914 resultados para medical outcomes
Resumo:
This paper reports on the design, implementation and outcomes of a mentoring program involving 18 employees in the IT Division of WorkCover Queensland. The paper provides some background information to the development of the program and the design and implementation phases including recruitment and matching of participants, orientation and training, and the mentoring process including transition and/or termination. The paper also outlines the quantitative and qualitative evaluation processes that occurred and the outcomes of that evaluation. Results indicated a wealth of positive individual, mentoring, and organisational outcomes. The organisation and semi-structured processes provided in the program are considered as major contributing factors to the successful outcomes of the program. These outcomes are likely to have long-term benefits for the individuals involved, the IT Division, and the broader organisation
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Recent reports from Bangladesh about the Grameen Bank (GB) having to seriously review its policies and restructure its procedures have not stopped countries like the Philippines from making a success of Grameen Bank Replicas (GBRs). Women across Asia continue to benefit from microfinance initiatives and are motivated to move out of poverty through the influence of the GB and other microfinance institutes. This paper addresses specifically the microfinance activities in the Philippines and reports on some of the issues surrounding the successes and setbacks of programs in that country.
Resumo:
Abstract Maintaining the health of a construction project can help to achieve the desired outcomes of the project. An analogy is drawn to the medical process of a human health check where it is possible to broadly diagnose health in terms of a number of key areas such as blood pressure or cholesterol level. Similarly it appears possible to diagnose the current health of a construction project in terms of a number of Critical Success Factors (CSFs) and key performance indicators (KPIs). The medical analogy continues into the detailed investigation phase where a number of contributing factors are evaluated to identify possible causes of ill health and through the identification of potential remedies to return the project to the desired level of health. This paper presents the development of a model that diagnoses the immediate health of a construction project, investigates the factors which appear to be causing the ill health and proposes a remedy to return the project to good health. The proposed model uses the well-established continuous improvement management model (Deming, 1986) to adapt the process of human physical health checking to construction project health.
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A prospective, consecutive series of 106 patients receiving endoscopic anterior scoliosis correction. The aim was to analyse changes in radiographic parameters and rib hump in the two years following surgery. Endoscopic anterior scoliosis correction is a level sparing approach, therefore it is important to assess the amount of decompensation which occurs after surgery. All patients received a single anterior rod and vertebral body screws using a standard compression technique. Cleared disc spaces were packed with either mulched femoral head allograft or rib head/iliac crest autograft. Radiographic parameters (major, instrumented, minor Cobb, T5-T12 kyphosis) and rib hump were measured at 2,6,12 and 24 months after surgery. Paired t-tests and Wilcoxon signed ranks tests were used to assess the statistical significant of changes between adjacent time intervals.----- Results: Mean loss of major curve correction from 2 to 24 months after surgery was 4 degrees. Mean loss of rib hump correction was 1.4 degrees. Mean sagittal kyphosis increased from 27 degrees at 2 months to 30.6 degrees at 24 months. Rod fractures and screw-related complications resulted in several degrees less correction than patients without complications, but overall there was no clinically significant decompensation following complications. The study concluded that there are small changes in deformity measures after endoscopic anterior scoliosis surgery, which are statistically significant but not clinically significant.
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As the 21st century progresses, the most successful economies and societies will be creative ones. Worldwide, governments are producing strategies to encourage the development of creative industries and to strengthen the role of knowledge cities nationally and internationally. There is a significant policy discussion regarding the role of creative clusters in strengthening local economies and significant energy has been expended discussing the many positive outcomes of such developments. This article takes these issues as a starting point and considers the role of creative industries within broader concerns regarding uneven metropolitan development. By developing a typology of jobs across Australia’s metropolitan regions, the article will consider the broad social and economic impacts of uneven development of creative industry jobs between metropolitan regions and also the implications for individual metropolitan regions and policy outcomes.
