869 resultados para Hospital services
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The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investigate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women’s Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related differences in lignan intake. Forty-five percent of women consumed at least one serve of a soy and/or linseed item and were defined as a soy/linseed consumer. Median (range) intakes by consumers for isoflavones and lignans (3.9 (0-172) mg/d and 2.4 (0.1-33) mg/d) were higher than intakes by non-consumers (0.004 (0-2.6) mg/d and 1.57 (0.44-4.7) mg/d), respectively (p<0.001). Consumers had higher intakes of dietary fibre (p=0.003), energy (p=0.04) and polyunsaturated fat (p=0.004), and higher levels of physical activity (p=0.006), socio-economic position (p<0.001), education (p<0.001) and supplement use (p<0.001). Women who consumed soy or linseed foods differed in lifestyle and demographic characteristics suggesting these factors should be considered when investigating associations with chronic disease outcomes.
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This document presents the newly updated strategic directions for strengthening nursing and midwifery services (SDNM) for the period 2011–2015. Complementing and building on the 2002–2008 SDNM, it seeks to provide policymakers, practitioners and other stakeholders at every level with a flexible framework for broad-based, collaborative action to enhance the capacity of nurses and midwives to contribute to: * universal coverage * people-centred health care * policies affecting their practice and working conditions, and the * scaling up of national health systems to meet global goals and targets. The SDNM for 2011–2015 draws on several key World Health Assembly resolutions, and are underpinned by the associated global policy recommendations and codes of practice. (1,2) After two years of extensive research and consultation, a SDNM task force was developed, and a consensus on a range of specific activities revolving around 13 objectives in five interrelated key results areas (KRAs), was achieved: n health system and service strengthening n policy and practice * education, training and career development * workforce management and * partnership. Stakeholders, although free to prioritize certain parts of the framework to meet their own particular needs, are encouraged to adhere to the cornerstone of collaborative action, namely the common goal enshrined in the core SDNM 2011–2015 vision statement: improved health outcomes for individuals, families and communities through the provision of competent, culturally sensitive, evidence-based nursing and midwifery services.
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Effective strategies for the design of effi cient and environmentally sensitive buildings require a close collaboration between architects and engineers in the design of the building shell and environmental control systems at the outset of projects. However, it is often not practical for engineers to be involved early on in the design process. It is therefore essential that architects be able to perform preliminary energy analyses to evaluate their proposed designs prior to the major building characteristics becoming fi xed. Subsequently, a need exists for a simplifi ed energy design tool for architects. This paper discusses the limitations of existing analysis software in supporting early design explorations and proposes a framework for the development of a tool that provides decision support by permitting architects to quickly assess the performance of design alternatives.
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Potentially harmful substance use is common, but many affected people do not receive treatment. Brief face-to-face treatments show impact, as do strategies to assist self-help remotely, by using bibliotherapies, computers or mobile phones. Remotely delivered treatments offer more sustained and multifaceted support than brief interventions, and they show a substantial cost advantage as users increase in number. They may also build skills, confidence and treatment fidelity in providers who use them in sessions. Engagement and retention remain challenges, but electronic treatments show promise in engaging younger populations. Recruitment may be assisted by integration with community campaigns or brief opportunistic interventions. However, routine use of assisted self-help by standard services faces significant challenges. Strategies to optimize adoption are discussed. ----- ----- Research Highlights: ► Many people with risky or problematic drinking do not currently receive treatment. ► Assisted self-help has a significant impact and can be delivered at low cost. ► Maximal effects from assisted self-help require engagement of potential users. ► Marketing campaigns and integration into existing service models may assist.
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Methicillin-resistant Staphylococcus Aureus (MRSA) is a pathogen that continues to be of major concern in hospitals. We develop models and computational schemes based on observed weekly incidence data to estimate MRSA transmission parameters. We extend the deterministic model of McBryde, Pettitt, and McElwain (2007, Journal of Theoretical Biology 245, 470–481) involving an underlying population of MRSA colonized patients and health-care workers that describes, among other processes, transmission between uncolonized patients and colonized health-care workers and vice versa. We develop new bivariate and trivariate Markov models to include incidence so that estimated transmission rates can be based directly on new colonizations rather than indirectly on prevalence. Imperfect sensitivity of pathogen detection is modeled using a hidden Markov process. The advantages of our approach include (i) a discrete valued assumption for the number of colonized health-care workers, (ii) two transmission parameters can be incorporated into the likelihood, (iii) the likelihood depends on the number of new cases to improve precision of inference, (iv) individual patient records are not required, and (v) the possibility of imperfect detection of colonization is incorporated. We compare our approach with that used by McBryde et al. (2007) based on an approximation that eliminates the health-care workers from the model, uses Markov chain Monte Carlo and individual patient data. We apply these models to MRSA colonization data collected in a small intensive care unit at the Princess Alexandra Hospital, Brisbane, Australia.
