932 resultados para culturally relevant services


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Background: All Canadian jurisdictions require certain professionals to report suspected or observed child maltreatment. This study examined the types of maltreatment, level of harm and child functioning issues, controlling for family socioeconomic status, age and gender of the child reported by healthcare and non-healthcare professionals. Methods: We conducted chi-square analyses and logistic regression on a national child welfare sample from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003) and compared the differences in professional reporting with its previous cycle (CIS-1998) using Bonferroni-corrected confidence intervals. Results: Our analysis of CIS-2003 data revealed that the majority of substantiated child maltreatment is reported to service agencies by non-healthcare professionals (57%), followed by non-professionals (33%) and healthcare professionals (10%). The number of professional reports increased 2.5 times between CIS-1998 and CIS-2003, while non-professionals’ increased 1.7 times. Of the total investigations, professional reports represented 59% in CIS-1998 and 67% in CIS-2003 (p<0.001). Compared to non-healthcare professionals, healthcare professionals more often reported younger children, children who experienced neglect and emotional maltreatment and those assessed as suffering harm and child functioning issues, but less often exposure to domestic violence. Conclusion: The results indicate that healthcare professionals played an important role in identifying children in need of protection considering harm and other child functioning issues. The authors discuss the reasons why underreporting is likely to remain an issue.

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Purpose: Physical activity has become a focus of cancer recovery research as it has the potential to reduce treatment-related burden and optimize health-related quality of life (HRQoL). However, the potential for physical activity to influence recovery may be age-dependent. This paper describes physical activity levels and HRQoL among younger and older women after surgery for breast cancer and explores the correlates of physical inactivity. Methods: A population-based sample of breast cancer patients diagnosed in South-East Queensland, Australia, (n=287) were assessed once every three months, from 6 to 18 months post-surgery. The Functional Assessment of Cancer Therapy-Breast questionnaire (FACTB+4) and items from the Behavioral Risk Factor Surveillance System (BRFSS) questionnaire were used to measure HRQoL and physical activity, respectively. Physical activity was assigned metabolic equivalent task (MET) values, and categorized as < 3, 3 to 17.9 and 18+ MET-hours/weeks. Descriptive statistics, generalized linear models with age stratification (<50 years versus 50+ years), and logistic regression were used for analyses (p=0.05, two-tailed). Results: Younger women who engaged in 3 or more MET-hours/week of physical activity reported a higher HRQoL at 18 months compared to their more sedentary counterparts (p<0.05). Older women reported similar HRQoL irrespective of activity level and consistently reported clinically higher HRQoL than younger women. Increasing age, being overweight or obese, and restricting use of the treated side at six months post-surgery increased the likelihood of sedentary behavior (OR>3, p<0.05). Conclusions: Age influences the potential to observe HRQoL benefits related to physical activity participation. These results also provide relevant information for the design of exercise interventions for breast cancer survivors and highlights that some groups of women are at greater risk of long-term sedentary behavior.

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One of the definitions of the term myth is ‘an unproved or false collective belief that is used to justify a social institution’ (see http://dictionary.reference.com/browse/myth). Before we are criticized for suggesting such an irreverent thought might apply to tourism academia, readers must recognize that organizations and industries often operate using shared collective myths (see Meyer and Rowan 1977). Institutionalized rules and processes function as myths that provide legitimacy. The question of interest in this paper is not in the context of the quality of tourism academic research output, which is addressed by other papers in this research probe section. Rather, of importance is enhancing understanding of the extent to which our collective knowledge, legitimized through publishing in peer reviewed academic publications, is proving of value to industry stakeholders, an axiom that appears to be largely unquestioned and unproven.

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This paper developed a model for rostering ambulance crew in order to maximise the coverage throughout a planning horizon and minimise the number of ambulance crew. Rostering Ambulance Services is a complex task, which considers a large number of conflicting rules related to various aspects such as limits on the number of consecutive work hours, the number of shifts worked by each ambulance staff and restrictions on the type of shifts assigned. The two-stage models are developed using nonlinear integer programming technique to determine the following sub-problems: the shift start times; the number of staff required to work for each shift; and a balanced schedule of ambulance staff. At the first stage, the first two sub-problems have been solved. At the second stage, the third sub-problem has been solved using the first stage outputs. Computational experiments with real data are conducted and the results of the models are presented.

