119 resultados para access to knowledge


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Researchers are experiencing intense pressures to publish and increase research outputs. Recently many research funders have introduced policies and mandates related to open access, which have contributed to the increasing popularity of open access journals. Dubbed gold open access, open access journals offer researchers another publishing option. However, some publishers with questionable practices and journals of dubious quality have emerged exploiting the ‘author pays’ open access model and researchers' need to publish. Hence an ability to publish research outputs through the most appropriate outlet for a particular field is crucial for researchers in order to maximise the impact of their research. Notwithstanding the proliferation of open access journals, the literature indicates that some researchers may not have a full understanding of the operations, implications and issues around open access and other publishing issues. This understanding is known as scholarly publishing literacy. With knowledge of scholarly publishing and access to resources and tools, academic libraries and librarians are well-positioned to play an active role in providing support to researchers. This paper argues that scholarly publishing literacy should be treated as an extension of information literacy delivered through a broader research support framework. This paper presents a research librarian's perspective, and draws on literature and the author's practice to illustrate key points. Issues for further investigation are identified.

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An appropriate use of various pedagogical strategies is fundamental for the effective transfer of knowledge in a flourishing e-learning environment. The resultant information superfluity, however, needs to be tackled for developing sustainable e-learning. This necessitates an effective representation and intelligent access to learning resources. Topic maps address these problems of representation and retrieval of information in a distributed environment. The former aspect is particularly relevant where the subject domain is complex and the later aspect is important where the amount of resources is abundant but not easily accessible. Conversely, effective presentation of learning resources based on various pedagogical strategies along with global capturing and authentication of learning resources are an intrinsic part of effective management of learning resources. Towards fulfilling this objective, this paper proposes a multi-level ontology-driven topic mapping approach to facilitate an effective visualization, classification and global authoring of learning resources in e-learning.

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Background
Renal access coordinators contribute specifically to dialysis access care for people with chronic and end stage renal disease. Since the introduction of renal access coordinators into Australia in the early 2000s, there have been anecdotal examples of associated improvements in patient outcomes and service delivery; however scant published quantitative evidence exists. Thus, the impact of the implementation of renal access coordinators has not undergone a rigorous review to date.

Objective
The objective of this systematic review was to critically appraise and synthesize the best available evidence related to the impact of renal access coordinators on dialysis patient outcomes and associated service delivery.

INCLUSION CRITERIA

Types of participants

This review considered studies that included renal access coordinators (noting variations of the titles) and adult hemodialysis patients (aged 18 years and over).

Types of intervention(s)
This review considered studies that evaluated the effectiveness of the renal access coordinator. This role typically consists of clinical and administration duties such as providing pre dialysis access coordination, access surveillance patient education and nurse education.

Types of studies
The types of studies considered within this review included experimental and epidemiological study designs. Thus randomized controlled trials (RCT), non-randomized controlled trials, and quasi-experimental, before and after studies, prospective and retrospective cohort studies were considered as were case control studies, analytical cross sectional studies and descriptive cross sectional studies.

Types of outcomes

Patient outcomes considered included: days to first vascular access complication (such as stenosis or thrombosis) and/or primary intervention (such as angioplasty or surgical intervention); percentage of central line insertions (negative); rate of arteriovenous fistula (AVF)/arteriovenous graft (AVG)/central venous catheter (CVC) at start of dialysis (incidence); prevalent rate of AVF/AVG/CVC; time to occlusion of AVF and time from referral to surgery. Service outcomes included: knowledge/up skilling of renal nurses; cannulation skills, ultrasound skills, knowledge of anatomy and physiology and other access related knowledge.

Search strategy
The search strategy aimed to locate published and unpublished studies, utilizing a three-step searching approach. Studies published in English from 1990 to October 2013 were considered for inclusion in this review.

Methodological quality
The studies were assessed by two independent reviewers using the appropriate standardized critical appraisal instruments from the Joanna Briggs Institute.

Data collection

Data were extracted from papers included in the review using the standardised data extraction tool from the Joanna Briggs Institute, namely JBI Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).

Data synthesis
This review aimed to conduct meta-analyses of the findings: however, because of the limitations of the data found, this was not possible and so the findings are presented in a narrative format.

Results
Five studies were identified for inclusion in the review. No RCTs were found, therefore four of the five studies were pre-post intervention cohort studies and one was a prospective quality assurance report. Data were heterogeneous and thus did not allow for meta-analysis. All studies included multidisciplinary teams with variable emphasis on the renal access coordinator role. The pre post intervention cohort studies measured incident and/or prevalent AVF, AVG and CVC rates in the hemodialysis population and the quality assurance report measured the difference in patency rates between AVF and AVG. All discussed the role of central coordination as a contributor to the success of vascular access care.

