662 resultados para Incontinence Impact Questionnaire


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Developing an effective impact evaluation framework, managing and conducting rigorous impact evaluations, and developing a strong research and evaluation culture within development communication organisations presents many challenges. This is especially so when both the community and organisational context is continually changing and the outcomes of programs are complex and difficult to clearly identify.----- This paper presents a case study from a research project being conducted from 2007-2010 that aims to address these challenges and issues, entitled Assessing Communication for Social Change: A New Agenda in Impact Assessment. Building on previous development communication projects which used ethnographic action research, this project is developing, trailing and rigorously evaluating a participatory impact assessment methodology for assessing the social change impacts of community radio programs in Nepal. This project is a collaboration between Equal Access – Nepal (EAN), Equal Access – International, local stakeholders and listeners, a network of trained community researchers, and a research team from two Australian universities. A key element of the project is the establishment of an organisational culture within EAN that values and supports the impact assessment process being developed, which is based on continuous action learning and improvement. The paper describes the situation related to monitoring and evaluation (M&E) and impact assessment before the project began, in which EAN was often reliant on time-bound studies and ‘success stories’ derived from listener letters and feedback. We then outline the various strategies used in an effort to develop stronger and more effective impact assessment and M&E systems, and the gradual changes that have occurred to date. These changes include a greater understanding of the value of adopting a participatory, holistic, evidence-based approach to impact assessment. We also critically review the many challenges experienced in this process, including:----- • Tension between the pressure from donors to ‘prove’ impacts and the adoption of a bottom-up, participatory approach based on ‘improving’ programs in ways that meet community needs and aspirations.----- • Resistance from the content teams to changing their existing M&E practices and to the perceived complexity of the approach.----- • Lack of meaningful connection between the M&E and content teams.----- • Human resource problems and lack of capacity in analysing qualitative data and reporting results.----- • The contextual challenges, including extreme poverty, wide cultural and linguistic diversity, poor transport and communications infrastructure, and political instability.----- • A general lack of acceptance of the importance of evaluation within Nepal due to accepting everything as fate or ‘natural’ rather than requiring investigation into a problem.

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There is a growing literature (Arthur, Inkson, & Pringle, 1999; Collin & Young, 2000; Hall & Associates, 1996; Peiperl, Arthur,& Anand, 2002) about the changing workplace and the consequent changes to our understanding of the place of career in individuals’ lives (Richardson, 1996, 2000) - “Careers are becoming more varied and more difficult to manage for both individuals and organisations” (Arnold et al, 2005, p. 523). This chapter will present the background to the changes in the world of work and the changes which inevitably impact individuals’ careers. It will then focus on the close relationship between career development and lifelong learning and the importance of ongoing professional learning for individuals to maintain employability in a changing work world.

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The rising problems associated with construction such as decreasing quality and productivity, labour shortages, occupational safety, and inferior working conditions have opened the possibility of more revolutionary solutions within the industry. One prospective option is in the implementation of innovative technologies such as automation and robotics, which has the potential to improve the industry in terms of productivity, safety and quality. The construction work site could, theoretically, be contained in a safer environment, with more efficient execution of the work, greater consistency of the outcome and higher level of control over the production process. By identifying the barriers to construction automation and robotics implementation in construction, and investigating ways in which to overcome them, contributions could be made in terms of better understanding and facilitating, where relevant, greater use of these technologies in the construction industry so as to promote its efficiency. This research aims to ascertain and explain the barriers to construction automation and robotics implementation by exploring and establishing the relationship between characteristics of the construction industry and attributes of existing construction automation and robotics technologies to level of usage and implementation in three selected countries; Japan, Australia and Malaysia. These three countries were chosen as their construction industry characteristics provide contrast in terms of culture, gross domestic product, technology application, organisational structure and labour policies. This research uses a mixed method approach of gathering data, both quantitative and qualitative, by employing a questionnaire survey and an interview schedule; using a wide range of sample from management through to on-site users, working in a range of small (less than AUD0.2million) to large companies (more than AUD500million), and involved in a broad range of business types and construction sectors. Detailed quantitative (statistical) and qualitative (content) data analysis is performed to provide a set of descriptions, relationships, and differences. The statistical tests selected for use include cross-tabulations, bivariate and multivariate analysis for investigating possible relationships between variables; and Kruskal-Wallis and Mann Whitney U test of independent samples for hypothesis testing and inferring the research sample to the construction industry population. Findings and conclusions arising from the research work which include the ranking schemes produced for four key areas of, the construction attributes on level of usage; barrier variables; differing levels of usage between countries; and future trends, have established a number of potential areas that could impact the level of implementation both globally and for individual countries.

