914 resultados para medical outcomes


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The literature supporting the notion that active, student-centered learning is superior to passive, teacher-centered instruction is encyclopedic (Bonwell & Eison, 1991; Bruning, Schraw, & Ronning, 1999; Haile, 1997a, 1997b, 1998; Johnson, Johnson, & Smith, 1999). Previous action research demonstrated that introducing a learning activity in class improved the learning outcomes of students (Mejias, 2010). People acquire knowledge and skills through practice and reflection, not by watching and listening to others telling them how to do something. In this context, this project aims to find more insights about the level of interactivity in the curriculum a class should have and its alignment with assessment so the intended learning outcomes (ILOs) are achieved. In this project, interactivity is implemented in the form of problem- based learning (PBL). I present the argument that a more continuous formative feedback when implemented with the correct amount of PBL stimulates student engagement bringing enormous benefits to student learning. Different levels of practical work (PBL) were implemented together with two different assessment approaches in two subjects. The outcomes were measured using qualitative and quantitative data to evaluate the levels of student engagement and satisfaction in the terms of ILOs.

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In the university education arena, it is becoming apparent that traditional methods of conducting classes are not the most effective ways to achieve desired learning outcomes. The traditional class/method involves the instructor verbalizing information for passive, note-taking students who are assumed to be empty receptacles waiting to be filled with knowledge. This method is limited in its effectiveness, as the flow of information is usually only in one direction. Furthermore, “It has been demonstrated that students in many cases can recite and apply formulas in numerical problems, but the actual meaning and understanding of the concept behind the formula is not acquired (Crouch & Mazur)”. It is apparent that memorization is the main technique present in this approach. A more effective method of teaching involves increasing the students’ level of activity during, and hence their involvement in the learning process. This technique stimulates self- learning and assists in keeping these students’ levels of concentration more uniform. In this work, I am therefore interested in studying the influence of a particular TLA on students’ learning-outcomes. I want to foster high-level understanding and critical thinking skills using active learning (Silberman, 1996) techniques. The TLA in question aims to promote self-study by students and to expose them to a situation where their learning-outcomes can be tested. The motivation behind this activity is based on studies which suggest that some sensory modalities are more effective than others. Using various instruments for data collection and by means of a thorough analysis I present evidence of the effectiveness of this action research project which aims to improve my own teaching practices, with the ultimate goal of enhancing student’s learning.

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This research addresses whether educators should consider measuring if students have learned what was intended, as recommended by education researchers. Students in an Introductory Marketing subject were asked to complete a voluntary survey rating their own progress on the intended learning outcomes for the course. One hundred and one surveys were completed by students in the second-last teaching week of the semester. Student identification numbers were used to link student perceptions with their grade outcomes. Regression analysis was used to ascertain whether student perceptions of their progress on the intended learning outcomes for the course could be used to predict their grades. While the results were significant, student perceptions of their progress on learning outcomes were a poor predictor of grade outcomes. The results of this study suggest that student perceptions may not mirror the reality. These results are somewhat surprising and future research examining the degree of change in the learning outcomes perceived by students is warranted. This will further contribute to decisions surrounding whether educators should measure if students have learned what was intended.

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Background Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Methods/Design The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. “live”). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures. Discussion If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance. Trial registration Trial registration number: ACTRN12611000936921

