774 resultados para Nursing practices


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Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age.

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Background Malnutrition and unintentional weight loss are major clinical issues in people with dementia living in residential aged care facilities (RACFs) and are associated with serious adverse outcomes. However, evidence regarding effective interventions is limited and strategies to improve the nutritional status of this population are required. This presentation describes the implementation and results of a pilot randomised controlled trial of a multi-component intervention for improving the nutritional status of RACF residents with dementia. Method Fifteen residents with moderate-severe dementia living in a secure long-term RACF participated in a five week pilot study. Participants were randomly allocated to either an Intervention (n=8) or Control group (n=7). The intervention comprised four elements delivered in a separate dining room at lunch and dinner: the systematic reinforcement of residents’ eating behaviors using a specific communication protocol; family-style dining; high ambiance table presentation; and routine Dietary-Nutrition Champion supervision. Control group participants ate their meals according to the facility’s standard practice. Baseline and follow-up assessments of nutritional status, food consumption, and body mass index were obtained by qualified nutritionists. Additional assessments included measures of cognitive functioning, mealtime agitation, depression, wandering status and multiple measures of intervention fidelity. Results No participant was malnourished at study commencement and participants in both groups gained weight from follow-up to baseline which was not significantly different between groups (t=0.43; p=0.67). A high degree of treatment fidelity was evident throughout the intervention. Qualitative data from staff indicate the intervention was perceived to be beneficial for residents. Conclusions This multi-component nutritional intervention was well received and was feasible in the RACF setting. Participants’ sound nutritional status at baseline likely accounts for the lack of an intervention effect. Further research using this protocol in malnourished residents is recommended. For success, a collaborative approach between researchers and facility staff, particularly dietary staff, is essential.

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Media reportage often act as interpretations of accountability policies thereby making the news media a part of the policy enactment process. Within such a process, their role is that of policy reinforcement rather than policy construction or contestation. This paper draws on the experiences of school leaders in regional Queensland, Australia, and their perceptions of the media frames that are used to report on accountability using school performance. The notion of accountability is theorised in terms of media understandings of ‘holding power to account’, and forms the theoretical framework for this study. The methodological considerations both contextualise aspects of the schools involved in the study, and outline how ‘framing theory’ was used to analyse the data. The paper draws on a number of participant experiences and newspaper accounts of schools to identify the frames that are used by the press when reporting on school performance. Three frames referring to school performance are discussed in this paper: those that rank performance such as league tables; frames that decontextualise performance isolating it from school circumstances and levels of funding; and frames that residualise government schools.

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In November 2014, the Australian Commission on Safety and Quality in Health Care (ACSQHC) released “A better way to care: Safe and high quality care for patients with cognitive impairment (dementia and delirium) in hospital”. http://www.safetyandquality.gov.au/our-work/cognitive-impairment. The handbook is available as three separate resources for the three audiences: clinicians, service managers and consumers. These resources are designed to inform and guide improved care for older patients with cognitive impairment (CI) (dementia, delirium) in acute care settings. In particular, the service managers resource recommends that organisations comprehensively prepare themselves so that they are alert to delirium and the risk it poses for patients, that they can recognise and respond to patients with CI, and that they are able to provide safe and high quality care tailored to individual patient’s needs. Service managers and clinicians should carefully consider the information provided in the resources and judiciously explore how best to modify and adapt everyday care practices where appropriate. It is important that clinical teams respond to the available information as the ACSQHC identifies that dementia and/or delirium is associated with adverse outcomes, including functional decline, increased risk of falls, and increased morbidity and mortality...

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This article draws together seven practitioners and scholars from across the diffuse GeoHumanities community to reflect on the pasts and futures of the GeoHumanities. Far from trying to circle the intellectual wagons around orthodoxies of practice or intent, or to determine possibilities in advance, these contributions and the accompanying commentary seek to create connections across the diverse communities of knowledge and practice that constitute the GeoHumanities. Ahead of these six contributions a commentary situates these discussions within wider concerns with interdisciplinarity and identifies three common themes—possibilities practices, and publics—worthy of further discus- sion and reflection. The introduction concludes by identifying a fourth theme, politics, that coheres these three themes in productive and important ways.

