ED. There is an inherent need to take a ‘whole of health service area’ approach to solve crowding issues.
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Quality oriented management systems and methods have become the dominant business and governance paradigm. From this perspective, satisfying customers’ expectations by supplying reliable, good quality products and services is the key factor for an organization and even government. During recent decades, Statistical Quality Control (SQC) methods have been developed as the technical core of quality management and continuous improvement philosophy and now are being applied widely to improve the quality of products and services in industrial and business sectors. Recently SQC tools, in particular quality control charts, have been used in healthcare surveillance. In some cases, these tools have been modified and developed to better suit the health sector characteristics and needs. It seems that some of the work in the healthcare area has evolved independently of the development of industrial statistical process control methods. Therefore analysing and comparing paradigms and the characteristics of quality control charts and techniques across the different sectors presents some opportunities for transferring knowledge and future development in each sectors. Meanwhile considering capabilities of Bayesian approach particularly Bayesian hierarchical models and computational techniques in which all uncertainty are expressed as a structure of probability, facilitates decision making and cost-effectiveness analyses. Therefore, this research investigates the use of quality improvement cycle in a health vii setting using clinical data from a hospital. The need of clinical data for monitoring purposes is investigated in two aspects. A framework and appropriate tools from the industrial context are proposed and applied to evaluate and improve data quality in available datasets and data flow; then a data capturing algorithm using Bayesian decision making methods is developed to determine economical sample size for statistical analyses within the quality improvement cycle. Following ensuring clinical data quality, some characteristics of control charts in the health context including the necessity of monitoring attribute data and correlated quality characteristics are considered. To this end, multivariate control charts from an industrial context are adapted to monitor radiation delivered to patients undergoing diagnostic coronary angiogram and various risk-adjusted control charts are constructed and investigated in monitoring binary outcomes of clinical interventions as well as postintervention survival time. Meanwhile, adoption of a Bayesian approach is proposed as a new framework in estimation of change point following control chart’s signal. This estimate aims to facilitate root causes efforts in quality improvement cycle since it cuts the search for the potential causes of detected changes to a tighter time-frame prior to the signal. This approach enables us to obtain highly informative estimates for change point parameters since probability distribution based results are obtained. Using Bayesian hierarchical models and Markov chain Monte Carlo computational methods, Bayesian estimators of the time and the magnitude of various change scenarios including step change, linear trend and multiple change in a Poisson process are developed and investigated. The benefits of change point investigation is revisited and promoted in monitoring hospital outcomes where the developed Bayesian estimator reports the true time of the shifts, compared to priori known causes, detected by control charts in monitoring rate of excess usage of blood products and major adverse events during and after cardiac surgery in a local hospital. The development of the Bayesian change point estimators are then followed in a healthcare surveillances for processes in which pre-intervention characteristics of patients are viii affecting the outcomes. In this setting, at first, the Bayesian estimator is extended to capture the patient mix, covariates, through risk models underlying risk-adjusted control charts. Variations of the estimator are developed to estimate the true time of step changes and linear trends in odds ratio of intensive care unit outcomes in a local hospital. Secondly, the Bayesian estimator is extended to identify the time of a shift in mean survival time after a clinical intervention which is being monitored by riskadjusted survival time control charts. In this context, the survival time after a clinical intervention is also affected by patient mix and the survival function is constructed using survival prediction model. The simulation study undertaken in each research component and obtained results highly recommend the developed Bayesian estimators as a strong alternative in change point estimation within quality improvement cycle in healthcare surveillances as well as industrial and business contexts. The superiority of the proposed Bayesian framework and estimators are enhanced when probability quantification, flexibility and generalizability of the developed model are also considered. The empirical results and simulations indicate that the Bayesian estimators are a strong alternative in change point estimation within quality improvement cycle in healthcare surveillances. The superiority of the proposed Bayesian framework and estimators are enhanced when probability quantification, flexibility and generalizability of the developed model are also considered. The advantages of the Bayesian approach seen in general context of quality control may also be extended in the industrial and business domains where quality monitoring was initially developed.
