992 resultados para 191-1179
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Background Patient-relevant outcome measures are essential for high-quality clinical research, and quality-of-life (QoL) tools are the current standard. Currently, there is no validated children's acute cough-specific QoL questionnaire. Objective The objective of this study was to develop and validate the Parent-proxy Children's Acute Cough-specific QoL Questionnaire (PAC-QoL). Methods Using focus groups, a 48-item PAC-QoL questionnaire was developed and later reduced to 16 items by using the clinical impact method. Parents of children with a current acute cough (<2 weeks) at enrollment completed 2 validated cough score measures, the preliminary 48-item PAC-QoL, and 3 other questionnaires (the State Trait Anxiety Inventory [STAI], the Short-Form 8-item 24-hour recall Health Survey [SF-8], and the Depression, Anxiety, and Stress 21-item Scale [DASS21]). All measures were repeated on days 3 and 14. Results The median age of the 155 children enrolled was 2.3 years (interquartile range, 1.3-4.6). Median cough duration at enrollment was 3 days (interquartile range, 2-5). The reduced 16-item scale had high internal consistency (Cronbach α = 0.95). Evidence for repeatability and criterion validity was shown by significant correlations between the domains and total PAC-QoL scores and the SF-8 (r = −0.36 and −0.51), STAI (r = −0.27 and −0.39), and DASS21 (r = −0.32 and −0.41) scales on days 0 and 3, respectively. The final PAC-QoL questionnaire was sensitive to change over time, with changes significantly relating to changes in cough score measures (P < .001). Conclusion The 16-item PAC-QoL is a reliable and valid outcome measure that assesses QoL related to childhood acute cough at a given time point and reflects changes in acute cough-specific QoL over time.
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Leptospirosis outbreaks have been associated with many common water events including water consumption, water sports, environmental disasters and occupational exposure. The ability of leptospires to survive in moist environments makes them a high risk agent for infection following contact with any contaminated water source. Water treatment processes reduce the likelihood of leptospirosis or other microbial agents causing infection provided they do not malfunction and the distribution networks are maintained. Notably, there are many differences in water treatment systems around the world, particularly between developing and developed countries. Detection of leptospirosis in water samples is uncommonly performed by molecular methods.
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This study investigated occupational therapy and physiotherapy students' level of confidence and knowledge of strategies for communicating with people with aphasia (PWA) before and after a communication partner-training (CPT) program. Twenty-eight physiotherapy and occupational therapy students participated in a pre–post CPT program. Students completed a customized mixed-methods questionnaire before and after the intervention. The CPT program involved a lecture about effective communication strategies followed by a conversation with PWA to practice strategies learnt. Before CPT, students were not confident with the possibility of communicating with PWA. Students demonstrated rudimentary knowledge of supported conversation, identifying a maximum of five strategies for communicating effectively with PWA. Following intervention, students demonstrated increased confidence. Students' knowledge of effective communication strategies improved, with students identifying a maximum of 16 suitable strategies post-training. The results suggest that occupational therapy and physiotherapy students have potential to benefit from practical training in supported communication with PWA, which may assist them during placements in clinical settings with neurological patients or subsequent employment.
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Confessions of a Non-Emigrant is innovative in combining two areas of investigation in creative writing and literature. I investigate both the idea of life writing as therapeutic for the author, and the (reflexive and enabling) blurred boundary between life writing and fiction. I set up a dynamic where the narrative of the story (fictionalised memoir) proposes the therapeutic advantage of utilising one’s life-story in fiction (increased sense of coherent identity and agency) and a perspective (through the device of multiple selves), on the constructedness and instability of identity. I mobilise and explore Pennebaker’s argument that making a narrative of one’s life enhances the writer’s sense of a connection with community and place (represented by Brisbane).
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Videogame control interfaces continue to evolve beyond their traditional roots, with devices encouraging more natural forms of interaction growing in number and pervasiveness. Yet little is known about their true potential for intuitive use. This paper proposes methods to leverage existing intuitive interaction theory for games research, specifically by examining different types of naturally mapped control interfaces for videogames using new measures for previous player experience. Three commercial control devices for a racing game were categorised using an existing typology, according to how the interface maps physical control inputs with the virtual gameplay actions. The devices were then used in a within-groups (n=64) experimental design aimed at measuring differences in intuitive use outcomes. Results from mixed design ANOVA are discussed, along with implications for the field.
