700 resultados para new knowledge for advancing practice in pain management


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Introduction The world is changing! It is volatile, uncertain, complex and ambiguous. As cliché as it may sound the evidence of such dynamism in the external environment is growing. Business-as-usual is more of the exception than the norm. Organizational change is the rule; be it to accommodate and adapt to change, or instigate and lead change. A constantly changing environment is a situation that all organizations have to live with. What makes some organizations however, able to thrive better than others? Many scholars and practitioners believe that this is due to the ability to learn. Therefore, this book on developing Learning and Development (L&D) professionals is timely as it explores and discusses trends and practices that impact organizations, the workforce and L&D professionals. Being able to learn and develop effectively is the cornerstone of motivation as it helps to address people’s need to be competent and to be autonomous (Deci & Ryan, 2002; Loon & Casimir, 2008; Ryan & Deci, 2000). L&D stimulates and empowers people to perform. Organizations that are better at learning at all levels; the individual, group and organizational level, will always have a better chance of surviving and performing. Given the new reality of a dynamic external environment and constant change, L&D professionals now play an even more important role in their organizations than ever before. However, L&D professionals themselves are not immune to the turbulent changes as their practices are also impacted. Therefore, the challenges that L&D professionals face are two-pronged. Firstly, in relation to helping and supporting their organization and its workforce in adapting to the change, whilst, secondly developing themselves effectively and efficiently so that they are able to be one-step ahead of the workforce that they are meant to help develop. These challenges are recognised by the CIPD, as they recently launched their new L&D qualification that has served as an inspiration for this book. L&D plays a crucial role at both strategic (e.g. organizational capability) and operational (e.g. delivery of training) levels. L&D professionals have moved from being reactive (e.g. following up action after performance appraisals) to being more proactive (e.g. shaping capability). L&D is increasingly viewed as a driver for organizational performance. The CIPD (2014) suggest that L&D is increasingly expected to not only take more responsibility but also accountability for building both individual and organizational knowledge and capability, and to nurture an organizational culture that prizes learning and development. This book is for L&D professionals. Nonetheless, it is also suited for those studying Human Resource Development HRD at intermediate level. The term ‘Human Resource Development’ (HRD) is more common in academia, and is largely synonymous with L&D (Stewart & Sambrook, 2012) Stewart (1998) defined HRD as ‘the practice of HRD is constituted by the deliberate, purposive and active interventions in the natural learning process. Such interventions can take many forms, most capable of categorising as education or training or development’ (p. 9). In fact, many parts of this book (e.g. Chapters 5 and 7) are appropriate for anyone who is involved in training and development. This may include a variety of individuals within the L&D community, such as line managers, professional trainers, training solutions vendors, instructional designers, external consultants and mentors (Mayo, 2004). The CIPD (2014) goes further as they argue that the role of L&D is broad and plays a significant role in Organizational Development (OD) and Talent Management (TM), as well as in Human Resource Management (HRM) in general. OD, TM, HRM and L&D are symbiotic in enabling the ‘people management function’ to provide organizations with the capabilities that they need.

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The first theme of the book is ‘Directions’. This theme concerns the present and potential future expectations that L&D professionals may face in their practice. Chapter 1 is about ‘Developing professional practice in L&D’. In the first section, I discuss what is ‘professionalism’ and what it means for L&D professionals in terms of their development. In this chapter, I argue that expectations of L&D from senior management are growing. L&D professionals need to be able demonstrate ability to influence decision making by developing new competencies that enable them to provide senior management with new insight, which in turn increases L&D’s strategic credibility. In examining the diverse activities and tasks that L&D professionals currently, and may be expected to undertake in the future, four roles emerge; capacity and capability builders, boundary spanners, consultants and change agents. Capacity building primarily concerns creating space, time, and cultivating the right environment for the workforce to develop, which can be a challenge given how fire-fighting appears to be prevalent in many organizations today. Capability building involves enhancing knowledge, developing skills and competencies of the workforces, whilst boundary spanning involves networking and growing partnerships within and outside the organization. ‘Being a consultant’ is briefly touched upon as it is further discussed in Chapter 5, whilst the role of a change agent involves instigating and managing change. This chapter concludes with a discussion of twelve important knowledge, skill and capability areas that L&D professionals must develop to advance their practice.

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The role of aquaculture in satisfying the global seafood demand is essential. The expansion of the aquaculture sector and the intensification of its activities have enhanced the circulation of infectious agents. Among these, the nervous necrosis virus (NNV) represents the most widespread in the Mediterranean basin. The NNV is responsible for a severe neuropathological condition named viral nervous necrosis (VNN), impacting hugely on fish farms due to the serious disease-associated losses. Therefore, it is fundamental to develop new strategies to limit the impact of VNN in this area, interconnecting several aspects of disease management, diagnosis and prevention. This PhD thesis project, focusing on aquatic animals’ health, deals with these topics. The first two chapters expand the knowledge on VNN epidemiology and distribution, showing the possibility of interspecies transmission, persistent infections and a potential carrier role for invertebrates. The third study expands the horizon of VNN diagnosis, by developing a quick and affordable multiplex RT-PCR able to detect and simultaneously discriminate between NNV variants, reducing considerably the time and costs of genotyping. The fourth study, with the development of a fluorescent in situ hybridization technique and its application to aquatic vertebrates and invertebrates’ tissues, contributes to expand the knowledge on NNV distribution at cellular level, localizing also the replication site of the virus. Finally, the last study dealing with an in vitro evaluation of the NNV susceptibility to a commercial biocide, stress the importance to implement proper disinfectant procedures in fish farms to prevent virus spread and disease outbreaks.