Conclusions
This review found insufficient data to make firm conclusions about the impact that renal access coordinators have on patient outcomes. The results of this review suggest an association between renal access coordinators and improved patient outcomes. These improved patient outcomes were apparent in an increase in incident and prevalent AVFs, and a decrease in the incidence and prevalence of CVCs. Both associations are correlated with a reduction in infection rates, length of hospital stay and healthcare costs.

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Objectives
Form a working group of renal vascular access nurses to develop peer reviewed, accessible, evidence based e-leaning modules related to vascular access principles and practice.

Key messages
Vascular access training and guidelines are often unit specific but the core principles of vascular access care are generally transferable. The vascular access e-learning module aims to utilize resources to minimize wasted time developing and keeping multiple individual vascular access training packages up to date.
Vascular access education is delivered from a variety of resources such as educators, senior staff and vascular access nurses. This e-learning module allows renal units the opportunity to provide a national learning package with general consensus on terminology and up to date evidence based practice.
Recently there has been a rise in the use of ultrasound to assess and perform image guided cannulation in vascular access to improve patient outcomes. There is only a small window of opportunity to provide education in ultrasound use. This module will provide education on this and other aspects of vascular access practices and patient care.

Implications for clinical practice
Implications include access to standardized learning packages based on current evidence based practice, eencouraging the utilization of new technology (e.g. Ultrasound observation and interpretation of results), reinforcing the underpinning knowledge of anatomy and physiology of vascular access, standardizing practice benefits to patients and nurses moving between dialysis units, improving accessibility by transitioning learning to smart phones and tablets and providing an opportunity for international collaboration related to vascular access e-learning concepts.

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The National Heart Foundation of Australia assembled an expert panel to provide guidance on policy and system changes to improve the quality of care for people with chronic heart failure (CHF). The recommendations have the potential to reduce emergency presentations, hospitalisations and premature death among patients with CHF. Best-practice management of CHF involves evidencebased, multidisciplinary, patient-centred care, which leads to better health outcomes. A CHF care model is required to achieve this. Although CHF management programs exist, ensuring access for everyone remains a challenge. This is particularly so for Aboriginal and Torres Strait Islander peoples, those from non-metropolitan areas and lower socioeconomic backgrounds, and culturally and linguistically diverse populations. Lack of data and inadequate identifi cation of people with CHF prevents effi cient patient monitoring, limiting information to improve or optimise care. This leads to ineff ectiveness in measuring outcomes and evaluating the CHF care provided. Expanding current cardiac registries to include patients with CHF and developing mechanisms to promote data linkage across care transitions are essential. As the prevalence of CHF rises, the demand for multidisciplinary workforce support will increase. Workforce planning should provide access to services outside of large cities, one of the main challenges it is currently facing. To enhance community-based management of CHF, general practitioners should be empowered to lead care. Incentive arrangements should favour provision of care for Aboriginal and Torres Strait Islander peoples, those from lower socioeconomic backgrounds and rural areas, and culturally and linguistically diverse populations. Ongoing research is vital to improving systems of care for people with CHF. Future research activity needs to ensure the translation of valuable knowledge and high quality evidence into practice.

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Objectives: The purpose of this project was to examine the copyright and licensing knowledge gap of academic staff to identify their current understanding of, and attitudes towards, copyright, licensing and the open access movement in relation to the content they use, create, and share in their teaching and research practice. The motivation behind this study was to gather information to assist the Library in creating and providing effective information resources and training for academic staff.

Methods: An anonymous online survey was distributed to Faculty of Health academic staff at Deakin University. Seventy individuals in the Faculty of Health completed the survey.

Results: The results suggested that most of the academics have used content created by others in their teaching materials, but they are not confident about complying with copyright or licensing conditions whilst doing so. Most had not posted any of their own content online, but would generally be willing for it to be used by others, with attribution. Around half had never posted their published articles in an institutional or discipline repository, but again, would be willing for them to be used for educational purposes. Most academics have never shared their research data online, and some were very unwilling to do so - despite current pushes to broaden access to research data sets. Finally, most had never applied a Creative Commons licence to a piece of work, and over half were unaware of what rights they had retained under publishing agreements for their work. It was strongly indicated that an informational website would be very helpful in providing guidance around topics of copyright, licensing and sharing.

Conclusions: Results were largely consistent with other similar studies conducted around these topics. There is a clear role for librarians to continue providing such training and resources as the push for Open Access resources, publishing, and data only gains momentum.

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 Background: The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.
Methods: The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health.
Results: In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making.
Conclusions: This study makes an important contribution to understanding how evidence is used within the public health LG context.

