543 resultados para service de santé


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Public services face several workforce challenges, including impending retirements and austerity programs. Although employing more young people is a likely solution to balancing the demographic profile of public services, the literature and theory suggest that young people would have fared worse during the global financial crisis. This research tests propositions around the vulnerability of young people in selected Australian public services during the global financial crisis, in terms of quantity and quality of jobs obtained. Surprisingly, the findings suggest that many young people fared as well or sometimes better than other age cohorts during the global financial crisis in terms of both recruitment and access to ongoing jobs. There are several indications that perhaps public services provided a safe haven in a turbulent labour market.

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This paper begins with a brief review of recent literature about relationships between offending behaviour and mental illness, classifying studies by the settings within which they occurred. The establishment and role of a mental health court liaison (MHCL) service is then described, together with findings from a 3-year service audit, including an examination of relationships between clients’ characteristics and offence profiles, and comparisons with regional offence data. During the audit period, 971 clients (767 males, 204 females) were referred to the service, comprising 1139 service episodes, 35.5% of which involved a comorbid substance use diagnosis. The pattern of offences for MHCL clients was reasonably similar to the regional offence data, except that among MHCL clients there were proportionately more offences against justice procedures (e.g., breaches of apprehended violence orders [AVOs]) and fewer driving offences and “other offences”. Additionally, male MHCL clients had proportionately more malicious damage and robbery offences and lower rates of offensive behaviour and drug offences. A range of service and research issues is also discussed. Overall, the new service appears to have forged more effective links between the mental health and criminal justice systems.

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Objective: This study assessed 12-month service use patterns among people with psychotic disorders and sought to identify determinants of service use. Methods: As part of a large two-phase Australian study of psychotic disorders, structured interviews were conducted with a stratified random sample of adults who screened positive for psychosis. Demographic characteristics, social functioning, symptoms, mental health diagnoses, and use of psychiatric and nonpsychiatric services were assessed. Data were analyzed for 858 persons who had an ICD-10 diagnosis of a psychotic disorder and who had been hospitalized for less than six months during the previous year. Results: People with psychotic disorders had high levels of use of health services, both in absolute terms and relative to people with nonpsychotic disorders. Those with psychotic disorders were estimated to have an average of one contact with health services per week. Use of psychiatric inpatient services was associated with parenthood, higher symptom levels, recent attempts at suicide or self-harm, personal disability, medication status, and frequency of alcohol consumption. Services provided by general practitioners (family physicians) were more likely to be obtained by older people, women, people with greater availability of friends, those with fewer negative symptoms, and those whose service needs were unmet by other sources. People who were high users of health services also reported having more contact with a range of non-health agencies. Conclusions: The predictors of service use accounted for small proportions of the variance in overall use of health services. The role of general practitioners in providing and monitoring treatment programs and other psychosocial interventions needs to be acknowledged and enhanced.

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In Australia, for more than two decades, a ‘social science’ integrated framework was the favoured approach for delivering subjects such as history and geography. However, such interdisciplinary approaches have continued to attract criticism from various parts of the academic and public spheres and since 2009, a return to teaching the disciplines has been heralded as the ‘new’ way forward. Using discourse analysis techniques associated with Foucauldian archaeology, the purpose of this paper is to examine the Australian Curriculum: Geography document to ascertain the discourses necessary for pre-service teachers to enact effective teaching of geography in a primary setting. Then, based on pre-service teachers’ online survey responses, the paper investigates if such future teachers have the knowledge and skills to interpret, deliver and enact the new geography curriculum in primary classrooms. Finally, as teacher educators, our interest lies in preparing pre-service teachers effectively for the classroom so the findings are used to inform the content of a teacher education course for pre-service primary teachers.

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Rove n Rave ™ is a website designed and created for, and with, people with an intellectual disability. Its aim is to provide them with a user-friendly online platform where they can share opinions and experiences, and where they can find reviews which will help them to choose a place to visit themselves. During the development process, input on design requirements was gathered from a group of people with an intellectual disability and the disability service provider. This group then tested the product and provided further feedback on improving the website. It was found that the choice of wording, icons, pictures, colours and some functions significantly affected the users' ability to understand the content of the website. This demonstrated that a partnership between the developer and the user is essential when designing and delivering products or services for people with an intellectual disability.

