961 resultados para Categories of impact


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This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand District Health Board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.

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The study of risk for sexual recidivism has undergone substantial development in recent years. The foundation for advances in this area has been the use of actuarial measures to identify subgroups of offenders with different observed rates of sexual re-offending over time. An unresolved issue within this research area has been the moderating function of age in the assessment of risk. The current study examined sexual re-offending as a function of age and actuarial risk in a large sample of sexual offenders released from prison between 1990 and 2004. There was an overall decrease in the rate of sexual re-offending over the age of 50. However, a small group of offenders from the higher actuarial risk categories of the older age groups continued to re-offend at higher rates than their lower-risk peers.

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Background--Diabetes mellitus increases the risk of cardiovascular disease (CVD) and all-cause mortality. The relationship between milder elevations of blood glucose and mortality is less clear. This study investigated whether impaired fasting glucose and impaired glucose tolerance, as well as diabetes mellitus, increase the risk of all-cause and CVD mortality.

Methods and Results
--In 1999 to 2000, glucose tolerance status was determined in 10 428 participants of the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). After a median follow-up of 5.2 years, 298 deaths occurred (88 CVD deaths). Compared with those with normal glucose tolerance, the adjusted all-cause mortality hazard ratios (HRs) and 95% confidence intervals (CIs) for known diabetes mellitus and newly diagnosed diabetes mellitus were 2.3 (1.6 to 3.2) and 1.3 (0.9 to 2.0), respectively. The risk of death was also increased in those with impaired fasting glucose (HR 1.6, 95% CI 1.0 to 2.4) and impaired glucose tolerance (HR 1.5, 95% CI 1.1 to 2.0). Sixty-five percent of all those who died of CVD had known diabetes mellitus, newly diagnosed diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance at baseline. Known diabetes mellitus (HR 2.6, 95% CI 1.4 to 4.7) and impaired fasting glucose (HR 2.5, 95% CI 1.2 to 5.1) were independent predictors for CVD mortality after adjustment for age, sex, and other traditional CVD risk factors, but impaired glucose tolerance was not (HR 1.2, 95% CI 0.7 to 2.2).

Conclusions--This study emphasizes the strong association between abnormal glucose metabolism and mortality, and it suggests that this condition contributes to a large number of CVD deaths in the general population. CVD prevention may be warranted in people with all categories of abnormal glucose metabolism.

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Objective: To examine gender differences in the characteristics and prevalence of various categories of glucose tolerance in a population study in Mauritius.

Research design and methods: In 1998, a community-based cross-sectional survey was conducted in Mauritius. Categories of glucose metabolism were determined in 5388 adults, with an oral glucose tolerance test given to those who did not have previously diagnosed diabetes (n = 4036). Other cardiovascular risk factors were assessed among those without known diabetes.

Results
: For men and women the prevalence of diabetes (22.0 vs. 21.8%, respectively) and the prevalence of coexisting impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (3.2 vs. 2.9%) were similar. However, men were twice as likely as women to have isolated IFG [5.1% (4.2–6.0) vs. 2.9% (2.3–3.5)], despite being younger, thinner and with lower plasma insulin but higher lipids. Conversely, the prevalence of isolated IGT was lower in men [9.0% (7.9–10.2) vs. 13.9% (12.6–15.1)]. Among non-diabetic individuals, fasting glucose was higher in men than women, whereas 2-h glucose was higher in women. In people without diabetes, women had significantly higher body mass index, beta cell function (HOMA-B), fasting and 2-h insulin than men and significantly lower waist-hip ratios, waist circumference, insulin sensitivity (HOMA-S) and triglycerides.

Conclusion: In Mauritius, the distribution of impaired glucose metabolism differs by sex. The observation that IFG is more prevalent in men and IGT more prevalent in women raises important questions about their underlying aetiology and the ability of the current glucose thresholds to equally identify men and women at high-risk of developing diabetes. IFG should be seen as a complimentary category of abnormal glucose tolerance, rather than a replacement for IGT.

