720 resultados para community medicine


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There is little evidence that workshops alone have a lasting impact on the day-to-day practice of participants. The current paper examined a strategy to increase generalization and maintenance of skills in the natural environment using pseudo-patients and immediate performance feedback to reinforce skills acquisition. A random half of pharmacies (N=30) took part in workshop training aimed at optimizing consumers' use of nonprescription analgesic products. Pharmacies in the training group also received performance feedback on their adherence to the recommended protocol. Feedback occurred immediately after a pseudo-patient visit in which confederates posed as purchasers of analgesics, and combined positive and corrective elements. Trained pharmacists were significantly more accurate at identifying people who misused the medication (P<0.001). The trained pharmacists were more likely than controls to use open-ended questions (P<0.001), assess readiness to change problematic use (P <0.001), and to deliver a brief intervention that was tailored to the person's commitment to alter his/her usage (P <0.001). Participants responded to the feedback positively. Results were consistent with the hypothesis that when workshop is combined with on-site performance feedback, it enhances practitioners' adherence to protocols in the natural setting.

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The discourse surrounding recent Aboriginal social policy regularly refers to pragmatism and partnership. In a simpler world, we might call this ‘getting things done with Aboriginal people.’ To that extent, the discourse draws on an indisputable common sense, and it is not surprising that a variety of political agendas can be packaged within such language. While many things need to be done, the quantity and particularly the quality of social networks required to take effective policy into effective practice is something we ought to consider more carefully. This is where the concept of social capital could be useful, since it focuses attention on the social resources required to construct social policy, as well as the social resources that could be produced by effective social policy. Partnerships and pragmatism are therefore related at a most fundamental level in terms of social policy. We question whether this important conceptual bedrock has been fully explored. Hence we review here some recent ‘big plans’ for Aboriginal Australia, and ask whether the size of the theory matches the size of the plans.

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This project utilised the materials of the Index for Inclusion (Booth & Ainscow, 2002) to enhance the development of a learning community of educators in Education Queensland in 2009. The values, dimensions and indicators of the Index for Inclusion, were incorporated into the professional development package, On the Same Page (Education Queensland, 2008), to enhance its wider purpose to improve inclusive education practices explicit within the P-12 Curriculum Framework (Education Queensland, 2008). The incorporation of the values, dimensions and indicators of the Index enabled deeper reflection by participants about their expectations of students and their resulting teaching practices. The subsequent development of action plans assisted participants to develop “a curriculum for all” (Education Queensland, 2008, p. 9). Deeper reflection, action planning and ‘distance travelled’ in understanding of inclusive education were apparent in the comments by participants and their evaluation of the professional development package.

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Background: The incidence of obesity is increasing; this is of major concern, as obesity is associated with cardiovascular disease, stroke, type 2 diabetes, respiratory tract disease, and cancer. Objectives/methods: This evaluation is of a Phase II clinical trial with tesofensine in obese subjects. Results: After 26 weeks, tesofensine caused a significant weight loss, and may have a higher maximal ability to reduce weight than the presently available anti-obesity agents. However, tesofensine also increased blood pressure and heart rate, and may increase psychiatric disorders. Conclusions: It is encouraging that tesofensine 0.5 mg may cause almost double the weight loss observed with sibutramine or rimonabant. As tesofensine and sibutramine have similar pharmacological profiles, it would be of interest to compare the weight loss with tesofensine in a head-to-head clinical trial with sibutramine, to properly assess their comparative potency. Also, as teso fensine 0.5 mg increases heart rate, as well as increasing the incidence of adverse effects such as nausea, drug mouth, flatulence, insomnia, and depressed mode, its tolerability needs to be further evaluated in large Phase III clinical trials.

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Community service learning is the integration of experiential learning and community service into coursework such that community needs are met and students gain both professional skills and a sense of civic responsibility. A critical component is student reflection. This paper provides an example of the application of community service learning within an undergraduate health unit at the Queensland University of Technology. Based on survey data from 36 program participants, it demonstrates the impact of CSL on student outcomes. Results show that students benefited by developing autonomy through real world experiences, through increased self-assurance and achievement of personal growth, through gaining new insights into the operations of community service organisations and through moving towards becoming responsible citizens. Students expect their CSL experience to have long-lasting impact on their lives, with two-thirds of participants noting that they would like to continue volunteering as part of their future development.

