138 resultados para Best practices of transformation


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Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.

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This thesis describes a discrete component of a larger mixed-method (survey and interview) study that explored the health-promotion and risk-reduction practices of younger premenopausal survivors of ovarian, breast and haematological cancers. This thesis outlines my distinct contribution to the larger study, which was to: (1) Produce a literature review that thoroughly explored all longer-term breast cancer treatment outcomes, and which outlined the health risks to survivors associated with these; (2) Describe and analyse the health-promotion and risk-reduction behaviours of nine younger female survivors of breast cancer as articulated in the qualitative interview dataset; and (3) Test the explanatory power of the Precede-Proceed theoretical framework underpinning the study in relation to the qualitative data from the breast cancer cohort. The thesis reveals that breast cancer survivors experienced many adverse outcomes as a result of treatment. While they generally engaged in healthy lifestyle practices, a lack of knowledge about many recommended health behaviours emerged throughout the interviews. The participants also described significant internal and external pressures to behave in certain ways because of the social norms surrounding the disease. This thesis also reports that the Precede-Proceed model is a generally robust approach to data collection, analysis and interpretation in the context of breast cancer survivorship. It provided plausible explanations for much of the data in this study. However, profound sociological and psychological implications arose during the analysis that were not effectively captured or explained by the theories underpinning the model. A sociological filterâsuch as Turnerâs explanation of the meaning of the body and embodiment in the social sphere (Turner, 2008)âand the psychological concerns teased out in Mishelâs (1990) Uncertainty in Illness Theory, provided a useful dimension to the findings generated through the Precede-Proceed model. The thesis concludes with several recommendations for future research, clinical practice and education in this context.

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There are ever increasing demands and expectations in the research world, related to the quality of research supervision. It can be difficult for an individual research supervisor to recognize their own quality of research supervision. On top of this are the added challenges of trying to improve that quality of research supervision. Reflective practice is consistently identified as a way for developing professional practice in research supervision. This chapter offers a number of frameworks to facilitate reflective practice about research supervision. It does not propose to solve the problem of quality research supervision but to provide ways in which a research supervisor can reflect on this aspect of their professional academic practice and begin to plan ways in which their practice can improve.

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Aims. This article is a report of a study done to identify how renal nurses experience information about renal care and the information practices that they used to support everyday practice. Background. What counts as nursing knowledge remains a contested area in the discipline yet little research has been undertaken. Information practice encompasses a range of activities such as seeking, evaluation and sharing of information. The ability to make informed judgement is dependent on nurses being able to identify relevant sources of information that inform their practice and those sources of information may enable the identification of what knowledge is important to nursing practice. Method. The study was philosophically framed from a practice perspective and informed by Habermas and Schatzki; it employed qualitative research techniques. Using purposive sampling six registered nurses working in two regional renal units were interviewed during 2009 and data was thematically analysed. Findings. The information practices of renal nurses involved mapping an information landscape in which they drew on information obtained from epistemic, social and corporeal sources. They also used coupling, a process of drawing together information from a range of sources, to enable them to practice. Conclusion. Exploring how nurses engage with information, and the role the information plays in situating and enacting epistemic, social and corporeal knowledge into everyday nursing practice is instructive because it indicates that nurses must engage with all three modalities in order to perform effectively, efficiently and holistically in the context of patient care. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

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There is little research on HRM practices in knowledge-intensive firms (KIFs), especially in comparison to that conducted in traditional production environments. Whether such HRM practices are appropriate for KIFs, particularly ones that differentiate themselves on their ability to innovate, is the basis of this research. The study investigates the HRM practices being used by four innovative firms: two KIFs and two traditional production companies. The findings suggest that there are some similarities between the HRM practices of the case firms, but there are also important differences. Specifically, the KIFs emphasise use of selection criteria and processes that secure a workforce with a desire for challenging work and the ability to work collaboratively. The KIFs are also more likely to provide a breadth of training and development opportunities for teams and individuals, to make extensive use of performance management systems, and to utilise a range of strategies to encourage and reward innovation.

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Malaysian teachers are now using interactive courseware in their teaching practices as part of teaching activity in classroom, to teach some subjects such as languages, mathematics, and science. Towards this, there is some debate going on the effectiveness of interactive courseware used in classroom. This paper reports data from interviews conducted with school principals and teachers from six selected primary Smart Schools across Malaysia.The interview conducted is looked on their current school practices and challenges in the implementation of interactive courseware in the classroom. The interview covers several aspects of their school facilities, the causes attributed and their concerns. However, the findings revealed that these six schools generally need more supports in the physical and technical form, in order to utilize the interactive courseware. Initially, the current support from the Malaysian Ministry of Education in physical form has proved that not very helpful. Thus, the respondents suggested that supports should be both: physical and technical. Therefore, this preliminary findings could be used as a pointer to the Malaysian government and other stakeholders to the improvement of interface design for future interactive courseware.