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The Mineral and Petroleum Resources Development Act 28 of 2002 has created new categories of rights to "minerals" that may be granted to applicants by the Minister of Minerals and Energy. In this article the nature of these rights will be examined. The legislature has labelled prospecting rights and mining rights to minerals as limited real rights in the MPRD Act. The remaining rights to minerals are not labelled. Provision is made for registration or recording rights in the revived Mining Titles Registration Act 16 of 1967 (as amended). Registered rights are claimed to constitute a limited real right binding against third parties. Discrepancies and contradictions regarding the nature of rights to minerals are created by the two statutes. It is concluded that only upon clarification of the provisions of the two sister statutes, would the nature of rights to minerals be more evident. The proposed amendment of section 5(1) of the MPRD Act would be in line with property doctrine based upon the common law and is to be welcomed.

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Background: Support for patient self-management is an accepted role for health professionals. Little evidence exists on the appropriate basis for the role of health professionals in achieving optimum self-management outcomes. This study explores the perceptions of people with type 2 diabetes about their self-management strategies and how relationships with health professionals may support this.

Methods
: Four focus groups were conducted with people with type 2 diabetes:  two with English speaking and one each with Turkish and Arabic-speaking. Transcripts from the groups were analysed drawing on grounded hermeneutics and interpretive description.

Results
: We describe three conceptually linked categories of text from the focus groups based on emotional context of self management, dominant approaches to self management and support from health professionals for self management. All groups described important emotional contexts to living with and self-managing diabetes and these linked closely with how they approached their diabetes management and what they looked for from health professionals. Culture seemed an important influence in shaping these linkages.

Conclusion
: Our findings suggest people construct their own individual self-management and self-care program, springing from an important emotional base. This is shaped in part by culture and in turn determines the aims each  person has in pursuing self-management strategies and the role they make available to health professionals to support them. While health professionals'  support for self-care strategies will be more congruent with patients' expectations if they explore each person's social, emotional and cultural circumstances, pursuit of improved health outcomes may involve a careful balance between supporting as well as helping shift the emotional constructs surrounding a patient life with diabetes.

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Aim. We characterized changes in reporting rates and abundances of bird species over a period of severe rainfall deficiency and increasing average temperatures. We also measured flowering in eucalypts, which support large numbers of nectarivores characteristic of the region.

Location.  A 30,000-km2 region of northern Victoria, Australia, consisting of limited amounts of remnant native woodlands embedded in largely agricultural landscapes.

Methods. There were three sets of monitoring studies, pitched at regional  (survey programmes in 1995–97, 2004–05 and 2006–08), landscape (2002–03 and 2006–07) and site (1997–2008 continuously) scales. Bird survey techniques used a standard 2-ha, 20-min count method. We used Bayesian analyses of reporting rates to document statistically changes in the avifauna through time at each spatial scale.

Results. Bird populations in the largest remnants of native vegetation (up to 40,000 ha), some of which have been declared as national parks in the past decade, experienced similar declines to those in heavily cleared andscapes. All categories of birds (guilds based on foraging substrate, diet, nest site; relative mobility; geographical distributions) were affected similarly. We detected virtually no bird breeding in the latest survey periods. Eucalypt flowering has declined significantly over the past 12 years of drought.

Main conclusions. Declines in the largest woodland remnants commensurate with those in cleared landscapes suggest that reserve systems may not be relied upon to sustain species under climate change. We attribute population declines to low breeding success due to reduced food. Resilience of bird populations in this woodland system might be increased by active management to enhance habitat quality in existing vegetation and restoration of woodland in the more fertile parts of landscapes.