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This paper presents a detailed description of the influence of critical parameters that govern the vulnerability of columns under lateral impact loads. Numerical simulations are conducted by using the Finite Element program LS-DYNA, incorporating steel reinforcement, material models and strain rate effects. A simplified method based on impact pulse generated from full scale impact tests is used for impact reconstruction and effects of the various pulse loading parameters are investigated under low to medium velocity impacts. A constitutive material model which can simulate failures under tri-axial state of stresses is used for concrete. Confinement effects are also introduced to the numerical simulation and columns of Grade 30 to 50 concrete under pure axial loading are analysed in detail. This research confirmed that the vulnerability of the axially loaded columns can be mitigated by reducing the slenderness ratio and concrete grade, and by choosing the design option with a minimal amount of longitudinal steel. Additionally, it is evident that approximately a 50% increase in impact capacity can be gained for columns in medium rise buildings by enhancing the confinement effects alone. Results also indicated that the ductility as well as the mode of failure under impact can be changed with the volumetric ratio of lateral steel. Moreover, to increase the impact capacity of the vulnerable columns, a higher confining stress is required. The general provisions of current design codes do not sufficiently cover this aspect and hence this research will provide additional guidelines to overcome the inadequacies of code provisions.

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This paper seeks to identify the approaches undertaken in implementing equal employment opportunity in the transport industry in Australia and the links between these approaches and indicators of increased participation of women. This male dominated industry employs limited numbers of women with fewer numbers of women in management. The study analyses data from a unique set of equal opportunity progress reports from all organisations in the transport industry that are required to provide public reports under Australian legislation. The findings indicate a correlation between some approaches to equal opportunity and increased numbers of women in some areas. The study is equally remarkable for what it does not find. Despite widespread equal opportunity implementation across a broad number of employment measures there are limited measures that predict increases in the numbers of women in management or in non-traditional roles. This study differs from others in that it identifies issues specific to one industry and links organisational approach to equal opportunity with the employment status of both women and men.

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Background. There is considerable debate regarding the clinical issues surrounding the wish to hasten death (WTHD) in the terminally ill. The clinical factors contributing to the WTHD need further investigation among the terminally ill in order to enhance understanding of the clinical assessment and treatment needs that underlie this problem. A more detailed understanding may assist with the development of appropriate therapeutic interventions. Method. A sample of terminally ill cancer patients (N=256) recruited from an in-patient hospice unit, home palliative care service and a general hospital palliative care consulting service from Brisbane Australia between 1998–2001 completed a questionnaire assessing psychological (depression and anxiety), social (family relationship, social support, level of burden on others) and the impact of physical symptoms. The association between these factors and the WTHD was investigated. Results. A high WTHD was reported by 14% of patients. A discriminant function analysis revealed that the following variables were associated with a high WTHD (P<0·001): higher levels of depressive symptoms, being admitted to an in-patient hospice setting, a greater perception of being a burden on others, lower family cohesion, lower levels of social support, higher levels of anxiety and greater impact of physical symptoms. Conclusions. Psychological and social factors are related to a WTHD among terminally ill cancer patients. Greater attention needs to be paid to the assessment of psychological and social issues in order to provide appropriate therapeutic interventions for terminally ill patients.