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It has long been recognised that government and public sector services suffer an innovation deficit compared to private or market-based services. This paper argues that this can be explained as an unintended consequence of the concerted public sector drive toward the elimination of waste through efficiency, accountability and transparency. Yet in an evolving economy this can be a false efficiency, as it also eliminates the 'good waste' that is a necessary cost of experimentation. This results in a systematic trade0off in the public sector between the static efficiency of minimizing the misuse of public resources and the dynamic efficiency of experimentation. this is inherently biased against risk and uncertainty and therein, explains why governments find service innovation so difficult. In the drive to eliminate static inefficiencies, many political systems have susequently overshot and stifled policy innovation. I propose the 'Red Queen' solution of adaptive economic policy.

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Objective: To systematically review the published evidence of the impact of health information technology (HIT) on the quality of medical and health care specifically clinicians’ adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. In order to be as inclusive as possible the research examined literature discussing the use of health information technologies and systems in both medical care such as clinical and surgical, and other health care such as allied health and preventive services.----- Design: Systematic review----- Data Sources: Relevant literature was systematically searched on English language studies indexed in MEDLINE and CINAHL(1998 to 2008), Cochrane Library, PubMed, Database of Abstracts of Review of Effectiveness (DARE), Google scholar and other relevant electronic databases. A search for eligible studies (matching the inclusion criteria) was also performed by searching relevant conference proceedings available through internet and electronic databases, as well as using reference lists identified from cited papers.----- Selection criteria: Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measures could be either changes in clinical processes resulting from a change of the providers’ behaviour or specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. ----- Methods: Studies were reviewed and summarised in tabular and text form. Due to heterogeneity between studies, meta-analysis was not performed.----- Results: Out of 17 studies that assessed the impact of health information technology on health care practitioners’ performance, 14 studies revealed a positive improvement in relation to their compliance with evidence-based guidelines. The primary domain of improvement was evident from preventive care and drug ordering studies. Results from the studies that included an assessment for patient outcomes however, were insufficient to detect either clinically or statistically important improvements as only a small proportion of these studies found benefits. For instance, only 3 studies had shown positive improvement, while 5 studies revealed either no change or adverse outcomes.----- Conclusion: Although the number of included studies was relatively small for reaching a conclusive statement about the effectiveness of health information technologies and systems on clinical care, the results demonstrated consistency with other systematic reviews previously undertaken. Widescale use of HIT has been shown to increase clinician’s adherence to guidelines in this review. Therefore, it presents ongoing opportunities to maximise the uptake of research evidence into practice for health care organisations, policy makers and stakeholders.

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In a competitive environment, companies continuously innovate to offer superior services at lower costs. ‘Shared services’ have been extensively adopted in practice as one means for improving organisational performance. Shared services is considered most appropriate for support functions, and is widely adopted in Human Resource Management, Finance and Accounting; more recently being employed across the Information Systems function. IS applications and infrastructure are an important enabler and driver of shared services in all functional areas. As computer based corporate information systems have become de facto and the internet pervasive and increasingly the backbone of administrative systems, the technical impediments to sharing have come down dramatically. As this trend continues, CIOs and IT professionals will need a deeper understanding of the shared services phenomenon and its implications. The advent of shared services has consequential implications for the IS academic discipline. Yet, archival analysis of IS the academic literature reveals that shared services, though mentioned in more than 100 articles, has received little in depth attention. This paper is the first attempt to investigate and report on the current status of shared services in the IS literature. The paper presents detailed review of literature from main IS journals and conferences, findings evidencing a lack of focus and definitions and objectives lacking conceptual rigour. The paper concludes with a tentative operational definition, a list of perceived main objectives of shared services, and an agenda for related future research.

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In Australia seven schemes (apart from the Superannuation Complaints Tribunal) provide alternative dispute resolution services for complaints brought by consumers against financial services industry members. Recently the Supreme Court of New South Wales held that the decisions of one scheme were amenable to judicial review at the suit of a financial services provider member and the Supreme Court of Victoria has since taken a similar approach. This article examines the juristic basis for such a challenge and contends that judicial review is not available, either at common law or under statutory provisions. This is particularly the case since Financial Industry Complaints Service Ltd v Deakin Financial Services Pty Ltd (2006) 157 FCR 229; 60 ACSR 372 decided that the jurisdiction of a scheme is derived from a contract made with its members. The article goes on to contend that the schemes are required to give procedural fairness and that equitable remedies are available if that duty is breached.