Resumo:
Background Advanced paternal age (APA) is associated with an increased risk of neurodevelopmental disorders such as autism and schizophrenia, as well as with dyslexia and reduced intelligence. The aim of this study was to examine the relationship between paternal age and performance on neurocognitive measures during infancy and childhood. Methods and Findings A sample of singleton children (n = 33,437) was drawn from the US Collaborative Perinatal Project. The outcome measures were assessed at 8 mo, 4 y, and 7 y (Bayley scales, Stanford Binet Intelligence Scale, Graham-Ernhart Block Sort Test, Wechsler Intelligence Scale for Children, Wide Range Achievement Test). The main analyses examined the relationship between neurocognitive measures and paternal or maternal age when adjusted for potential confounding factors. Advanced paternal age showed significant associations with poorer scores on all of the neurocognitive measures apart from the Bayley Motor score. The findings were broadly consistent in direction and effect size at all three ages. In contrast, advanced maternal age was generally associated with better scores on these same measures. Conclusions The offspring of older fathers show subtle impairments on tests of neurocognitive ability during infancy and childhood. In light of secular trends related to delayed fatherhood, the clinical implications and the mechanisms underlying these findings warrant closer scrutiny.
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The issue of health professionals facing criminal charges of manslaughter or criminal negligence causing death or grievous bodily harm as a result of alleged negligence in their professional practice was thrown into stark relief by the recent acquittal of four physicians accused of mismanaging Canada’s blood system in the early 1980s. Stories like these, as well as international reports detailing an increase in the numbers of physicians being charged with (and in some cases convicted of) serious criminal offences as the result of alleged negligence in their professional practice, have resulted in some anxiety about the apparent increase in the incidence of such charges and their appropriateness in the healthcare context. Whilst research has focused on the incidence, nature and appropriateness of criminal charges against health professionals, particularly physicians, for alleged negligence in their professional practice in the United Kingdom, the United States, Japan, and New Zealand, the Canadian context has yet to be examined. This article examines the Canadian context and how the criminal law is used to regulate the negligent acts or omissions of a health care professional in the course of their professional practice. It also assesses the appropriateness of such use. It is important at this point to state that the analysis in this article does not focus on those, fortunately few, cases where a health professional has intentionally killed his or her patients but rather when patients’ deaths or grievous injuries were allegedly as a result of that health professional’s negligent acts or omissions when providing health services to that patient.
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As the problems involving infrastructure delivery have become more complex and contentious, there has been an acknowledgement that these problems cannot be resolved by any one body working alone. This understanding has driven multi-sectoral collaboration and has led to an expansion of the set of actors, including stakeholders, who are now involved in delivery of infrastructure projects and services. However, more needs to be understood about how to include stakeholders in these processes and the optimal ways of developing the requisite combination of stakeholders to achieve effective outcomes. This thesis draws on stakeholder theory and governance network theory to obtain insights into how three networks delivering public outcomes within the Roads Alliance in Queensland engage with stakeholders in the delivery of complex and sensitive infrastructure services and projects. New knowledge about stakeholders will be obtained by testing a model of Stakeholder Salience and Engagement which combines and extends the stakeholder identification and salience theory (Mitchell, Agle, and Wood, 1997), ladder of stakeholder management and engagement (Friedman and Miles, 2006) and the model of stakeholder engagement and moral treatment of stakeholders (Greenwood, 2007). By applying this model, the broad research question: “Who or what decides how stakeholders are optimally engaged by governance networks delivering public outcomes?” will be addressed. The case studies will test a theoretical model of stakeholder salience and engagement which links strategic management decisions about stakeholder salience with the quality and quantity of engagement strategies for engaging different types of stakeholders. The outcomes of this research will contribute to and extend stakeholder theory by showing how stakeholder salience impacts on decisions about the types of engagement processes implemented. Governance network theory will be extended by showing how governance networks interact with stakeholders through the concepts of stakeholder salience and engagement. From a practical perspective this research will provide governance networks with an indication of how to optimise engagement with different types of stakeholders.
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Thirty-five clients who had received counselling completed a letter to a friend describing in as much detail as possible what they had learned from counselling. The participants' written responses were analysed and classified using the Structure of Learning Outcomes (SOLO) taxonomy. The results suggested that an expanded SOLO offers a promising and exciting way to view the outcomes of counselling within a learning framework. If the SOLO taxonomy is found to be stable in subsequent research, and clients are easily able to be classified using the taxonomy, then this approach may have implications for the process of counselling. To maximise the learning outcomes, counsellors could use strategies and techniques to enhance their clients' learning.