822 resultados para current medical knowledge


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This small-scale study was undertaken to assess what knowledge nursing staff from a General Intensive Care Unit held with regard to noise exposure. To assess knowledge a self-administered multiple-choice questionnaire was used. Rigorous peer-review insured content validity. This study produced poor results in terms of the knowledge nurses held with regard to noise related issues in particular the psychophysiological effects and current legislation concerning its safe exposure. Non-parametric testing, using Kruskal–Wallis found no significant difference between nursing grades, however, descriptive analysis demonstrated that the staff nurse grade (D and E) performed better overall. Whilst the results of this study may seem self-evident in some respects, it is the problems of exposure to excessive noise levels for both patients and hospital personnel, which are clearly not understood. The effects noise exposure has on individuals for example decreased wound healing; sleep deprivation and cardiovascular stimulation must be of concern especially in terms of patient care but more so for nursing staff especially the effects noise levels can have on cognitive task performance.

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Creative Development: The Body and Light. Within the current cultural climate, the independent choreographer struggles to pursue and establish their artistic career outside the infrastructure of mainstream dance companies. The independent choreographer is challenged to articulate alternative choreographic models without the support of that infrastructure. My research examines that challenge by exploring my own independent choreographic practice through a number of performance-based dance projects. This exploration will be underpinned by theoretical research to enable clarification of the tacit understandings of an embodied practice and the point of intersection between practice and theory so as to articulate alternative choreographic models. As a starting point for that enquiry, an example is provided of how questions that emerge from within the choreographic practice can be discussed in terms of research through an initial investigation exploring light in relation to the moving body and the implications of atmospheres.

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Background Many studies have found associations between climatic conditions and dengue transmission. However, there is a debate about the future impacts of climate change on dengue transmission. This paper reviewed epidemiological evidence on the relationship between climate and dengue with a focus on quantitative methods for assessing the potential impacts of climate change on global dengue transmission. Methods A literature search was conducted in October 2012, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search focused on peer-reviewed journal articles published in English from January 1991 through October 2012. Results Sixteen studies met the inclusion criteria and most studies showed that the transmission of dengue is highly sensitive to climatic conditions, especially temperature, rainfall and relative humidity. Studies on the potential impacts of climate change on dengue indicate increased climatic suitability for transmission and an expansion of the geographic regions at risk during this century. A variety of quantitative modelling approaches were used in the studies. Several key methodological issues and current knowledge gaps were identified through this review. Conclusions It is important to assemble spatio-temporal patterns of dengue transmission compatible with long-term data on climate and other socio-ecological changes and this would advance projections of dengue risks associated with climate change. Keywords: Climate; Dengue; Models; Projection; Scenarios

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Nutrition knowledge is associated with dietary choices in the general population and has been proposed to contribute to socioeconomic differences in food choices and corresponding socioeconomic gradients in mortality and morbidity for a number of diet-related illnesses. This paper explores current evidence regarding socioeconomic differences in nutrition knowledge, reviewing the components of nutrition knowledge that have been assessed, the dietary intake or food choice outcomes considered, and the socioeconomic indicators used. In addition, this paper considers how socioeconomic differences in nutrition knowledge may arise, and potential determinants of inequalities in the application of nutrition knowledge. It highlights issues to consider when developing strategies to improve nutrition knowledge and facilitate knowledge application among those of lower socioeconomic position.

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This paper examines collaborative researcher-practitioner knowledge work around assessment data in culturally diverse, low- socioeconomic school communities in Queensland, Australia. Specifically, the paper draws on interview accounts about the work of a bridging knowledge flows between a local university and a cluster of schools. We draw on Bernstein’s (2000) concept of recontextualisation to explore the processes of knowledge mediation in dialogues around student assessment data to design instructional innovations. We argue that critical policy studies need to explore the complex ways in which neoliberal education policies are enacted in local sites. Moreover, we suggest that an analysis of collaborative knowledge work designed to improve student learning outcomes in low-socioeconomic school communities necessitates attention to the principles regulating knowledge flows across boundaries. In addition, it necessitates attention to the ways in which mediators navigate dilemmatic spaces, anxieties and affects/feelings in order to generate innovative learning designs in the current global context of high-stakes national testing and accountability regimes.

