70 resultados para Thiele,Colin, 1920-2006


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The 20th May 2006 lava dome collapse of the Soufrière Hills Volcano, Montserrat, had a total non-dense rock equivalent (non-DRE) collapse volume of approximately 115 × 10 6 m 3. The majority of this volume was deposited into the ocean. The collapse was rapid, 85% of the mobilized volume being removed in just 35 min, giving peak pyroclastic flow flux of 66 × 10 3 m 3 s -1. Channel and levee facies on the submarine flanks of the volcano and formation of a thick, steep-sided ridge, suggest that the largest and most dense blocks were transported proximally as a high concentration granular flow. Of the submerged volume, 30% was deposited from the base of this granular flow, forming a linear, high-relief ridge that extends 7 km from shore. The remaining 70% of the submerged volume comprises the finer grain sizes, which were transported at least 40 km by turbidity currents on gradients of <2°. At several localities, the May 2006 distal turbidity currents ran up 200 m of topography and eroded up to 20 cm of underlying substrate. Multiple turbidites are preserved, representing current reflection from the graben margins and deflection around topography. The high energy of the May 2006 collapse resulted in longer submarine run out than the larger (210 × 10 6 m 3) Soufrière Hills dome collapse in July 2003.

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Objective. The aim of this paper is to report the clinical practice changes resulting from strategies to standardise diabetic foot clinical management in three diverse ambulatory service sites in Queensland, Australia. Methods. Multifaceted strategies were implemented in 2008, including: multidisciplinary teams, clinical pathways, clinical training, clinical indicators, and telehealth support. Prior to the intervention, none of the aforementioned strategies were used, except one site had a basic multidisciplinary team. A retrospective audit of consecutive patient records from July 2006 to June 2007 determined baseline clinical activity (n = 101).Aclinical pathway teleform was implemented as a clinical activity analyser in 2008 (n = 327) and followed up in 2009 (n = 406). Pre- and post-implementation data were analysed using Chi-square tests with a significance level set at P < 0.05. Results. There was an improvement in surveillance of the high risk population of 34% in 2008 and 19% in 2009, and treating according to risk of 15% in 2009 (P < 0.05). The documentation of all best-practice clinical activities performed improved 13–66% (P < 0.03). Conclusion. These findings support the use of multifaceted strategies to standardise practice and improve diabetic foot complications management in diverse ambulatory services.

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Background Diabetic foot complications are recognised as the most common reason for diabetic related hospitalisation and lower extremity amputations. Multi-faceted strategies to reduce diabetic foot hospitalisation and amputation rates have been successful. However, most diabetic foot ulcers are managed in ambulatory settings where data availability is poor and studies limited. The project aimed to develop and evaluate strategies to improve the management of diabetic foot complications in three diverse ambulatory settings and measure the subsequent impact on ospitalisation and amputation. Methods Multifaceted strategies were implemented in 2008, including: multi-disciplinary teams, clinical pathways and training, clinical indicators, telehealth support and surveys. A retrospective audit of consecutive patient records from July 2006 – June 2007 determined baseline clinical indicators (n = 101). A clinical pathway teleform was implemented as a clinical record and clinical indicator analyser in all sites in 2008 (n = 327) and followed up in 2009 (n = 406). Results Prior to the intervention, clinical pathways were not used and multi-disciplinary teams were limited. There was an absolute improvement in treating according to risk of 15% in 2009 and surveillance of the high risk population of 34% and 19% in 2008 and 2009 respectively (p < 0.001). Improvements of 13 – 66% (p < 0.001) were recorded in 2008 for individual clinical activities to a performance > 92% in perfusion, ulcer depth, infection assessment and management, offloading and education. Hospitalisation impacts recorded reductions of up to 64% in amputation rates / 100,000 population (p < 0.001) and 24% average length of stay (p < 0.001) Conclusion These findings support the use of multi-faceted strategies in diverse ambulatory services to standardise practice, improve diabetic foot complications management and positively impact on hospitalisation outcomes. As of October 2010, these strategies had been rolled out to over 25 ambulatory sites, representing 66% of Queensland Health districts, managing 1,820 patients and 13,380 occasions of service, including 543 healed ulcer patients. It is expected that this number will rise dramatically as an incentive payment for the use of the teleform is expanded.

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This presentation describes the available trauma education programs, both formal and informal, that are currently being provided in Australia.

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Participation in sufficient levels of physical activity provides significant health benefits, particularly in older adults. The monitoring of physical activity levels in the Western Australian population is therefore necessary for developing and implementing strategies and programs for increasing participation. The Premier’s Physical Activity Taskforce (PATF) conducted a survey in 2006 to measure physical activity levels among Western Australian adults to follow-up the 1999 and 2002 state physical activity surveys. There is now widespread agreement that many health problems of older life – including the onset of frailty and disability – can be postponed or delayed by adopting health-enhancing habits such as physical activity. Adults over 65 years are the most rapidly growing age group and will continue to rise as more persons turn 65. If older adults could be encouraged to be more active as they age, frailty and disability associated with falls would be reduced, and function and physical and mental health in older people would be improved thereby reducing the burden of disease and injury. Given that physical inactivity is one of the most important and modifiable risk factors contributing to ill health, particularly for people as they age, the overall aim of this study was to examine patterns of physical activity in those aged 45 years and over – referred to hereafter as baby boomers+ – in more detail.