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Exercise during growth may increase peak bone mass; if the benefits are maintained it may reduce the risk of fracture later in life (1). It is hypothesised that exercise will preferentially enhance bone formation on the surface of cortical bone that is undergoing bone modeling at the time (2). Therefore, exercise may increase bone mass accrual on the outer periosteal surface during the pre- and peri-pubertal years, and on the inner endocortical surface during puberty (3). An increase in bone formation on the periosteal surface is, however, more effective for increasing bone strength than medullary contraction (4). While exercise may have a role in osteoporosis prevention, there is little evidential basis to support this notion. It is generally accepted that weight-bearing exercise is important, but it is not known how much, how often, what magnitude or how long children need to exercise before a clinically important increase in bone density is obtained. In this thesis, the effect of exercise on the growing skeleton is investigated in two projects. The first quantifies the magnitude and number of loads associated with and in a moderate and low impact exercise program and non-structured play. The second project examines how exercise affects bone size and shape during different stages of growth. Study One: The Assessment of the Magnitude of Exercise Loading and the Skeletal Response in Girls Questions: 1) Does moderate impact exercise lead to a greater increase in BMC than low impact exercise? 2) Does loading history influence the osteogenic response to moderate impact exercise? 3) What is the magnitude and number of loads that are associated with a moderate and low impact exercise program? Methods: Sixty-eight pre-and early-pubertal girls (aged 8.9±0.2 years) were randomised to either a moderate or low impact exercise regime for 8.5-months. In each exercise group the girls received either calcium fortified (-2000 mg/week) or non-fortified foods for the duration of the study. The magnitude and number of loads associated with the exercise programs and non-structured play were assessed using a Pedar in-sole mobile system and video footage, respectively. Findings: After adjusting for baseline BMC, change in length and calcium intake, the girls in the moderate exercise intervention showed greater increases in BMC at the tibia (2.7%) and total body (1.3%) (p ≤0.05). Girl's who participated in moderate impact sports outside of school, showed greater gains in BMC in response to the moderate impact exercise program compared to the low impact exercise program (2.5 to 4.5%, p ≤0.06 to 0.01). The moderate exercise program included -400 impacts per class, that were applied in a dynamic manner and the magnitude of impact was up to 4 times body weight. Conclusion: Moderate-impact exercise may be sufficient to enhance BMC accrual during the pre-pubertal years. However, loading history is likely to influence the osteogenic response to additional moderate impact exercise. These findings contribute towards the development of school-based exercise programs aimed at improving bone health of children. Study Two: Exercise Effect on Cortical Bone Morphology During Different Stages of Maturation in Tennis Players Questions: 1) How does exercise affect bone mass (BMC) bone geometry and bone strength during different stages of growth? 2) Is there an optimal stage during growth when exercise has the greatest affect on bone strength? Methods: MRI was used to measure average total bone, cortical and medullary areas at the mid- and distal-regions of the playing and non-playing humerii in 47 pre-, peri- and post-pubertal competitive female tennis players aged 8 to 17 years. To assess bone rigidity, each image was imported into Scion Image 4.0.2 and the maximum, minimum and polar second moments of area were calculated using a custom macro. DXA was used to measure BMC of the whole humerus. Longitudinal data was collected on 37 of the original cohort. Findings: Analysis of the entire cohort showed that exercise was associated with increased BMC and cortical area (8 to 14%), and bone rigidity (11 to 23%) (all p ≤0.05). The increase in cortical bone area was associated with periosteal expansion in the pre-pubertal years and endocortical contraction in the post-pubertal years (p ≤0.05). The exercise-related gains in bone mass that were accrued at the periosteum during the pre-pubertal years, did not increase with advanced maturation and/or additional training. Conclusion: Exercise increased cortical BMC by enhancing bone formation on the periosteal surface during the pre-pubertal years and on the endocortical surface in the post-pubertal years. However, bone strength only increased in response to bone acquisition on the periosteal surface. Therefore the pre-pubertal years appear to be the most opportune time for exercise to enhance BMC accrual and bone strength

