301 resultados para Cur met tilt


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Entry provides a concise description of obligations prescribed by laws and regulations, or procedural rules met by individuals or organisations. In the event of noncompliance, penalties are imposed. A conceptual overview, critical commentary and future directions on compliance provide the framework for this entry. The International Encyclopedia of Organization Studies is a definitive description of the field, spanning individual, organizational, societal, and cultural perspective in a cross-disciplinary manner. The Encyclopedia is thoroughly cross-referenced and entries are based around a series of broad themes. Key Features- Offers a comprehensive overview of many of the major ideas, concepts, terms, and approaches that characterise this diverse field of organization studies - Illustrates the fluidity, dynamism, and innovation that now occur in organization studies-internationally - Brings together a team of international contributors from the fields of: Management, Psychology, Sociology, Communications, Education, Political Science, Public Administration, Anthropology, Law and other related areas. - Examines how organizations are devices for structuring life and lives are structured by organizations

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Background: There is an increasing interest in measuring quality of life (QOL) in clinical settings and in clinical trials. None of the commonly used QOL instrument have been validated for use postnatally. Aim: To assess the psychometric properties of the 26-item WHOQOL-BREF among women following childbirth. Methods: Using a prospective cohort design we recruited 320 women within the first few days of childbirth. At six weeks postpartum, participants were asked to complete the WHOQOL-BREF, the Edinburgh Postnatal Depression Index and the Australian Unity Wellbeing Index. Validation of the WHOQOL-BREF included an analysis of internal consistency, discriminate validity, convergent validity and an examination of the domain structure. Results: 221 (69.1%) women returned their six-week questionnaire. All domains of the WHOQOL-BREF met reliability standards (alpha coefficient exceeding 0.70). The questionnaire discriminated well between known groups (depressed and non-depressed women. P = <0.000) and demonstrated satisfactory correlations with the Australian Unity Wellbeing index (r = >0.45). The domain structure of the WHOQOL-BREF was also valid in this population of new mothers, with moderate to high correlation between individual items and the domain structure to which the items were originally assigned. Conclusion: The WHOQOL-BRF is well-accepted and valid instrument in this population and may be used in postnatal clinical settings or for assessing intervention effects in research studies.

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Abstract Providing water infrastructure in times of accelerating climate change presents interesting new problems. Expanding demands must be met or managed in contexts of increasingly constrained sources of supply, raising ethical questions of equity and participation. Loss of agricultural land and natural habitats, the coastal impacts of desalination plants and concerns over re-use of waste water must be weighed with demand management issues of water rationing, pricing mechanisms and inducing behaviour change. This case study examines how these factors impact on infrastructure planning in South East Queensland, Australia: a region with one of the developed world’s most rapidly growing populations, which has recently experienced the most severe drought in its recorded history. Proposals to match forecast demands and potential supplies for water over a 20 year period are reviewed by applying ethical principles to evaluate practical plans to meet the water needs of the region’s activities and settlements.

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Four studies report on outcomes for long-term unemployed individuals who attend occupational skills/personal development training courses in Australia. Levels of distress, depression, guilt, anger, helplessness, positive and negative affect, life satisfaction and self esteem were used as measures of well-being. Employment value, employment expectations and employment commitment were used as measures of work attitude. Social support, financial strain, and use of community resources were used as measures of life situation. Other variables investigated were causal attribution, unemployment blame, levels of coping, self efficacy, the personality variable of neuroticism, the psycho-social climate of the training course, and changes to occupational status. Training courses were (a) government funded occupational skills-based programs which included some components of personal development training, and (b) a specially developed course which focused exclusively on improving well-being, and which utilised the cognitive-behavioural therapy (CBT) approach. Data for all studies were collected longitudinally by having subjects complete questionnaires pre-course, post-course, and (for 3 of the 4 studies) at 3 months follow-up, in order to investigate long-term effects. One of the studies utilised the case-study methodology and was designed to be illustrative and assist in interpreting the quantitative data from the other 3 evaluations. The outcomes for participants were contrasted with control subjects who met the same sel~tion criteria for training. Results confirmed earlier findings that the experiences of unemployment were negative. Immediate effects of the courses were to improve well-being. Improvements were greater for those who attended courses with higher levels of personal development input, and the best results were obtained from the specially developed CBT program. Participants who had lower levels of well-being at the beginning of the courses did better as a result of training than those who were already functioning at higher levels. Course participants gained only marginal advantages over control subjects in relation to improving their occupational status. Many of the short term well-being gains made as a result of attending the courses were still evident at 3 months follow-up. Best results were achieved for the specially designed CBT program. Results were discussed in the context of prevailing theories of Ynemployment (Fryer, 1986,1988; Jahoda, 1981, 1982; Warr, 1987a, 1987b).