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Background: Timely access to appropriate cardiac care is critical for optimising outcomes. Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services for Australia's 20,387 population locations. Methods: An expert panel defined a single patient care pathway. Using geographic information systems (GIS) the numeric/alpha index was modelled in two phases. The acute phase index (numeric) ranged from 1 (access to tertiary centre with PCI ≤1 h) to 8 (no ambulance service, >3 h to medical facility, air transport required). The aftercare index was modelled into 5 alphabetic categories; A (Access to general practitioner, pharmacy, cardiac rehabilitation, pathology ≤1 h) to E (no services available within 1 h). Results: Approximately 70% or 13.9 million people lived within a CardiacARIAindex category 1A location. Disparity continues in access to category 1A cardiac services for 5.8 million (30%) of all Australians, 60% of Aboriginal and Torres Strait Islander people and 32% of people over 65 years of age. In a cardiac emergency only 40% of the Indigenous population reside within one hour of category 1 hospital. Approximately 30% (81,491 Indigenous persons) are more than one to three hours from basic cardiac services. Conclusion: Geographically, the majority of Australian's have timely access for survival of a cardiac event. The CardiacARIAindex objectively demonstrates that the healthcare system may not be providing for the needs of 60% of Indigenous people residing outside the 1A geographic radius. Innovative clinical practice maybe required to address these disparities.

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Background Scientific research is an essential component in guiding improvements in health systems. There are no studies examining the Sri Lankan medical research output at international level. The present study evaluated the Sri Lankan research performance in medicine as reflected by the research publications output between years 2000-2009. Methods This study was based on Sri Lankan medical research publication data, retrieved from the SciVerse Scopus® from January 2000 to December 2009. The process of article selection was as follows: Affiliation - 'Sri Lanka' or 'Ceylon', Publication year - 'January 2000 to December 2009' and Subject area - 'Life and Health Sciences'. The articles identified were classified according to disease, medical speciality, institutions, major international collaborators, authors and journals. Results Sri Lanka's cumulative medical publications output between years 2000-2009 was 1,740 articles published in 160 different journals. The average annual publication growth rate was 9.1%. Majority of the articles were published in 'International' (n = 950, 54.6%) journals. Most articles were descriptive studies (n = 611, 35.1%), letters (n-345, 19.8%) and case reports (n = 311, 17.9%). The articles were authored by 148 different Sri Lankan authors from 146 different institutions. The three most prolific local institutions were Universities of; Colombo (n = 547), Kelaniya (n = 246) and Peradeniya (n = 222). Eighty four countries were found to have published collaborative papers with Sri Lankan authors during the last decade. UK was the largest collaborating partner (n = 263, 15.1%). Malaria (n = 75), Diabetes Mellitus (n = 55), Dengue (n = 53), Accidental injuries (n = 42) and Lymphatic filariasis (n = 40) were the major diseases studied. The 1,740 publications were cited 9,708 times, with an average citation of 5.6 per paper. The most cited paper had 203 citations, while there were 597 publications with no citations. The Sri Lankan authors' contribution to the global medical research output during the last decade was only 0.086%. Conclusion The Sri Lankan medical research output during the last decade is only a small fraction of the global research output. There it is a necessity to setup an enabling environment for research, with a proper vision, support, funds and training. In addition, collaborations across the region need to be strengthened to face common regional health challenges. Keywords: Sri Lanka, Medical research, Publication, Analysis

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Safety culture is a concept that has long been accepted in high risk industries such as aviation, nuclear industries and mining, however, considerable research is now also being undertaken within the construction sector. This paper discusses three recent interlocked projects undertaken in the Australian construction industry. The first project examined the development and implementation of a safety competency framework targeted at safety critical positions (SCP's) across first tier construction organisations. Combining qualitative and quantitative methods, the project: developed a matrix of SCP's (n=11) and safety management tasks (SMTs; n=39); mapped the process steps for their acquisition and development; detailed the knowledge, skills and behaviours required for all SMTs; and outlined potential organisational cultural outcomes from a successful implementation of the framework. The second project extended this research to develop behavioural guidelines for leaders to drive safety culture change down to second tier companies and to assist them to customise their own competency framework and implementation guidelines to match their aspirations and resources. The third interlocked project explored the use of safety effectiveness indicators (SEIs) as an industry-relevant assessment tool for reducing risk on construction sites. With direct linkages to safety competencies and SMT's, the SEIs are the next step towards an integrated safety cultural approach to safety and extend the concept of positive performance indicators (PPIs) by providing a valid, reliable, and user friendly measurement platform. Taken together, the results of the interlocked projects suggest that industry engaged collaborative safety culture research has many potential benefits for the construction industry.