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To defeat the heirs of the enlightenment with their own weapon i.e. reason itself. To reduce all philosophy all science all views to irrational meaningless babble using their own epistemic conditions of truth. To confound the products of reason by reason itself. To show that the rational in fact collapses into the irrational. By reason itself all products of human reason reduce to intellectual chaos. To shatter the categories of thought, to rob all views and ideas of any epistemic worth by using reason to show that they end in stultification foolishness, or absurdity. Reason confounds reason and convicts reason by it's own standard to unintelligibility, babble, stultification, incoherence foolishness and absurdity, or meaninglessness. Reasons critique of reason shows that there is no consistency in ally product of reason, no order , no coherence only chaos and absurdity, or meaninglessness. The life-jacket, or anchor reason gives in the void of meaninglessness is broken by reason itself. Into the void of nothing reason drops us. Cut adrift in meaninglessness we are free to acquire other insights other realizations by transcending reason. Meaning can be reduced to absurdity. Meaninglessness can be reduced to absurdity but for those who hold meaninglessness as a view, or meaning there is no hope.

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The diet of Powerful Owls (Ninox strenua) living at Christmas Hills, 35km north-east of Melbourne was examined by analysis of 686 regurgitated pellets collected over two years. An aid was also developed to help identify potential mammalian prey species based on hair and skeletal characteristics. The following features were found to be most useful in distinguishing between the three species of arboreal marsupials - Common Ringtail Possum (Pseudocheirus peregrinus), Common Brushtail Possum (Trichosurus vulpecula) and Sugar Glider (Petaurus breviceps): - Cross-sectional width of primary guard hairs. - The size and shape of the nasal, frontal, parietal and squamosal bones of the skull. - Dentition. The size and shape of the upper incisor, canine and premolar teeth. The size and shape of the lower incisor and premolar teeth. - The size of the humerus. The Sugar Glider has a much smaller humerus than that of the Common Ringtail Possum and the Common Brushtail Possum. In the Common Brushtail Possum the entepicondyle ends in a very sharp point but the Common Ringtail Possum this point is not as sharp. - The Common Ringtail Possum’s femur has a very prominent trochanter which projects further than that in the Common Brushtail Possum. The femur of the Sugar Glider is distinguished by having a very large depression between the condyle and the trochanter. - The Common Brushtail Possum’s scapula has a narrower lower blade (relative to length) than that in the Common Ringtail Possum. The scapula of the Sugar Glider is smaller in size than that of the other two possums.The pelvic girdle Of the Common Brushtail Possum has a much wider ischium than those of the Common Brushtail Possum and the Sugar Glider. The ilium of the Sugar is much narrower and smaller than that of the other two possums Mammalian prey was found in 89%, insects in 13% and birds in 10% of the pellets. Of the mammals, Common Ringtail Possums occurred most frequently in the pellets over the year. There was no seasonal difference in the frequency of occurrence of Common Ringtail Possums and Sugar Gliders in pellets. However, Common Brushtail Possums were more likely to be taken in spring than in the other seasons. More adult Common Ringtail Possums were taken as prey than were other age classes over the year, except in summer when high numbers of young were consumed by the owls. The habitat of the Powerful Owl was examined by ground surveys and spotlight surveys in sixteen sites within the Warrandyte-Kinglake Nature Conservation Link. Four categories of survey sites were chosen with the following features. Category A - Sites with a dense understorey of shrubs and small trees, as well as many old trees (>10/ha) which might be suitable for nest hollows. Category B - Sites which lacked a dense understorey of shrubs and small trees and containing few or no old trees suitable for nest hollows. Category C - Sites with a dense understorey of shrubs and small trees but containing few or no old trees suitable for nest hollows. Category D - Sites which lacked a dense understorey of shrubs and small trees but having old trees (>10/ha) which might be suitable for nest hollows. High prey densities strongly correlated with the presence of hollows at these sites. In the light of the results, management recommendations were made for the future conservation of the Powerful Owls living at Christmas Hills. The following recommendations were particularly important: 1. Cleared or semi - cleared land within the Warrandyte Kinglake Nature Conservation Link be revegetated using indigenous species of eucalypts and waffles in order to provide a contiguous native forest corridor for the movement of possums and gliders between the Yarra River Valley and the Kinglake Plateau. 2. Continued planting of Eucalyptus spp. and Acacia spp. in the forested areas of the Warrandyte-Kinglake Nature Conservation Link. 3. Continued protection of healthy living trees to provide a continuous supply of hollow trees. 4. No falling of dead standing trees for firewood collecting as these can provide nest hollows for prey species of the Powerful Owl.