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Physical infrastructure assets are important components of our society and our economy. They are usually designed to last for many years, are expected to be heavily used during their lifetime, carry considerable load, and are exposed to the natural environment. They are also normally major structures, and therefore present a heavy investment, requiring constant management over their life cycle to ensure that they perform as required by their owners and users. Given a complex and varied infrastructure life cycle, constraints on available resources, and continuing requirements for effectiveness and efficiency, good management of infrastructure is important. While there is often no one best management approach, the choice of options is improved by better identification and analysis of the issues, by the ability to prioritise objectives, and by a scientific approach to the analysis process. The abilities to better understand the effect of inputs in the infrastructure life cycle on results, to minimise uncertainty, and to better evaluate the effect of decisions in a complex environment, are important in allocating scarce resources and making sound decisions. Through the development of an infrastructure management modelling and analysis methodology, this thesis provides a process that assists the infrastructure manager in the analysis, prioritisation and decision making process. This is achieved through the use of practical, relatively simple tools, integrated in a modular flexible framework that aims to provide an understanding of the interactions and issues in the infrastructure management process. The methodology uses a combination of flowcharting and analysis techniques. It first charts the infrastructure management process and its underlying infrastructure life cycle through the time interaction diagram, a graphical flowcharting methodology that is an extension of methodologies for modelling data flows in information systems. This process divides the infrastructure management process over time into self contained modules that are based on a particular set of activities, the information flows between which are defined by the interfaces and relationships between them. The modular approach also permits more detailed analysis, or aggregation, as the case may be. It also forms the basis of ext~nding the infrastructure modelling and analysis process to infrastructure networks, through using individual infrastructure assets and their related projects as the basis of the network analysis process. It is recognised that the infrastructure manager is required to meet, and balance, a number of different objectives, and therefore a number of high level outcome goals for the infrastructure management process have been developed, based on common purpose or measurement scales. These goals form the basis of classifYing the larger set of multiple objectives for analysis purposes. A two stage approach that rationalises then weights objectives, using a paired comparison process, ensures that the objectives required to be met are both kept to the minimum number required and are fairly weighted. Qualitative variables are incorporated into the weighting and scoring process, utility functions being proposed where there is risk, or a trade-off situation applies. Variability is considered important in the infrastructure life cycle, the approach used being based on analytical principles but incorporating randomness in variables where required. The modular design of the process permits alternative processes to be used within particular modules, if this is considered a more appropriate way of analysis, provided boundary conditions and requirements for linkages to other modules, are met. Development and use of the methodology has highlighted a number of infrastructure life cycle issues, including data and information aspects, and consequences of change over the life cycle, as well as variability and the other matters discussed above. It has also highlighted the requirement to use judgment where required, and for organisations that own and manage infrastructure to retain intellectual knowledge regarding that infrastructure. It is considered that the methodology discussed in this thesis, which to the author's knowledge has not been developed elsewhere, may be used for the analysis of alternatives, planning, prioritisation of a number of projects, and identification of the principal issues in the infrastructure life cycle.