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This small exploratory study sought to understand how people with End Stage Kidney Disease (ESKD) experience the information environment and what information practices they employ in order to inform the decisions they make in relation to treatment and care. Using a constructivist methodology, in-depth interviews were conducted with five people who were receiving haemodialysis in two small satellite dialysis units located in regional and rural communities in New South Wales, Australia. Thematic analysis revealed two types of patients. The first type appears to adopt a received view of information, who do not question their condition; and passively accept information. In the other type, patients were found to be engaged; they actively identified their information needs and quickly learned what that they needed to ask and who to ask. Knowing the information practices of people with ESKD is useful for nephrology nurses when providing patient education.

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We examine the corporate governance environment of smaller listed Australian firms to investigate the factors that determine how firms respond to recommendations contained in corporate governance codes. We group corporate governance recommendations into three distinct categories and argue that differences in adoption costs between categories, together with firm specific factors, determine a firmâs decision to conform with the recommendation or to explain the reasons for non-conformance. Analysis of the conformance by smaller firms with governance recommendations highlights substantial differences in adoption rates between categories of recommendations. Our results also reveal that the cost of adopting specific recommendations, together with profitability, external audit quality, and ownership dispersion, jointly explain a firmâs decision to â˜comply or explainâ. This study provides insights for policy makers and regulators regarding the appropriateness of corporate governance recommendations for smaller firms

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What are the information practices of teen content creators? In the United States over two thirds of teens have participated in creating and sharing content in online communities that are developed for the purpose of allowing users to be producers of content. This study investigates how teens participating in digital participatory communities find and use information as well as how they experience the information. From this investigation emerged a model of their information practices while creating and sharing content such as film-making, visual art work, story telling, music, programming, and web site design in digital participatory communities. The research uses grounded theory methodology in a social constructionist framework to investigate the research problem: what are the information practices of teen content creators? Data was gathered through semi-structured interviews and observation of teenâs digital communities. Analysis occurred concurrently with data collection, and the principle of constant comparison was applied in analysis. As findings were constructed from the data, additional data was collected until a substantive theory was constructed and no new information emerged from data collection. The theory that was constructed from the data describes five information practices of teen content creators. The five information practices are learning community, negotiating aesthetic, negotiating control, negotiating capacity, and representing knowledge. In describing the five information practices there are three necessary descriptive components, the community of practice, the experiences of information and the information actions. The experiences of information include information as participation, inspiration, collaboration, process, and artifact. Information actions include activities that occur in the categories of gathering, thinking and creating. The experiences of information and information actions intersect in the information practices, which are situated within the specific community of practice, such as a digital participatory community. Finally, the information practices interact and build upon one another and this is represented in a graphic model and explanation.

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In this paper, we examine the lawfulness of a proposal to provide elective ventilation to incompetent patients who are potential organ donors. Under the current legal framework, this depends on whether the best interests test could be satisfied. It might be argued that, because the Mental Capacity Act 2005 (UK) (and the common law) makes it clear that the best interests test is not confined to the patient's clinical interests, but extends to include the individual's own values, wishes and beliefs, the proposal will be in the patient's best interests. We reject this claim. We argue that, as things currently stand, the proposal could not lawfully be justified as a blanket proposition by reference to the best interests test. Accordingly, a modification of the law would be necessary to render the proposal lawful. We conclude with a suggestion about how that could be achieved.

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Restorative practices have often been considered both as emerging from the customs of Indigenous peoples, and ways of responding to crime that might be most suitable for Indigenous individuals and communities. This paper, which consists of two parts, will reconsider these claims from a critical perspective. The first part of the paper draws on my Ph.D. research on the emergence of restorative justice in Western criminal justice systems. It will argue that although many advocates of restorative justice uncritically and unproblematically accept that restorative practices emerged from the customs of Indigenous peoples, the relationship between Indigenous justice customs and the emergence of restorative justice is much more nuanced than proponents imply. The paper will examine, therefore, the legitimating rationalities associated with the diverse historical â˜truthsâ obscured in advocatesâ accounts of the role of Indigenous customs and the emergence of restorative justice. The second section draws on the findings of recent research undertaken at the Australian Institute of Criminology, and will present data on the numbers of Indigenous juveniles who participate in restorative conferences in each jurisdiction. These data will be used to elucidate the disparity between the rhetoric or â˜promiseâ of restorative justice, and its apparent impact in relation to Indigenous juveniles. This paper will conclude with a consideration of the continued relevance of restorative justice for Indigenous young people in Australia.

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Young adults represent the largest group of first time donors to the Australian Red Cross Blood Service, but they are also the least loyal group and often do not return after their first donation. At the same time, many young people use the internet and various forms of social media on a daily basis. Web and mobile based technological practices and communication patterns change the way that young people interact with one another, with their families, and communities. Combining these two points of departure, this study seeks to identify best practices of employing mobile apps and social media in order to enhance the loyalty rates of young blood donors. The findings reported in this paper are based on a qualitative approach presenting a nuanced understanding of the different factors that motivate young people to donate blood in the first place, as well as the obstacles or issues that prevent them from returning. The paper discusses work in progress with a view to inform the development of interactive prototypes trialling three categories of features: personal services (such as scheduling); social media (such as sharing the donation experience with friends to raise awareness); and data visualisations (such as local blood inventory levels). We discuss our translation of research findings into design implications.