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Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

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Objective: This paper explores the effects of perceived stage of cancer (PSOC) on carers' anxiety and depression during the patients' final year. Methods: A consecutive sample of patients and carers (N=98) were surveyed at regular intervals regarding PSOC, and anxiety and depression using the Hospital Anxiety and Depression Scale. Means were compared by gender using the Mann-Whitney U-test. The chi-square was used to analyse categorical data. Agreement between carers' and patients' PSOC was estimated using kappa statistics. Correlations between carers' PSOC and their anxiety and depression were calculated using the Spearman's rank correlation. Results: Over time, an increasing proportion of carers reported that the cancer was advanced, culminating at 43% near death. Agreement regarding PSOC was fair (kappa=0.29-0.34) until near death (kappa=0.21). Carers' anxiety increased over the year; depression increased in the final 6 months. Females were more anxious (p=0.049, 6 months; p=0.009, 3 months) than males, and more depressed until 1 month to death. The proportion of carers reporting moderate-severe anxiety almost doubled over the year to 27%, with more females in this category at 6 months (p=0.05). Carers with moderate-severe depression increased from 6 to 15% over the year. Increased PSOC was weakly correlated with increased anxiety and depression. Conclusions: Carers' anxiety exceeded depression in severity during advanced cancer. Females generally experienced greater anxiety and depression. Carers were more realistic than patients regarding the ultimate outcome, which was reflected in their declining mental health, particularly near the end.

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The Study Process Questionnaire (Biggs, 1987) has been widely used in studies investigating learning behaviours in tertiary education. Many of the studies that have used the instrument have investigated the construct validity of the SPQ using a variety of factor analytic methods and techniques in an atheoretical way. Contrary to this method, Burnett and Dart (1997) argued that the hypothesised structure of a scale should be used when assessing the construct validity of an existing instrument. This study investigated the factor structure of the SPQ using a theoretical approach and found strong support for the three approaches to learning structure of the instrument.

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This study contributes to the growth of design knowledge in China, where vehicle design for the local, older user is in its initial developmental stages. Therefore, this research has explored the travel needs of older Chinese vehicle users in order to assist designers to better understand users’ current and future needs. A triangulation method consisting of interviews, logbook and co-discovery was used to collect multiple forms of data and so explore the research question. Grounded theory has been employed to analyze the research data. This study found that users’ needs are reflected through various ‘meanings’ that they attach to vehicles – meanings that give a tangible expression to their experiences. This study identified six older-user need categories: (i) safety, (ii) utility, (iii) comfort, (iv) identity, (v) emotion and (vi) spirituality. The interrelationships among these six categories are seen as an interactive structure, rather than as a linear or hierarchical arrangement. Chinese cultural values, which are generated from particular local context and users’ social practice, will play a dynamic role in linking and shaping the travel needs of older vehicle users in the future. Moreover, this study structures the older-user needs model into three levels of meaning, to give guidance to vehicle design direction: (i) the practical meaning level, (ii) the social meaning level and (ii) the cultural meaning level. This study suggests that a more comprehensive explanation exists if designers can identify the vehicle’s meaning and property associated with the fulfilled older users’ needs. However, these needs will vary, and must be related to particular technological, social, and cultural contexts. The significance of this study lies in its contributions to the body of knowledge in three areas: research methodology, theory and design. These theoretical contributions provide a series of methodological tools, models and approaches from a vehicle design perspective. These include a conditional/consequential matrix, a travel needs identification model, an older users’ travel-related needs framework, a user information structure model, and an Older-User-Need-Based vehicle design approach. These models suggest a basic framework for the new design process which might assist in the design of new vehicles to fulfil the needs of future, aging Chinese generations. The models have the potential to be transferred to other design domains and different cultural contexts.

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Nurses working in community settings are increasingly required to care for people with chronic, life limiting conditions. Innovative educational programs are required to ensure nurses are equipped to deal with this challenging area of practice. The Program of Experience in the Palliative Approach (PEPA) started in 2003 as an initiative of the Australian Government, Department of Health and Ageing. The overall aim of PEPA is to improve the quality, availability and access to palliative care for people who are dying, and their families, by improving the skills and expertise of health practitioners, and enhancing collaboration between primary and specialist palliative care services. PEPA provides nurses with an opportunity to develop knowledge and skills in the palliative approach to care through funded clinical workforce placements or workshops.