859 resultados para case outcomes
Resumo:
A questionnaire was distributed on the Australian republic issue to examine the interplay between norms and relevance of the issue to the group on voting intentions. Supporters of an Australian republic (N = 188) indicated the level of support for a republic within their peer Group, the relevance of the republic issue to the group, and measures designed to assess voting intentions and other attitude outcomes. Analysis revealed an interaction between normative support and relevance of the issue to the group. On the measure of intention, increasing normative support was associated with increased intention to vote in an attitude-consistent way at both relevance levels, but the effect was heightened when the issue was highly relevant to the group. On the outcomes of willingness to express opinion and perceived personal importance of the republic issue, normative support had a positive effect only when the issue was highly relevant to the group. Mediation analyses revealed that the impact of normative support and group relevance on intention were mediated through perceived personal importance of the republic issue.
Resumo:
Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.
Resumo:
Very few empirically validated interventions for improving metacognitive skills (i.e., self-awareness and self-regulation) and functional outcomes have been reported. This single-case experimental study presents JM, a 36-year-old man with a very severe traumatic brain injury (TBI) who demonstrated long-term awareness deficits. Treatment at four years post-injury involved a metacognitive contextual intervention based on a conceptualization of neuro-cognitive, psychological, and socio-environmental factors contributing to his awareness deficits. The 16-week intervention targeted error awareness and self-correction in two real life settings: (a) cooking at home: and (b) volunteer work. Outcome measures included behavioral observation of error behavior and standardized awareness measures. Relative to baseline performance in the cooking setting, JM demonstrated a 44% reduction in error frequency and increased self-correction. Although no spontaneous generalization was evident in the volunteer work setting, specific training in this environment led to a 39% decrease in errors. JM later gained paid employment and received brief metacognitive training in his work environment. JM's global self-knowledge of deficits assessed by self-report was unchanged after the program. Overall, the study provides preliminary support for a metacognitive contextual approach to improve error awareness and functional Outcome in real life settings.
Resumo:
The demand for palliative care is increasing, yet there are few data on the best models of care nor well-validated interventions that translate current evidence into clinical practice. Supporting multidisciplinary patient-centered palliative care while successfully conducting a large clinical trial is a challenge. The Palliative Care Trial (PCT) is a pragmatic 2 x 2 x 2 factorial cluster randomized controlled trial that tests the ability of educational outreach visiting and case conferencing to improve patient-based outcomes such as performance status and pain intensity. Four hundred sixty-one consenting patients and their general practitioners (GPs) were randomized to the following: (1) GP educational outreach visiting versus usual care, (2) Structured patient and caregiver educational outreach visiting versus usual care and (3) A coordinated palliative care model of case conferencing versus the standard model of palliative care in Adelaide, South Australia (3:1 randomization). Main outcome measures included patient functional status over time, pain intensity, and resource utilization. Participants were followed longitudinally until death or November 30, 2004. The interventions are aimed at translating current evidence into clinical practice and there was particular attention in the trial's design to addressing common pitfalls for clinical studies in palliative care. Given the need for evidence about optimal interventions and service delivery models that improve the care of people with life-limiting illness, the results of this rigorous, high quality clinical trial will inform practice. Initial results are expected in mid 2005. (c) 2005 Elsevier Inc. All rights reserved.
Resumo:
The focus of the discipline of neuropsychology is shifting towards a greater emphasis on understanding the relationship between assessment results and performance of everyday tasks (ecological validity). To date, the literature has highlighted the importance of this concept in the assessment of patients with brain injury or disease (e.g. in rehabilitation and forensic settings). This paper presents the argument that there is another important area in which the ecological validity of neuropsychological assessments should be considered: in clinical outcomes studies using neurologically intact participants. For example, determining the extent to which a medical procedure or intervention affects performance of everyday cognitive tasks can provide useful information that can potentially guide decision-making regarding treatment options. It is argued that tests designed with ecological validity in mind (the verisimilitude approach), as opposed to traditional tests, may be most effective at predicting everyday functioning. Explanations are proposed as to why researchers may be reluctant to use tests with verisimilitude in favor of more traditional measures. (c) 2006 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved.
Resumo:
The key aspects and features of the case study undertaken Griffith Law School to review assessment policies and practices to ensure that they were taking into account difficulties experienced by students from equity target groups are discussed. Some of the outcomes of the case study and benefits are highlighted.
Resumo:
Quantitative databases are limited to information identified as important by their creators, while databases containing natural language are limited by our ability to analyze large unstructured bodies of text. Leximancer is a tool that uses semantic mapping to develop concept maps from natural language. We have applied Leximancer to educational based pathology case notes to demonstrate how real patient records or databases of case studies could be analyzed to identify unique relationships. We then discuss how such analysis could be used to conduct quantitative analysis from databases such as the Coronary Heart Disease Database.
