160 resultados para Modèle de consultation
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This article describes the rationale, developmental process, and content of a resilience-building program that has been implemented with new recruits to a police academy. The process of extensive consultation with the police service (consistent with community-based participatory research principles) has helped to provide a sustainable and pragmatic program framework. The Promoting Resilient Officers (PRO) program is a seven-session strength-based program that integrates CBT and interpersonal perspectives within a salutogenic paradigm. PRO also includes two “refresher” sessions delivered online up to 18 months post the initial face-to-face sessions. PRO was delivered with high fidelity as an integral part of police recruit training and made sustainable by using psychologists within the police service to deliver the intervention. Implementation incorporated a Randomized Controlled design by which a rigorous evaluation of program effectiveness is being conducted. Initial data presented indicates a high level of engagement and acceptability of the PRO program.
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Background Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Methods/Design The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. “live”). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures. Discussion If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance. Trial registration Trial registration number: ACTRN12611000936921
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Introduction The suitability of video conferencing (VC) technology for clinical purposes relevant to geriatric medicine is still being established. This project aimed to determine the validity of the diagnosis of dementia via VC. Methods This was a multisite, noninferiority, prospective cohort study. Patients, aged 50 years and older, referred by their primary care physician for cognitive assessment, were assessed at 4 memory disorder clinics. All patients were assessed independently by 2 specialist physicians. They were allocated one face-to-face (FTF) assessment (Reference standard – usual clinical practice) and an additional assessment (either usual FTF assessment or a VC assessment) on the same day. Each specialist physician had access to the patient chart and the results of a battery of standardized cognitive assessments administered FTF by the clinic nurse. Percentage agreement (P0) and the weighted kappa statistic with linear weight (Kw) were used to assess inter-rater reliability across the 2 study groups on the diagnosis of dementia (cognition normal, impaired, or demented). Results The 205 patients were allocated to group: Videoconference (n = 100) or Standard practice (n = 105); 106 were men. The average age was 76 (SD 9, 51–95) and the average Standardized Mini-Mental State Examination Score was 23.9 (SD 4.7, 9–30). Agreement for the Videoconference group (P0= 0.71; Kw = 0.52; P < .0001) and agreement for the Standard Practice group (P0= 0.70; Kw = 0.50; P < .0001) were both statistically significant (P < .05). The summary kappa statistic of 0.51 (P = .84) indicated that VC was not inferior to FTF assessment. Conclusions Previous studies have shown that preliminary standardized assessment tools can be reliably administered and scored via VC. This study focused on the geriatric assessment component of the interview (interpretation of standardized assessments, taking a history and formulating a diagnosis by medical specialist) and identified high levels of agreement for diagnosing dementia. A model of service incorporating either local or remote administered standardized assessments, and remote specialist assessment, is a reliable process for enabling the diagnosis of dementia for isolated older adults.
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Evidence from the infrastructure and building sectors suggests issues of drugs and alcohol and its association with safety risk on construction sites. While most Australian jurisdictions have identified this as a critical safety issue, information is limited regarding the prevalence of alcohol and other drugs in the workplace and there is limited evidential guidance on how to effectively and efficiently address such an issue. A nationally consistent collaborative approach across the construction workforce - involving employers and employees; clients, unions; contractors and sub-contractors is required to engender a cultural change in the construction workforce – in a similar manner to the on-going initiative in securing a cultural change to drink-driving in our society where peer intervention and support is encouraged. A study to address these issues has three key objectives. Firstly, using the standard World Health Organisation Alcohol Use Disorders Identification Test (AUDIT), and a wide ranging set of structured interviews, a national qualitative and quantitative assessment of the use of drugs and alcohol is being undertaken. Secondly, the development of an appropriate industry policy with an adoption of an educative and rehabilitative approach is planned in consultation with employers and employees across the infrastructure and building sectors, with an aim of national adoption. Finally, an industry-specific cultural change management program will be developed through a nationally collaborative approach to reducing the risk of impaired performance on construction sites and increasing workers’ commitment to drugs and alcohol safety. The study outcomes stand to benefit not only occupational health and safety, through a greater understanding of the safety impacts of alcohol and other drugs at work, but also alcohol and drug use as a wider community health issue. This presentation will provide an analysis and discussion of the data collected in objective 1 and how the final results will inform the subsequent phases of the study.
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This paper focuses on the turning point experiences that worked to transform the researcher during a preliminary consultation process to seek permission to conduct of a small pilot project on one Torres Strait Island. The project aimed to learn from parents how they support their children in their mathematics learning. Drawing on a community research design, a consultative meeting was held with one Torres Strait Islander community to discuss the possibility of piloting a small project that focused on working with parents and children to learn about early mathematics processes. Preliminary data indicated that parents use networks in their community. It highlighted the funds of knowledge of mathematics that exist in the community and which are used to teach their children. Such knowledges are situated within a community’s unique histories, culture and the voices of the people. “Omei” tree means the Tree of Wisdom in the Island community.
