752 resultados para Advanced practice nurses


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Abstract: Purpose – Several major infrastructure projects in the Hong Kong Special Administrative Region (HKSAR) have been delivered by the build-operate-transfer (BOT) model since the 1960s. Although the benefits of using BOT have been reported abundantly in the contemporary literature, some BOT projects were less successful than the others. This paper aims to find out why this is so and to explore whether BOT is the best financing model to procure major infrastructure projects. Design/methodology/approach – The benefits of BOT will first be reviewed. Some completed BOT projects in Hong Kong will be examined to ascertain how far the perceived benefits of BOT have been materialized in these projects. A highly profiled project, the Hong Kong-Zhuhai-Macau Bridge, which has long been promoted by the governments of the People's Republic of China, Macau Special Administrative Region and the HKSAR that BOT is the preferred financing model, but suddenly reverted back to the traditional financing model to be funded primarily by the three governments with public money instead, will be studied to explore the true value of the BOT financial model. Findings – Six main reasons for this radical change are derived from the analysis: shorter take-off time for the project; difference in legal systems causing difficulties in drafting BOT agreements; more government control on tolls; private sector uninterested due to unattractive economic package; avoid allegation of collusion between business and the governments; and a comfortable financial reserve possessed by the host governments. Originality/value – The findings from this paper are believed to provide a better understanding to the real benefits of BOT and the governments' main decision criteria in delivering major infrastructure projects.

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In this chapter I introduce an ecological-philosophical approach to artmaking that has guided my work over the past 16 years. I call this ‘Ecosophical praxis’. To illustrate how this infuses and directs my research methodologies, I draw upon a case study called Knowmore (House of Commons), an emerging interactive installation due for first showings in late 2008. This allows me to tease out the complex interrelationships between research and practice within my work, and describe how they comment upon and model these eco-cultural theories. I conclude with my intentions and hopes for the continued emergence of a contemporary eco-political modality of new media praxis that self-reflexively questions how we might re-focus future practices upon ‘sustaining the sustainable’.

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This article examines the continued relevance of the 16-19 business education curriculum in the UK, stimulated by doubts expressed by Thomas (1996), over its continued relevance. We express a concern that business education needs, but is struggling, to respond to significant societal shifts in consumption and production strategies that do not sit easily within traditional theories of business practice currently underpinning 16-19 business education. We examine firstly, the extent to which a formal body of knowledge couched in a modernist discourse of facts and objectivity can cope with the changing and fluid developments in much current business practice that is rooted in the cultural and symbolic. Secondly, the extent to which both academic and vocational competences provide the means for students to develop a framework of critical understanding that can respond effectively to rapidly changing business environments.Findings are based on research conducted jointly by the University of Manchester and the Manchester Institute for Popular Culture at Manchester Metropolitan University. The growth of dynamism of the cultural industries sector - largely micro-businesses and small and medium sized enterprises (SMEs) -encapsulates forms of business knowledge, business language and business practice which may not immediately fit with the models provided within business education. Results suggest increasingly reflexive forms of consumption being met by similarly reflexive and flexible modes of production.Our evidence suggests that whilst modernist business knowledge is often the foundation for many 16-19 business education courses, these programmes of study/training do not usually reflect the activities of SME and micro-business practitioners in the cultural industries. Given the importance of cultural industries in terms of the production strategies required to meet increasingly reflexive markets, it is suggested that there may be a need to incorporate a postmodern approach to the current content and pedagogy; one that is contextual, cultural and discursive.

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Using the generative processes developed over two stages of creative development and the performance of The Physics Project at the Loft at the Creative Industries Precinct at the Queensland University of Technology (QUT) from 5th – 8th April 2006 as a case study, this exegesis considers how the principles of contemporary physics can be reframed as aesthetic principles in the creation of contemporary performance. The Physics Project is an original performance work that melds live performance, video and web-casting and overlaps an exploration of personal identity with the physics of space, time, light and complementarity. It considers the acts of translation between the language of physics and the language of contemporary performance that occur via process and form. This exegesis also examines the devices in contemporary performance making and contemporary performance that extend the reach of the performance, including the integration of the live and the mediated and the use of metanarratives.

