917 resultados para Providers
Resumo:
The higher education sector is undergoing a number of significant changes, the implications of which have yet to emerge. One such change is the increasing reliance by higher education providers on the revenue generated by full fee paying international students to fund their operating expenses. The report by the Victorian Ombudsman, Investigation into how Universities Deal with International Students ('Victorian Ombudsman's Report') tabled in the Victorian Parliament on 27 October 2011, provides evidence that Australian higher education providers may be failing to meet their legal obligations to international students. The Victorian Ombudsman's Report is the result of an investigation into four Victorian universities teaching international students with a focus on accounting and nursing schools. The report contains evidence that the universities were admitting students with scores below, or at the lower end of, the International English Language Testing System ('IELTS') score considered acceptable. Alternatively, they were relying upon their own language testing admission standards and not on an independent test like the IELTS test. While the universities provided English language support services for their international students after they had been admitted, the Ombudsman was concerned that the universities 'have not dedicated sufficient resources to meet the level of need amongst international students'.
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Background: Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods: Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results: Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal weight pregnant women. Even care providers who reported few weight-stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions: Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.
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Abstract Background: Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design: This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous) and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion: This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient-clinician exchange. This approach may provide a way forward to reduce the appalling health disadvantage experienced within the Indigenous Australian communities. Keywords: Patient-clinician engagement, Qualitative, Cardiovascular disease, Focus groups, Indigenous
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Clinicians who support people from refugee and asylum seeking backgrounds are routinely exposed to stories of trauma as part of their work. Hearing these stories can be highly distressing for clinicians, but simultaneously provide opportunities for positive personal growth. Adopting a longitudinal qualitative design, we interviewed twelve service providers at two time points a year apart. We used a semistructured interview protocol and analyzed the data according to interpretative phenomenological analysis. Five superordinate and 19 constituent themes emerged from the analysis at Time 1 and Time 2. We found that participants were both positively and negatively affected by their work, and their experiences remained relatively stable across time. The participants highlighted the use of organizational and personal coping strategies to help minimize distress and maximize wellbeing. Adopting a broad repertoire of such strategies is not only advantageous for the service providers, but ultimately for those people they seek to assist.
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Research has suggested that lesbian, gay, bisexual and transgender (LGBT) young people are “at-risk” of victimization and/or legally “risky.” Relatively few studies have examined the social construction of risk in “risk factor” research and whether risk as a concept influences the everyday lives of LGBT young people. This article reports how 35 LGBT young people and seven service provider staff in Brisbane, Queensland, Australia perceived LGBT youth–police interactions as reflecting discourses about LGBT riskiness and danger. The participants specifically note how they thought looking at-risk and/or looking risky informed their policing experiences. The article concludes with recommendations for improving future policing practice.
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Disagreement within the global science community about the certainty and causes of climate change has led the general public to question what to believe and who to trust on matters related to this issue. This paper reports on qualitative research undertaken with Australian residents from two rural areas to explore their perceptions of climate change and trust in information providers. While overall, residents tended to agree that climate change is a reality, perceptions varied in terms of its causes and how best to address it. Politicians, government, and the media were described as untrustworthy sources of information about climate change, with independent scientists being the most trusted. The vested interests of information providers appeared to be a key reason for their distrust. The findings highlight the importance of improved transparency and consultation with the public when communicating information about climate change and related policies.
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Background Interventions to promote physical activity (PA) in children attending family child care homes (FCCHs) require valid, yet practical, measurement tools. The aim of this study was to assess the validity of two proxy report instruments designed to measure PA in children attending FCCHs. Methods A sample of 37 FCCH providers completed the Burdette parent proxy report, modified for the family child care setting for 107 children 3.4±1.2 years of age. A second sample of 42 FCCH providers completed the Harro parent and teacher proxy report, modified for the family child care setting, for 131 children 3.8±1.3 years of age. Both proxy reports were assessed for validity using accelerometry as a criterion measure. Results Significant positive correlations were observed between provider-reported PA scores from the modified Burdette proxy report and objectively measured total PA (r=0.30; p<0.01) and moderate-to-vigorous PA (MVPA; r=0.34; p<0.01). Across levels of provider-reported PA, both total PA and MVPA increased significantly in a linear dose-response fashion. The modified Harro proxy report was not associated with objectively measured PA. Conclusion Proxy PA reports completed by family child care providers may be a valid assessment option in studies where more burdensome objective measures are not feasible.
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The antenatal paper hand-held record (PHR) has been used extensively in general practice (GP) shared-care management of pregnant women, but recently the antenatal electronic health record (EHR) was introduced. This study aimed to examine the experiences of women and health care providers who use the PHR and the EHR, and find out the relative role of these records in the integration of care. Purposive homogenous samples of women and health care providers were interviewed as users of the PHR in phase 1 and the EHR in phase 2 of the study. Qualitative data were collected via interview with women and GPs and focus groups held with hospital health care providers. Interviews were coded manually and analysed using qualitative content analysis. Fifteen women participated in phase 1 and 12 in phase 2. Seventeen GPs participated in phase 1 and 15 in phase 2. Five focus groups with hospital health care providers were conducted in each phase. Results were categorised into four themes: 1. Record purpose; 2. Perception of the record; 3. Content of the record, and; 4. Sharing information in the record. Both women and health care providers were familiar with the PHR, but identified that some information was missing or not utilised well, and reported underuse of the EHR. The study identified continued widespread use of the PHR and several issues concerning the use of the EHR. An improvement in the strategic implementation of the EHR is suggested as a mechanism to facilitate its wider adoption.