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Musculoskeletal health can be compromised by breast cancer treatment. In particular, bone loss and arthralgias are prevalent side effects experienced by women treated with chemotherapy and/or adjuvant endocrine therapy. Bone loss leads to osteoporosis and related fractures, while arthralgias threaten quality of life and compliance to treatment. Because the processes that lead to these musculoskeletal problems are initiated when treatment begins, early identification of women who may be at higher risk of developing problems, routine monitoring of bone density and pain at certain stages of treatment, and prudent application of therapeutic interventions are key to preventing and/or minimizing musculoskeletal sequelae. Exercise may be a particularly suitable intervention strategy because of its potential to address a number of impairments; it may slow bone loss, appears to reduce joint pain in noncancer conditions, and improves other breast cancer outcomes. Research efforts continue in the areas of etiology, measurement, and treatment of bone loss and arthralgias. The purpose of this review is to provide an overview of the current knowledge on the management and treatment of bone loss and arthralgias in breast cancer survivors and to present a framework for rehabilitation care to preserve musculoskeletal health in women treated for breast cancer.

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In the current era of global economic instability, business and industry have already identified a widening gap between graduate skills and employability. An important element of this is the lack of entrepreneurial skills in graduates. This Teaching Fellowship investigated two sides of a story about entrepreneurial skills and their teaching. Senior players in the innovation commercialisation industry, a high profile entrepreneurial sector, were surveyed to gauge their needs and experiences of graduates they employ. International contexts of entrepreneurship education were investigated to explore how their teaching programs impart the skills of entrepreneurship. Such knowledge is an essential for the design of education programs that can deliver the entrepreneurial skills deemed important by industry for future sustainability. Two programs of entrepreneurship education are being implemented at QUT that draw on the best practice exemplars investigated during this Fellowship. The QUT Innovation Space (QIS) focuses on capturing the innovation and creativity of students, staff and others. The QIS is a physical and virtual meeting and networking space; a connected community enhancing the engagement of participants. The Q_Hatchery is still embryonic; but it is intended to be an innovation community that brings together nascent entrepreneurial businesses to collaborate, train and support each other. There is a niche between concept product and business incubator where an experiential learning environment for otherwise isolated ‘garage-at-home’ businesses could improve success rates. The QIS and the Q_Hatchery serve as living research laboratories to trial the concepts emerging from the skills survey. The survey of skills requirements of the innovation commercialisation industry has produced a large and high quality data set still being explored. Work experience as an employability factor has already emerged as an industry requirement that provides employee maturity. Exploratory factor analysis of the skills topics surveyed has led to a process-based conceptual model for teaching and learning higher-order entrepreneurial skills. Two foundational skills domains (Knowledge, Awareness) are proposed as prerequisites which allow individuals with a suite of early stage entrepreneurial and behavioural skills (Pre-leadership) to further leverage their careers into a leadership role in industry with development of skills around higher order elements of entrepreneurship, management in new business ventures and progressing winning technologies to market. The next stage of the analysis is to test the proposed model through structured equation modelling. Another factor that emerged quickly from the survey analysis broadens the generic concept of team skills currently voiced in Australian policy documents discussing the employability agenda. While there was recognition of the role of sharing, creating and using knowledge in a team-based interdisciplinary context, the adoption and adaptation of behaviours and attitudes of other team members of different disciplinary backgrounds (interprofessionalism) featured as an issue. Most undergraduates are taught and undertake teamwork in silos and, thus, seldom experience a true real-world interdisciplinary environment. Enhancing the entrepreneurial capacity of Australian industry is essential for the economic health of the country and can only be achieved by addressing the lack of entrepreneurial skills in graduates from the higher education system. This Fellowship has attempted to address this deficiency by identifying the skills requirements and providing frameworks for their teaching.