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Abstract The purpose of this study was to identify place-specific dimensions of service quality in spectator sport settings and determine if the importance of these dimensions differed across cultures. The study was limited to the soccer industry and involved the collection of responses from identified soccer spectators to a range of items presented in a survey instrument. The survey was distributed to respondents face-to-face on a match day of the club they supported, or mailed to their home address. Responses were obtained from spectators from two clubs from Australia (n=277), one club from the USA (n=199), one club from the Netherlands (n=245) and one federation from Malaysia (n= 100). Based on the findings of a number of authors, six categories of potential place-specific dimensions of service quality in spectator sport settings were created and the research instrument contained a number of items that could be categorised under one of these headings. These categories were Home, Religion, Social facilitation, Sensory, Uncertainty of outcome, and Personal attention. In this thesis it was assumed that place-specific service quality issues are similar for sport spectators of different cultures, although differences in degree of importance of these dimensions (etic approach) were likely to emerge. In other words, although it was expected dimensions per country to be similar, differences in degree of importance of these dimensions were expected. Given the lack of confirmatory statistical evidence pertaining to the specific country samples, it was concluded that differences per country are likely to be more than just differences in degree. Both the overall structure and structures per country could not be confirmed, and hence the conclusion was drawn that differences in nature between the countries were present. In other words, what is a dimension of place-specific service quality in one country is not necessarily a dimension in another country. The results of a content analysis of ‘core component’ structures per country compared with a (full sample) core component structure delivered six components (referred to as place-specific dimensions of service quality) that were defined as Home, Hedonist, Religious follower, Safe atmosphere, Hospitality and Personal Attention. It was found that in most cases the cultural orientation of soccer spectators reflects the cultural orientation of the country as a whole as proposed by Hofstede (1991). However, in line with Huntington (1997), it was also argued that grouping people based on their country of origin as a proxy for their cultural orientation, will increasingly lead to flawed and incomplete research findings. As noted by Yoo etal. (1999), the identification of a person's cultural orientation is likely to deliver more direct results when measured at the individual level In that regard it is concluded that it may seem prudent to view Hofstede's dimensions of culture with increased conceptual scrutiny. Although having been replicated in multiple studies, it becomes increasingly unlikely that Hofstede's dimensions cover the complete spectrum of an individual person's cultural orientation. In conclusion, this study identified that soccer spectators (from a number of clubs) from Australia, the USA, the Netherlands and to a lesser extent Malaysia, perceive a range of place-specific service quality dimensions in spectator spoil settings to be important when visiting a soccer match. Before research into satisfaction with and value of place-specific dimensions of the spectator sport service product is initiated, it is pertinent the identified dimensions are further explored and confirmed in different country (culture) settings. The confusion that still exists about the place of the value concept (in relation to quality and satisfaction), where Holbrook (1994) defines quality as a type of value and Chelladurai and Chang (2000) argue that value is a type of quality, further underpins this necessity. It needs to be clear what are the targets of service quality before this information is integrated in larger holistic research frameworks. In the final section of the thesis a conceptual model for international services marketing research in the sport industry was presented as a first attempt to integrate the findings of this research and other researchers.

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This paper aims to identify current practice responses to the housing and support needs of people with high, complex or changing support needs. Case studies of current housing dilemmas and responses were provided by Annecto and Scope (Vic), and included data about the responses of other providers known to these agencies. The paper will first present case study data in three categories of accommodation: living independently (ie. living alone in self-rented or self-owned housing with or without formal support); living without a home (ie. living in non permanent or non secure housing); and living in the parental home and planning for change. The case studies are followed by a discussion of the key response strategies evident in each, and an analysis of significant ‘lessons’ for policy.