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Background: Significant recent attention has focussed on the role of antibiotic prescribing and usage with the aim of combating antibiotic resistance, a growing worldwide health concern. A significant gap in this literature concerns the consumption patterns and beliefs of consumers about antibiotics and their effects. We seek to remedy this gap by exploring a range of questionable antibiotic practices and obtaining reliable estimates of their prevalence as well as their normative status. Methods: We conducted an online survey of over 100 consumers. We used a new incentive compatible technique, the Bayesian Truth Serum (BTS), to elicit more truthful responding than standard self-report measures. We asked participants to indicate whether they engaged in a number of practices including whether they had: taken antibiotics when they are out of date and stored antibiotics at home for later use. We then sought estimates of the percentage of other patients (like them) who had engaged in each behaviour, as well as asking them among those patients who had, the percentage that would admit to having done so. We also asked about social acceptability and responsibility of the practices. Results: These results will show for each type of questionable practice how prevalent it is and whether consumers view it as both socially acceptable and socially responsible. We will gain the relative prevalence of each of these practices. Conclusion: These findings are of paramount importance in gaining a better understanding of consumers’ antibiotic consumption patterns. These will be vital for better targeting educational campaigns to lower inappropriate antibiotic consumption.

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In a study undertaken in Queensland, Australia, analysis of a survey that included both qualitative and quantitative questions revealed that, like their Japanese counterparts, early childhood teachers do not have well-developed ideas and practices in education for sustainability (EfS). Instead, they mainly practise traditional nature-based activities, such as gardening or playing outdoors, and teaching about resource conservation through books, posters or fact sheets. Teachers’ understandings of nature education, environmental education, and education for sustainability seem to influence their educational practices. Deeper understandings about sustainability are necessary to extend beyond such traditional practices. Even though national curriculum frameworks and guidelines point to the importance of sustainability within early childhood curriculum, these appear to be insufficient in strengthening early childhood teachers’ ideas of sustainability and how to practise it effectively. We suggest that it would be beneficial for early childhood teachers, both preservice and inservice, to have professional development opportunities that build deeper understandings of sustainability and its implementation in their settings.

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Despite the rhetoric of schools serving the needs of specific communities, it is evident that the work of teachers and principals is shaped by government imperatives to demonstrate success according to a set of standard ‘benchmarks’. In this chapter, we draw from our current study of new forms of educational leadership emerging in South Australian public primary schools to explore the ways in which test-based accountability requirements are being mediated by principals in schools that serve high poverty communities. Taking an institutional ethnography approach we focus on the everyday work of a principal and a literacy leader in one suburban primary school to show the complexity of the impact of national testing on practices of literacy leadership. We elaborate on the inescapable textual framings and tasks faced by the principal and literacy leader, and those that they create and modify – such as a common literacy agreement and ‘literacy chats’ between a literacy leader and classroom teacher – in order to ‘hold on to ethics’. We argue that while leaders’ and teachers’ everyday work is regulated by ‘ruling relations’ (Smith, 1999), it is also organic and responsive to the local context. We conclude with a reflection on the important situated work that school leaders do in mediating trans-local policies that might otherwise close down possibilities for engaging ethically with students and their learning in a particular school.

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In this chapter we detail our understandings of inclusive pedagogical practices that enable all students to assemble complex literate repertoires. We discuss generative concepts from international related literature (eg Au, Dyson, Janks, Luke, McNaughton, Moll, Thomson,). We then present descriptions of two lessons as examples of how inclusive pedagogical practices might look in primary and secondary classrooms. The focus will be on how texts work to represent the world in particular ways and not others – and the implications of this for the inclusion of diverse student cohorts in developing complex literate repertoires.

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One of the so-called ‘wicked problems’ confronting most nations is poverty, or the unequal distribution of resources. This problem is perennial, but how, where and with which physical, psychological, social and educational effects, and for which students (and their teachers), needs continual scrutiny. Poverty is relative. Entire populations may be poor or groups of people and individuals within nations may be poor. Poverty results from injustice. Not only the un- and under-employed are living in poverty, but also the ‘working poor’. Now we see affluent societies with growing pockets of persistent poverty. While there are those who dispute the statistics on the rise of poverty because different nations use different measures (for example see Biddle, 2013; http://theconversation.com/factcheck-is-poverty-on-the-rise-in-australia-17512), there seems to be little dispute that the gaps between the richest and the poorest are increasing (see http://www.stanford.edu/group/scspi/sotu/SOTU_2014_CPI.pdf)...

