87 resultados para Step-up (Program)

em Deakin Research Online - Australia


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The current study investigated the relationship between career-related mentoring, psychosocial mentoring, business success, and self-esteem in participants of a program that was designed to assist in the establishment of a new business. Seventy-seven protégés and their matched mentors were included in the study. A comparison of mentor and protégé perceptions revealed that mentors considered themselves to provide higher levels of psychosocial support than did the protégés. Protégé perceptions of business success were predicted by the frequency of mentor contact and the level of career-related support provided by their mentor.

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This research investigates whether club head speed is a valid determinant of golfing performance and the effects of a golf-specific warm-up program on club-head speed in male golfers in the immediate and short term (five-week)

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"Step up and play" begins the famous hit song 'Penny Arcade'. And so it
was for thousands of Australian families, as their eldest child began school
this year, and the associated endless merry-go-round of extra-curricular
activities also began. But how many of those families realise that the song ends "Roll up and spend your last dime!"? While the perceived benefits of
children's involvement in extracurricular activities are many and are widely accepted, there are also costs, not only in terms of money but also in terms
of time. Evidence from a study conducted in Melbourne highlights the fact that, for many families such as those on low incomes and those headed by a single parent, both the time and the money costs may be prohibitive. This article highlights parents' perceptions of the benefits·and costs of children's extra-curricular activities, and explores the implications of changing family and household structures for families' capacity to sustain such activities.

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Background

Early language delay is a high-prevalence condition of concern to parents and professionals. It may result in lifelong deficits not only in language function, but also in social, emotional/behavioural, academic and economic well-being. Such delays can lead to considerable costs to the individual, the family and to society more widely. The Language for Learning trial tests a population-based intervention in 4 year olds with measured language delay, to determine (1) if it improves language and associated outcomes at ages 5 and 6 years and (2) its cost-effectiveness for families and the health care system.

Methods/Design

A large-scale randomised trial of a year-long intervention targeting preschoolers with language delay, nested within a well-documented, prospective, population-based cohort of 1464 children in Melbourne, Australia. All children received a 1.25-1.5 hour formal language assessment at their 4th birthday. The 200 children with expressive and/or receptive language scores more than 1.25 standard deviations below the mean were randomised into intervention or ‘usual care’ control arms. The 20-session intervention program comprises 18 one-hour home-based therapeutic sessions in three 6-week blocks, an outcome assessment, and a final feed-back/forward planning session. The therapy utilises a ‘step up-step down’ therapeutic approach depending on the child’s language profile, severity and progress, with standardised, manualised activities covering the four language development domains of: vocabulary and grammar; narrative skills; comprehension monitoring; and phonological awareness/pre-literacy skills. Blinded follow-up assessments at ages 5 and 6 years measure the primary outcome of receptive and expressive language, and secondary outcomes of vocabulary, narrative, and phonological skills.

Discussion

A key strength of this robust study is the implementation of a therapeutic framework that provides a standardised yet tailored approach for each child, with a focus on specific language domains known to be associated with later language and literacy. The trial responds to identified evidence gaps, has outcomes of direct relevance to families and the community, includes a well-developed economic analysis, and has the potential to improve long-term consequences of early language delay within a public health framework.

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Type 2 diabetes (T2D) brings significant human and healthcare costs. Its progressive nature means achieving normoglycaemia is increasingly difficult, yet critical to avoiding long term vascular complications. Nearly one-half of people with T2D have glycaemic levels out of target. Insulin is effective in achieving glycaemic targets, yet initiation of insulin is often delayed, particularly in primary care. Given limited access to specialist resources and the size of the diabetes epidemic, primary care is where insulin initiation must become part of routine practice. This would also support integrated holistic care for people with diabetes. Our Stepping Up Program is based on a general practitioner (GP) and practice nurse (PN) model of care supported appropriately by endocrinologists and credentialed diabetes educator-registered nurses. Pilot work suggests the model facilitates integration of the technical work of insulin initiation within ongoing generalist care.

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Objective: To investigate the reliability and validity of five squat-based loading tests that are clinically appropriate for jumper's knee. The loading tests were step up, double leg squat, double leg squat on a 25-degree decline (decline squat), single leg decline squat, and decline hop. Design: Cross-sectional controlled cohort. Subjects without knee pain comprised controls, those with extensor tendon pain comprised the jumper's knee group. Setting: Institutional athlete study group in Australia. Participants: Fifty-six elite adolescent basketball players participated in this study, thirteen comprised the jumper's knee group, fifteen athletes formed a control group. Intervention: Each subject performed each loading test for baseline and reliability data on the first testing day. Subjects then performed three days of intensive (6 h daily) basketball training, after which each loading test was reexamined. Main outcome measures: Eleven point interval scale for pain. Results: The tests that best detected a change in pain due to intensive workload were the single leg decline squat and single leg decline hop. This study found that decline tests have better discriminative ability than the standard squat to detect change in jumper's knee pain due to intensive training. The typical error for these tests ranged from 0.3 to 0.5, however, caution should be exercised in the interpretation of these reliability figures due to relatively low scores. Conclusions: The single leg decline squat is recommended in the physical assessment of adolescent jumper's knee. The decline squat was selected as the best clinical test over the decline hop because it was easier to standardise performance.

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This paper examines the causal relationship between electricity consumption, exports and gross domestic product (GDP) for a panel of Middle Eastern countries. We find that for the panel as a whole there are statistically significant feedback effects between these variables. A 1 per cent increase in electricity consumption increases GDP by 0.04 per cent, a 1 per cent increase in exports increases GDP by 0.17 per cent and a 1 per cent increase in GDP generates a 0.95 per cent increase in electricity consumption. The policy implications are that for the panel as a whole these countries should invest in electricity infrastructure and step up electricity conservation policies to avoid a reduction in electricity consumption adversely affecting economic growth. Further policy implications are that for the panel as a whole promoting exports, particularly non-oil exports, is a means to promote economic growth and that expansion of exports can be realized without having adverse effects on energy conservation policies.

