950 resultados para Adult training


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Background: Historically rail organisations have been operating in silos and devising their own training agendas. However with the harmonisation of the Australian workplace health and safety legislation and the appointment of a national rail safety regulator in 2013, rail incident investigator experts are exploring the possibility of developing a unified approach to investigator training. Objectives: The Australian CRC for Rail Innovation commissioned a training needs analysis to identify if common training needs existed between organisations and to assess support for the development of a national competency framework for rail incident investigations. Method: Fifty-two industry experts were consulted to explore the possibility of the development of a standardised training framework. These experts were sourced from within 19 Australasian organisations, comprising Rail Operators and Regulators in Queensland, New South Wales, Victoria, Western Australia, South Australia and New Zealand. Results: Although some competency requirements appear to be organisation specific, the vast majority of reported training requirements were generic across the Australasian rail operators and regulators. Industry experts consistently reported strong support for the development of a national training framework. Significance: The identification of both generic training requirements across organisations and strong support for standardised training indicates that the rail industry is receptive to the development of a structured training framework. The development of an Australasian learning framework could: increase efficiency in course development and reduce costs; establish recognised career pathways; and facilitate consistency with regards to investigator training.

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Summary Background The final phase of a three phase study analysing the implementation and impact of the nurse practitioner role in Australia (the Australian Nurse Practitioner Project or AUSPRAC) was undertaken in 2009, requiring nurse telephone interviewers to gather information about health outcomes directly from patients and their treating nurse practitioners. A team of several registered nurses was recruited and trained as telephone interviewers. The aim of this paper is to report on development and evaluation of the training process for telephone interviewers. Methods The training process involved planning the content and methods to be used in the training session; delivering the session; testing skills and understanding of interviewers post-training; collecting and analysing data to determine the degree to which the training process was successful in meeting objectives and post-training follow-up. All aspects of the training process were informed by established educational principles. Results Interrater reliability between interviewers was high for well-validated sections of the survey instrument resulting in 100% agreement between interviewers. Other sections with unvalidated questions showed lower agreement (between 75% and 90%). Overall the agreement between interviewers was 92%. Each interviewer was also measured against a specifically developed master script or gold standard and for this each interviewer achieved a percentage of correct answers of 94.7% or better. This equated to a Kappa value of 0.92 or better. Conclusion The telephone interviewer training process was very effective and achieved high interrater reliability. We argue that the high reliability was due to the use of well validated instruments and the carefully planned programme based on established educational principles. There is limited published literature on how to successfully operationalise educational principles and tailor them for specific research studies; this report addresses this knowledge gap.

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A core component for the prevention of re-occurring incidents within the rail industry is rail safety investigations. Within the current Australasian rail industry, the nature of incident investigations varies considerably between organisations. As it stands, most of the investigations are conducted by the various State Rail Operators and Regulators, with the more major investigations in Australia being conducted or overseen by the Australian Transport Safety Bureau (ATSB). Because of the varying nature of these investigations, the current training methods for rail incident investigators also vary widely. While there are several commonly accepted training courses available to investigators in Australasia, none appear to offer the breadth of development needed for a comprehensive pathway. Furthermore, it appears that no single training course covers the entire breadth of competencies required by the industry. These courses range in duration between a few days to several years, and some were run in-house while others are run by external consultants or registered training organisations. Through consultations with rail operators and regulators in Australasia, this paper will identify capabilities required for rail incident investigation and explore the current training options available for rail incident investigators.