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A cross-sectional study was conducted between October 2011 and March 2012 in two major pig producing provinces in the Philippines. Four hundred and seventy one pig farms slaughtering finisher pigs at government operated abattoirs participated in this study. The objectives of this study were to group: (a) smallholder (S) and commercial (C) production systems into patterns according to their herd health providers (HHPs), and obtain descriptive information about the grouped S and C production systems; and (b) identify key HHPs within each production system using social network analysis. On-farm veterinarians, private consultants, pharmaceutical company representatives, government veterinarians, livestock and agricultural technicians, and agricultural supply stores were found to be actively interacting with pig farmers. Four clusters were identified based on production system and their choice of HHPs. Differences in management and biosecurity practices were found between S and C clusters. Private HHPs provided a service to larger C and some larger S farms, and have little or no interaction with the other HHPs. Government HHPs provided herd health service mainly to S farms and small C farms. Agricultural supply stores were identified as a dominant solitary HHP and provided herd health services to the majority of farmers. Increased knowledge of the routine management and biosecurity practices of S and C farmers and the key HHPs that are likely to be associated with those practices would be of value as this information could be used to inform a risk-based approach to disease surveillance and control. © 2014 Elsevier B.V.
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- Background Childcare providers are often “first responders” for suspected child abuse, and how they understand the concept of “reasonable suspicion” will influence their decisions regarding which warning signs warrant reporting. - Objective The purpose of this study was to investigate how childcare providers interpret the threshold for reporting suspected abuse, and to consider the implications of these findings for professional training and development. - Method A convenience sample of 355 childcare providers completed the Reasonable Suspicion of Child Abuse survey to quantify what likelihood of child abuse constitutes “reasonable suspicion.” Responses were examined for internal consistency, evidence of a group standard, and associations with professional and personal demographics. - Results On a Rank Order Scale, responses for what constitutes “reasonable suspicion” ranged from requiring that abuse be “the” most likely cause (8 %) of an injury, to the second most likely (9 %), third (18 %), fourth (18 %), to even the seventh (8 %) or eighth (5 %) most likely cause of an injury. On a numerical probability scale, 21 % of respondents indicated that “abuse” would need to be ≥83 % likely before reasonable suspicion existed; 40 % stated that a likelihood between 53–82 % was needed; 27 % identified the necessary likelihood between 33–52 %; and 12 % set a threshold between 1–32 %. - Conclusions The present finding that no consensus exists for interpreting “reasonable suspicion” suggests that a broadly accepted interpretive framework is needed in order to help prepare childcare providers to know when to report suspected abuse.
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When authors of scholarly articles decide where to submit their manuscripts for peer review and eventual publication, they often base their choice of journals on very incomplete information abouthow well the journals serve the authors’ purposes of informing about their research and advancing their academic careers. The purpose of this study was to develop and test a new method for benchmarking scientific journals, providing more information to prospective authors. The method estimates a number of journal parameters, including readership, scientific prestige, time from submission to publication, acceptance rate and service provided by the journal during the review and publication process. Data directly obtainable from the web, data that can be calculated from such data, data obtained from publishers and editors, and data obtained using surveys with authors are used in the method, which has been tested on three different sets of journals, each from a different discipline. We found a number of problems with the different data acquisition methods, which limit the extent to which the method can be used. Publishers and editors are reluctant to disclose important information they have at hand (i.e. journal circulation, web downloads, acceptance rate). The calculation of some important parameters (for instance average time from submission to publication, regional spread of authorship) can be done but requires quite a lot of work. It can be difficult to get reasonable response rates to surveys with authors. All in all we believe that the method we propose, taking a “service to authors” perspective as a basis for benchmarking scientific journals, is useful and can provide information that is valuable to prospective authors in selected scientific disciplines.
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The paper explores the effect of customer satisfaction with online supporting services on loyalty to providers of an offline core service. Supporting services are provided to customers before, during, or after the purchase of a tangible or intangible core product, and have the purpose of enhancing or facilitating the use of this product. The internet has the potential to dominate all other marketing channels when it comes to the interactive and personalised communication that is considered quintessential for supporting services. Our study shows that the quality of online supporting services powerfully affects satisfaction with the provider and customer loyalty through its effect on online value and enjoyment. Managerial implications are provided.
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In a computational grid, the presence of grid resource providers who are rational and intelligent could lead to an overall degradation in the efficiency of the grid. In this paper, we design incentive compatible grid resource procurement mechanisms which ensure that the efficiency of the grid is not affected by the rational behavior of resource providers.In particular, we offer three elegant incentive compatible mechanisms for this purpose: (1) G-DSIC (Grid-Dominant Strategy Incentive Compatible) mechanism (2) G-BIC (Grid-Bayesian Nash Incentive Compatible) mechanism (3) G-OPT(Grid-Optimal) mechanism which minimizes the cost to the grid user, satisfying at the same time, (a) Bayesian incentive compatibility and (b) individual rationality. We evaluate the relative merits and demerits of the above three mechanisms using game theoretical analysis and numerical experiments.