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Recent advances in the understanding of the genetic, neurochemical, behavioral and cultural underpinnings of addiction have led to rapid advances in the understanding of addiction as a disease. In fact, advances in basic science and the development of new pharmacological and behavioral therapies associated with them are appearing faster than can be assimilated not only by clinical researchers but practitioners and policy makers as well. Translation of science-based addictions knowledge into improved prevention, assessment and treatment, and communication of these changes to researchers and practitioners are significant challenges to the field. The general aim of this book is to summarize current and potential linkages between advances in addiction science and innovations in clinical practice. Whilst this book is primarily focused on translation, it also encompasses some scientific advances that are relevant to dissemination, and the book is itself a tool for disseminating innovative thinking. The goal is to generate interest in application opportunities from both recent research and theoretical advances.

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Youth population is increasing explosively particularly in developing countries as a result of rapid urbanization. This increase is bringing large number of social and economic problems. For instance the impacts of job and training availability, and the physical, social and cultural quality of urban environment on young people are enormous, and affect their health, lifestyles, and well-being (Gleeson and Sipe 2006). Besides this, globalization and technological developments are affecting youth in urban areas in all parts of the world, both positively and negatively (Robertson 1995). The rapidly advancing information and communications technologies (ICTs) helps in addressing social and economic problems caused by the rapid growth of urban youth populations in developing countries. ICTs offer opportunities to young people for learning, skill development and employment. But there are downsides: young people in many developing countries lack of having broad access to these new technologies, they are vulnerable to global market changes, and ICTs link them into global cultures which promote consumer goods, potentially eroding local cultures and community values (Manacorda and Petrongolo 1999). However we believe that the positives outweigh such negatives. At the beginning of the twenty-first century, the world’s young population number more than they ever have. There are over a billion young people between the ages of 15 and 24, which 85 per cent of them live in developing countries and mainly in urban environments. Many of these young people are in the process of making, or have already made, the transition from school to work. During the last two decades all around the world, these young people, as new workers, have faced a number of challenges associated with globalization and technological advances on labour markets (United Nations 2004). The continuous decrease in the manufacturing employment is made many of the young people facing three options: getting jobs in the informal economy with insecurity and poor wages and working conditions, or getting jobs in the low-tier service industries, or developing their vocational skills to benefit from new opportunities in the professional and advanced technical/knowledge sectors. Moreover in developing countries a large portion of young people are not even lucky enough to choose among any of these options, and consequently facing long-term unemployment, which makes them highly vulnerable. The United Nations’ World Youth Employment report (2004) indicates that in almost all countries, females tend to be far more vulnerable than males in terms of long-term unemployment, and young people who have advanced qualifications are far less likely to experience long-term unemployment than others. In the limited opportunities of the formal labour market, those with limited vocational skills resort to forced entrepreneurship and selfemployment in the informal economy, often working for low pay under hazardous conditions, with only few prospects for the future (United Nations 2005a). The International Labour Organization’s research (2004) revealed that the labour force participation rates for young people decreased by almost four per cent (which is equivalent of 88 million young people) between 1993 and 2003. This is largely as a result of the increased number of young people attending school, high overall unemployment rates, and the fact that some young people gave up any hope of finding work and dropped out of the labour market. At the regional level, youth unemployment was highest in Middle East and North Africa (MENA) (25.6%) and sub-Saharan Africa (21%) and lowest in East Asia (7%) and the industrialized economies(13.4%) (International Labour Organization 2004). The youth in economically disadvantaged regions (e.g. the MENA region) face many challenges in education and training that delivers them the right set of skills and knowledge demanded by the labour market. As a consequence, the transition from school to work is mostly unsuccessful and young population end up either unemployed or underemployed in the informal sectors (United Nations 2005b). Unemployment and lack of economic prospects of the urban youth are pushing many of them into criminal acts, excessive alcohol use, substance addiction, and also in many cases resulting in processes of social or political violence (Fernandez-Maldonado 2004; United Nations 2005a). Long-term unemployment leads young people in a process of marginalisation and social exclusion (United Nations 2004). The sustained high rates of long-term youth unemployment have a number of negative effects on societies. First, it results in countries failing to take advantage of the human resources to increase their productive potential, at a time of transition to a globalized world that inexorably demands such leaps in productive capacity. Second, it reinforces the intergenerational transmission of poverty. Third, owing to the discrepancy between more education and exposure to the mass media and fewer employment opportunities, it may encourage the spread of disruptive behaviours, recourse to illegal alternatives for generating income and the loss of basic societal values, all of which erode public safety and social capital. Fourth, it may trigger violent and intractable political conflicts. And lastly, it may exacerbate intergenerational conflicts when young people perceive a lack of opportunity and meritocracy in a system that favours adults who have less formal education and training but more wealth, power and job stability (Hopenhayn 2002). To assist in addressing youth’s skill training and employment problems this paper scrutinises useful international practices, policies, initiatives and programs targeting youth skill training, particularly in ICTs. The MENA national governments and local authorities could consider implementing similar initiative and strategies to address some of the youth employment issues. The broader aim of this paper is to investigate the successful practice and strategies for the information and communication related income generation opportunities for young people to: promote youth entrepreneurship; promote public-private partnerships; target vulnerable groups of young people; narrow digital divide; and put young people in charge. The rest of this paper is organised in five parts. First, the paper provides an overview of the literature on the knowledge economy, skill, education and training issues. Secondly, it reviews the role of ICTs for vocational skill development and employability. Thirdly, it discusses the issues surrounding the development of the digital divide. Fourthly, the paper underlines types and the importance of developing ICT initiatives targeting young people, and reviews some of the successful policy implementations on ICT-based initiatives from both developed and developing countries that offer opportunities to young people for learning, skill development and employment. Then the paper concludes by providing useful generalised recommendations for the MENA region countries and cities in: advocating possible opportunities for ICT generated employment for young people; and discussing how ICT policies could be modified and adopted to meet young people’s needs.