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Early intervention for children with hearing loss involves assistance in oral speech development, optimal use of hearing devices and fostering a holistic partnership between allied health and the children's families. Adequate access to early intervention has been shown to be vital in the positive development of long term language and social outcomes. However, there has been limited research to identify the factors which may influence access. This study aimed to explore whether access to early intervention by children with hearing loss is affected by: geographical location, socio-economic status and ethnic-minority family status.

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Aims and objectives: To examine the perceptions of a group of culturally and linguistically diverse participants with the comorbidities of diabetes, chronic kidney disease and cardiovascular disease to determine factors that influence their medication self-efficacy through the use of motivational interviewing. Background: These comorbidities are a global public health problem and their self-management is more difficult for culturally and linguistically diverse populations living in English-speaking communities. Few interventions have been tested in culturally and linguistically diverse people to improve their medication self-efficacy. Design: A series of motivational interviewing telephone calls were conducted in the intervention arm of a randomised controlled trial using interpreter services. Methods: Patients with these comorbidities aged ≥18 years of age whose preference it was to speak Greek, Italian or Vietnamese were recruited from nephrology outpatient clinics of two Australian metropolitan hospitals in 2009. Results: The average age of the 26 participants was 73·5 years. The fortnightly calls averaged 9·5 minutes. Thematic analysis revealed three core themes which were attitudes towards medication, having to take medication and impediments to chronic illness medication self-efficacy. A lack of knowledge about medications impeded confidence necessary for optimal disease self-management. Participants had limited access to resources to help them understand their medications. Conclusion: This work has highlighted communication gaps and barriers affecting medication self-efficacy in this group. Culturally sensitive interventions are required to ensure people of culturally and linguistically diverse backgrounds have the appropriate skills to self-manage their complex medical conditions. Relevance to clinical practice: Helping people to take their medications as prescribed is a key role for nurses to serve and protect the well-being of our increasingly multicultural communities. The use of interpreters in motivational interviewing requires careful planning and adequate resources for optimal outcomes.

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Cardiovascular diseases (CVD) are the main cause of morbidity and mortality worldwide. As prevention and treatment of CVD often requires active screening and lifelong follow up it is a challenge for health systems both in high-income and low and middle-income countries to deliver adequate care to those in need, with efficient use of resources.We developed a health service model for primary prevention of CVD suitable for implementation in the Nairobi slums, based on best practices from public health and the private sectors. The model consists of four key intervention elements focusing on increasing awareness, incentives for promoting access to screening and treatment, and improvement of long-term adherence to prescribed medications. More than 5,000 slum dwellers aged ≥35 years and above have been screened in the study resulting in more than 1000 diagnosed with hypertension and referred to the clinic.Some marginalized groups in high-income countries like African migrants in the Netherlands also have low rates of awareness, treatment and control of hypertension as the slum population in Nairobi. The parallel between both groups is that they have a combination of risky lifestyle, are prone to chronic diseases such as hypertension, have limited knowledge about hypertension and its complications, and a tendency to stay away from clinics partly due to cultural beliefs in alternative forms of treatment, and lack of trust in health providers. Based on these similarities it was suggested by several policymakers that the model from Nairobi can be applied to other vulnerable populations such as African migrants in high-income countries. The model can be contextualized to the local situation by adapting the key steps of the model to the local settings.The involvement and support of African communities' infrastructures and health care staff is crucial, and the most important enabler for successful implementation of the model in migrant communities in high-income countries. Once these stakeholders have expressed their interest, the impact of the adapted intervention can be measured through an implementation research approach including collection of costs from health care providers' perspective and health effects in the target population, similar to the study design for Nairobi.

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Purpose – The purpose of this paper is to report on a three-year Australian study of international business and accounting students and the transition to employment. For international students seeking to differentiate themselves in a highly competitive global labour market, foreign work experience is now an integral part of the overseas study “package”. Work-integrated learning (WIL) is seen to provide critical “employability” knowledge and skills, however, international students have low participation rates. The high value placed on WIL among international students poses challenges for Australia as well as opportunities. Understanding the issues surrounding international students and WIL is closely linked to Australia’s continued success in the international education sector which has broad, long-term, social and economic implications.Design/methodology/approach – This paper draws on 59 interviews with a range of stakeholders including international students, universities, government, employers and professional bodies. Central to the paper is an in-depth case study of WIL in the business and accounting discipline at one Australian university.Findings – Providing international students with access to discipline-related work experience has emerged as a critical issue for Australian universities. The study finds that enhancing the employability skills of internationals students via integrated career education, a focus on English language proficiency and “soft skills” development are central to success in WIL. Meeting the growing demand for WIL among international students requires a multipronged approach which hinges on cooperation between international students, universities, employers and government.Originality/value – This project aims to fill a critical knowledge gap by advancing theories in relation to international students and WIL. While there is a significant body of research in the fields of international education and WIL, there is an absence of research exploring the intersection between the two fields. The study will contribute to the advancement of knowledge in both fields by exploring the emerging issue of WIL and international students.