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Purpose This thesis is about liveability, place and ageing in the high density urban landscape of Brisbane, Australia. As with other major developed cities around the globe, Brisbane has adopted policies to increase urban residential densities to meet the main liveability and sustainability aim of decreasing car dependence and therefore pollution, as well as to minimise the loss of greenfield areas and habitats to developers. This objective hinges on urban neighbourhoods/communities being liveable places, which residents do not have to leave for everyday living. Community/neighbourhood liveability is an essential ingredient in healthy ageing in place and has a substantial impact upon the safety, independence and well-being of older adults. It is generally accepted that ageing in place is optimal for both older people and the state. The optimality of ageing in place generally assumes that there is a particular quality to environments or standard of liveability in which people successfully age in place. The aim of this thesis was to examine if there are particular environmental qualities or aspects of liveability that test optimality and to better understand the key liveability factors that contribute to successful ageing in place. Method A strength of this thesis is that it draws on two separate studies to address the research question of what makes high density liveable for older people. In Chapter 3, the two methods are identified and differentiated as Method 1 (used in Paper 1) and Method 2 (used in Papers 2, 3, 4 and 5). Method 1 involved qualitative interviews with 24 inner city high density Brisbane residents. The major strength of this thesis is the innovative methodology outlined in the thesis as Method 2. Method 2 involved a case study approach employing qualitative and quantitative methods. Qualitative data was collected using semi-structured, in-depth interviews and time-use diaries completed by participants during the week of tracking. The quantitative data was gathered using Global Positioning Systems for tracking and Geographical Information Systems for mapping and analysis of participants’ activities. The combination of quantitative and qualitative analysis captured both participants’ subjective perceptions of their neighbourhoods and their patterns of movement. This enhanced understanding of how neighbourhoods and communities function and of the various liveability dimensions that contribute to active ageing and ageing in place for older people living in high density environments. Both studies’ participants were inner-city high density residents of Brisbane. The study based on Method 1 drew on a wider age demographic than the study based on Method 2. Findings The five papers presented in this thesis by publication indicate a complex inter-relationship of the factors that make a place liveable. The first three papers identify what is comparable and different between the physical and social factors of high density communities/neighbourhoods. The last two papers explore relationships between social engagement and broader community variables such as infrastructure and the physical built environments that are risk or protective factors relevant to community liveability, active ageing and ageing in place in high density. The research highlights the importance of creating and/or maintaining a barrier-free environment and liveable community for ageing adults. Together, the papers promote liveability, social engagement and active ageing in high density neighbourhoods by identifying factors that constitute liveability and strategies that foster active ageing and ageing in place, social connections and well-being. Recommendations There is a strong need to offer more support for active ageing and ageing in place. While the data analyses of this research provide insight into the lived experience of high density residents, further research is warranted. Further qualitative and quantitative research is needed to explore in more depth, the urban experience and opinions of older people living in urban environments. In particular, more empirical research and theory-building is needed in order to expand understanding of the particular environmental qualities that enable successful ageing in place in our cities and to guide efforts aimed at meeting this objective. The results suggest that encouraging the presence of more inner city retail outlets, particularly services that are utilised frequently in people’s daily lives such as supermarkets, medical services and pharmacies, would potentially help ensure residents fully engage in their local community. The connectivity of streets, footpaths and their role in facilitating the reaching of destinations are well understood as an important dimension of liveability. To encourage uptake of sustainable transport, the built environment must provide easy, accessible connections between buildings, walkways, cycle paths and public transport nodes. Wider streets, given that they take more time to cross than narrow streets, tend to .compromise safety - especially for older people. Similarly, the width of footpaths, the level of buffering, the presence of trees, lighting, seating and design of and distance between pedestrian crossings significantly affects the pedestrian experience for older people and impacts upon their choice of transportation. High density neighbourhoods also require greater levels of street fixtures and furniture for everyday life to make places more useable and comfortable for regular use. The importance of making the public realm useful and habitable for older people cannot be over-emphasised. Originality/value While older people are attracted to high density settings, there has been little empirical evidence linking liveability satisfaction with older people’s use of urban neighbourhoods. The current study examined the relationships between community/neighbourhood liveability, place and ageing to better understand the implications for those adults who age in place. The five papers presented in this thesis add to the understanding of what high density liveable age-friendly communities/ neighbourhoods are and what makes them so for older Australians. Neighbourhood liveability for older people is about being able to age in place and remain active. Issues of ageing in Australia and other areas of the developed world will become more critical in the coming decades. Creating livable communities for all ages calls for partnerships across all levels of government agencies and among different sectors within communities. The increasing percentage of older people in the community will have increasing political influence and it will be a foolish government who ignores the needs of an older society.