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Our students come from diverse backgrounds. They need flexibility in their learning. First year students tend to worry when they miss lectures or part of lectures. Having the lecture as an on line resource allows students to miss a lecture without stressing about it and to be more relaxed in the lecture, knowing that anything they may miss will be available later. The resource: The Windows based program from Blueberry Software (not Blackberry!) - BB Flashback - allows the simultaneous recording of the computer screen together with the audio, as well as Webcam recording. Editing capabilities include adding pause buttons, graphics and text to the file before exporting it in a flash file. Any diagrams drawn on the board or shown via visualiser can be photographed and easily incorporated. The audio from the file can be extracted if required to be posted as podcast. Exporting modes other than Flash are also available, allowing vodcasting if you wish. What you will need: - the recording software: it can be installed on the lecture hall computer just prior to lecture if needed - a computer: either the ones in lecture halls, especially if fitted with audio recording, or a laptop (I have used audio recording via Bluetooth for mobility). Feedback from students has been positive and will be presented on the poster.

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Protein-energy wasting (PEW) is commonly seen in patients with chronic kidney disease (CKD). The condition is characterised by chronic, systemic low-grade inflammation which affects nutritional status by a variety of mechanisms including reducing appetite and food intake and increasing muscle catabolism. PEW is linked with co-morbidities such as cardiovascular disease, and is associated with lower quality of life, increased hospitalisations and a 6-fold increase in risk of death1. Significant gender differences have been found in the severity and effects of several markers of PEW. There have been limited studies testing the ability of anti-inflammatory agents or nutritional interventions to reduce the effects of PEW in dialysis patients. This thesis makes a significant contribution to the understanding of PEW in dialysis patients. It advances understanding of measurement techniques for two of the key components, appetite and inflammation, and explores the effect of fish oil, an anti-inflammatory agent, on markers of PEW in dialysis patients. The first part of the thesis consists of two methodological studies conducted using baseline data. The first study aims to validate retrospective ratings of hunger, desire to eat and fullness on visual analog scales (VAS) (paper and pen and electronic) as a new method of measuring appetite in dialysis patients. The second methodological study aims to assess the ability of a variety of methods available in routine practice to detect the presence of inflammation. The second part of the thesis aims to explore the effect of 12 weeks supplementation with 2g per day of Eicosapentaenoic Acid (EPA), a longchain fatty acid found in fish oil, on markers of PEW. A combination of biomarkers and psychomarkers of appetite and inflammation are the main outcomes being explored, with nutritional status, dietary intake and quality of life included as secondary outcomes. A lead in phase of 3 months prior to baseline was used so that each person acts as their own historical control. The study also examines whether there are gender differences in response to the treatment. Being an exploratory study, an important part of the work is to test the feasibility of the intervention, thus the level of adherence and factors associated with adherence are also presented. The studies were conducted at the hemodialysis unit of the Wesley Hospital. Participants met the following criteria: adult, stage 5 CKD on hemodialysis for at least 3 months, not expected to receive a transplant or switch to another dialysis modality during the study, absence of intellectual impairment or mental illness impairing ability to follow instructions or complete the intervention. A range of intermediate, clinical and patient-centred outcome measures were collected at baseline and 12 weeks. Inflammation was measured using five biomarkers: c-reactive protein (CRP), interleukin-6 (IL6), intercellular adhesion molecule (sICAM-1), vascular cell adhesion molecule (sVCAM-1) and white cell count (WCC). Subjective appetite was measured using the first question from the Appetite and Dietary Assessment (ADAT) tool and VAS for measurements of hunger, desire to eat and fullness. A novel feature of the study was