79 resultados para person-centred practice
Resumo:
For the last decade or so, educational policy makers and researchers in many countries have been calling for significant changes to the way mathematics is taught in secondary schools. Australian mathematics curriculum documents now promote learning goals that go beyond mastery of a pre-determined body of knowledge and procedures - the traditional emphasis on facts, skills, formulae - to include mathematical reasoning and problem solving, communication, and real world applications. There is also pressure to move away from over-reliance on teacher-centred practices such as exposition and individual seatwork, towards activities that promote learners' involvement in constructing, applying, and evaluating mathematical ideas. Further impetus for reform comes from research recommending that if learners are to develop mathematically powerful forms of thinking and habits of mind, then classrooms should immerse them in the authentic practices of the discipline by supporting a culture of collaboration and sense-making. Teaching Secondary School Mathematics - incorporates recent developments in research and practice and applications to teaching mathematics in Australian secondary schools. Covering such areas as curriculum, pedagogy and assessment; teaching mathematical content; equity and diversity in the classroom; and professional and community engagement, it is an invaluable resource for all practising and pre-service mathematics teachers.
Motivational interviewing techniques : facilitating behaviour change in the general practice setting
Resumo:
Background: One of the biggest challenges that primary care practitioners face is helping people change longstanding behaviours that pose significant health risks.
Objective: To explore current understanding regarding how and why people change, and the potential role of motivational interviewing in facilitating behaviour change in the general practice setting.
Discussion: Research into health related behaviour change highlights the importance of motivation, ambivalence and resistance. Motivational interviewing is a counselling method that involves enhancing a patient's motivation to change by means of four guiding principles, represented by the acronym RULE: Resist the righting reflex; Understand the patient's own motivations; Listen with empathy; and Empower the patient. Recent meta-analyses show that motivational interviewing is effective for decreasing alcohol and drug use in adults and adolescents and evidence is accumulating in others areas of health including smoking cessation, reducing sexual risk behaviours, improving adherence to treatment and medication and diabetes management.
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While diagnosis has traditionally been viewed as an essential concept in medicine, particularly when selecting treatments, we suggest that the use of diagnosis alone may be limited, particularly within mental health. The concept of clinical case formulation advocates for collaboratively working with patients to identify idiosyncratic aspects of their presentation and select interventions on this basis. Identifying individualized contributing factors, and how these could influence the person's presentation, in addition to attending to personal strengths, may allow the clinician a deeper understanding of a patient, result in a more personalized treatment approach, and potentially provide a better clinical outcome.
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In this chapter we focus on face appearance-based biometrics. The cheap and readily available hardware used to acquire data, their non-invasiveness and the ease of employing them from a distance and without the awareness of the user, are just some of the reasons why these continue to be of great practical interest. However, a number of research challenges remain. Specifically, face biometrics have traditionally focused on images acquired in the visible light spectrum and these are greatly affected by such extrinsic factors such as the illumination, camera angle (or, equivalently, head pose) and occlusion. In practice, the effects of changing pose are usually least problematic and can oftentimes be overcome by acquiring data over a time period, e.g., by tracking a face in a surveillance video. Consequently, image sequence or image set matching has recently gained a lot of attention in the literature [137–139] and is the paradigm adopted in this chapter as well. In other words, we assume that the training image set for each individual contains some variability in pose, but is not obtained in scripted conditions or in controlled illumination. In contrast, illumination is much more difficult to deal with: the illumination setup is in most cases not practical to control and its physics is difficult to accurately model. Thermal spectrum imagery is useful in this regard as it is virtually insensitive to illumination changes, as illustrated in Fig. 6.1. On the other hand, it lacks much of the individual, discriminating facial detail contained in visual images. In this sense, the two modalities can be seen as complementing each other. The key idea behind the system presented in this chapter is that robustness to extreme illumination changes can be achieved by fusing the two. This paradigm will further prove useful when we consider the difficulty of recognition in the presence of occlusion caused by prescription glasses.
Resumo:
Recognition algorithms that use data obtained by imaging faces in the thermal spectrum are promising in achieving invariance to extreme illumination changes that are often present in practice. In this paper we analyze the performance of a recently proposed face recognition algorithm that combines visual and thermal modalities by decision level fusion. We examine (i) the effects of the proposed data preprocessing in each domain, (ii) the contribution to improved recognition of different types of features, (iii) the importance of prescription glasses detection, in the context of both 1-to-N and 1-to-1 matching (recognition vs. verification performance). Finally, we discuss the significance of our results and, in particular, identify a number of limitations of the current state-of-the-art and propose promising directions for future research.