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The epidemic of obesity is impacting an increasing proportion of children, adolescents and adults with a common feature being low levels of physical activity (PA). Despite having more knowledge than ever before about the benefits of PA for health and the growth and development of youngsters, we are only paying lip-service to the development of motor skills in children. Fun, enjoyment and basic skills are the essential underpinnings of meaningful participation in PA. A concurrent problem is the reported increase in sitting time with the most common sedentary behaviors being TV viewing and other screen-based games. Limitations of time have contributed to a displacement of active behaviors with inactive pursuits, which has contributed to reductions in activity energy expenditure. To redress the energy imbalance in overweight and obese children, we urgently need out-of-the-box multisectoral solutions. There is little to be gained from a shame and blame mentality where individuals, their parents, teachers and other groups are singled out as causes of the problem. Such an approach does little more than shift attention from the main game of prevention and management of the condition, which requires a concerted, whole-of-government approach (in each country). The failure to support and encourage all young people to participate in regular PA will increase the chance that our children will live shorter and less healthy lives than their parents. In short, we need novel environmental approaches to foster a systematic increase in PA. This paper provides examples of opportunities and challenges for PA strategies to prevent obesity with a particular emphasis on the school and home settings.

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This practice-led research project examines some of the factors and issues facing artists working in the public domain who wish to engage with the community as audience. Using the methodology of action research, the three major creative projects in this study use art as a socio-political tool with the aim of providing an effective vehicle for broadening awareness, understanding forms of social protest and increasing tolerance for diversity. The three projects: Floodline November 7, 2004, Look in, Look out, and The Urban Terrorist Project, dealt with issues of marginalisation of communities, audiences and graffiti artists respectively. The artist/researcher is outlined as both creator and collaborator in the work. Processes included ephemeral elements, such as temporary installation and performance, as well as interactive elements that encouraged direct audience involvement as part of the work. In addition to the roles of creator and collaborator, both of which included audience as well as artist, the presence of an outside entity was evident. Whether local, legal authorities or prevailing attitudes, outside entities had an unavoidable impact on the processes and outcomes of the work. Each project elicited a range of responses from their respective audiences; however, the overarching concept of reciprocity was seen to be the crucial factor in conception, artistic methods and outcomes.

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Background: SEQ Catchments Ltd and QUT are collaborating on groundwater investigations in the SE Qld region, which utilise community engagement and 3D Visualisation methodologies. The projects, which have been funded by the Australian Government’s NHT and Caring for our Country programmes, were initiated from local community concerns regarding groundwater sustainability and quality in areas where little was previously known. ----- Objectives: Engage local and regional stakeholders to tap all available sources of information;•Establish on-going (2 years +) community-based groundwater / surface water monitoring programmes;•Develop 3D Visualisation from all available data; and•Involve, train and inform the local community for improved on-ground land and water use management. ----- Results and findings: Respectful community engagement yielded information, access to numerous monitoring sites and education opportunities at low cost, which would otherwise be unavailable. A Framework for Community-Based Groundwater Monitoring has been documented (Todd, 2008).A 3D visualisation models have been developed for basaltic settings, which relate surface features familiar to the local community with the interpreted sub-surface hydrogeology. Groundwater surface movements have been animated and compared to local rainfall using the time-series monitoring data.An important 3D visualisation feature of particular interest to the community was the interaction between groundwater and surface water. This factor was crucial in raising awareness of potential impacts of land and water use on groundwater and surface water resources.