Resumo:
This paper examines the connected speech process described by Wells (1982b) as the T to R rule in the West Midlands speech variety associated with the Black Country. The T to R rule is well known as a linguistic marker of local varieties of the middle and far north of England. Less well understood is its position in the phonological systems of Midlands varieties. Varieties of the Midlands of England are underresearched in comparison with varieties of the north, and what is known about the application of the T to R rule in this transitional dialect area is correspondingly nebulous. This paper focuses on the Black Country area, and examines the possible outputs in the contexts which give rise to /t/ becoming [?] in local varieties of the north. I examine the written and spoken evidence which suggests that the T to R rule does indeed operate in the Black Country variety. My analysis focuses on possible phonetic outcomes of the T to R rule across time. In my conclusion, I discuss briefly the possibility that, lying on a bundle of isoglosses separating north from south, the variety of the Black Country reflects this in that a T to [?] rule, rather than a T to R rule, is the dominant output of this connected speech process in the Black Country.
Resumo:
Offshore oil and gas pipelines are vulnerable to environment as any leak and burst in pipelines cause oil/gas spill resulting in huge negative Impacts on marine lives. Breakdown maintenance of these pipelines is also cost-intensive and time-consuming resulting in huge tangible and intangible loss to the pipeline operators. Pipelines health monitoring and integrity analysis have been researched a lot for successful pipeline operations and risk-based maintenance model is one of the outcomes of those researches. This study develops a risk-based maintenance model using a combined multiple-criteria decision-making and weight method for offshore oil and gas pipelines in Thailand with the active participation of experienced executives. The model's effectiveness has been demonstrated through real life application on oil and gas pipelines in the Gulf of Thailand. Practical implications. Risk-based inspection and maintenance methodology is particularly important for oil pipelines system, as any failure in the system will not only affect productivity negatively but also has tremendous negative environmental impact. The proposed model helps the pipelines operators to analyze the health of pipelines dynamically, to select specific inspection and maintenance method for specific section in line with its probability and severity of failure.
Resumo:
This research concerns the development of coordination and co-governance within three different regeneration programmes within one Midlands city over the period from 1999 to 2002. The New Labour government, in office since 1997, had an agenda for ‘joining-up’ government, part of which has had considerable impact in the area of regeneration policy. Joining-up government encompasses a set of related activities which can include the coordination of policy-making and service delivery. In regeneration, it also includes a commitment to operate through co-governance. Central government and local and regional organisations have sought to put this idea into practice by using what may be referred to as network management processes. Many characteristics of new policies are designed to address the management of networks. Network management is not new in this area, it has developed at least since the early 1990s with the City Challenge and Single Regeneration Budget (SRB) programmes as a way of encouraging more inclusive and effective regeneration interventions. Network management theory suggests that better management can improve decision-making outcomes in complex networks. The theories and concepts are utilised in three case studies as a way of understanding how and why regeneration attempts demonstrate real advances in inter-organisational working at certain times whilst faltering at others. Current cases are compared to the historical case of the original SRB programme as a method of assessing change. The findings suggest that: The use of network management can be identified at all levels of governance. As previous literature has highlighted, central government is the most important actor regarding network structuring. However, it can be argued that network structuring and game management are both practised by central and local actors; Furthermore, all three of the theoretical perspectives within network management (Instrumental, Institutional and Interactive), have been identified within UK regeneration networks. All may have a role to play with no single perspective likely to succeed on its own. Therefore, all could make an important contribution to the understanding of how groups can be brought together to work jointly; The findings support Klijn’s (1997) assertion that the institutional perspective is dominant for understanding network management processes; Instrumentalism continues on all sides, as the acquisition of resources remains the major driver for partnership activity; The level of interaction appears to be low despite the intentions for interactive decision-making; Overall, network management remains partial. Little attention is paid to the issues of accountability or to the institutional structures which can prevent networks from implementing the policies designed by central government, and/or the regional tier.
Resumo:
The aim of this research is to assess the acquisition and absorption technology capabilities of the public sector in developing countries, with specific focus on the State of Kuwait. The assessment process of these two capabilities was conducted using a model originally designed for the private sector. In addition, the research aims to propose a framework to enhance the technological capability of developing countries, as well as the performance of the public sector. To achieve these aims, an investigation of the technology process to three public ministries in Kuwait was conducted. The prime interest of this investigation was to evaluate the role of the transferred technology in enhancing the indigenous technological capability of the public sector. The research is based on a case study approach, comprising a main case study (Ministry of Electricity and Water) and three minor case studies. Based on the outcomes from an extensive literature review and the preliminary sectoral visits, the research question and four hypotheses were formulated. These hypotheses were then tested using interview-based survey and documentation. The findings of the research revealed the weakness of the acquisition and absorption technological capabilities of the public sector. Consequently, the public sector relies extensively on foreign contractors and expatriates to compensate for this weakness. Also, it was found that Kuwait Government has not taken the necessary measures to develop its technological capability. This research has proposed a framework which could lead, if properly managed, to the enhancement of indigenous capability. It has also proposed how to improve performance and productivity in the public sector. Finally, the findings suggest that the assessment model, with minor adjustment, is applicable to the public sector.