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Aim The purpose of the study was to explore nurses' perceptions and understanding of patient-centred care (PCC) in Bhutan. Background Nurses' perceptions and understanding of PCC in Bhutan are unknown. Methods A non-probability convenience sample was taken and a mixed method (quantitative and qualitative descriptive) used. Survey questionnaires were administered to 87 Bhutanese nurses in three types of hospitals -- the National Referral Hospital, the regional referral hospital and the district hospital. Descriptive statistics including frequency distribution, mean and standard deviation (SD) were used for analysis. Spearman's correlation coefficients were used to investigate relationships between demographic variables. Results The nursing labour force in Bhutan knows which behaviours are considered necessary for practising PCC. The mean (SD) rating of behaviours considered critical for practising PCC was 4.29 (0.22), five being the highest score. Bhutanese nurses described PCC, according to qualitative descriptive analysis, as being based on individual patient assessment (22/87 or 25% of respondents), using a holistic model of care (38/87 or 44%) that was based on evidence (38/87 or 44%). A higher level of education (79/87 or 91%) was found to be the main factor that would facilitate the development of PCC, while inadequate staffing, in terms of insufficient numbers of staff and lack of advanced practitioners (56/87 or 64%), was revealed as the main factor that hinders development of PCC. Conclusion Bhutanese nurses believed certain behaviours were critical to PCC. Reform of higher nursing education, putting an emphasis on PCC, would improve nursing practice and increase its scope.
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The move by the Medical Board of Australia to commence a conversation with the medical profession about revalidation reflects that patient-centred care is at the heart of good medical practice. Patients judge their doctors' commitment to them based on whether their individual interactions with doctors meet their needs. We argue that ensuring that doctors are continuing to perform at a level that the community regards as acceptable is a demonstration of an individual doctor's professionalism and thus their commitment to patient-centred care. This impacts on the profession as a whole, which needs to commit to what we call 'demonstrable professionalism' - the ongoing and active demonstration of performance that the community regards as acceptable. This needs to be supported by organisations in which doctors work, reflecting the importance of organisational context to clinical practice. Revalidation processes thus need both to reflect the work of doctors and be meaningful to the community. The move to consider revalidation of doctors by regulatory authorities should not be seen by the profession as a threat, but more as an opportunity to demonstrate the profession's commitment to patient-centred care
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The implementation of the first iteration of a curriculum for an applied learning programme for police trainers received a hostile response from participants. It was perceived as irrelevant and supplanting, rather than augmenting, trainers’ fixed and untested training practices. This paper presents the reflections on my journey as a nonpolice person straddling an outsider-insider position while challenging that which is taken-for-granted and introducing an educative intent, as opposed to a doctrinal, technical intent, to police training. On a daily basis I simultaneously work within and against the prevailing D/discourses and dominant subcultures, while establishing and nurturing relationships with police trainers: being teacher, coach and ‘critical friend’. The response to the second and now third iterations of the learning programme has been increasingly positive, revealing shifts in trainers’ thinking and practice.
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Background
Provision of high quality transitional care is a challenge for health care providers in many western countries. This systematic review was conducted to (1) identify and synthesise research, using randomised control trial designs, on the quality of transitional care interventions compared with standard hospital discharge for older people with chronic illnesses, and (2) make recommendations for research and practice.
Methods
Eight databases were searched; CINAHL, Psychinfo, Medline, Proquest, Academic Search Complete, Masterfile Premier, SocIndex, Humanities and Social Sciences Collection, in addition to the Cochrane Collaboration, Joanna Briggs Institute and Google Scholar. Results were screened to identify peer reviewed journal articles reporting analysis of quality indicator outcomes in relation to a transitional care intervention involving discharge care in hospital and follow-up support in the home. Studies were limited to those published between January 1990 and May 2013. Study participants included people 60 years of age or older living in their own homes who were undergoing care transitions from hospital to home. Data relating to study characteristics and research findings were extracted from the included articles. Two reviewers independently assessed studies for risk of bias.