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The heavy rain falls that we have been experiencing have had their impact on the public transport system, especially the ferries. September 2010 was the Brisbane area’s wettest on record, and early to mid October has shaped up much the same. So much so that the South East Queensland’s main water storages, the Wivenhoe and Somerset Dams, which are fed by the Stanley and Brisbane Rivers’ upper catchments, have filled to capacity. SEQ Water consequently released the floodgates on the Wivenhoe Dam for the first time in almost a decade, with bipartisan support of State and Local Governments.
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We present three competing predictions of the organizational gender diversity-performance relationship: a positive linear prediction, a negative linear prediction, and an inverted U-shaped curvilinear prediction. The paper also proposes a moderating effect of industry type (services vs. manufacturing). The predictions were tested using archival quantitative data with a longitudinal design. The results show partial support for the positive linear and inverted U-shaped curvilinear predictions as well as for the proposed moderating effect of industry type. The results help reconcile the inconsistent findings of past research. The findings also show that industry context can strengthen or weaken gender diversity effects.
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QUT Library and the High Performance Computing and Research Support (HPC) Team have been collaborating on developing and delivering a range of research support services, including those designed to assist researchers to manage their data. QUT’s Management of Research Data policy has been available since 2010 and is complemented by the Data Management Guidelines and Checklist. QUT has partnered with the Australian Research Data Service (ANDS) on a number of projects including Seeding the Commons, Metadata Hub (with Griffith University) and the Data Capture program. The HPC Team has also been developing the QUT Research Data Repository based on the Architecta Mediaflux system and have run several pilots with faculties. Library and HPC staff have been trained in the principles of research data management and are providing a range of research data management seminars and workshops for researchers and HDR students.
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Increasingly, Australian universities are facing the challenges of global education. While overseas students studying in Australia provide the primary source of export earnings for educational institutions, a number of institutions, including QUT, are also involved in international trade in educational services by providing services offshore. This paper discusses driving forces behind moves by Australian universities to enter the international education market. It then briefly describes Queensland University of Technology’s internationalisation strategy. The paper concludes with a case study describing how the School of Construction Management has pioneered the development of offshore courses at QUT. The introduction of the Master of Project Management and Graduate Diploma of Project Management programs in Singapore in November 1993 represented QUT’s first experience in this area. With the experience of 18 months of operation, the School now has the opportunity to reflect on the outcomes of this venture and consider future options.
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This talk explores a new opportunity renewable energy technology has for society.
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Background This economic evaluation reports the results of a detailed study of the cost of major trauma treated at Princess Alexandra Hospital (PAH), Australia. Methods A bottom-up approach was used to collect and aggregate the direct and indirect costs generated by a sample of 30 inpatients treated for major trauma at PAH in 2004. Major trauma was defined as an admission for Multiple Significant Trauma with an Injury Severity Score >15. Direct and indirect costs were amalgamated from three sources, (1) PAH inpatient costs, (2) Medicare Australia, and (3) a survey instrument. Inpatient costs included the initial episode of inpatient care including clinical and outpatient services and any subsequent representations for ongoing-related medical treatment. Medicare Australia provided an itemized list of pharmaceutical and ambulatory goods and services. The survey instrument collected out-of-pocket expenses and opportunity cost of employment forgone. Inpatient data obtained from a publically funded trauma registry were used to control for any potential bias in our sample. Costs are reported in Australian dollars for 2004 and 2008. Results The average direct and indirect costs of major trauma incurred up to 1-year postdischarge were estimated to be A$78,577 and A$24,273, respectively. The aggregate costs, for the State of Queensland, were estimated to range from A$86.1 million to $106.4 million in 2004 and from A$135 million to A$166.4 million in 2008. Conclusion These results demonstrate that (1) the costs of major trauma are significantly higher than previously reported estimates and (2) the cost of readmissions increased inpatient costs by 38.1%.