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Speaker verification is the process of verifying the identity of a person by analysing their speech. There are several important applications for automatic speaker verification (ASV) technology including suspect identification, tracking terrorists and detecting a person’s presence at a remote location in the surveillance domain, as well as person authentication for phone banking and credit card transactions in the private sector. Telephones and telephony networks provide a natural medium for these applications. The aim of this work is to improve the usefulness of ASV technology for practical applications in the presence of adverse conditions. In a telephony environment, background noise, handset mismatch, channel distortions, room acoustics and restrictions on the available testing and training data are common sources of errors for ASV systems. Two research themes were pursued to overcome these adverse conditions: Modelling mismatch and modelling uncertainty. To directly address the performance degradation incurred through mismatched conditions it was proposed to directly model this mismatch. Feature mapping was evaluated for combating handset mismatch and was extended through the use of a blind clustering algorithm to remove the need for accurate handset labels for the training data. Mismatch modelling was then generalised by explicitly modelling the session conditions as a constrained offset of the speaker model means. This session variability modelling approach enabled the modelling of arbitrary sources of mismatch, including handset type, and halved the error rates in many cases. Methods to model the uncertainty in speaker model estimates and verification scores were developed to address the difficulties of limited training and testing data. The Bayes factor was introduced to account for the uncertainty of the speaker model estimates in testing by applying Bayesian theory to the verification criterion, with improved performance in matched conditions. Modelling the uncertainty in the verification score itself met with significant success. Estimating a confidence interval for the "true" verification score enabled an order of magnitude reduction in the average quantity of speech required to make a confident verification decision based on a threshold. The confidence measures developed in this work may also have significant applications for forensic speaker verification tasks.

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Objective: To evaluate the fruit and vegetable intakes of Australian adults aged 19-64 years. Methods: Intake data were collected as part of the National Nutrition Survey 1995 representing all Australian States and Territories, including city, metropolitan, rural and remote areas. Dietary intake of 8,891 19-to-64 year-olds was assessed using a structured 24-hour recall. Intake frequency was assessed as the proportion of participants consuming fruit and vegetables on the day prior to interview and variety was assessed as the number of subgroups of fruit and vegetables consumed. Intake levels were compared with the recommendations of the Australian Guide to Healthy Eating (AGHE). Results: Sixty-two per cent of participants consumed some fruit and 89% consumed some vegetables on the day surveyed. Males were less likely to consume fruit and younger adults less likely to consume fruit and vegetables compared with females and older adults respectively. Variety was primarily low (1 subcategory) for fruit and medium (3-4 subcategories) for vegetables. Thirty-two per cent of adults consumed the minimum two serves of fruit and 30% consumed the minimum five serves of vegetables as recommended by the AGHE. Eleven per cent of adults met the minimum recommendations for both fruit and vegetables. Conclusion: A large proportion of adults have fruit and vegetable intakes below the AGHE minimum recommendations. Implications: A nationally integrated, longterm campaign to increase fruit and vegetable consumption, supported by policy changes to address structural barriers to consumption, is vital to improve fruit and vegetable consumption among adults

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Aim This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce.

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Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

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The world’s increasing complexity, competitiveness, interconnectivity, and dependence on technology generate new challenges for nations and individuals that cannot be met by “continuing education as usual” (The National Academies, 2009). With the proliferation of complex systems have come new technologies for communication, collaboration, and conceptualization. These technologies have led to significant changes in the forms of mathematical thinking that are required beyond the classroom. This paper argues for the need to incorporate future-oriented understandings and competencies within the mathematics curriculum, through intellectually stimulating activities that draw upon multidisciplinary content and contexts. The paper also argues for greater recognition of children’s learning potential, as increasingly complex learners capable of dealing with cognitively demanding tasks.