Results
Twelve articles met the inclusion criteria. Transitional care interventions reported in most studies reduced re-hospitalizations, with the exception of general practitioner and primary care nurse models. All 12 studies included outcome measures of re-hospitalization and length of stay indicating a quality focus on effectiveness, efficiency, and safety/risk. Patient satisfaction was assessed in six of the 12 studies and was mostly found to be high. Other outcomes reflecting person and family centred care were limited including those pertaining to the patient and carer experience, carer burden and support, and emotional support for older people and their carers. Limited outcome measures were reported reflecting timeliness, equity, efficiencies for community providers, and symptom management.
Conclusions
Gaps in the evidence base were apparent in the quality domains of timeliness, equity, efficiencies for community providers, effectiveness/symptom management, and domains of person and family centred care. Further research that involves the person and their family/caregiver in transitional care interventions is needed.
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Evidence of patients' experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit; investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia.
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BACKGROUND: Patient participation is a way for patients to engage in their nursing care. In view of the possible link between patient participation and safety, there is a need for an updated review to assess patient participation in nursing care. OBJECTIVES: To investigate patients' and nurses' perceptions of and behaviours towards patient participation in nursing care in the context of hospital medical wards. DESIGN: Integrative review. DATA SOURCES: Three search strategies were employed in August 2013; a computerised database search of Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Medline and PsychINFO; reference lists were hand-searched; and forward citation searching was executed. REVIEW METHODS: After reviewing the studies, extracting study data and completing summary tables the methodological quality was assessed using the Mixed-Methods Assessment Tool by two reviewers. Reviewers met then to discuss discrepancies as well as the overall strengths and limitations of the studies. Discrepancies were overcome through consensus or a third reviewer adjudicated the issue. Within and across study analysis and synthesis of the findings sections was undertaken using thematic synthesis. RESULTS: Eight studies met inclusion criteria. Four themes were identified - enacting participation, challenges to participation, promoting participation and types of participation. Most studies included were conducted in Europe. The majority of studies used qualitative methodologies, with all studies sampling patients; nurses were included in three studies. Data were largely collected using self-reported perceptions; two studies included observational data. Methodological issues included a lack of reflexivity, un-validated data collection tools, sampling issues and low response rates. CONCLUSIONS: On medical wards, patients and nurses desire, perceive or enact patient participation passively. Challenging factors for patient participation include patients' willingness, nurses' approach and confusion around expectations and roles. Information-sharing was identified as an activity that promotes patient participation, suggesting nurses encourage active communication with patients in practice. Involving patients in assessment and care planning may also enhance patient participation. For education, enhancing nurses' understanding of the attributes of patient participation, as well as patient-centred care approaches may be beneficial for medical ward nurses. From here, researchers need to examine ways to overcome the barriers to patient participation; further nurse participants and observational data is required on medical wards.
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I propose that a learnt somatic experience of dance can translate into another discipline such as visual art. In my visual art practice I combine both photography, which is traditionally seen as a still medium, and performance in order to create a new form of embodiment. I have developed two series of art works of prints and video made in response to the Australian landscape. By analyzing my method of movement and photography I will describe how an embodied dance language can result in a material outcome – a series of drawings of light and movement, a body signature made possible through old and new technology. I have activated a performative state while capturing images discovering new ways of using technology reliant upon my knowledge of dance, performance and photography. Making a human size camera to make analogue prints I gained an intuitive knowledge of light – a skill that has become foundational in performance and photography. In response to space and light in the Australian landscape I then built a custom made camera that allows for the longest possible time to capture an image. I move while taking the image and use the camera as if an eye at the end of my arm. In this way I activate dance skills and embodied knowledge of space, timing and light, opening up a radical space for new thinking, making and performing.Furthermore this process engages memory and sentiment embodied through age. Many artists have responded to the unique qualities of the Australian landscape and by using a performative/photographic approach I have engaged with my own body memory. Being brought up in the landscape and training in ballet my body has acquired memories at a cellular level. My method has given memory a voice. In doing these works I have become conscious of how unconscious memories of the space and light in the landscape is a movement vocabulary activated in a way that ‘feels’ like dancing. As an ageing person this experience is profound and the resultant materialisation of the photographs and videos leave a material record of the event. The sentiments evoked through my process bridge the past with the present, the body with the mind, memory with body and space connecting disciplines in a new way.The materialisation of artworks itself continues cross-disciplinary processes using a technique that is a continuum of the performative. Through using technology I release memory of the landscape and pixel by pixel build imagery that relies on and is a part of the performative process. It is a photographic performance dance manifesting as pigment on paper exhibited a gallery context. The exhibition allows a space for the viewer to respond - re-membering the universal the act of moving. The works titled ‘body signatures’ and ‘Fly Rhythm’ become a communicative device in the gallery context.My paper through an analysis of process and methods used in making the two series will talk to several of the subjects listed and reveal a new way of connecting performance and visual art and old and new technologies.