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Providing precise positioning services in regional areas to support agriculture, mining, and construction sectors depends on the availability of ground continuously operating GNSS reference stations and communications linking these stations to central computers and users. With the support of CRC for Spatial Information, a more comprehensive review has been completed recently to examine various wired and wireless communication links available for precise positioning services, in particular in the Queensland regional areas. The study covers a wide range of communication technologies that are currently available, including fixed, mobile wireless, and Geo-stationary and or low earth orbiting satellites. These technologies are compared in terms of bandwidth, typical latency, reliability, coverage, and costs. Additionally, some tests were also conducted to determine the performances of different systems in the real environment. Finally, based on user application requirements, the paper discusses the suitability of different communication links.

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This submission has been prepared in response to the Parliamentary Travelsafe Committee's Inquiry into vehicle impoundment for drink drivers to address research relevant to the committee’s investigation into whether: • Drink drivers in Queensland continue to drive illegally after being apprehended by police or disqualified from driving by the courts; • The incidence of repeat drink driving undermines the effectiveness of existing penalties for drink driving offences; and • Vehicle impoundment and/or ignition key confiscation are cost-effective deterrents that will reduce drink driving recidivism, relating to other existing or potential methods of managing offenders.

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Over the last decade, system integration has grown in popularity as it allows organisations to streamline business processes. Traditionally, system integration has been conducted through point-to-point solutions – as a new integration scenario requirement arises, a custom solution is built between the relevant systems. Bus-based solutions are now preferred, whereby all systems communicate via an intermediary system such as an enterprise service bus, using a common data exchange model. This research investigates the use of a common data exchange model based on open standards, specifically MIMOSA OSA-EAI, for asset management system integration. A case study is conducted that involves the integration of processes between a SCADA, maintenance decision support and work management system. A diverse number of software platforms are employed in developing the final solution, all tied together through MIMOSA OSA-EAI-based XML web services. The lessons learned from the exercise are presented throughout the paper.

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Dr Gillian Hallam is project leader for the Queensland Government Agency Libraries Review. As an initial step in the project, a literature review was commissioned to guide the research activities and inform the development of options for potential future service delivery models for the Government agency libraries. The review presents an environmental scan and review of the professional and academic literature to consider a range of current perspectives on library and information services. Significant in this review is the focus on the specific issues and challenges impacting on contemporary government libraries and their staff. The review incorporates four key areas: current directions in government administration; trends in government library services; issues in contemporary special libraries; and the skills and competencies of special librarians. Rather than representing an exhaustive review, the research has primarily centred on recent journal articles, conference papers, reports and web resources. Commentary prepared by national and international library associations has also played a role informing this review, as does the relevant State and Federal government documentation and reporting.

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The Queensland University of Technology (QUT) is known for several flagship eResearch centres. It also has a number of mature, centralised research support services that address a several of areas of eResearch. The university has openly stated its aspiration to be an institution with a strongly embedded eResearch capability and to this end it has expressed the desire to establish a university-wide eResearch support service. However, articulating this desire is much easier than realising it. During 2008 QUT undertook a major review into eResearch that made recommendations on the development of university-wide eResearch support service and the building of eResearch capabilities and capacity throughout the university. The results of this review were reported last year at this conference. In 2009, QUT is progressing a second, follow-on project – Building eResearch Support Capability and Capacity. It has been designed to build upon existing strengths in HPC, repositories, data management, and the delivery of integrated skills for eresearch. The purpose of this presentation is to give an update on QUT’s journey, one year on from its first major report into eResearch. It will outline how the university is approaching this challenge, the current work being carried out and the strategies being employed. We will also discuss the lessons learned.

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Information and communication technologies (particularly websites and e-mail) have the potential to deliver health behavior change programs to large numbers of adults at low cost. Controlled trials using these new media to promote physical activity have produced mixed results. User-centered development methods can assist in understanding the preferences of potential participants for website functions and content, and may lead to more effective programs. Eight focus group discussions were conducted with 40 adults after they had accessed a previously trialed physical activity website. The discussions were audio taped, transcribed and interpreted using a themed analysis method. Four key themes emerged: structure, interactivity, environmental context and content. Preferences were expressed for websites that include simple interactive features, together with information on local community activity opportunities. Particular suggestions included online community notice boards, personalized progress charts, e-mail access to expert advice and access to information on specific local physical activity facilities and services. Website physical activity interventions could usefully include personally relevant interactive and environmentally focused features and services identified through a user-centered development process.