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Twenty-three patients treated with intracerebroventricular (ICV) morphine in this study not only obtained excellent pain relief without rapid increases in dose, but also experienced a reduction in morphine-related side effects. By 24 h after initiation of ICV morphine, the mean trough cerebrospinal fluid (CSF) morphine concentration (approximately 20 mu M) was 50-fold higher than the baseline concentration (approximately 0.4 mu M), and the CSF concentration of morphine-6-glucuronide (M6G) was undetectable (

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Improved drug therapy for schizophrenia may represent the best strategy for reducing the costs of schizophrenia and the recurrent chronic course of the disease. Olanzapine and risperidone are atypical antipsychotic agents developed to meet this need. We report a multicenter, double-blind, parallel, 30-week study designed to compare the efficacy, safety, and associated resource use for olanzapine and risperidone in Australia and New Zealand. The study sample consisted of 65 patients who met DSM-IV criteria for schizophrenia, schizoaffective disorder, or schizophreniform disorder. Olanzapine-treated patients showed a significantly greater reduction in Positive and Negative Syndrome Scale (PANSS) total, Brief Psychiatric Rating Scale (BPRS) total, and PANSS General Psychopathology scores at endpoint compared to the risperidone-treated patients. Response rates through 30 weeks showed a significantly greater proportion of olanzapine-treated patients had achieved a 20% or greater improvement in their PANSS total score compared to risperidone-treated patients. Olanzapine and risperidone were equivalent in their improvement of PANSS positive and negative scores and Clinical Global Impression-Severity of Illness scale (CGI-S) at endpoint. Using generic and disease-specific measures of quality of life, olanzapine-treated patients showed significant within-group improvement in most measures, and significant differences were observed in favor of olanzapine over risperidone in Quality of Life Scale (QLS) Intrapsychic Foundation and Medical Outcomes Study Short Form 36-item instrument (SF-36) Role Functioning Limitations-Emotional subscale scores. Despite the relatively small sample size, our study suggests that olanzapine has a superior risk:benefit profile compared to risperidone. (C) 2002 Elsevier Science B.V. All rights reserved.

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Seasonal climate forecasting offers potential for improving management of crop production risks in the cropping systems of NE Australia. But how is this capability best connected to management practice? Over the past decade, we have pursued participative systems approaches involving simulation-aided discussion with advisers and decision-makers. This has led to the development of discussion support software as a key vehicle for facilitating infusion of forecasting capability into practice. In this paper, we set out the basis of our approach, its implementation and preliminary evaluation. We outline the development of the discussion support software Whopper Cropper, which was designed for, and in close consultation with, public and private advisers. Whopper Cropper consists of a database of simulation output and a graphical user interface to generate analyses of risks associated with crop management options. The charts produced provide conversation pieces for advisers to use with their farmer clients in relation to the significant decisions they face. An example application, detail of the software development process and an initial survey of user needs are presented. We suggest that discussion support software is about moving beyond traditional notions of supply-driven decision support systems. Discussion support software is largely demand-driven and can compliment participatory action research programs by providing cost-effective general delivery of simulation-aided discussions about relevant management actions. The critical role of farm management advisers and dialogue among key players is highlighted. We argue that the discussion support concept, as exemplified by the software tool Whopper Cropper and the group processes surrounding it, provides an effective means to infuse innovations, like seasonal climate forecasting, into farming practice. Crown Copyright (C) 2002 Published by Elsevier Science Ltd. All rights reserved.

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Respiratory therapy has historically been considered the primary role of the physiotherapist in neonatal intensive care in Australia. In 2001 a survey was undertaken of all level three neonatal intensive care units in Australia to determine the role of the physiotherapist and of respiratory therapy in clinical practice. It appears that respiratory therapy is provided infrequently, with the number of infants treated per month ranging from 0 to 10 in 15 of the 20 units who provide respiratory therapy, regardless of therapist availability. The median number of respiratory treatments per month during the week was three, and on weekends it was one. Respiratory therapy was carried out by physiotherapists and nurses in 54.6% of units, by physiotherapists only in 36.4% of units, and by nurses only in the remaining 9% of units surveyed. There was also a diminution of the role of respiratory therapy in the extubation of premature infants. A review of the literature shows that overall the use of respiratory therapy reflects current evidence. The question remains whether it is possible to maintain the competency of staff and justify the cost of training in the current healthcare economic climate. It seems probable that the future role of physiotherapists in neonatal intensive care unit may be in the facilitation of optimal neurological development of surviving very low birth weight infants.

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ABSTRACT This study was conducted to assess mental health knowledge, attitude and practices among health care workers in Belize before and immediately after a competency based training program in mental health. A baseline Knowledge, Attitudes and Practices (KAP) survey was given to health personnel, mainly nurses, working primary and secondary care. The intervention was a 13-week face-to-face training course for health care professionals with the objective of increasing their competency in mental health and reducing stigma. After the training a post intervention KAP survey was conducted among the original respondents. 88 health care workers completed the baseline survey and 61 of those respondents completed the post-intervention questionnaire. The results showed that the level of knowledge of the participants had improved by the training intervention and that in general, the intervention was effective in correcting some misconceptions about mental illness and reducing stigmatizing attitudes among the participants.

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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

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Management of Private Practice in Health Services Hospitals in Northern Ireland: A Handbook