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This qualitative evaluation of a chronic disease self-management project in rural South Australia considers the sustainability of client-centred care planning under current organisational and funding arrangements. The study involved consultation with a range of five stakeholder types over two stages (40 in the beginning stage and 39 in the middle stage) about their satisfaction with the care planning and self-management approach used in the project. All stakeholder types valued the client-centred approach because they perceived that clients were better able to accept and deal with the long-term management of their condition. However, this required that care planning should deal with a wider range of issues than just medical management, and so it took longer, which raised its sustainability in general practice under the current funding through the national health insurance programme (Medicare). The study concludes that sustainability may be addressed through further research into the role of and funding for peer-led self-management groups and the employment of care planners in organisational settings that are conducive to a client-centred approach.
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Background: In 2006, Oslin and Mitchell published a review of the game-centred approaches (GCAs) to teaching and coaching literature highlighting a number of core concepts thought to provide justification for the use of GCAs including (a) its potential to enhance participant motivation, (b) potential for tactical transfer, and (c) development of decision-making skills and effective decision-makers. Oslin and Mitchell also suggested recommendations for future GCA research.Purpose: The purpose of this paper was threefold: (a) to present a review of Anglophone research into GCAs building on the previous review of Oslin and Mitchell published in 2006; (b) to identify new trends in research since 2006; and (c) to investigate the extent to which the initial suggestions and future research directions suggested by Oslin and Mitchell have been addressed.Data collection: GCA literature since 2006 was searched systematically using a three-phase approach. Phase 1 included initial searches of the EBSCO database using terms associated with GCAs and their acronyms (e.g. TGfU (teaching games for understanding), GS (Game Sense), etc.). Phase 2 expanded the search adopting more generic terms from keywords located in the recent literature (e.g. teaching games, tactical development, game performance, etc.). Multiple searches through the EBSCO database were conducted, whereby key terms were cross-referenced until a saturation point was reached. Phase 3 involved removing those publications that were not empirical, peer reviewed, intervention studies or published in English.Findings: Forty-four studies on GCA implementation were identified and the methodological and substantive nature of these studies was examined. The review noted two positive trends: (a) the expansion of research which included the growth of research on GCAs in Europe and Southeast Asia and (b) an increased amount of research in the affective domain. The review found, however, that a number of key challenges remain within GCA research, which include (a) the need for improved articulation of GCA verification procedures; (b) further assessment of tactical awareness development; (c) extended inquiry about GCAs in coaching contexts; (d) more research into ‘newer’ GCAs (i.e. PP (play practice), IGCM (invasion game competence model) and TDLM (tactical decision learning model)); (e) use of longitudinal research designs; (f) inadequate length of GCA induction and training for teachers and coaches, and (g) examination of GCAs in terms of fitness and special populations.Conclusions: GCA pedagogies are of significant importance as they have the potential to promote change within current adult-centric cultures of youth sport and encourage engagement in physical activity over the life course. To meet these needs, it is recommended that GCA research undergo continued expansion with the use of research designs and data collection techniques that aid the examination of different philosophical understandings of GCAs (e.g. ethnographic, phenomenological and psycho-phenomenological). These are paramount to the exploration of ‘who the individual is’ and ‘how the learner is motivated to continue to participate’ and further permit the in-depth, contextual and ecological analysis of GCA interventions that Oslin and Mitchell recommended in their previous review.
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Using a Bourdieuian social analysis the thesis explores the interplay of personal identity formation and system demands captured in the powerful narratives of experienced principals. Astute strategists, they are employing agentic actions centred on learning, democratic practice and social equity that are countering the prevailing logics of the education field.