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The year 2010 was the wettest year on record for Queensland, Australia and the wettest year since 1974 for Southeast Queensland. The extremely heavy rain in early January 2011 fell on the catchments of heavily saturated Brisbane and Stanley Rivers systems resulting in significant runoff which rapidly produced a widespread and devastating flood event. The area of inundation was equivalent to the total land area of France and Germany combined. Over 200,000 people were affected leaving 35 people dead and 9 missing. The damage bill was estimated at over $1B and cost to the economy at over $10B with over 30,000 homes and 6,000 business flooded and 86 towns and regional centres affected. The need to disburse disaster funding in a prompt manner to the affected population was paramount to facilitate individuals getting their lives back to some normality. However, the payout of insurance claims has proved to be a major area of community anger. The ongoing impasse in payment of insurance compensation is attributed to the nature and number of claims, confusing definition of flooding and the lack or accuracy of information needed to determine individually the properties affected and legitimacy of claims. Information was not readily available at the micro-level including, extent and type of inundation, flood heights at property level and cause of damage. Events during the aftermath highlighted widespread community misconceptions concerning the technical factors associated with the flood event and the impact of such on access to legitimate compensation and assistance. Individual and community wide concerns and frustration, anger and depression, have arisen resulting from delays in the timely settlement of insurance claims. Lessons learnt during the aftermath are presented in the context of their importance as a basis for inculcating communities impacted by the flood event with resilience for the future.
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This paper explores the link between experience and context. It places the lived experiences of Karen refugees during settlement in Brisbane, Australia within the socio-political context of Burma, or particularly the historical context of persecution. Two key events – the Wrist-tying Ceremony and the Karen New Year – provide a link between experience and context. The findings of this study show a community strategically at work in a new and ongoing settlement process. This process pays respect to the complexities of cultural integrity whilst also engaging with the challenges of integration. The complexities are local (in terms of cultural, linguistic and religious diversity), national (maintaining a broader sense of community that includes linkages across Australia, as well as an engagement with the Australian socio-political context), and transnational (participating in a global Karen community). This transnational community encompasses Karen settling elsewhere in the world, Karen in refugee camps neighbouring Burma, and Karen living inside Burma. This paper argues that substantial “identity work” is involved in Karen settlement. The two key community events are useful vignettes of this identity work. Both events demonstrate how Karen cultural practices can meaningfully negotiate deeply historical ideas of Karen identity with contemporary challenges of settlement. In addition, they set out a version of settlement that departs from traditional settlement constructs; they show how the lived experience of settlement is messy, complex and dynamic, and not reflective of the neat, idealistic models that immigration policy and settlement theory project.
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Parkinson’s disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson’s disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.
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Student voice is a powerful signifier for sharing the institutional habitus of a campus. With our new Caboolture Campus Community Stories initiative, we place students in the role of vloggers (video bloggers) to capture and distribute the stories, activities and events of the QUT environment. These stories present visual narratives through the eyes of students about university experience, academic practice and the transition from High School to first year, all intending to promote a sense of community and belonging, normalize academic practices and build an inclusive institutional habitus. These stories are placed on community websites and digital signage around campus as resources for first year students and prospective students.
