153 resultados para Delivery, Obstetric.


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In the early 1990s, Australian policymakers began explicitly promoting increased use of flexible delivery in vocational education and training (VET). Some researchers argued that many students lack the learning skills required to deal with the unique demands of flexible delivery. Concerns were also raised about the VET sector's capacity to help students develop needed cognitive and metacognitive skills. A review of the literature revealed wide agreement that students' success in flexible delivery and open and distance education in Australia and elsewhere is generally determined by a complex interplay of factors, including the following: readiness for self-directed learning; ability to balance the time demands of study with other commitments such as family and work; level of literacy; ability to understand and deal with assessment requirements; level of motivation; and previous educational experiences. Two case studies based on the actual experiences of two of six students interviewed about their experiences in flexible VET delivery were reviewed. Both students decided to withdraw from their VET course because of several interconnected factors that built up over time. Both cases illustrated that some problems that can be addressed quickly in face-to-face learning environments are much more difficult to resolve when students are off campus.

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The potential for online learning to enhance learning opportunities of those living in regional Australia cannot be over-emphasised. This chapter* describes a study where online delivery was mapped to determine ‘what’ is happening and ‘why’. This enabled the benefits, barriers and ‘promoters’ of online learning to be identified. However, an important conclusion of this study is that there is a lack of consistent, comparable enrolment data relating to online learning, which obviously affects funding allocation decisions. To ensure high-quality learning experiences and appropriate support for students and staff, institutions require adequate funding and resources based on models which reflect the reality of online delivery and learning.

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Introduction: New technologies such as the Internet offer an increasing number of options for the delivery of continuing education (CE) to community pharmacists. Many of these options are being utilized to overcome access- and cost-related problems. This paper identifies learning preferences of Australian community pharmacists for CE and identifies issues with the integration of these into contemporary models of CE delivery.
Methods: Four focus group teleconferences were conducted with practicing community pharmacists (n = 15) using a semistructured format and asking generally about their CE and continuing professional development (CPD) experiences.
Results: Pharmacists reported preferences for CE that were very closely aligned to the principles of adult learning. There was a strong preference for interactive and multidisciplinary CE. Engaging in CPD was seen as valuable in promoting reflective learning.
Discussion: These results suggest that pharmacists have a strong preference for CE that is based on adult learning principles. Professional organizations should take note of this and ensure that new CE formats do not compromise the ability of pharmacists to engage in interactive, multidisciplinary, and problem-based CE. Equally, the role of attendance-based CE in maintaining peer networks should not be overlooked.

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OBJECTIVE: To describe how intensive care nurses manage the administration of supplemental oxygen to patients during the first 24 hours after cardiac surgery.
METHODS: A retrospective audit was conducted of the medical records of 245 adult patients who underwent cardiac surgery between 1 January 2005 and 31 May 2008 in an Australian metropolitan hospital. Physiological data (oxygen saturation measured by pulse oximetry and respiratory rate) and intensive care unit management data (oxygen delivery device, oxygen flow rate and duration of mechanical ventilation) were collected at hourly intervals over the first 24 hours of ICU care.
RESULTS: Of the 245 patients whose records were audited, 185 were male; mean age was 70 years (SD, 10), and mean APACHE II score was 17.5 (SD, 5.14). Almost half the patients (122, 49.8%) were extubated within 8 hours of ICU admission. The most common oxygen delivery device used immediately after extubation was the simple face mask (214 patients, 87%). Following extubation, patients received supplemental oxygen via, on average, two different delivery devices (range, 1-3), and had the delivery device changed an average of 1.38 times (range, 0-6) during the 24 hours studied. Twenty-two patients (9%) received non-invasive ventilation or high-flow oxygen therapy, and 16 (7%) experienced one or more episode of hypoxaemia during mechanical ventilation. A total of 148 patients (60%) experienced one or more episodes of low oxygenation or abnormal respiratory rate during the first 24 hours of ICU care despite receiving supplemental oxygen.
CONCLUSION: These findings suggest that the ICU environment does not protect cardiac surgical patients from suboptimal oxygen delivery, and highlights the need for strategies to prompt the early initiation of interventions aimed at optimising blood oxygen levels in cardiac surgical patients in the ICU.

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This paper details the design of a closed-loop insulin delivery device, consisting of a glucose sensing circuit, and a basic microprocessor-based syringe pump. The glucose sensing circuit contains the required components to interface with CGMS's glucose sensor assembly, while the syringe pump design uses microprocessor to allow flexible control over the pump driver. Instrumentation developed in this paper provides a ready reference to other researchers on the construction of a closed-loop insulin delivery apparatus with amperometric glucose sensor.