the assessment of the appetite peptides leptin, ghrelin and peptide YY as biomarkers of appetite. Nutritional status/inflammation was assessed using the Malnutrition-Inflammation Score (MIS) and the Patient-Generated Subjective Global Assessment (PG-SGA). Dietary intake was measured using 3-day records. Quality of life was measured using the Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SF™ v1.3 © RAND University), which combines the Short-Form 36 (SF36) with a kidney-disease specific module2. A smaller range of these variables was available for analysis during the control phase (CRP, ADAT, dietary intake and nutritional status). Statistical analysis was carried out using SPSS version 14 (SPSS Inc, Chicago IL, USA). Analysis of the first part of the thesis involved descriptive and bivariate statistics, as well as Bland-Altman plots to assess agreement between methods, and sensitivity analysis/ROC curves to test the ability of methods to predict the presence of inflammation. The unadjusted (paired ttests) and adjusted (linear mixed model) change over time is presented for the main outcome variables of inflammation and appetite. Results are shown for the whole group followed by analyses according to gender and adherence to treatment. Due to the exploratory nature of the study, trends and clinical significance were considered as important as statistical significance. Twenty-eight patients (mean age 61±17y, 50% male, dialysis vintage 19.5 (4- 101) months) underwent baseline assessment. Seven out of 28 patients (25%) reported sub-optimal appetite (self-reported as fair, poor or very poor) despite all being well nourished (100% SGA A). Using the VAS, ratings of hunger, but not desire to eat or fullness, were significantly (p<0.05) associated with a range of relevant clinical variables including age (r=-0.376), comorbidities (r=-0.380) nutritional status (PG-SGA score, r=-0.451), inflammatory markers (CRP r=-0.383; sICAM-1 r=-0.387) and seven domains of quality of life. Patients expressed a preference for the paper and pen method of administering VAS. None of the tools (appetite, MIS, PG-SGA, albumin or iron) showed an acceptable ability to detect patients who are inflamed. It is recommended that CRP should be tested more frequently as a matter of course rather than seeking alternative methods of measuring inflammation. 27 patients completed the 12 week intervention. 20 patients were considered adherent based on changes in % plasma EPA, which rose from 1.3 (0.94)% to 5.2 (1.1)%, p<0.001, in this group. The major barriers to adherence were forgetting to take the tablets as well as their size. At 12 weeks, inflammatory markers remained steady apart from the white cell count which decreased (7.6(2.5) vs 7.0(2.2) x109/L, p=0.058) and sVCAM-1 which increased (1685(654) vs 2249(925) ng/mL, p=0.001). Subjective appetite using VAS increased (51mm to 57mm, +12%) and there was a trend towards reduction in peptide YY (660(31) vs 600(30) pg/mL, p=0.078). There were some gender differences apparent, with the following adjusted change between baseline and week 12: CRP (males -3% vs females +17%, p=0.19), IL6 (males +17% vs females +48%, p=0.77), sICAM-1 (males -5% vs females +11%, p=0.07), sVCAM-1 (males +54% vs females +19%, p=0.08) and hunger ratings (males 20% vs females -5%, p=0.18). On balance, males experienced a maintainence or reduction in three inflammatory markers and an improvement in hunger ratings, and therefore appeared to have responded better to the intervention. Compared to those who didn’t adhere, adherent patients maintained weight (mean(SE) change: +0.5(1.6) vs - 0.8(1.2) kg, p=0.052) and fat-free mass (-0.1 (1.6) vs -1.8 (1.8) kg, p=0.045). There was no difference in change between the intervention and control phase for CRP, appetite, nutritional status or dietary intake. The thesis makes a significant contribution to the evidence base for understanding of PEW in dialysis patients. It has advanced knowledge of methods of assessing inflammation and appetite. Retrospective ratings of hunger on a VAS appear to be a valid method of assessing appetite although samples which include patients with very poor appetite are required to confirm this. Supplementation with fish oil appeared to improve subjective appetite and dampen the inflammatory response. The effectiveness of the intervention is influenced by gender and adherence. Males appear to be more responsive to the primary outcome variables than females, and the quality of response is improved with better adherence. These results provide evidence to support future interventions aimed at reducing the effects of PEW in dialysis patients.