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AIMS: Increases in inflammatory markers, hepatic enzymes and physical inactivity are associated with the development of the metabolic syndrome (MetS). We examined whether inflammatory markers and hepatic enzymes are correlated with traditional risk factors for MetS and studied the effects of resistance training (RT) on these emerging risk factors in individuals with a high number of metabolic risk factors (HiMF, 2.9 +/- 0.8) and those with a low number of metabolic risk factors (LoMF, 0.5 +/- 0.5). METHODS: Twenty-eight men and 27 women aged 50.8 +/- 6.5 years (mean +/- sd) participated in the study. Participants were randomized to four groups, HiMF training (HiMFT), HiMF control (HiMFC), LoMF training (LoMFT) and LoMF control (LoMFC). Before and after 10 weeks of RT [3 days/week, seven exercises, three sets with intensity gradually increased from 40-50% of one repetition maximum (1RM) to 75-85% of 1RM], blood samples were obtained for the measurement of pro-inflammatory cytokines, C-reactive protein (CRP), gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT). RESULTS: At baseline, HiMF had higher interleukin-6 (33.9%), CRP (57.1%), GGT (45.2%) and ALT (40.6%) levels, compared with LoMF (all P < 0.05). CRP, GGT and ALT correlated with the number of risk factors (r = 0.48, 0.51 and 0.57, respectively, all P < 0.01) and with other anthropometric and clinical measures (r range from 0.26 to 0.60, P < 0.05). RT did not significantly alter inflammatory markers or hepatic enzymes (all P > 0.05). CONCLUSIONS: HiMF was associated with increased inflammatory markers and hepatic enzyme concentrations. RT did not reduce inflammatory markers and hepatic enzymes in individuals with HiMF.

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BACKGROUND: Studies have shown that nurse staffing levels, among many other factors in the hospital setting, contribute to adverse patient outcomes. Concerns about patient safety and quality of care have resulted in numerous studies being conducted to examine the relationship between nurse staffing levels and the incidence of adverse patient events in both general wards and intensive care units. AIM: The aim of this paper is to review literature published in the previous 10 years which examines the relationship between nurse staffing levels and the incidence of mortality and morbidity in adult intensive care unit patients. METHODS: A literature search from 2002 to 2011 using the MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Australian digital thesis databases was undertaken. The keywords used were: intensive care; critical care; staffing; nurse staffing; understaffing; nurse-patient ratios; adverse outcomes; mortality; ventilator-associated pneumonia; ventilator-acquired pneumonia; infection; length of stay; pressure ulcer/injury; unplanned extubation; medication error; readmission; myocardial infarction; and renal failure. A total of 19 articles were included in the review. Outcomes of interest are patient mortality and morbidity, particularly infection and pressure ulcers. RESULTS: Most of the studies were observational in nature with variables obtained retrospectively from large hospital databases. Nurse staffing measures and patient outcomes varied widely across the studies. While an overall statistical association between increased nurse staffing levels and decreased adverse patient outcomes was not found in this review, most studies concluded that a trend exists between increased nurse staffing levels and decreased adverse events. CONCLUSION: While an overall statistical association between increased nurse staffing levels and decreased adverse patient outcomes was not found in this review, most studies demonstrated a trend between increased nurse staffing levels and decreased adverse patient outcomes in the intensive care unit which is consistent with previous literature. While further more robust research methodologies need to be tested in order to more confidently demonstrate this association and decrease the influence of the many other confounders to patient outcomes; this would be difficult to achieve in this field of research.

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Grenada’s New Jewel Movement, led by Maurice Bishop, was the first indigenous political grouping in the history of the English-speaking Caribbean to overthrow an existing government by armed force. Yet most of the four and a half years of the Revolution (1979-83) were characterized by considerable popular support for the new People’s Revolutionary Government before it came to it’s tragic, unexpected and shocking end in October 1983. Social, economic and political change seems possible in the 1970s and ‘80s. People in newly decolonizing countries were encouraged by the beginnings of the Non-Aligned Movement of Third World nations demanding new international economic order that would win them some economic justice after the ravages of colonialism. People also saw that some radical regimes, such as that led by Michael Manley in Jamaica and the Sandinistas in Nicaragua, were articulating and implementing basic rights that held the promise of countering the social and political oppression that they had endured throughout the centuries of colonial history. A majority of Grenadians committed themselves to fighting by the side of the People’s Revolutionary Government for such new goals. This chapter will analyse how the Grenada Revolution reconceptualised the education, planned new goals, and implemented bold new educational policies. It will discuss the extent to which the government and people were able to reshape education as a tool for national reconstruction and the raising of national consciousness.