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Australia is currently experiencing a huge cultural shift as it moves from a State-based curriculum, to a national education system. The Australian State-based bodies that currently manage teacher registration, teacher education course accreditation, curriculum frameworks and syllabi are often complex organisations that hold conflicting ideologies about education and teaching. The development of a centralised system, complete with a single accreditation body and a national curriculum can be seen as a reaction to this complexity. At the time of writing, the Australian Curriculum is being rolled out in staggered phases across the states and territories of Australia. Phase one has been implemented, introducing English, Mathematics, History and Science. Subsequent phases (Humanities and Social Sciences, the Arts, Technologies, Health and Physical Education, Languages, and year 9-10 work studies) are intended to follow. Forcing an educational shift of this magnitude is no simple task; not least because the States and Territories have and continue to demonstrate varying levels of resistance to winding down their own curricula in favour of new content with its unfamiliar expectations and organisations. The full implementation process is currently far from over, and far from being fully resolved. The Federal Government has initiated a number of strategies to progress the implementation, such as the development of the Australian Institute for Teaching and School Leadership (AITSL) to aid professional educators to implement the new curriculum. AITSL worked with professional and peak specialist bodies to develop Illustrations of Practice (hereafter IoP) for teachers to access and utilise. This paper tells of the building of one IoP, where a graduate teacher and a university lecturer collaborated to construct ideas and strategies to deliver visual arts lessons to early childhood students in a low Socio- Economic Status [SES] regional setting and discusses the experience in terms of its potential for professional learning in art education.

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The story of the Aboriginal women who participated in Australias nursing history remains largely untold. In the first six decades of the twentieth century, Aboriginal people were confronted with harsh exclusionary practices that forced them to live in settlements, reserves and missions.¹ While many Aboriginal women worked in domestic roles (in white peoples homes and on rural properties), small numbers were trained at public hospitals and some Aboriginal women received training to be native nurses who worked in hospitals on settlements

In this chapter, an indigenous historical lens is applied to the status of Indigenous nurses and midwives in Australia.

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This paper will discuss the complexities of the role of contemporary dancer in this current epoch, with a particular focus on the multiple identities dancers embody within dance practice and how these accumulate to form a creative self-in-process or ‘moving identity’. Wider issues, such as training will be explored questioning how technical skills can be imparted alongside autonomous learning approaches to ensure that dancers are prepared to negotiate the entrepreneurial ecology of various dance sectors. Furthermore, the paper will examine the shifting relationship between choreographer and dancer from hierarchical to co-creative including how, in spite of the often collaborative nature of dance creation, the marketplace continues to celebrate the singular authorial position of the choreographer. Each of these elements will reflect back the complex issues of agency and creative self-hood that dancers must negotiate in an increasingly diverse and changeable arts environment.

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Background Poor clinical handover has been associated with inaccurate clinical assessment and diagnosis, delays in diagnosis and test ordering, medication errors and decreased patient satisfaction in the acute care setting. Research on the handover process in the residential aged care sector is very limited. Purpose The aims of this study were to: (i) Develop an in-depth understanding of the handover process in aged care by mapping all the key activities and their information dynamics, (ii) Identify gaps in information exchange in the handover process and analyze implications for resident safety, (iii) Develop practical recommendations on how information communication technology (ICT) can improve the process and resident safety. Methods The study was undertaken at a large metropolitan facility in NSW with more than 300 residents and a staff including 55 registered nurses (RNs) and 146 assistants in nursing (AINs). A total of 3 focus groups, 12 interviews and 3 observation sessions were conducted over a period from July to October 2010. Process mapping was undertaken by translating the qualitative data via a five-category code book that was developed prior to the analysis. Results Three major sub-processes were identified and mapped. The three major stages are Handover process (HOP) I “Information gathering by RN”, HOP II “Preparation of preliminary handover sheet” and HOP III “Execution of handover meeting”. Inefficient processes were identified in relation to the handover including duplication of information, utilization of multiple communication modes and information sources, and lack of standardization. Conclusion By providing a robust process model of handover this study has made two critical contributions to research in aged care: (i) a means to identify important, possibly suboptimal practices; and (ii) valuable evidence to plan and improve ICT implementation in residential aged care. The mapping of this process enabled analysis of gaps in information flow and potential impacts on resident safety. In addition it offers the basis for further studies into a process that, despite its importance for securing resident safety and continuity of care, lacks research.