152 resultados para physician shortage

em Queensland University of Technology - ePrints Archive


Relevância:

20.00% 20.00%

Publicador:

Resumo:

In most of the advanced economies, students are losing interest in careers especially in engineering and related industries. Hence, western economies are confronting a critical skilled labour shortage in areas of technology, science and engineering. The aim of this paper is to document how the organisational and institutional elements of one industry-school partnerships initiative – The Gateway Schools Program - contribute to productive knowledge sharing and networking. In particular this paper focuses on an initiative of an Australian State government in response to a perceived crisis around the skills shortage in an economy transitioning from a localised to a global knowledge production economy. The Gateway Schools initiative signals the first sustained attempt in Australia to incorporate schools into production networks through strategic partnerships linking them to partner organisations at the industry level. We provide case examples of how four schools operationalise the partnerships with the mining and energy industries and how these partnerships as knowledge assets impact the delivery of curriculum and capacity building among teachers. A program theory approach to analysis, informed by theoretical perspectives of Bailey (1994), Bagnall (2007) and Walsh (2004) was adopted. Each of these theorists provides a related but different perspective on the establishment, purpose, and effectiveness respectively of partnerships. Our ultimate goal is to define those characteristics of successful partnerships that do contribute to enhanced interest and engagement by students in those careers that are currently experiencing critical shortages.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Objective This study examined whether maternal psychological distress mediates the relationship between presence of adolescent asthma and number of physician visits, and whether the association between maternal psychological distress and physician visits is moderated by adolescent general health. Methods Data were obtained from the Mater University Study of Pregnancy and included 4025 adolescents. Path analysis was used to examine mediating and moderating effects. Results Maternal psychological distress was found to partially mediate the relationship between adolescent asthma and number of physician visits, accounting for 25% of the effect of adolescent asthma on physician visits (p = .046). There was no evidence to suggest that adolescent general health moderated the association between maternal psychological distress and physician visits (p = .093). Conclusions The findings suggest that maternal psychological distress is associated with increased physician visits, regardless of adolescents' general health. Lowering maternal psychological distress may serve to reduce health care utilization and costs among adolescents with asthma.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Aim To review recent studies which identify the factors that contribute to stress, burnout and job satisfaction for nurses who are working in haemodialysis units. Background Regardless of where nurses work, stress, job burnout and dissatisfaction are known to cause high rates of nurse resignations and for many of those to leave the profession entirely. Understanding factors that contribute to job satisfaction, stress and burnout could increase haemodialysis nurse retention and improve health outcomes for people receiving haemodialysis. Evaluation Studies of job stress, burnout and satisfaction for nurses working in haemodialysis units published in English from January 2000 to December 2009 were identified. Specific inclusion criteria were developed resulting in eleven articles selected for this review. Key issues Specifically for haemodialysis nurses’ job stress and burnout was found to originate from two factors related to either patient care or organisations. Patient care factors included unrealistic patient expectations, progressive decline of a patient’s health, and violence and verbal abuse from patients. Organisational factors included shortage of time to complete tasks, lack of resources and unsupportive work environments. Increased job satisfaction for haemodialysis nurses was due to having job security, freedom to use one’s judgement and the quality of nurse/physician interactions. Conclusion Job stress and burnout are problematic for haemodialysis nurses. Instituting strategies which prevent and/or ameliorate stress or burnout could result in improved job satisfaction and also the retention of highly skilled haemodialysis nurses.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Introduction. This is a pilot study of quantitative electro-encephalographic (QEEG) comodulation analysis, which is used to assist in identifying regional brain differences in those people suffering from chronic fatigue syndrome (CFS) compared to a normative database. The QEEG comodulation analysis examines spatial-temporal cross-correlation of spectral estimates in the resting dominant frequency band. A pattern shown by Sterman and Kaiser (2001) and referred to as the anterior posterior dissociation (APD) discloses a significant reduction in shared functional modulation between frontal and centro-parietal areas of the cortex. This research attempts to examine whether this pattern is evident in CFS. Method. Eleven adult participants, diagnosed by a physician as having CFS, were involved in QEEG data collection. Nineteen-channel cap recordings were made in five conditions: eyes-closed baseline, eyes-open, reading task one, math computations task two, and a second eyes-closed baseline. Results. Four of the 11 participants showed an anterior posterior dissociation pattern for the eyes-closed resting dominant frequency. However, seven of the 11 participants did not show this pattern. Examination of the mean 8-12 Hz amplitudes across three cortical regions (frontal, central and parietal) indicated a trend of higher overall alpha levels in the parietal region in CFS patients who showed the APD pattern compared to those who did not have this pattern. All patients showing the pattern were free of medication, while 71% of those absent of the pattern were using antidepressant medications. Conclusions. Although the sample is small, it is suggested that this method of evaluating the disorder holds promise. The fact that this pattern was not consistently represented in the CFS sample could be explained by the possibility of subtypes of CFS, or perhaps co-morbid conditions. Further, the use of antidepressant medications may mask the pattern by altering the temporal characteristics of the EEG. The results of this pilot study indicate that further research is warranted to verify that the pattern holds across the wider population of CFS sufferers.