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Embedding metallic nanoparticles in organic solar cells can enhance the photoabsorption through light trapping processes. This paper investigates how gold islands obtained by annealing 1–5 nm thick Au layers affect the photoabsorption. Using finite-difference time-domain simulations, the cell efficiency for various island geometries and thicknesses are analyzed and the properties of the islands for maximal photocurrent are discussed. It is shown that a careful choice of size and concentration of gold islands could contribute to enhance the power conversion efficiencies when compared to standard organic solar cell devices. The conclusions are then compared to experimental data for thermally annealed gold islands in bulk heterojunction solar cells. The results of this paper will contribute to the optimization of plasmonic organic solar cell systems and will pave the way for the development of highly efficient organic solar cell devices.
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This chapter discussed the various modes of operation of the Doubly Fed Induction Generator (DFIG) based wind farm system. The impact of a auxiliary damping controller on the different modes of operation for the DFIG based wind generation system is investigated. The co-ordinated tuning of the damping controller to enhance the damping of the oscillatory modes using Bacteria Foraging (BF) technique is presented. The results from eigenvalue analysis are presented to elucidate the effectiveness of the tuned damping controller in the DFIG system under Super/Sub-synchronous speed of operation. The robustness issue of the damping controller is also investigated.
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Children are particularly susceptible to air pollution and schools are examples of urban microenvironments that can account for a large portion of children’s exposure to airborne particles. Thus this paper aimed to determine the sources of primary airborne particles that children are exposed to at school by analyzing selected organic molecular markers at 11 urban schools in Brisbane, Australia. Positive matrix factorization analysis identified four sources at the schools: vehicle emissions, biomass burning, meat cooking and plant wax emissions accounting for 45%, 29%, 16% and 7%, of the organic carbon respectively. Biomass burning peaked in winter due to prescribed burning of bushland around Brisbane. Overall, the results indicated that both local (traffic) and regional (biomass burning) sources of primary organic aerosols influence the levels of ambient particles that children are exposed at the schools. These results have implications for potential control strategies for mitigating exposure at schools.
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In recent times a widespread consensus on the reality and gravity of anthropogenic climate change has emerged. Perceived inadequacies in the Australian government’s legal and policy responses to climate change issues have resulted in environmental activists increasingly turning to the courts as a strategy to promote greater action to address adverse climate impacts. The efficacy of this strategy for achieving climate goals is limited by the time and expense of litigating, the restrictions inherent in environmental law administrative challenges, and the possibility that judicial decisions may be overruled by the legislature. To date, climate change litigation in Australia has met with varied success, yet its significance extends beyond the court room as an important mechanism for raising public, political and commercial awareness about climate change issues. Ultimately, however, the types of far-reaching changes needed to mitigate and manage adverse climate impacts require strong regulatory backing. The most effective approach to addressing the complex challenges posed by climate change is a coordinated suite of regulatory measures spearheaded by the Federal Government.
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This study examines hospital care system performance in Iran. We first briefly review hospital care delivery system in Iran. Then, the hospital care system in Iran has been investigated from financial, utilization, and quality perspectives. In particular, we examined the extent to which health care system in Iran protects people from the financial consequence of health care expenses and whether inpatient care distributed according to need. We also empirically analyzed the quality of hospital care in Iran using patient satisfaction information collected in a national health service survey. The Iranian health care system consists of unequal access to hospital care; mismatch between the distribution of services and inpatients' need; and high probability of financial catastrophe due to out-of-pocket payments for inpatient services. Our analysis indicates that the quality of hospital care among Iranian provinces favors patients residing in provinces with high numbers of hospital beds per capita such as Esfahan and Yazd. Patients living in provinces with low levels of accessibility to hospital care (e.g. Gilan, Kermanshah, Hamadan, Chahar Mahall and Bakhtiari, Khuzestan, and Sistan and Baluchestan) receive lower-quality services. These findings suggest that policymakers in Iran should work on several fronts including utilization, financing, and service quality to improve hospital care.