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On 1 January 2010, the Assisted Reproductive Treatment Act 2008 (Vic) came into force. The legislation was the outcome of a detailed review and consultation process undertaken by the Victorian Law Reform Commission. Arguably, the change to the regulatory framework represents a significant shift in policy compared to previous regulatory approaches on this topic in Victoria. This article considers the impact of the new legislation on eligibility for reproductive treatments, focusing on the accessibility of such services for the purpose of creating a “saviour sibling”. It also highlights the impact of the Victorian regulatory body’s decision to abolish its regulatory policies on preimplantation genetic diagnosis and preimplantation tissue-typing, concluding that the regulatory approach in relation to these latter issues is similar to other Australian jurisdictions where such practices are not addressed by a statutory framework.
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The recently introduced Australian Curriculum: English Version 3.0 (Australian Curriculum, Assessment and Reporting Authority [ACARA], 2012) requires students to ‘read’ multimodal text and describe the effects of structure and organisation. We begin this article by tracing the variable understandings of what reading multimodal text might entail through the Framing Paper (National Curriculum Board, 2008), the Framing Paper Consultation Report (National Curriculum Board, 2009a), the Shaping Paper (National Curriculum Board, 2009b) and Version 3.0 of the Australian Curriculum English (ACARA, 2012). Our findings show that the theoretical and descriptive framework for doing so is implicit. Drawing together multiple but internally coherent theories from the field of semiotics, we suggest one way to work towards three Year 5 learning outcomes from the reading/writing mode. The affordances of assembling a broad but explicit technical metalanguage for an informed reading of the integrated design elements of multimodal texts are noted.
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Determining entry level competency of new graduates, as they transition from university to practice is not always black and white. Holistic competency emerges as acculturation and experience develops in the workplace. This project, funded by the Dietitians Association Australia (DAA), aimed to develop tools to guide the assessment process. Range variable statements and evidence guides were developed to inform the assessment of DAA Entry Level Competency Standards (ELCS) at university and to define the core fields of study required in Australian university curricula for university accreditation and international benchmarking purposes. Range variables contextualise competency by defining the boundaries for competency and the associated performance criteria. Evidence guides provide the range of contexts and critical aspects of competency which would usually be assessed together. Core fields of study defi ne the underpinning knowledge and skills required in the curriculum to achieve competency. Draft range variable statements and evidence guides were developed against each of the units and elements of the ELCS. Two rounds of consultation occurred with the fourteen Australian universities undertaking dietetic education and the project management committee, via teleconference and email. Core fi elds of study were informed by these consultations, as well as interviews of new graduates about core activities undertaken in their workplace. The final versions of these documents were presented to the project management committee, the Australian Dietetic Council and the DAA Board to be integrated into the DAA Accreditation Manual and website information.
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The development of the Learning and Teaching Academic Standards Statement for Architecture (the Statement) centred on requirements for the Master of Architecture and proceeded alongside similar developments in the building and construction discipline under the guidance and support of the Australian Deans of Built Environment and Design (ADBED). Through their representation of Australian architecture programs, ADBED have provided high-level leadership for the Learning and Teaching Academic Standards Project in Architecture (LTAS Architecture). The threshold learning outcomes (TLOs), the description of the nature and extent of the discipline, and accompanying notes were developed through wide consultation with the discipline and profession nationally. They have been considered and debated by ADBED on a number of occasions and have, in their fi nal form, been strongly endorsed by the Deans. ADBED formed the core of the Architecture Reference Group (chaired by an ADBED member) that drew together representatives of every peak organisation for the profession and discipline in Australia. The views of the architectural education community and profession have been provided both through individual submissions and the voices of a number of peak bodies. Over two hundred individuals from the practising profession, the academic workforce and the student cohort have worked together to build consensus about the capabilities expected of a graduate of an Australian Master of Architecture degree. It was critical from the outset that the Statement should embrace the wisdom of the greater ‘tribe’, should ensure that graduates of the Australian Master of Architecture were eligible for professional registration and, at the same time, should allow for scope and diversity in the shape of Australian architectural education. A consultation strategy adopted by the Discipline Scholar involved meetings and workshops in Perth, Melbourne, Sydney, Canberra and Brisbane. Stakeholders from all jurisdictions and most universities participated in the early phases of consultation through a series of workshops that concluded late in October 2010. The Draft Architecture Standards Statement was formed from these early meetings and consultation in respect of that document continued through early 2011. This publication represents the outcomes of work to establish an agreed standards statement for the Master of Architecture. Significant further work remains to ensure the alignment of professional accreditation and recognition procedures with emerging regulatory frameworks cascading from the establishment of the Tertiary Education Quality and Standards Agency (TEQSA). The Australian architecture community hopes that mechanisms can be found to integrate TEQSA’s quality assurance purpose with well-established and understood systems of professional accreditation to ensure the good standing of Australian architectural education into the future. The work to build renewed and integrated quality assurance processes and to foster the interests of this project will continue, for at least the next eighteen months, under the auspices of Australian Learning and Teaching Council (ALTC)-funded Architecture Discipline Network (ADN), led by ADBED and Queensland University of Technology. The Discipline Scholar gratefully acknowledges the generous contributions given by those in stakeholder communities to the formulation of the Statement. Professional and academic colleagues have travelled and gathered to shape the Standards Statement. Debate has been vigorous and spirited and the Statement is rich with the purpose, critical thinking and good judgement of the Australian architectural education community. The commitments made to the processes that have produced this Statement reflect a deep and abiding interest by the constituency in architectural education. This commitment bodes well for the vibrancy and productivity of the emergent Architecture Discipline Network (ADN). Endorsement, in writing, was received from the Australian Institute of Architects National Education Committee (AIA NEC): The National Education Committee (NEC) of the Australian Institute of Architects thank you for your work thus far in developing the Learning and Teaching Academic Standards for Architecture In particular, we acknowledge your close consultation with the NEC on the project along with a comprehensive cross-section of the professional and academic communities in architecture. The TLOs with the nuanced levels of capacities – to identify, develop, explain, demonstrate etc – are described at an appropriate level to be understood as minimum expectations for a Master of Architecture graduate. The Architects Accreditation Council of Australia (AACA) has noted: There is a clear correlation between the current processes for accreditation and what may be the procedures in the future following the current review. The requirement of the outcomes as outlined in the draft paper to demonstrate capability is an appropriate way of expressing the measure of whether the learning outcomes have been achieved. The measure of capability as described in the outcome statements is enhanced with explanatory descriptions in the accompanying notes.