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AIMS AND OBJECTIVES: To examine the challenges and opportunities of undertaking a video ethnographic study on medication communication among nurses, doctors, pharmacists and patients. BACKGROUND: Video ethnography has proved to be a dynamic and useful method to explore clinical communication activities. This approach involves filming actual behaviours and activities of clinicians to develop new knowledge and to stimulate reflections of clinicians on their behaviours and activities. However, there is limited information about the complex negotiations required to use video ethnography in actual clinical practice. DESIGN: Discursive paper. METHOD: A video ethnographic approach was used to gain better understanding of medication communication processes in two general medical wards of a metropolitan hospital in Melbourne, Australia. This paper presents the arduous and delicate process of gaining access into hospital wards to video-record actual clinical practice and the methodological and ethical issues associated with video-recording. CONCLUSIONS: Obtaining access to clinical settings and clinician consent are the first hurdles of conducting a video ethnographic study. Clinicians may still feel intimidated or self-conscious in being video recorded about their medication communication practices, which they could perceive as judgements being passed about their clinical competence. By thoughtful and strategic planning, video ethnography can provide in-depth understandings of medication communication in acute care hospital settings. Ethical issues of informed consent, patient safety and respect for the confidentiality of patients and clinicians need to be carefully addressed to build up and maintain trusting relationships between researchers and participants in the clinical environment. RELEVANCE TO CLINICAL PRACTICE: By prudently considering the complex ethical and methodological concerns of using video ethnography, this approach can help to reveal the unpredictability and messiness of clinical practice. The visual data generated can stimulate clinicians' reflexivity about their norms of practice and bring about improved communication about managing medications.

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Although psychiatric crises are very common in people with mental illness, little is known about consumer perceptions of mental health crisis care. Given the current emphasis on recovery-oriented approaches, shared decision-making, and partnering with consumers in planning and delivering care, this knowledge gap is significant. Since the late 1990s, access to Australian mental health services has been facilitated by 24/7 telephone-based mental health triage systems, which provide initial psychiatric assessment, referral, support, and advice. A significant proportion of consumers access telephone-based mental health triage services in a state of crisis, but to date, there has been no published studies that specifically report on consumer perceptions on the quality and effectiveness of the care provided by these services. This article reports on a study that investigated consumer perceptions of accessing telephone-based mental health triage services. Seventy-five mental health consumers participated in a telephone interview about their triage service use experience. An eight-item survey designed to measure the responsiveness of mental health services was used for data collection. The findings reported here focus on the qualitative data produced in the study. Consumer participants shared a range of perspectives on telephone-based mental health triage that provide invaluable insights into the needs, expectations, and service use experiences of consumers seeking assistance with a mental health problem. Consumer perceptions of crisis care have important implications for practice. Approaches and interventions identified as important to quality care can be used to inform educational and practice initiatives that promote person-centred, collaborative crisis care.

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INTRODUCTION: Interventional radiology (IR) plays a vital role in modern medicine, with increasing demand for services, but with a shortage of experienced interventionalists. The aim of this study was to determine the impact of a recently introduced IR curriculum on perception, knowledge, and interest of medical students regarding various aspects of IR. METHODS: In 2014, an anonymous web-based questionnaire was sent to 309 4th year medical students in a single institution within an EU country, both before and after delivery of a 10-h IR teaching curriculum. RESULTS: Seventy-six percent (236/309) of the respondents participated in the pre-IR module survey, while 50 % (157/309) responded to the post-IR module survey. While 62 % (147/236) of the respondents reported poor or no knowledge of IR compared to other medical disciplines in the pre-IR module survey, this decreased to 17 % (27/157) in the post-IR module survey. The correct responses regarding knowledge of selected IR procedures improved from 70 to 94 % for venous access, 78 to 99 % for uterine fibroid embolization, 75 to 97 % for GI bleeding embolization, 60 to 92 % for trauma embolization, 71 to 92 % for tumor ablation, and 81 to 94 % for angioplasty and stenting in peripheral arterial disease. With regard to knowledge of IR clinical roles, responses improved from 42 to 59 % for outpatient clinic review of patients and having inpatient beds, 63-76 % for direct patient consultation, and 43-60 % for having regular ward rounds. The number of students who would consider a career in IR increased from 60 to 73 %. CONCLUSION: Delivering an undergraduate IR curriculum increased the knowledge and understanding of various aspects of IR and also the general enthusiasm for pursuing this specialty as a future career choice.