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This thesis examines the learning preferences and learning strategies of apprentices, and the contexts within which they learn in their workplaces. Since the end of the 1980s Australian vocational education and training (VET) structures and processes have undergone radical change in attempts to develop skills in the workforce that will ensure enterprise, national, and international competitiveness. A major strategy in the national reforms has been the encouragement of flexible delivery as a means through which workplace-based learning can be accessed by a larger number of workers in ways that are cost-efficient, and that reduce the amount of time that workers spend away from their jobs. Although flexible delivery has been championed by governments and industry alike, there has been little attempt to identify the preparedness of either learners or their workplaces for the demands of flexible learning. The thesis examines the economic context for these changes to VET, and also examines the literature available on workplace learning. Additionally, the thesis examines the conceptualisations of flexible delivery that are available in the literature, pointing to the possibility that the wide range of meanings associated with the term ‘flexible delivery’ may result in quite different practices and expectations. The thesis also examines the literature on independent learning and self-directed learning, and explores the concept of ‘client-focused’ flexible delivery. The study of learner preferences uses data collected from apprentices over a period of some years, in the four occupational areas commanding the highest number of apprentices in Australia. These occupational areas are Metals and Machining, Building, Electrical, and Hairdressing. These data on learning preferences are collected using the commercially available Canfield Learning Styles Inventory (CLSI). The data from the sample of 389 apprentices are analysed statistically through analyses of variance, and indicate that variables such as age, gender, and occupational area are related to learning preferences. Apprentices are shown by this analysis to prefer structured programs of instruction that are instructor-led, and to not have a high preference for independent learning or the development of their own learning goals. Additionally, they are shown to have very low preferences for learning through reading, preferring instead to learn through direct hands-on experience. While these characteristics are largely common among the four occupational groups, the Hairdressing apprentices are shown to have a slightly higher preference for independent learning and goal setting. Females are shown to have a higher preference than males for learning qualitative material through reading. Interestingly, the younger apprentices are shown to have a higher preference than the older ones for self-directed learning. Some possibilities for that finding are discussed. The research also shows that the learning preferences displayed by different groups of apprentices in any one program are much the same over time, providing some confidence that data generated from one group of apprentices can be used to make instructional decisions for future groups in the same program. The data are also factor analysed to indicate three major factors underlying apprentice learning preferences. The first factor indicates a Verbal–Non-verbal preference factor, with apprentices clearly preferring to learn through non-verbal means. A second factor is described as Structure–Content, with apprentices showing a preference for learning from structured programs in a structured environment. A third factor, Self-directed–Social preference, indicates apprentices preferring to learn through socially mediated presentations and contexts rather than through more independent forms of learning. Qualitative data are also generated through interviewing eight apprentices, and focusing on the learning strategies they employ while constructing knowledge in the workplace. That component of the research uses a modification of the Marland, Patching and Putt (1992a, 1992b) stimulated recall technique, and a set of learning strategies derived from the work of O’Malley and Chamot (1990) and Billett (1996a). The eight apprentices are drawn from the Metals and Machining, Electrical, and Hairdressing trades. The findings indicate that the learning strategies most often used by apprentices in the workplace are those associated with the construction of knowledge that is structured and provided by the instructor or learning program, and those that include social mediation of learning. Additionally, the strategies associated with demonstration and hands-on practice are most favoured. The qualitative data are confirmatory of the quantitative data. The research also indicates, through the apprentice interviews, that support for apprentice’s learning in their workplace is typically unplanned and haphazard. Their experience was sometimes characterised by a reluctance on the part of the workplace to acknowledge learning needs such as trialling and practice of new knowledge, or pro-actively seeking understanding from other more skilled workers. The learning preferences and learning strategies findings for apprentices, coupled with the findings of typically poor or unplanned support in the workplace, indicate that effective flexible delivery of training to apprentices in the workplace provides a number of challenges. These challenges, it is argued, demand strategies to be developed and implemented to prepare both learners and workplaces for effective engagement with flexible delivery. Using as a theoretical framework Kember’s (1995) two-dimensional model of open learning for adults, the thesis integrates the findings into a proposed two-dimensional model of learner and workplace preparedness for flexible delivery. The model provides for a Learner Development Space, a Workplace Development Space, and a Strategy Space. Within the Learner Development Space, focuses for the development of learner preparedness are identified in terms of self-directed learning, skills developments, and effective participation in a community of practice. Focuses for workplace development identified in the Workplace Development Space are those associated with development of training policies, training structures, and trainer skills and abilities. The Strategy Space then provides detail of seventy-nine specific strategies developed to enhance learner and workplace preparedness within each of the focuses identified.

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This thesis examines issues in Australian undergraduate engineering management studies in the context of flexible learning delivery. It is proposed that, within an Australian context: a) the management skills and competencies required by graduate engineers can be determined and classified on a rational basis, permitting an educational focus on those elements most appropriate for graduates; and b) on-line and other computer-based technologies are a practical and effective method for the support of undergraduate engineering management studies. The doctoral project incorporates: • an examination of the nature of engineering management; • a review of the relevant literature establishing the importance of management studies in undergraduate engineering courses; • a review of historical and recent developments in Australian undergraduate engineering management studies; • an investigation of the management skills and competencies required by graduate engineers - based on original research; • an examination of flexible delivery of engineering education - based on professional practice experience; and • an evaluation of case studies of flexible delivery of engineering management education - based on original research and professional practice experience. A framework of ranked classified management skills is developed. Broadly, the ranking framework is generic professional skills, followed by general management skills and technical discipline specific management skills, followed by other professional discipline skills and theoretical skills. This framework provides a rational basis for design of undergraduate engineering management studies. This is supplemented by consideration of the management skills required for the future of engineering practice. It is concluded that undergraduate engineering management education is well suited to delivery and support by on-line and computer-based technology. Recent developments in improved access to the Internet, software systems for on-line collaboration and changes in copyright legislation to create a broad-based right to communication via on-line media have contributed to the facilitation of on-line delivery of teaching and learning. It is noted that though many on-line infrastructure issues have been satisfactorily resolved, higher level issues will emerge as being crucial, including the academic staff development and reward for operating in an online teaching environment and the financial sustainability of on-line development and delivery of courses.