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In recent years, academic literacy has been a subject of heated scholarly and political debates. How academic literacy is defined, whom it serves, and what its purposes are shape both educational policies and the pedagogical practices adopted in classrooms. Any definition of academic literacy, its purposes and its learners also constructs powerful notions of difference. For instance, many traditional definitions of academic literacy posit “out of school” literacy (or literacies) as its opposite; current literacy standards and performance measures create categories of students as able or struggling; and so on. At a time when English classrooms around the world are becoming more multicultural, multilingual and international, how might understandings of academic literacy respond to cultural, linguistic, gender, economic, (dis)ability and other differences? How can literacy be taught to difference without reducing it to sameness? Framing the curriculum around dominant cultural literacy and establishing communal homogeneity, whilst de-legitimizing the Other and announcing ever-new strangers, is not feasible in a new multilingual, multiculural order. There is an increasing need to resist conservative tendencies and to continue a socially critical model of literacy education that is more response-able to the lives of strangers and other forms of difference in a late-modern, globalized society at the same time that it provides opportunities for all students to expand their communicative repertoires and to gain agency in the “design of their social futures” (New London Group, 2000). Articles in this issue respond in different ways to this agenda.

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This paper examines the different ways in which carbon rights have been verified as property interests. A carbon right is a new and unique form of land interest that confers upon the holder a right to the incorporeal benefit of carbon sequestration on a piece of forested land. Carbon sequestration refers to the absorption from the atmosphere of carbon dioxide by vegetation and soils and the storage of carbon in vegetation and soils. Innovative legislation has been introduced in each state seeking to separate the incorporeal benefit of carbon sequestration from the natural rights flowing from land ownership. The fragmentation of land ownership in this way is a constituent of broader climate change strategies and is particularly important for an Australian emissions trading scheme where carbon rights will acquire value as tradable offsets. This paper will explore the different legislative responses of each state to the proprietary characterisation of the carbon right as a land interest. It will argue that verifying the carbon right as a new statutory property interest, in line with the approach set out in the Carbon Rights Act 2003 (WA), is preferable to aligning it with preconceived categories of common law servitude. By articulating the  carbon right as a new form of statutory interest, unique in status and form, its sui generis character is more accurately reflected. Further, statutory validation of the carbon right as a new land interest is more efficient as legislative rules are more visible and therefore come to the attention of other market participants more quickly and at a lower cost without the burden and complexity associated with expressing the right through the prism of pre-conceived and non-responsive common law forms.

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The objective of this research is to examine how Victorian local government annual reports disclose information on intellectual capital. The idea of intellectual capital has become part of the working organisational vocabulary, and is widely held in management literature to be the pre-eminent economic resource and a key driver of efficiency, effectiveness and continual improvement in the private and public sectors. Under the recent Best Value Victoria policy, local governments are under increasing pressure to acquire and apply intellectual capital to improve responsiveness to community needs and meet cost and quality criteria. Annual reports exist as vehicles for communication, accountability and decision making. This study examines how the internal, external and human categories of intellectual capital are represented in the annual reports for the 2000 year for 77 of the 78 Victorian local
governments.

Using a matrix approach derived from Petty and Guthrie's (2000) framework, content analysis is employed to examine the incidence and intensity with which specific elements of intellectual capital are reported. This research indicates that generally the content of annual reports have not provided clear and coherent representations of how local government in Victoria are developing, applying and measuring intellectual capital. The nature and extent of intellectual capital reporting varies considerably between councils, and the disclosure of the human elements of intellectual capital is particularly underdeveloped. The findings suggest that more research in this area is needed to determine the extent to which intellectual capital should be disclosed and whether the current paucity of disclosure stems from disinterest or technical problems. There is also the need for further research into the need to identify and describe elements of intellectual capital, and into effective
reporting strategies and techniques. This may lead to the development of a 'best practice' reporting model for intellectual capital. Furthermore, the preliminary investigations indicate a perceived need to raise the consciousness of public sector
managers as to the existence of intellectual capital within their organisations, and ultimately lead to more informed and effective management of this asset.