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Background

Externalising and internalising problems affect one in seven school-aged children and are the single strongest predictor of mental health problems into early adolescence. As the burden of mental health problems persists globally, childhood prevention of mental health problems is paramount. Prevention can be offered to all children (universal) or to children at risk of developing mental health problems (targeted). The relative effectiveness and costs of a targeted only versus combined universal and targeted approach are unknown. This study aims to the effectiveness, costs and uptake of two approaches to early childhood prevention of mental health problems ie: a Combined universal-targeted approach, versus a Targeted only approach, in comparison to current primary care services (Usual care).
Design

Three armed, population-level cluster randomised trial (2010-2014) within the universal, well child Maternal Child Health system, attended by more than 80% of families in Victoria, Australia at infant age eight months. Participants: Families of eight month old children from nine participating local government areas. Randomised to one of three groups: Combined, Targeted or Usual care. Intervention: (a) the Combined universal and targeted program where all families are offered the universal Toddlers Without Tears group parenting program followed by the targeted Family Check-Up one-on-one program or (b) the Targeted Family Check-Up program. The Family Check-Up program is only offered to children at risk of behavioural problems. Analysis: Participants will be analysed according to the trial arm to which they were randomised, using logistic and linear regression models to compare primary and secondary outcomes. An economic evaluation (cost consequences analysis) will compare incremental costs to all incremental outcomes from a societal perspective.
Discussion

This trial will inform public health policy by making recommendations about the effectiveness and cost-effectiveness of these early prevention programs. If effective prevention programs can be implemented at the population level, the growing burden of mental health problems could be curbed.

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 Urban Heat Island (UHI) has become a growing concern to the quality of densely built urban environments, particularly in tropical cities. Wind speed has widely been reported to have decreased the intensity of heat island effect in urban areas. The cooling effect of the wind helps to mitigate the adverse effects of heat island on the micro climate and human thermal comfort. This paper investigates the existence of heat island in Muar, one of the fast growing cities in southern part of Malaysia and its possible causes, and then examines the effects of different urban geometry on the wind flow. The results of this study indicate that the chaotic development in Muar has caused reduced ventilation in urban canyons. The heat island intensity in the city center was recorded as 4. °C during the day and 3.2. °C during the night. Investigation of various urban geometry modifications showed that step up configuration was the most effective geometry as it can distribute the wind evenly allowing the wind to reach even the leeward side of each building. © 2014 Elsevier Ltd.

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Background: The health benefit associated with a daily step-count target within pedometer pro- grams is unclear. The aim of this study was to determine if the daily step-count attained during a four month pedometer-based workplace health program was associated with change in waist circumference (WC).

Methods: 762 Australian adults enrolled in a workplace pedometer pro- gram were recruited from ten workplaces in 2008. At the end of the program (four months), 436 participants were eligible for the current analysis. Data included demographics, perceived physical activity change during the program, measured WC at baseline and follow-up, and reported daily pedometer step-counts throughout the program. The association between daily step count and change in WC was examined using linear re- gression.

Results: WC improved by an average of –1.61cm (95% CI: –2.13, –1.09) by the end of the program. There was no relationship between daily step-count and the degree of change in WC. However, among participants reporting an in- crease in physical activity during the program a relationship between daily step count and change in WC was observed, such that those who un-dertook on average 10,000 steps or more per day improved their WC by –1.38cm (95%CI: –2.14, –0.63) more than those who did not achieve an average of 10,000 steps per day. Similarly, among individuals not meeting WC guidelines at baseline a greater daily step count was associ-ated with a greater decrease in WC.

Conclusions: Within a workplace pedometer program, reported daily step count was not associated with greater reductions in WC. However, it was a useful in-dicator of potential health benefits in those who increased their level of physical activity during the program. Pedometer programs need to com- municate clearly the importance of both a step goal and improvement in step count to manage participant expectations about improvements in health markers.

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The term ‘program management’, while referred to occasionally in journals, organisation publications and by training consultants, is not a widely acknowledged notion. While literature on project management is plentiful and the concept is well entrenched in both a practical and academic
sense, program management is a term that is used differently by various sectors. Its meaning is less defined and more broadly applied than that of project management. For example, although Program Managers are sometimes recruited under that title, the definition still remains somewhat
obscure. Seen mostly in the health and education public sectors, program management is commonly thought of as separate to project management but, as this paper will suggest, program management is more likely an extension of project management and a complementary tool to achieving
organisational outcomes. This paper attempts to clarify the distinctions between the management approaches by looking at existing literature and comparing it to common practice in a government instrumentality. It will become apparent that further research is needed regarding this significant
step in the evolution of management practices.

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Background
Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred.
Objective
To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities.
Design
A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started.
Settings
Two 300–400 bed veteran homes in Taiwan.
Participants
The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded.
Methods
The STEP was implemented three times a week, 50 min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization.
Results
A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p<.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p<.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038).
Conclusions
Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults.

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Background : Osteoporosis affects over 220 million people worldwide, and currently there is no 'cure' for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition.

Methods :
The 'Osteo-cise: Strong Bones for Life' study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function, and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged 60 years or above will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month 'research to practise' translational phase. Participants will be randomly assigned to either the 'Osteo-cise' intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed.

Discussion :
The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial Registration: Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291