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The theoretical contribution of this study lies with its focus on subjective experiencing, that is, the emotional convergence between feeling states, and perceptions of servicescapes and holiday activities. An empirical study models the impact of recreational needs on the perceived importance of destination attributes and intentions to participate in activities. A sample of prospective tourists was asked to indicate how important they considered servicescape elements to be in their general holiday planning. They were also asked to report on their emotional state (orientation) as a proxy for their needs for recreation, and to state their intention and likely involvement with holiday activities. Results suggest that those with high recreational needs (self-reflexive and inward-looking) regard elements of tourism servicescapes as significantly more important than those without (who are outward-looking and energetic), as well as show significant variations in their inclinations to be active and explorative at destinations. Rather, those with higher recreational needs as measured by combinations of lack of energy, self-confidence, and physiological well-being look for creature comfort, coziness, and familiarity, in other words, for things they already know and have experienced before. Subjective experiencing and service performance evaluations are thereby suggested to be influenced by emotional states. These states may also impact tourists' recognition of destination uniqueness as a major component of a destination's competitive advantage that cannot easily be copied. As a consequence, it may be worth reconsidering the role of recreation in tourism service design. Turning an inwardlooking focus bent on recreation to an outward-looking one interested in discovery would enable more tourists to more fully experience the destination before they leave.

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An increasing range of technology services are now offered on a self-service basis. However, problems with self-service technologies (SSTs) occur at times due to the technical error, staff error, or consumers’ own mistakes. Considering the role of consumers as co-producers in the SST context, we aim to study consumer’s behaviours, strategies, and decision making in solving their problem with SST and identify the factors contributing to their persistence in solving the problem. This study contributes to the information systems research, as it is the first study that aims to identify such a process and the factors affecting consumers’ persistence in solving their problem with SST. A focus group with user support staff has been conducted, yielding some initial results that helped to conduct the next phases of the study. Next, using Critical Incident Technique, data will be gathered through focus groups with users, diary method, and think-aloud method.

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This report presents the findings from a study of the financial impact of work-integrated learning commonly referred to as 'placement' among social work and human services students. Based on a survey of 214 respondants, 14 in-depth interviews and two focus groups, the findings indicate that two thirds of the surveyed group felt tired and anxious about their experience of balancing paid work and placement, with 2 in 5 reporting their learning experience was compromised as a result. The significant implications and potential solutions are also discussed.

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Introduction Chest pain is common in emergency department (ED) patients and represents a considerable burden for rural health services. Health services reforms to improve access to care need appropriately skilled and supported clinicians in the delivery of safe and effective care, including the use of emergency nurse practitioners (ENPs). Despite increasing use of ENPs, little is known about the safety and quality of the service in the rural ED context. The aims of this study are (1) to examine the safety and quality of the ENP service model in the provision of care in the rural environment and (2) to evaluate the effectiveness of the service in the management of patients presenting with undifferentiated chest pain. Methods and analysis This is the protocol for a prospective longitudinal nested cohort study to compare the effectiveness of ENP service with that of standard care. Adults presenting to three rural EDs in Queensland, Australia with a primary presenting complaint of atraumatic chest pain will be eligible for enrolment. We will measure (1) clinician's use of evidence-based guidelines (2) diagnostic accuracy of ECG interpretation for the management of patients with suspected or confirmed ACS (3) service indicators of waiting times, length-of-stay and did-not-wait rates and (4) clinician's diagnostic accuracy as measured by rates of unplanned representation within 7 days (5) satisfaction with care, (6) quality-of-life and (7) functional status. To assess these outcomes we will use a combination of measures collected from routinely collected data, medical record review and questionnaires (with 30-day follow-up). Ethics and dissemination Queensland Health Human Research Ethics Committee (HREC) has approved this protocol. The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

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Staffing rural and remote schools is an important policy issue for the public good. This paper examines the private issues it also poses for teachers with families working in these communities, as they seek to reconcile careers with educational choices for children. The paper first considers historical responses to staffing rural and remote schools in Australia, and the emergence of neoliberal policy encouraging marketisation of the education sector. We report on interviews about considerations motivating household mobility with 11 teachers across regional, rural and remote communities in Queensland. Like other middle-class parents, these teachers prioritised their children’s educational opportunities over career opportunities. The analysis demonstrates how teachers in rural and remote communities constitute a special group of educational consumers with insider knowledge and unique dilemmas around school choice. Their heightened anxieties around school choice under neoliberal policy are shown to contribute to the public issue of staffing rural and remote schools.