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This article explores the opportunities and challenges surrounding a viable cross-disciplinary engagement between the Humanities disciplines and the Creative Practice disciplines within the innovative context of the Creative Industries Faculty at the Queensland University of Technology. This will involve a charting of the intersection of the emerging field of creative practice-led research with various disciplines in the Humanities such as cultural studies. The potential for a reciprocal, transformative process in these creative fields will be addressed. Several examples of postgraduate students’ research will be foregrounded as case studies of the issues involved in fostering a genuine cultural critique both within and through creative practice. Some observers may argue that the research higher degree creative practitioner in effect looks outward from the symbolic material forms being created, in search of an interpretative paradigm, thereby trawling the Humanities for a theory. Several current debates within the postgraduate research arena regarding the balance between the theoretical exegesis and the creative work (e.g. performance, drama, dance, visual art, creative writing, film and screen production, music, interactive media etc) will also be critically examined.

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The supervision of research higher degree (RHD) candidates in creative practice-led programs poses challenges for both candidates and supervisors. Changes in international postgraduate training agendas have complicated this ever-shifting terrain. This paper investigates the honours research training year. This fourth year is made up of a project and coursework and is a traditional entry point for doctoral study. At Creative Industries, honours acts as a precursor and model for supervisory practice in postgraduate creative arts in an interdisciplinary faculty. The findings indicate that best practice may involve ‘bending and stretching’ existing pedagogical approaches for an increasingly interdisciplinary and mobile research environment. This discussion considers the supervision of candidates enrolled in Queensland University of Technology Faculty of Creative Industries honours courses that encompass a range of disciplines including creative writing, fashion, animation and performance studies. We present results of an analysis of the work of honours students who are creative practitioners (many of whom will, or have, moved into the RHD environment). This examination was undertaken in order to develop an understanding of the dynamics of creative practice at this level, particularly in light of the growing emphasis on early research training in Australian universities. Specific pedagogical strategies mooted include establishing a common research vocabulary, an increasing focus on research design, and a linking of theory and practice.

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The aim of this exploratory study was to gain an insight into Asian and Western public relations practices by investigating them through job advertisements and thus reflecting on what organisations expect from the public relations professionals. Grunig's (1984) four models of public relations and the concept of relationships management were used as the foundation for this study. Australia was used to represent the Western region and India was used to represent the Asian region. Sample sets of public relations recruitment advertisements from both countries were examined against Grunig's one-way communication, two-way communication and relationship management attributes.