32 resultados para Aftermath of cerebrovascular event

em University of Queensland eSpace - Australia


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The impact of the implementation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 is making itself felt across the US. Welfare roles are down dramatically, and public officials hail a new day of personal responsibility, but the popular press and ethnographic accounts increasingly challenge that interpretation, pointing to staggering human costs among those who are standing in the ideological crossfire.

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It has been suggested that although the most theorisation about globalisation has emerged from “western” contexts, the material implications of globalisation have been felt most strongly in non-western regions. With this in mind, we are undertaking a situated analysis of how two states, Singapore and Hong Kong, are interacting with the broader processes of globalisation through their educational policies. We apply Foucault's conceptual tool of governmentality to understand (i) the conduct of governing in the contemporary nation-state, and (ii) how the “right” rationalities are being inculcated by government to create “desiring subjects” who will play their part in ensuring national prosperity. We use the Asian Economic Crisis as a point of departure to show how global-local tensions are being managed by Singapore and Hong Kong. We conclude that both these global cities have adroitly managed the Asian economic crisis to steer their citizens away from pursuits of greater political freedom and towards concerns of material well being. They have done so through a selective interpretation of globalisation, by simultaneously resisting and embracing the contradictory strands of globalisation. Education has emerged as a critical space for this selective absorption of globalising trends.

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This study explored the impact of downsizing on levels of uncertainty, coworker and management trust, and communicative effectiveness in a health care organization downsizing during a 2-year period from 660 staff to 350 staff members. Self-report data were obtained from employees who were staying (survivors), from employees were being laid off (victims), and from employees with and without managerial responsibilities. Results indicated that downsizing had a similar impact on the amount of trust that survivors and victims had for management. However, victims reported feeling lower levels of trust toward their colleagues compared with survivors. Contrary to expectations, survivors and victims reported similar perceptions of job and organizational uncertainty and similar levels of information received about changes. Employees with no management responsibilities and middle managers both reported lower scores than did senior managers on all aspects of information received. Implications for practice and the management of the communication process are discussed.

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Background. A sample of 1089 Australian adults was selected for the longitudinal component of the Quake Impact Study, a 2-year, four-phase investigation of the psychosocial effects of the 1989 Newcastle earthquake. Of these, 845 (78%) completed a survey 6 months post-disaster as well as one or more of the three follow-up surveys. Methods. The phase I survey was used to construct dimensional indices of self-reported exposure to threat the disruption and also to classify subjects by their membership of five 'at risk' groups (the injured; the displaced; owners of damaged small businesses; helpers in threat and non-threat situations). Psychological morbidity was assessed at each phase using the 12-item General Health Questionnaire (GHQ-12) and the Impact of Event Scale (IES). Results. Psychological morbidity declined over time but tended to stabilize at about 12 months post-disaster for general morbidity (GHQ-12) and at about 18 months for trauma-related (IES) morbidity. Initial exposure to threat and/or disruption were significant predictors of psychological morbidity throughout the study and had superior predictive power to membership of the targeted 'at risk' groups. The degree of ongoing disruption and other life events since the earthquake were also significant predictors of morbidity. The injured reported the highest levels of distress, but there was a relative absence of morbidity among the helpers. Conclusions. Future disaster research should carefully assess the threat and disruption experiences of the survivors at the time of the event and monitor ongoing disruptions in the aftermath in order to target interventions more effectively.

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This paper summarises the major findings from the Quake Impact Study (QIS), a four-phase longitudinal project that was conducted in the aftermath of the 1989 Newcastle (Australia) earthquake. A total of 3,484 subjects participated in at least one component of the QIS, comprising a stratified sample of 3,007 drawn from community electoral rolls and 477 from specially targeted supplementary samples (the injured, the displaced, the owners of damaged businesses, and the helpers). Subjects' initial earthquake experiences were rated in terms of weighted indices of exposure to threat and disruption. Psychological morbidity was measured at each phase using the General Health Questionnaire (GHQ-12) and the Impact of Event Scale (IES). Selected findings and key conclusions are presented for each of six areas of investigation: service utilisation during the first 6 months post-disaster; patterns of earthquake experience and short-term (6-month) psychosocial outcome; earthquake exposure and medium term (2-year) psychosocial outcome; vulnerability factors and medium-term psychosocial outcome: specific community groups at increased risk (e.g., the elderly and immigrants from non-English-speaking backgrounds); the effects of stress debriefing for helpers. Threshold morbidity (i.e., likely caseness) rates are also presented for a broad range of subgroups. In addition to presenting an overview of the QIS, this paper synthesises the major findings and discusses their implications for future disaster management and research from a mental health perspective.

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Research into consumer responses to event sponsorships has grown in recent years. However, the effects of consumer knowledge on sponsorship response have received little consideration. Consumers' event knowledge is examined to determine whether experts and novices differ in information processing of sponsorships and whether a sponsor's brand equity influences perceptions of sponsor-event fit. Six sponsors (three high equity/three low equity) were paired with six events. Results of hypothesis testing indicate that experts generate more total thoughts about a sponsor-event combination. Experts and novices do not differ in sponsor-event congruence for high-brand-equity sponsors, but event experts perceive less of a match between sponsor and event for low-brand-equity sponsors. (C) 2004 Wiley Periodicals, Inc.