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BACKGROUND The incidence of skin cancer, both melanoma and keratinocyte cancers (KC) is rising throughout the world, specifically squamous cell carcinomas(SCC) and basal cell carcinoma(BCC), being the most common of all cancers. OBJECTIVE To determine trends in incidence of Melanoma, BCC and SCC among 1.7 million members of Maccabi Healthcare Services from 2006 to 2011. METHODS Data on newly diagnosed Melanoma, SCC and BCC cases was collected from the MHS Cancer Registry and based on histology reports from the centralized pathology lab. Age-specific and overall age-adjusted European standardized rates were computed. Trends were estimated by calculating Average Annual Percentage Change(AAPC). RESULTS During the six year study period, a total of 16,079 subjects were diagnosed with at least one BCC, 4,767 with SCC and 1,264 with invasive melanoma. Age-standardized incidence rates were 188, 58 and 17 per 100,000 person years for BCC, SCC and melanoma, respectively. All lesions were more common among males and primarily affected the elderly. BCC rates were stable throughout the study period(AAPC -0.7%, 95%CI -4.5% to 3.2%) while SCC incidence increased significantly(AAPC 15.5%, 95%CI: 2.6% to 30.0%). In contrast, melanoma rates continuously decreased with a significant AAPC of -3.0%, 95%CI (-4.5 to -0.1). CONCLUSIONS Previously unreported, the incidence of KC in Israel is high. The disparities in incidence trends between SCC, BCC and melanoma allude to their different etiologies. These findings underscore the importance of continuous monitoring, education and prevention programs in a growing high risk population.

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The Tamworth Regional Social Plan is a document for collaborative planning involving the three spheres of government, the community and commercial sectors, with the aim of enhancing the quality and fairness of life in Tamworth. The Plan is a way of identifying needs and priorities for community facilities and services for Tamworth. The Social Plan reflects Council’s ongoing commitment to the people of the Tamworth Region and, in particular, the social needs and aspirations of our community. The Local Government (General) Amendment (Community and Social Plans) Regulation 1998 grew out of the 1996 NSW Social Justice Directions Statement “Fair Go, Fair Share, Fair Say” which committed the Department of Local Government to ensuring government services are responsive to community needs and diversity. The regulation is designed to:- • Improve Councils’ ability to take account of community needs when formulating their management plans; • Assist Councils to provide or advocate for appropriate and accessible services/facilities; and • Increase the community’s ability to monitor Council efforts in addressing community needs over time. The Local Government (General) Regulation 1999 requires that all councils develop a community/social plan and that all plans be prepared in accordance with guidelines issued by the Department. While Council has a broad function of providing leadership for Tamworth, it is not the only group responsible for providing community services. Developing the Social Plan has required cooperation with various State and Federal agencies as well as with Tamworth’s community groups and agencies.

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A common finding in brand extension literature is that extension’s favorability is a function of the perceived fit between the parent brand and its extension (Aaker and Keller 1990; Park, Milberg, and Lawson 1991; Volckner and Sattler 2006) that is partially mediated by perceptions of risk (Milberg, Sinn, and Goodstein 2010; Smith and Andrews 1995). In other words, as fit between the parent brand and its extension increases, parent brand beliefs become more readily available, thus increasing consumer certainty and confidence about the new extension, which results in more positive evaluations. On the other hand, as perceived fit decreases, consumer certainty about the parent brand’s ability to introduce the extension is reduced, leading to more negative evaluations. Building on the notion that perceived fit of vertical line extensions is a function of the price/quality distance between parent brand and its extension (Lei, de Ruyter, and Wetzels 2008), traditional brand extension knowledge predicts a directionally consistent impact of perceived fit on evaluations of vertical extensions. Hence, vertical (upscale or downscale) extensions that are placed closer to the parent brand in the price/quality spectrum should lead to higher favorability ratings compared to more distant ones.

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One quarter of Australian children are overweight or obese (ABS, 2010), putting them at increased risk of physical and psychological health problems (Reilly et al., 2003). Overweight and obesity in childhood tends to persist into adulthood and is associated with premature death and morbidity (Reilly & Kelly, 2011). Increases in Australian children’s weight have coincided with declines in active transportation, such as walking, to school (Salmon et al., 2005). Investigating the factors which influence walking to school is therefore important, particularly since walking to school is a low cost and effective means of reducing excess weight (Rosenberg et al., 2006) that can be easily integrated into daily routine (Brophy et al., 2011). While research in this area has expanded (e.g., Brophy et al., 2011; Giles-Corti et al., 2010), it is largely atheoretical (exceptions Napier et al., 2011). This is an important gap from a social marketing perspective given the use of theory lies at the foundation of the framework (NSMC, 2006) and a continued lack of theory use is observed (Luca & Suggs, 2013). The aim of this paper is to empirically examine a widely adopted theory, the deconstructed Theory of Reasoned Action (TRA) (Fishbein & Azjen, 1975), to understand the relative importance of attitude and subjective norms in determining intentions to increase walk to school behaviour.