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Aim: To review the titles, roles and scope of practice of Advanced Practice Nurses internationally.----- Background: There is a worldwide shortage of nurses but there is also an increased demand for nurses with enhanced skills who can manage a more diverse, complex and acutely ill patient population than ever before. As a result, a variety of nurses in advanced practice positions has evolved around the world. The differences in nomenclature have led to confusion over the roles, scope of practice and professional boundaries of nurses in an international context.----- Method: CINAHL, Medline, and the Cochrane database of Systematic Reviews were searched from 1987 to 2008. Information was also obtained through government health and professional organisation websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant.----- Findings: There are many names for Advanced Practice Nurses, and although many of these roles are similar in their function, they can often have different titles.----- Conclusion: Advanced Practice Nurses are critical for the future, provide cost-effective care and are highly regarded by patients/clients. They will be a constant and permanent feature of future health care provision. However, clarification regarding their classification and regulation is necessary in some countries.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Selecting an appropriate business process modelling technique forms an important task within the methodological challenges of a business process management project. While a plethora of available techniques has been developed over the last decades, there is an obvious shortage of well-accepted reference frameworks that can be used to evaluate and compare the capabilities of the different techniques. Academic progress has been made at least in the area of representational analyses that use ontology as a benchmark for such evaluations. This paper reflects on the comprehensive experiences with the application of a model based on the Bunge ontology in this context. A brief overview of the underlying research model characterizes the different steps in such a research project. A comparative summary of previous representational analyses of process modelling techniques over time gives insights into the relative maturity of selected process modelling techniques. Based on these experiences suggestions are made as to where ontology-based representational analyses could be further developed and what limitations are inherent to such analyses.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The shortage of donor hearts for patients with end stage heart failure has accelerated the development of ventricular assist devices (VAD) that act as a replacement heart. Mechanical devices involving pulsatile, axial and centrifugal devices have been proposed. Recent clinical developments indicate that centrifugal devices are not only beneficial for bridge to transplantation applications, but may also aid myocardial recovery. The results of a recent study have shown that patients who received a VAD have extended lives and improved quality of life compared to recipients of drug therapy. Unfortunately 25% of these patients develop right heart failure syndrome, sepsis and multi-organ failure. It was reported that 17% of patients initially receiving an LVAD later required a right ventricular assist device (RVAD). Hence, current research focus is in the development of a bi-ventricular assist device (BVAD). Current BVAD technology is either too bulky or necessitates having to implant two pumps working independently. The latter requires two different controllers for each pump leading to the potential complication of uneven flow dynamics and the requirements for a large amount of body space. This paper illustrates the combination of the LVAD and RVAD as one complete device to augment the function of both the left and right cardiac chambers with double impellers. The proposed device has two impellers rotating in counter directions, hence eliminating the necessity of the body muscles and tubing/heart connection to restrain the pump. The device will also have two separate chambers with independent rotating impeller for the left and right chambers. A problem with centrifugal impellers is the fluid stagnation underneath the impeller. This leads to thrombosis and blood clots.This paper presents the design, construction and location of washout hole to prevent thrombus for a Bi-VAD centrifugal pump. Results using CFD will be used to illustrate the superiority of our design concept in terms of preventing thrombus formation and hemolysis.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The results of a recent study have shown that there is a severe shortage of donor hearts to meet the demand of patients suffering from acute heart failures, and patients who received a left ventricular assist device (LVAD) have extended lives. However, some of them develop right heart failure syndrome, and these patients required a right ventricular assist device (RVAD). Hence, current research focus is in the development of a bi-ventricular assist device (Bi-VAD). Computational Fluid Dynamics (CFD) is useful for estimating blood damage for design of a Bi-VAD centrifugal heart pump to meet the demand of the left and right ventricles of a normal hearts with a flow rate of 5 lit/min and the supply pressure of 100 mmHg for the left ventricle and 20 mmHg for the right ventricle. Numerical studies have been conducted to predict pressure, flow rate, the velocity profiles, and streamlines in a continuous flow Bi-VAD using. Based on the predictions of numerical simulations, only few flow regions in the Bi-VAD exhibited signs of velocity profiles and stagnation points, thereby signifying potentially low levels of thrombogenesis.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Aiming at the shortage of prevailing prediction methods about highway truck conveyance configuration in over-limit freight research that transferring the goods attributed to over-limit portion to another fully loaded truck of the same configuration and developing the truck traffic volume synchronously, a new way to get accumulated probability function of truck power tonnage in basal year by highway truck classified by wheel and axle type load mass spectrum investigation was presented. Logit models were used to forecast overall highway freight diversion and single cargo tonnage diversion when the weight rules and strict of enforcement intensity of overload were changed in scheme year. Assumption that the probability distribution of single truck loadage should be consistent with the probability distribution of single goods freighted, the model describes the truck conveyance configuration in the future under strict over-limit prohibition. The model was used and tested in Highway Over-limit Research Project in Anhui by World Bank.