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Management of project knowledge is a critical factor for project success. Project Management Office (PMO) is a unit within organisations to centrally facilitate, manage and control organisational project for improving the rate of project success. Due to increasing interest of developing PMO, the Project Management Maturity Model (PMMM) has been proposed to develop PMOs gradually. The PMMM contributes to evolvement of PMO from immature to mature level through addressing appropriate PM practices. Despite the importance of project knowledge, it has not been extensively investigated in project environments. In addition, the existing PMMMs not only do not address management of project knowledge, but also they recommend little criteria to assess the maturity of PMO from KM point of view. The absence of KM discussion in current PMMMs was defined as the subject of a research project in order for addressing KM practices at various maturity levels of PMO. In order to address the mentioned gap, a framework has been developed based on the current discussions of both PM and KM. The proposed framework comprises three premises: KM processes and practices, PMMM, and KM Maturity Model (KMMM). The incorporation of KMMM practices at various maturity levels of PMO is one of the significance of this framework. It proposes numbers of KM strategies, processes, and practices to address project knowledge management at various levels PMO. This framework shall be useful guidance for developing PMOs from KM perspective. In other words, it contributes to management of project knowledge, as a key for project success. The proposed framework follows the process-based approach and it could be employed alongside the current PMMMs for PMO development. This paper presents the developed framework, theoretical background, premises, proposed KM practices, and processes to be employed in Project-based Organisations and PMOs. This framework has been examined at numbers of case studies with different maturity levels. The case studies outcomes, which will be subjects for future papers, have not shown any significant contradiction yet, however, more investigations are being conducted to validate the proposed framework.

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Recent literature on Enterprise System (ES) implementation projects highlights the importance of Knowledge Integration (KI) for implementation success. The fundamental characteristics of ES - integration of modules, business process view, and aspects of information transparency - necessitate that all frequent end-users share a reasonable amount of common knowledge and integrate their knowledge to yield new knowledge. Unfortunately, the importance of KI is often overlooked and little about the role of KI in ES success is known. In this chapter, the authors study the KI impact on ES success that is relevant to the ES post-implementation in support of organizations' returns on their ES investments. They adopt the ES post-implementation segment of ES utilization to explore whether the KI approach is causally linked to ES success. The research model was tested in a multi-industry sample in Malaysia from which data was gathered from managerial and operational employees spread across six large organizations. Consistent with the explanation by knowledge-based theory, the results show that KI was valid and significantly related to the outcome of ES that relates to an organization's performance, which the authors refer to as ES success. The KI positive impact on the success of ES drives one to highlight the importance of ontological KI in the complexity of the ES environment. The authors believe that focusing on an ontology through the KI perspective can make significant contributions to current ES problems.

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We report a new tuneable alternating current (ac) electrohydrodynamics (ac-EHD) force referred to as “nanoshearing” which involves fluid flow generated within a few nanometers of an electrode surface. This force can be externally tuned via manipulating the applied ac-EHD field strength. The ability to manipulate ac-EHD induced forces and concomitant fluid micromixing can enhance fluid transport within the capture domain of the channel (e.g., transport of analytes and hence increase target–sensor interactions). This also provides a new capability to preferentially select strongly bound analytes over onspecifically bound cells and molecules. To demonstrate the utility and versatility of nanoshearing phenomenon to specifically capture cancer cells, we present proof-of-concept data in lysed blood using two microfluidic devices containing a long array of asymmetric planar electrode pairs. Under the optimal experimental conditions, we achieved high capture efficiency (e.g., approximately 90%; %RSD=2, n=3) with a 10-fold reduction in nonspecific dsorption of non-target cells for the detection of whole cells expressing Human Epidermal Growth Factor Receptor 2 (HER2). We believe that our ac-EHD devices and the use of tuneable nanoshearing phenomenon may find relevance in a wide variety of biological and medical applications.