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Submission to the Australian Government Attorney General’s Department consultation paper on Revising the Scope of the Copyright ‘Safe Harbour Scheme’
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With the development of enterprise informatisation, Product Lifecycle Management (PLM) systems have been widely deployed and applied in enterprises. This paper analyzes the requirement that conducting version operations on business objects as specified in process models should be compliant with the versioning policies imposed by product lifecycles. This leads to the introduction of the concept of versioning compliance, and the approach of compliance checking that we proposed in our earlier work, which comprises both syntactical compatibility and behavioural compatibility checking. The paper then focuses on the tool implementation for providing automated support to the versioning compliance checking. An empirical evaluation of the tool was also performed with industrial partners using the well-known questionnaire-based method. The evaluation and feedback from practitioners further evidence the practical significance of this research question in the PLM field and demonstrate that the proposed solution with its automated tool support possesses a high application potential.
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On 1 November 2011 the Minister for Financial Services and Superannuation, the Honourable Bill Shorten MP, announced that Australia would be undertaking a reform of the ‘transfer pricing rules in the income tax law and Australia’s future tax treaties to bring them into line with international best practice, improving the integrity and efficiency of the tax system.’ Mr Shorten stated that the reason for the reform was that ‘recent court decisions suggest our existing transfer pricing rules may be interpreted in a way that is out-of-kilter with international norms.’ Further, he stated that ‘the Government has asked the Treasury to review how the transfer pricing rules can be improved, including but not limited to how to be more in line with international best practice.’ He urged all interested parties to participate in this consultation process. On 16 March 2012, an Exposure Draft and accompanying Explanatory Memorandum outlining the proposed amendments to implement the first stage of the transfer pricing reforms were released. Within the proposed changes is the explicit embedding of the use of the OECD’s Model Tax Convention on Income and on Capital and Transfer Pricing Guidelines for Multinational Enterprises and Tax Administrations to help determine the arm’s length price. Does this mean that Australia engages in an international tax regime?
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On 1 November 2011 the Minister for Financial Services and Superannuation, the Honourable Bill Shorten MP, announced that Australia would be undertaking a reform of the ‘transfer pricing rules in the income tax law and Australia's future tax treaties to bring them into line with international best practice, improving the integrity and efficiency of the tax system.’ Mr Shorten stated that the reason for the reform was that ‘recent court decisions suggest our existing transfer pricing rules may be interpreted in a way that is out-of-kilter with international norms.’ Further, he stated that ‘the Government has asked the Treasury to review how the transfer pricing rules can be improved, including but not limited to how to be more in line with international best practice.’ He urged all interested parties to participate in this consultation process.
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Background Physical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion. Discussion Medical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology. Summary It is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research include investigating ways to promote successful referrals and subsequent engagement in comprehensive community support programs to increase physical activity levels of inactive patients. Additionally, future clinical trials of physical activity interventions should be evaluated in the context of a broader framework of outcomes to inform a systematic consideration of broad strengths and weaknesses regarding not only efficacy but cost-effectiveness and likelihood of successful translation of interventions to clinical contexts.
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This report reviews the use of point-to-point speed enforcement internationally in order to provide principles for better practice for its use in Australia and New Zealand. Point-to-point enforcement is a relatively new technological approach to speed enforcement which involves measuring the average speed of vehicles passing a series of cameras, by using automatic number plate recognition (ANPR) and other technologies. The approach has been implemented or trialled in a number of countries including Australia, New Zealand, the United Kingdom, the Netherlands, Austria, Italy, Switzerland and France. The major research activities were undertaken for the preparation of this report included: (1) an extensive review of the international literature; (2) stakeholder consultation with international and domestic organisations. To date, there have been no formal evaluations of point-to- point speed enforcement in Australia or New Zealand.