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Background: The “Curriculum renewal in legal education” project has been funded by the Australian Learning and Teaching Council with the core objectives being the articulation of a set of final year curriculum design principles, and the development of a model of a transferable final year program. Through these principles and the development of the model, it is anticipated that the final year experience for law students will provide greater opportunity for them to understand the relevance of their learning, and will enhance their capacity to make decisions regarding their career path. Discussion / Argument: This paper reports on the project’s progress to date, and presents an argument for the inclusion of work integrated learning (WIL) as a component of the final year experience in undergraduate law programs. The project has identified that the two principal objectives of capstone experiences are to provide closure and to facilitate transition to post-university life. Reflective practice and Bruner’s spiral curriculum model are the central theoretical foundations by which these objectives can be achieved. Experiential learning is also increasingly seen as an essential element of a capstone experience. WIL is consistent with the objectives of capstones in focusing on the transition to professional practice and providing opportunities for reflection. However, the ability of WIL to meet all of the objectives of capstones, particularly closure and integration, may be limited. Conclusions / Implications: The paper posits that while WIL should be considered as a potential component of a capstone experience, educators should ensure that WIL is not equated with a capstone experience unless it is carefully designed to ensure that all of the objectives of capstones are met. Keywords: Work-integrated learning, capstone, final year experience, law

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Vitamin D, along with calcium, may help decrease the risk of falls and fractures in older adults. Sunlight and other sources of ultraviolet radiation are not recommended because they increase the risk of skin cancers and sun-induced eye disorders. Rather, vitamin D and calcium needs should be met through foods and dietary supplements. As a preventive measure to reduce the risk of falls and fractures, it is recommended that older adults meet the 2005 Dietary Guidelines and consume 1000 IU of vitamin D, preferably as vitamin D3.

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The launch of the Apple iPad in January 2010 was one of the most anticipated and publicised launched of a new technological device in recent history. Positioning itself as between a smart phone and a PC, but with the attributes of both, Apple have sought to develop a new market niche with the iPad for tablet PC devices, and early signs are that market expectations are being met.. The iPad’s launch was potentially fortuitous for the newspaper industry worldwide, as it offered the potential to address its two recurring problems: the slow but inexorable decline of print media circulation, and the inability to satisfactorily monetise online readerships. As a result, the Apple iPad has benefited from an enormous amount of free publicity in newspapers, as they develop their own applications (apps) for the device. This paper reports on findings from work undertaken through Smart Services CRC into potential take-up and likely uses of the iPad, and their implications for the news media industry. It reports on focus group analysis undertaken in the mid-2010 using “customer job mapping” methodologies, that draw attention to current gaps in user behaviour in terms of available devices, in order to anticipate possibilities beyond the current “three screens” of PC, mobile phone and television.

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Objective: Diarrhoea in the enterally tube fed (ETF) intensive care unit (ICU) patient is a multifactorial problem. Diarrhoeal aetiologies in this patient cohort remain debatable; however, the consequences of diarrhoea have been well established and include electrolyte imbalance, dehydration, bacterial translocation, peri anal wound contamination and sleep deprivation. This study examined the incidence of diarrhoea and explored factors contributing to the development of diarrhoea in the ETF, critically ill, adult patient. ---------- Method: After institutional ethical review and approval, a single centre medical chart audit was undertaken to examine the incidence of diarrhoea in ETF, critically ill patients. Retrospective, non-probability sequential sampling was used of all emergency admission adult ICU patients who met the inclusion/exclusion criteria. ---------- Results: Fifty patients were audited. Faecal frequency, consistency and quantity were considered important criteria in defining ETF diarrhoea. The incidence of diarrhoea was 78%. Total patient diarrhoea days (r = 0.422; p = 0.02) and total diarrhoea frequency (r = 0.313; p = 0.027) increased when the patient was ETF for longer periods of time. Increased severity of illness, peripheral oxygen saturation (Sp02), glucose control, albumin and white cell count were found to be statistically significant factors for the development of diarrhoea. ---------- Conclusion: Diarrhoea in ETF critically ill patients is multi-factorial. The early identification of diarrhoea risk factors and the development of a diarrhoea risk management algorithm is recommended.