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Scientific efforts to understand and reduce the occurrence of road crashes continue to expand, particularly in the areas of vulnerable road user groups. Three groups that are receiving increasing attention within the literature are younger drivers, motorcyclists and older drivers. These three groups are at an elevated risk of being in a crash or seriously injured, and research continues to focus on the origins of this risk as well as the development of appropriate countermeasures to improve driving outcomes for these cohorts. However, it currently remains unclear what factors produce the largest contribution to crash risk or what countermeasures are likely to produce the greatest long term positive effects on road safety. This paper reviews research that has focused on the personal and environmental factors that increase crash risk for these groups as well as considers direction for future research in the respective areas. A major theme to emerge from this review is that while there is a plethora of individual and situational factors that influence the likelihood of crashes, these factors often combine in an additive manner to exacerbate the risk of both injury and fatality. Additionally, there are a number of risk factors that are pertinent for all three road user groups, particularly age and the level of driving experience. As a result, targeted interventions that address these factors are likely to maximise the flow-on benefits to a wider range of road users. Finally, there is a need for further research that aims to bridge the research-to-practice gap, in order to develop appropriate pathways to ensure that evidenced-based research is directly transferred to effective policies that improve safety outcomes.

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Disasters, particularly those triggered by nature are often followed by a swift humanitarian relief response to address the resultant emergencies. These efforts are then transitioned through the medium recovery stage, eventually aimed at providing a long term post-disaster reconstruction solution. Emergency humanitarian relief focuses on responding to the immediate need for restoration of basic services, medical treatment and medical supplies, food and temporary shelter, and is a short term strenuous effort. Reconstruction of permanent houses, on the other hand, is a continuous process that often requires decades of effort to return a community to normality. Whilst emergency relief is generally perceived to be very effective, post-disaster housing reconstruction projects often fail to meet their set objectives. This paper outlines and discusses factors that contribute to the failure of post-disaster housing reconstruction projects and the subsequent immediate and long term negative impacts of failure on project outcomes.

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Evidence from the infrastructure and building sectors suggests issues of drugs and alcohol and its association with safety risk on construction sites. While most Australian jurisdictions have identified this as a critical safety issue, information is limited regarding the prevalence of alcohol and other drugs in the workplace and there is limited evidential guidance on how to effectively and efficiently address such an issue. A nationally consistent collaborative approach across the construction workforce - involving employers and employees; clients, unions; contractors and sub-contractors is required to engender a cultural change in the construction workforce – in a similar manner to the on-going initiative in securing a cultural change to drink-driving in our society where peer intervention and support is encouraged. A study to address these issues has three key objectives. Firstly, using the standard World Health Organisation Alcohol Use Disorders Identification Test (AUDIT), and a wide ranging set of structured interviews, a national qualitative and quantitative assessment of the use of drugs and alcohol is being undertaken. Secondly, the development of an appropriate industry policy with an adoption of an educative and rehabilitative approach is planned in consultation with employers and employees across the infrastructure and building sectors, with an aim of national adoption. Finally, an industry-specific cultural change management program will be developed through a nationally collaborative approach to reducing the risk of impaired performance on construction sites and increasing workers’ commitment to drugs and alcohol safety. The study outcomes stand to benefit not only occupational health and safety, through a greater understanding of the safety impacts of alcohol and other drugs at work, but also alcohol and drug use as a wider community health issue. This presentation will provide an analysis and discussion of the data collected in objective 1 and how the final results will inform the subsequent phases of the study.

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Ultrasound is used extensively in the field of medical imaging. In this paper, the basic principles of ultrasound are explained using ‘everyday’ physics. Topics include the generation of ultrasound, basic interactions with material and the measurement of blood flow using the Doppler effect.

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