Resumo:
The purpose of this paper is to deal with the outcomes of a so-called “employability management needs analysis” that is meant to provide more insight into current employability management activities and its possible benefits for Information and Communication Technology (ICT) professionals working in Small- and Medium-sized enterprises (SMEs) throughout Europe. A considerable series of interviews (N=107) were conducted with managers in SMEs in seven European countries, including Germany, Greece, Italy, the Netherlands, Norway, Poland, and the UK. A semi-structured interview protocol was used during the interviews to cover three issues: employability (13 items), ageing (8 items), and future developments and requirements (13 items). Analysis of all final interview transcriptions was at a national level using an elaborate common coding scheme. Although an interest in employability emerged, actual policy and action lagged behind. The recession in the ICT sector at the time of the investigation and the developmental stage of the sector in each participating country appeared connected. Ageing was not seen as a major issue in the ICT sector because managers considered ICT to be a relatively young sector. There appeared to be a serious lack of investment in the development of expertise of ICT professionals. Generalization of the results to large organizations in the ICT sector should be made with caution. The interview protocol developed is of value for further research and complements survey research undertaken within the employability field of study. It can be concluded that proactive HRM (Human Resource Management) policies and strategies are essential, even in times of economic downturn. Employability management activities are especially important in the light of current career issues. The study advances knowledge regarding HRM practices adopted by SMEs in the ICT sector, especially as there is a gap in knowledge about career development issues in that particular sector.
Resumo:
This study is a consumer-survey conducted with former Marriage Guidance Council clients. The objectives were to identify and examine why they chose the agency, what their expectations and experiences were of marital counselling and whether anything was achieved. The material was derived from tape recorded interviews with 51 former M.G. clients (17 men and 34 women) from 42 marriages and with 21 counsellors; data from written material and a card-sort completed by the research sample; and the case record sheets of the research population (174 cases). The results from the written data of clients showed that 49% were satisfied with counselling, 25.5% were satisfied in some ways but not in others, and 25.5% were dissatisfied. Forty-six percent rated they had benefited from counselling, either a great deal or to some degree, 4% were neutral and 50% recorded they had not benefited. However the counsellors' assessments were more optimistic. It was also ascertained that 50% of the research sample eventually separated or divorced subsequent to counselling. A cross-check revealed that the majority who rated they were satisfied with counselling were those who remained married, whilst dissatisfied clients were the ones who unwillingly separated or divorced. The study then describes, discusses and assesses the experiences of clients in the light of these findings on a number of dimensions. From this it was possible to construct a summary profile of a "successful" client describing the features which would contribute to "success". Two key themes emerged from the data. (1) the discrepancy between clients expectations and the counselling offered, which included mis match over the aims and methods of counselling, and problem definition; and (2) the importance of the client/counsellor relationship. The various implications for the agency are then discussed which include recommendations on policy, the training of counsellors and further research.
Resumo:
This thesis is a qualitative case study drawing on discourse analysis and ethnographic traditions. The aim of the study is to provide a description of the discourse consciously constructed by a group of six TESOL professionals in the interests of their own development. Once a week, the group met for one hour and took turns to act as 'Speaker'. The other five individuals acted as Understanders. The extra space given to the Speaker allowed a fuller articulation of a problem or focus than would normally be possible in other professional talk. The Understanders contributed moves to support this articulation. The description covers a two-year period (1998-2000) of this constructed discourse. Data, collected during this period, are drawn from several different sources: recordings, interviews, diaries and critical incident journals. The main recordings are of the actual Group Development Meetings (GDMs). Discussion of six transcribed GDMs demonstrates which discourse choices and decisions were important. In particular, the study looks at the key role played by 'Reflection' in this process. It is argued that Reflection is the key element in supporting the Speaker. The analysis of Reflection, which is considered from four perspectives (values, purpose, form and outcomes) draws on data from the featured cases. Issues relating to the transfer to other groups of this discourse-based approach to professional development are considered.
Resumo:
This paper examines the impact of ownership structures of emerging-market firms, which are shaped by local institutions, on the decision of these firms to undertake outward FDI. Our results suggest that family firms and firms with concentrated ownerships (both ubiquitous in emerging markets) are less likely to invest overseas, and that strategic equity holding by foreign investors facilitates outward FDI. We conclude that organisational forms such as family firms, which are optimal outcomes of institutions prevailing in emerging markets, may be suboptimal in a changing business environment in which outward FDI is necessary for access to resources and markets.