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Micro and small businesses contribute the majority of business activity in most developed economies. They are typically embedded in local communities and therefore well placed to influence community wellbeing. While there has been considerable theoretical and empirical analysis of corporate citizenship and corporate social responsibility (CSR), the nature of micro-business community responsibility (mBCR) remains relatively under-explored. This article presents findings from an exploratory study of mBCR that examined the approaches, motivations and barriers of this phenomenon. Analysis of data from 36 semi structured interviews with micro-business owner-operators in the Australian city of Brisbane revealed three mBCR approaches, suggesting an observable mBCR typology. Each mBCR type was at least partly driven by enlightened self interest (ESI). In addition to a pure ESI approach, findings revealed ESI combined with philanthropic approaches and ESI combined with social entrepreneurial approaches. The combination of doing business and doing good found amongst participants in this study suggests that many micro-business owner-operators are supporters of their local communities, and therefore driven by more than profit. This study provides a fine-grained understanding of micro-business involvement in community wellbeing through a lens of responsible business behaviour.
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Objectives: Researchers have suggested that approximately 1% of individuals within the community have psychopathic tendencies (Neumann and Hare, 2008), although confirmatory evidence is scant. Design: The current study aimed to extend previous research beyond university student samples to explore the effect of impression management and self-deception on the identification of psychopathic traits. Methods: A non-incarcerated community sample comprising of 300 adults completed the Self-Reported Psychopathy scale – version 3 (SRP-III; Paulhus, Hemphill & Hare, in press) as well as the Paulhus Deception Scales (PDS; Paulhus, 1998). Results: Results indicated that at least 1% of the current community sample had clear psychopathic tendencies, and that such tendencies were found in younger males who mis-used alcohol. Conclusions: Importantly, individuals with psychopathic traits did not present with an inflated propensity to distort assessment responses, which provides support for future research endeavours that aim to conduct larger-scale psychopathy assessments within the community. This paper further outlines the study implications in regards to the practical assessment of psychopathy.
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Background and Aims: Falls and fall-related injuries result in reduced functioning, loss of independence, premature nursing home admissions and mortality. Malnutrition is associated with falls in the acute setting, but little is known about malnutrition and falls risk in the community. The aim of this study was to assess the association between malnutrition risk, falls risk and falls over a one-year period in community-dwelling older adults. Methods: Two hundred and fifty four subjects >65 years of age were recruited to participate in a study in order to identify risk factors for falls. Malnutrition risk was determined using the Mini Nutritional Assessment–Short Form. Results: 28.6% had experienced a fall and according to the Mini Nutritional Assessment-Short Form 3.9% (n=10) of subjects were at risk of malnutrition. There were no associations between malnutrition risk, the risk of falls, nor actual falls in healthy older adults in the community setting. Conclusions: There was a low prevalence of malnutrition risk in this sample of community-dwelling older adults and no association between nutritional risk and falls. Screening as part of a falls prevention program should focus on the risk of developing malnutrition as this is associated with falls.
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Chronic leg ulcers cause significant pain, cost, decreased quality of life and morbidity for a considerable segment of the older population (Graham et al., 2003a). At any given time the prevalence of patients with open leg ulcers receiving treatment is between 0.11% - 0.18% (Briggs & Closs 2003). Chronic leg ulcers occur in approximately 1 - 2% of the over 60 population in the US, UK, Europe and Australia (Baker & Stacey 1994; Johnson 1995; Lees & Lambert 1992; Margolis et al. 2002). Considerable research has been undertaken to determine the best treatment practices that will aid in the management and the healing of these ulcers, and practical and effective strategies and techniques for healing venous leg ulcers have been trialled to demonstrate their beneficial effects (Nelson et al. 2004; Cullum et al. 2001)...