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Aboriginal protocol usually links the right to tell a story with a declaration of involvement or connection to the story. I am Aboriginal . . . I am a woman, daughter, sister, aunty and wife. I am also a mother to three beautiful children aged 6, 4 and 2 years. To my children at this point in their lives, I am their provider, nurturer, teacher, cook, taxi driver, mediator, stylist, Elder, slave, and expert on all there is to know in the world. Being the centre of the universe to three impressionable young minds is a role that I cherish deeply, and I take the responsibilities of it very seriously. I love the job of parenting. As any parent would agree, it is the most challenging and difficult job of all, but the opportunity to bring a life into the world and shape and mould a little person into a big person brings rewards that no career can.
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The United Nations Convention on the Rights of the Child provides a significant platform to include children’s views on issues that affect their lives, yet, in many contexts, particularly in educational practice, children’s perspectives continue to be irregularly sought and are rarely acted upon. By providing children’s perspectives on what they would like adults to know, this article explores a unique view of childhood and the interactions with family, community, educational experiences and well-being. The children’s insights about their worlds that they feel adults are missing potentiate the development and incorporation of voice-inclusive practice. While the sense that each child makes of their Lebenswelt – the ‘ingredients’ – is idiosyncratic and will be influenced by many factors, including peers, teachers, parents, other adults and the media, it is the nature of this personal understanding that is poorly understood, and consequently ignored by adults. By exploring the commentary of more than 1000 children across five countries – Australia, England, New Zealand, Italy and Sweden – this research reveals an overwhelming collection of what the authors describe as ‘comments that rhyme’ in terms of the identification of expressed sentiment and thematic representations of their perspectives.
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Online interactions are becoming commonplace for a multitude of educational purposes. Each context presents a unique and dynamic mix of variables that combine to shape the practice and the identities of those involved. In this article, sociocultural theories of learning and sociocultural theories of technology are explored as a way to view and to map the complex interactions that can occur. The case of synchronous online moderation meetings are used as an example of the combination of variables that can impact on the development of shared understandings of a practice. Online moderation can involve teachers from geographically diverse areas discussing and negotiating their judgement decisions. These discussions represent an intersection of a national curriculum, standards-referenced assessment, moderation protocols, site-specific practices and understandings, and individual teachers’ knowledges and histories. It is suggested that the proposed theoretical combination addresses some of the limitations of each of the theories when investigating such a dynamic context. As higher education moves into increasing use of online modes of communication and a higher level of accountability the relevance of this discussion to higher education is evident.
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Background: The inconsistent definition of non-therapeutic medication omissions, under-reporting, and a poor understanding of their associated factors hamper efforts to improve medication administration practices. Aim: To examine the incidence of non-therapeutic medication omissions among acutely ill medical and surgical adult patients; and to identify the patient-, drug- and system-related predictors of these omissions. Method: A medication chart audit of 288 acutely ill adult medical and surgical patients admitted to 4 target wards (2 surgical and 2 medical) at an Australian hospital. Patients admitted to these wards from December 2008 to November 2009, with at least one regularly prescribed medication, were eligible. The sample was stratified according to gender, season and ward. A medication chart audit identified medication omissions, and data were collected on gender, age, length of stay, comorbidities, medication history and clinical pharmacy review. Results: Of the 288 medication charts audited, 220 (75%) had one or more medication omissions. Of the 15 020 medication administration episodes, there were 1687 omissions, resulting in an omission rate per medication administration episode of 11%. Analgesics and aperients were the most frequently omitted medications, with failure to sign the medication record and patient refusal, the main reasons for omission. Female gender (p < 0.001) and the number of medication administration episodes (p < 0.001) were statistically significant predictors of non-therapeutic medication omissions. Conclusion: The high incidence of medication omissions suggests there is need for an agreed definition of medication omission and its inclusion as a reportable incident. Increasing medication reconciliation via implementation of the Medication Management Plan may also reduce the opportunity for error. J Pharm Pract Res 2011; 41: 188-91.