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The growth of APIs and Web services on the Internet, especially through larger enterprise systems increasingly being leveraged for Cloud and software-as-a-service opportunities, poses challenges for improving the efficiency of integration with these services. Interfaces of enterprise systems are typically larger, more complex and overloaded, with single operations having multiple data entities and parameter sets, supporting varying requests, and reflecting versioning across different system releases, compared to fine-grained operations of contemporary interfaces. We propose a technique to support the refactoring of service interfaces by deriving business entities and their relationships. In this paper, we focus on the behavioural aspects of service interfaces, aiming to discover the sequential dependencies of operations (otherwise known as protocol extraction) based on the entities and relationships derived. Specifically, we propose heuristics according to these relationships, and in turn, deriving permissible orders in which operations are invoked. As a result of this, service operations can be refactored on business entity CRUD lines, with explicit behavioural protocols as part of an interface definition. This supports flexible service discovery, composition and integration. A prototypical implementation and analysis of existing Web services, including those of commercial logistic systems (Fedex), are used to validate the algorithms proposed through the paper.

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Climate change and solar ultraviolet radiation may affect vaccine-preventable infectious diseases (VPID), the human immune response process and the immunization service delivery system. We systematically reviewed the scientific literature and identified 37 relevant publications. Our study shows that climate variability and ultraviolet radiation may potentially affect VPID and the immunization delivery system through modulating vector reproduction and vaccination effectiveness, possibly influencing human immune response systems to the vaccination, and disturbing immunization service delivery. Further research is needed to determine these affects on climate-sensitive VPID and on human immune response to common vaccines. Such research will facilitate the development and delivery of optimal vaccination programs for target populations, to meet the goal of disease control and elimination.

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Internationally there is interest in developing the research skills of pre-service teachers as a means of ongoing professional renewal with a distinct need for systematic and longitudinal investigation of student learning. The current study takes a unique perspective by exploring the research learning journey of pre-service teachers participating in a transnational degree programme. Using a case-study design that includes both a self-reported and direct measure of research knowledge, the results indicate a progression in learning, as well as evidence that this research knowledge is continued or maintained when the pre-service teachers return to their home university. The findings of this study have implications for both pre-service teacher research training and transnational programmes.

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Objective: This paper reflects on the recent growth of cancer research being conducted through some of Australia’s rural centres. It encompasses work being done across the fields of clinical, translational and health services research. Design: This is a collaborative piece with contributions from rural health researchers, clinical and cancer services staff from several different regions. Conclusion: The past decade has seen an expansion in cancer research in rural and regional Australia driven in part by the recognition that cancer patients in remote areas experience poorer outcomes than their metropolitan counterparts. This work has led to the development of more effective cancer networks and new models of care designed to meet the particular needs of the rural cancer patient. It is hoped that the growth of cancer research in regional centres will, in time, reduce the disparity between rural and urban communities and improve outcomes for cancer patients across both populations.

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Purpose This study investigates the effects of service innovation exploration-exploitation on financial performance through the delivery of quality services. Additional emphasis is also given to examining the extent to which employee empowerment and slack resources enhance or suppress the performance benefits of service firms engaging in service innovation exploration versus exploitation. Design/methodology/approach Data were drawn from a multi-informant survey of service firms using a drop-and-collect approach. The survey gathered data from managers, customer service employees and customers to test the hypotheses. Findings The results show that excelling at both exploitative and exploratory innovation helps enhance the quality of services, which in turn yield superior financial performance. Further, empowering employees enhances the relationship between exploratory and exploitative service innovation and service quality. We also show that the extent managers’ perceived their market to be competitive influences in the pursuit of high levels of both service innovation exploration and exploitation and that this relationship is impacted by the extent they believe they have available slack resources. Practical implications The findings suggest that service firms need to pursue both exploitation and exploration at high levels simultaneously and empower their employees to stay ahead of competitors in delivering quality services, which ultimately contribute to the achievement of superior financial outcomes. Also, the findings highlight the importance of employee empowerment, market competitiveness and slack resources in the pursuit of high levels of both service innovation exploration and exploitation. Originality/value These findings and our theory indicate that this study is the first to empirically examine organizational ambidexterity in the context of service innovation exploration – exploitation adopting the principles of combined and balanced innovation. The study provides insights into the critical role of customers’ perceptions of service quality in contributing to firms’ financial performance. Our insights are unique in that the study incorporates managers, employees and customers in an integrated service innovation model.