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Video-based training combined with flotation tank recovery may provide an additional stimulus for improving shooting in basketball. A pre-post controlled trial was conducted to assess the effectiveness of a 3 wk intervention combining video-based training and flotation tank recovery on three-point shooting performance in elite female basketball players. Players were assigned to an experimental (n=10) and control group (n=9). A 3 wk intervention consisted of 2 x 30 min float sessions a week which included 10 min of video-based training footage, followed by a 3 wk retention phase. A total of 100 three-point shots were taken from 5 designated positions on the court at each week to assess three-point shooting performance. There was no clear difference in the mean change in the number of successful three-point shots between the groups (-3%; ±18%, mean; ±90% confidence limits). Video-based training combined with flotation recovery had little effect on three-point shooting performance.

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This report looks at opportunities in relation to what is either already available or starting to take off in Information and Communication Technology (ICT). ICT focuses on the entire system of information, communication, processes and knowledge within an organisation. It focuses on how technology can be implemented to serve the information and communication needs of people and organisations. An ICT system involves a combination of work practices, information, people and a range of technologies and applications organised to make the business or organisation fully functional and efficient, and to accomplish goals in an organisation. Our focus is on vocational, workbased education in New Zealand. It is not about eLearning, although we briefly touch on the topic. We provide a background on vocational education in New Zealand, cover what we consider to be key trends impacting workbased, vocational education and training (VET), and offer practical suggestions for leveraging better value from ICT initiatives across the main activities of an Industry Training Organisation (ITO). We use a learning value chain approach to demonstrate the main functions ITOs engage in and also use this approach as the basis for developing and prioritising an ICT strategy. Much of what we consider in this report is applicable to the wider tertiary education sector as it relates to life-long learning. We consider ICT as an enabler that: a) connects education businesses (all types including tertiary education institutions) to learners, their career decisions and their learning, and as well, b) enables those same businesses to run more efficiently. We suggest that these two sets of activities are considered as interconnected parts of the same education or training business ICT strategy.

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This review evaluates a report prepared by Lynda Achren, Jude Newcombe and Drew Roberts of Adult Migrant Education Services (AMES) for the ACFE (Adult, Community and Further Education Board), Victoria, Australia.

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Background: Critically ill patients are at high risk for pressure ulcer (PrU) development due to their high acuity and the invasive nature of the multiple interventions and therapies they receive. With reported incidence rates of PrU development in the adult critical care population as high as 56%, the identification of patients at high risk of PrU development is essential. This paper will explore the association between PrU development and risk factors. It will also explore PrU development and the use of risk assessment scales for critically ill patients in adult intensive care units. Method: A literature search from 2000 to 2012 using the CINHAL, Cochrane Library, EBSCOHost, Medline (via EBSCOHost), PubMed, ProQuest and Google Scholar databases was conducted. Key words used were: pressure ulcer/s; pressure sore/s; decubitus ulcer/s; bed sore/s; critical care; intensive care; critical illness; prevalence; incidence; prevention; management; risk factor; risk assessment scale. Results: Nineteen articles were included in this review; eight studies addressing PrU risk factors, eight studies addressing risk assessment scales and three studies overlapping both. Results from the studies reviewed identified 28 intrinsic and extrinsic risk factors which may lead to PrU development. Development of a risk factor prediction model in this patient population, although beneficial, appears problematic due to many issues such as diverse diagnoses and subsequent patient needs. Additionally, several risk assessment instruments have been developed for early screening of patients at higher risk of developing PrU in the ICU. No existing risk assessment scales are valid for identification high risk critically ill patient,with the majority of scales potentially over-predicting patients at risk for PrU development. Conclusion: Research studies to inform the risk factors for potential pressure ulcer development are inconsistent. Additionally, there is no consistent or clear evidence which demonstrates any scale to better or more effective than another when used to identify the patients at risk for PrU development. Furthermore robust research is needed to identify the risk factors and develop valid scales for measuring the risk of PrU development in ICU.