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Background: Ambulance ramping within the Emergency Department (ED) is a common problem both internationally and in Australia. Previous research has focused on various issues associated with ambulance ramping such as access block, ED overcrowding and ambulance bypass. However, limited research has been conducted on ambulance ramping and its effects on patient outcomes. ----- ----- Methods: A case-control design was used to describe, compare and predict patient outcomes of 619 ramped (cases) vs. 1238 non-ramped (control) patients arriving to one ED via ambulance from 1 June 2007 to 31 August 2007. Cases and controls were matched (on a 1:2 basis) on age, gender and presenting problem. Outcome measures included ED length of stay and in-hospital mortality. ----- ----- Results: The median ramp time for all 1857 patients was 11 (IQR 6—21) min. Compared to nonramped patients, ramped patients had significantly longer wait time to be triaged (10 min vs. 4 min). Ramped patients also comprised significantly higher proportions of those access blocked (43% vs. 34%). No significant difference in the proportion of in-hospital deaths was identified (2%vs. 3%). Multivariate analysis revealed that the likelihood of having an ED length of stay greater than eight hours was 34% higher among patients who were ramped (OR 1.34, 95% CI 1.06—1.70, p = 0.014). In relation to in-hospital mortality age was the only significant independent predictor of mortality (p < 0.0001). ----- ----- Conclusion: Ambulance ramping is one factor that contributes to prolonged ED length of stay and adds additional strain on ED service provision. The potential for adverse patient outcomes that may occur as a result of ramping warrants close attention by health care service providers.
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Under a Services Agreement dated 16th April 2010 the Australian Capital Territory (ACT) engaged Knowledge Consulting Pty Ltd to conduct an independent review of operations at the Alexander Maconochie Centre (AMC) in the ACT. The Review was commissioned following a motion passed in the ACT Legislative Assembly as follows: “That this Assembly: (1) notes: (a) concerns regarding the operation of the AMC; (b) the unanimous findings of the Standing Committee on Justice and Community Safety report, Inquiry into the delay in the commencement of operations at the Alexander Maconochie Centre; and (c) the Government’s intention to have a review into the operation of the AMC after its first year of operation; and (2) calls on the Government to: (a) commission an independent reviewer to conduct the one year review into the AMC; (b) ensure that the review be open and transparent and public, and include input from community and non-government groups with an interest or involvement in the AMC, including on the terms of reference for the review; (c) ensure the review is completed in a timely manner and be tabled in the Legislative Assembly immediately upon completion; and (d) report upon the progress of the review in August 2010;”
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Empirical findings on the link between gender diversity and performance have been inconsistent. This paper presents three competing predictions of the organizational gender diversity-performance relationship: a positive linear prediction derived from the resource-based view of the firm, a negative linear prediction derived from self-categorization and social identity theories, and an inverted U-shaped curvilinear prediction derived from the integration of the resource-based view of the firm with self-categorization and social identity theories. This paper also proposes a moderating effect of industry type (services vs. manufacturing) on the gender diversity-performance relationship. The predictions were tested in publicly listed Australian organizations using archival quantitative data with a longitudinal research design. The results show partial support for the positive linear and inverted U-shaped curvilinear predictions as well as for the proposed moderating effect of industry type. The curvilinear relationship indicates that different proportions of organizational gender diversity have different effects on organizational performance, which may be attributed to different dynamics as suggested by the resource-based view and self-categorization and social identity theories. The results help reconcile the inconsistent findings of past research that focused on the linear gender diversity-performance relationship. The findings also show that industry context can strengthen or weaken the effects of organizational gender diversity on performance.
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Business transformations are large-scale organizational change programs that, evidence suggests, are often unsuccessful. Our interest is in identifying the management capabilities required for the successful execution of these projects. We advance a service-oriented view of the enterprise, which suggests that different management services need to be identified and integrated in order to execute business transformation. In order to identify those management services that require integration, we conducted an exploratory empirical study of the demand for management services in US and Asia, and we show that two archetypes of management services exist in business transformation initiatives: transactional and transformational management services. We identify the relevant set of transactional and transformational services and discuss what the demand for these services implies for the execution of business transformations.