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News of the attacks on New York and Washington on September 11th 2001 spread fast, mainly through dramatic images of the events broadcast via a global television media, particularly 24-hour news channels such as BBC News 24 and CNN. Following the initial report many news channels moved to dedicated live coverage of the story. This move, to what Liebes (1998) describes as a 'disaster marathon', entails shifting from the routine, regular news agenda to one where the event and its aftermath become the main story and reference for all other news. In this paper, we draw upon recordings from the BBC News 24 channel on September 11th 2001 during the immediate aftermath of the attacks on the World Trade Centre and Pentagon to argue that the coverage of this event, and other similar types of events, may be characterised as news permeated with strategic and emergent silences. Identifying silence as both concrete and metaphorical, we suggest that there are a number of types of silence found in the coverage and that these not only act to cover for lack of new news, or give emphasis or gravitas, but also that the vacuum created by a lack of news creates an emotional space in which collective shock, grieving or wonder are managed through news presented as phatic communion.

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A major task of traditional temporal event sequence mining is to predict the occurrences of a special type of event (called target event) in a long temporal sequence. Our previous work has defined a new type of pattern, called event-oriented pattern, which can potentially predict the target event within a certain period of time. However, in the event-oriented pattern discovery, because the size of interval for prediction is pre-defined, the mining results could be inaccurate and carry misleading information. In this paper, we introduce a new concept, called temporal feature, to rectify this shortcoming. Generally, for any event-oriented pattern discovered under the pre-given size of interval, the temporal feature is the minimal size of interval that makes the pattern interesting. Thus, by further investigating the temporal features of discovered event-oriented patterns, we can refine the knowledge for the target event prediction.

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Background and Purpose-This report describes trends in the key indices of cerebrovascular disease over 6 years from the end of the 1980s in a geographically defined segment of the city of Perth, Western Australia. Methods-Identical methods were used to find and assess all cases of suspected stroke in a population of approximately 134 000 residents in a triangular area of the northern suburbs of Perth. Case fatality was measured as vital status at 28 days after the onset of symptoms. Data for first-ever strokes and for all strokes for equivalent periods of 12 months in 1989-1990 and 1995-1996 were compared by age-standardized rates and proportions and Poisson regression. Results-There were 355 strokes in 328 patients and 251 first-ever strokes (71%) for 1989-1990 and 290 events in 281 patients and 213 first-ever strokes (73%) for 1995-1996. In Poisson models including age and period, overall trends in the incidence of both first-ever strokes (rate ratio = 0.75; 95% confidence limits, 0.63, 0.90) and all strokes (rate ratio = 0.73; 95% confidence limits, 0.62, 0.85) were obviously significant, but only the changes in men were independently significant. Case fatality did not change, and the balance between hemorrhagic and occlusive strokes in 1995-1996 was almost indistinguishable from that observed in 1989-1990. Conclusions-Our results, which are the only longitudinal population-based data available for Australia for key indices of stroke, suggest that it is a change in the frequency of stroke, rather than its outcome, that is chiefly responsible nationally for the fall in mortality from cerebrovascular disease.

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Background and Purpose-Few reliable estimates of the long-term functional outcome after stroke are available. This population-based study aimed to describe disability, dependency, and related independent prognostic factors at 5 years after,a first-ever stroke in patients in Perth, Western Australia. Methods-All individuals with a suspected acute stroke who were resident in a geographically defined region (population, 138 708) of Perth, Western Australia, were registered prospectively and assessed according to standardized diagnostic criteria over a period of 18 months in 1989 to 1990. Patients were followed up prospectively at 4 and 12 months and 5 years after the index event. Results-There were 370 cases of first-ever stroke, and 277 patients survived to 30 days. Of these early survivors, 152 (55%) were alive at 5 years, and among those who were neither institutionalized (n=146) nor disabled (n=129) at the time of their stroke, 21 (14%) were institutionalized in a nursing home, and 47 (36%) were disabled. The most important predictors of death or disability at 5 years were increasing age, baseline disability defined by a Barthel Index score of <20/20 (odds ratio [OR], 6.3; 95% confidence interval [CI], 2.7 to 14), moderate hemiparesis (OR, 2.7. 95% CI, 1.1 to 6.2), severe hemiparesis (OR, 4.5; 95% CI, 1.1 to 19), and recurrent stroke (OR, 9.4; 95% CI, 3.0 to 30). A low level of activity before the stroke was a significant predictor of institutionalization, and subsequent recurrent stroke was a consistent, independent predictor of institutionalization, disability, and death or institutionalization, increasing the odds of each of these 3 adverse outcomes by 5- to 15-fold. Conclusions-Among 30-day survivors of first-ever stroke, about half survive 5 years; of survivors, one third remain disabled, and I in 7 are in permanent institutional care. The major modifiable predictors of poor long-term outcome are a low level of activity before the stroke and subsequent recurrent stroke. Efforts to increase physical activity among the elderly and to prevent recurrent stroke in survivors of a first stroke are likely to reduce the long-term burden of cerebrovascular disease.