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This study used a video-based hazard perception dual task to compare the hazard perception skills of young drivers with middle aged, more experienced drivers and to determine if these skills can be improved with video-based road commentary training. The primary task required the participants to detect and verbally identify immediate hazard on video-based traffic scenarios while concurrently performing a secondary tracking task, simulating the steering of real driving. The results showed that the young drivers perceived fewer immediate hazards (mean = 75.2%, n = 24, 19 females) than the more experienced drivers (mean = 87.5%, n = 8, all females), and had longer hazard perception times, but performed better in the secondary tracking task. After the road commentary training, the mean percentage of hazards detected and identified by the young drivers improved to the level of the experienced drivers and was significantly higher than that of an age and driving experience matched control group. The results will be discussed in the context of psychological theories of hazard perception and in relation to road commentary as an evidence-based training intervention that seems to improve many aspects of unsafe driving behaviour in young drivers.

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Executive Summary Child sexual abuse (CSA) in Christian Institutions continues to be of serious concern in public, criminal justice and institutional discourse. This study was conducted in conjunction with Project Kidsafe Foundation and sought the perspectives of Australian survivors of CSA by Personnel in Christian Institutions (PICIs). In total, 81 individual survivors responded to an online survey which asked them a range of questions about their current and childhood life circumstance; the nature, extent and location of abuse; grooming strategies utilised by perpetrators; their experiences of disclosure; and outcomes of official reporting to both criminal justice agencies and also official processes Christian institutions. Survey participants were given the option to further participate in a qualitative interview with the principal researcher. These interviews are not considered within this report. In summary, survey data examined here indicate that: • Instances of abuse included a range of offences from touching outside of clothing to serious penetrative offences. • The onset of abuse occurred at a young age: between 6 and 10 years for most female participants, and 11 and 13 years for male participants. • In the majority of cases the abuse ceased because of actions by survivors, not by adults within families or the Christian institution. • Participants waited significant time before disclosing their abuse, with many waiting 20 years or more. • Where survivors disclosed to family members or PICIs, they were often met with disbelief and unhelpful responses aimed at minimising the harm. • Where an official report was made, it was most often made to police. In these cases 53% resulted in an official investigations. • The primary reasons for reporting were to protect others from the perpetrator and make the Christian institution accountable to an external agency. • Where reports to Christian institutions were made, most survivors were dissatisfied with outcomes, and a smaller majority was extremely dissatisfied. This report reflects the long-held understanding that responding to CSA is a complex and difficult task. If effective and meaningful responses are not made, however, trauma to the survivor is most often compounded and recovery delayed. This report demonstrates the need for further independent analysis and oversight of responses made to CSA by both criminal justice, religious and social institutions. Meaningful change will only be accessible, however, if family, community and institutional environments are safe places for survivors to disclose their experiences of abuse and begin to seek ways of healing. There is much to be learnt from survivors that have already made this journey.

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The term ‘partnership’ is increasingly used by governments, industry, community organisations and schools in supporting their daily businesses. Similar to the terms ‘ICT’ and ‘learning’, ‘partnerships’ are now ubiquitous in policy discourse. Yet, the term remains ill-defined and ambiguous. This study reviews and reflects on a government led industry-school partnership initiative in the state of Queensland, Australia, to understand how the term is used in this initiative. Given the frequent use of Public Private Partnership (PPP) language, PPP was used as a framework to review this initiative. The methodology of this qualitative case study involved consultations with stakeholders and an analysis of Gateway schools documents, policy documents, and literature. The review suggests that despite the use of terminology akin to PPP projects in Gateway school and policy documents, the implicit suggestion that this initiative is a public-private partnership is untenable. The majority of principles shaping a PPP have not been considered to a significant extent in the Gateway project. Although the review recognises the legitimate and sincere purpose of the Gateway schools initiative, the adoption of a PPP framework during the design, monitoring, or evaluation stages could have strengthened the initiative in terms of outcomes, benefits, and sustainability.