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Hepatocellular carcinoma (HCC) is one of the primary hepatic malignancies and is the third most common cause of cancer related death worldwide. Although a wealth of knowledge has been gained concerning the initiation and progression of HCC over the last half century, efforts to improve our understanding of its pathogenesis at a molecular level are still greatly needed, to enable clinicians to enhance the standards of the current diagnosis and treatment of HCC. In the post-genome era, advanced mass spectrometry driven multi-omics technologies (e.g., profiling of DNA damage adducts, RNA modification profiling, proteomics, and metabolomics) stand at the interface between chemistry and biology, and have yielded valuable outcomes from the study of a diversity of complicated diseases. Particularly, these technologies are being broadly used to dissect various biological aspects of HCC with the purpose of biomarker discovery, interrogating pathogenesis as well as for therapeutic discovery. This proof of knowledge-based critical review aims at exploring the selected applications of those defined omics technologies in the HCC niche with an emphasis on translational applications driven by advanced mass spectrometry, toward the specific clinical use for HCC patients. This approach will enable the biomedical community, through both basic research and the clinical sciences, to enhance the applicability of mass spectrometry-based omics technologies in dissecting the pathogenesis of HCC and could lead to novel therapeutic discoveries for HCC.

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The use of Portable Medical Devices (PMDs) has become increasingly widespread over the last few years. A combination of factors; including advances in technology, the pressure to reduce public health costs and the desire to make health solutions accessible to a wider patient base are contributing to the growth in the PMD market. Design has a clear role to play in the current and future context of the PMD landscape. In this paper, we identify emerging trends in the design of PMDs; including changes in the form, purpose and mode of use, and explore how these trends are likely to fundamentally impact the nature of healthcare and the patient experience from an experience design perspective. We conclude by identifying a research opportunity for design within the healthcare and PMD context.

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Objective The move internationally by Governments and other health providers to encourage patients to have their own electronic personal health record (e-PHRs) is growing exponentially. In Australia the initiative for a personally controlled electronic health record (known as PCEHR) is directed towards the public at large. The first objective of this study then, is to examine how individuals in the general population perceive the promoted idea of having a PCEHR. The second objective is to extend research on applying a theoretically derived consumer technology acceptance model to guide the research. Method An online survey was conducted to capture the perceptions and beliefs about having a PCEHR identified from technology acceptance models and extant literature. The survey was completed by 750 Queensland respondents, 97% of whom did not have a PCEHR at that time. The model was examined using exploratory factor analysis, regressions and mediation tests. Results Findings support eight of the 11 hypothesised relationships in the model. Perceived value and perceived risk were the two most important variables explaining attitude, with perceived usefulness and compatibility being weak but significant. The perception of risk was reduced through partial mediation from trust and privacy concerns. Additionally, web-self efficacy and ease of use partially mediate the relationship between attitude and intentions. Conclusions The findings represent a snapshot of the early stages of implementing this Australian initiative and captures the perceptions of Queenslanders who at present do not have a PCEHR. Findings show that while individuals appreciate the value of having this record, they do not appear to regard it as particularly useful at present, nor is it particularly compatible with their current engagement with e-services. Moreover, they will need to have any concerns about the risks alleviated, particularly through an increased sense of trust and reduction of privacy concerns. It is noted that although the respondents are non-adopters, they do not feel that they lack the necessary web skills to set up and use a PCEHR. To the best of our knowledge this is one of a very limited number of studies that examines a national level implementation of an e-PHR system, where take-up of the PCEHR is optional rather than a centralised, mandated requirement.

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This thesis extends current understanding in management consulting research by investigating the ways in which management consultants and their clients shaped knowing over the course of nine different consulting engagements. The research illuminates the client experience of using consulting knowledge in organisations, and proposes a theoretical reconceptualisation of knowledge shaping in consulting engagements which incorporates how the knowing client is enacted. The research shows that knowledge shaping activities are planned and enacted to support novelty reduction in consulting engagements; that asymmetries in the structuring of the consultant–client relationship hamper knowledge transformation and the establishment of knowing; and that understanding of how the role identities of consultants and clients are established and maintained over the course of an engagement is integral to understanding knowledge shaping in consulting engagements.

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Self-development resources are a popular billion -dollar industry worldwide used to improve individuals quality of lives. However, there are insufficient studies for a contemporary conceptualization, especially when it comes to live self-development programs. This paper provides a literature review about current self-development definitions, ideology, concepts, and themes; quality of material provided; quality and characteristics of self-development providers; and the features of the participants who seek such programs. The paper will also discuss the relationsh ip between self-development and related disciplines including coaching, training, mentoring, and motivational speaking. Finally, a new definition will be proposed for self-development coaching programs. Gaps of knowledge are highlighted for further research.