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Obesity and type 2 diabetes mellitus (T2D) have reached epidemic proportions in many parts of the world with numbers projected to rise dramatically in coming decades (Wang and Lobstein, 2006; Zaninotto et al., 2006). In Australia, and consistent with much of the developed world, the problem has been described as a ‘juggernaut’ that is out of control (Zimmet and James, 2007). Unfortunately the burgeoning problem of non-communicable diseases, including obesity and T2D, is also impacting developing nations as populations are undergoing a nutrition transition (Caballero, 2005). The increased prevalence of overweight and obesity in children, adolescents and adults in both the developed and developing world is consistent with reductions in all forms of physical activity (Brownson et al., 2005). This brief paper provides an overview of the importance of physical activity and an outline of physical activity intervention studies with particular reference to the growing years. As many interventions studies involving physical activity have been undertaken in the context of childhood obesity prevention (Lobstein et al., 2004), and an increasing proportion of the childhood population is overweight or obese, this is a major focus of discussion.

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Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are emerging in southeast Queensland, Australia, but the incidence of carriage of CA-MRSA strains is unknown. The aim of this study was to assess the nasal carriage rate of S. aureus, including CA-MRSA strains, in the general adult population of southeast Queensland. 396 patients presenting to general practices in two Brisbane suburbs and 303 volunteers randomly selected from the electoral rolls in the same suburbs completed a medical questionnaire and had nasal swabs performed for S. aureus. All isolates of S. aureus underwent antibiotic susceptibility testing and single-nucleotide polymorphism (SNP) and binary typing, including determination of Panton–Valentine leukocidin (PVL). The nasal carriage rate of methicillin-susceptible S. aureus (MSSA) was 202/699 (28%), a rate similar to that found in other community-based nasal carriage studies. According to multivariate analysis, nasal carriage of S. aureus was associated with male sex, young adult age group and Caucasian ethnicity. Only two study isolates (one MSSA and one CA-MRSA) carried PVL. The nasal carriage rate of MRSA was low, at 5/699 (0.7%), and only two study participants (0.3%) had CA-MRSA strains. CA-MRSA is an emerging cause of infection in southeast Queensland, but as yet the incidence of carriage of CA-MRSA in the general community is low.

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Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury.---------- Aim: To quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.---------- Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.---------- Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.---------- Conclusion: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those are intensively implemented.

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This study sought to establish and develop innovative instructional procedures, in which scaffolding can be expanded and applied, in order to enhance learning of English as a Foreign Language (EFL) writing skills in an effective hybrid learning community (a combination of face-to-face and online modes of learning) at the university where the researcher is working. Many educational experts still believe that technology has not been harnessed to its potential to meet the new online characteristics and trends. There is also an urgency to reconsider the pedagogical perspectives involved in the utilisation of online learning systems in general and the social interactions within online courses in particular that have been neglected to date. An action research design, conducted in two cycles within a duration of four months, was utilised throughout this study. It was intended not only to achieve a paradigm shift from transmission-absorption to socio-constructivist teaching/learning methodologies but also to inform practice in these technology-rich environments. Five major findings emerged from the study. First, the scaffolding theory has been extended. Two new scaffolding types (i.e., quasi-transcendental scaffolding and transcendental scafolding), two scaffolding aspects (i.e., receptive and productive) and some scaffolding actions (e.g., providing a stimulus, awareness, reminder, or remedy) for EFL writing skills in an effective hybrid learning community have been identified and elaborated on. Second, the EFL ‘Effective Writing’ students used the scaffolds implemented in a hybrid environment to enhance and enrich their learning of writing of English essays. The online activities, conducted after the F2F sessions most of the time, gave students greater opportunities to both reinforce and expand the knowledge they had acquired in the F2F mode. Third, a variety of teaching techniques, different online tasks and discussion topics utilised in the two modes bolstered the students’ interests and engagement in their knowledge construction of how to compose English-language essays. Fourth, through the scaffolded activities, the students learned how to scaffold themselves and thus became independent learners in their future endeavours of constructing knowledge. Fifth, the scaffolding-to-scaffold activities provided the students with knowledge on how to effectively engage in transcendental scaffolding actions and facilitate the learning of English writing skills by less able peers within the learning community. Thus, the findings of this current study extended earlier understandings of scaffolding in an EFL hybrid learning environment and will contribute to the advancement of future ICT-mediated courses in terms of their scaffolding pedagogical aspects.