866 resultados para Mixed Methods


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The final publication is available at Springer via http://dx.doi.org/10.1007/s10671-014-9171-y

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Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Serviço Social, Programa de Pós-Graduação em Política Social, 2016.

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Teachers' beliefs about what it is (or is not) possible to achieve with digital games in educational contexts will inevitably influence the decisions that they make about how, when, and for what specific purposes they will bring these games into their classrooms. They play a crucial role in both shaping and responding to the complex contextual factors which influence how games are understood and experienced in educational settings. Throughout this article the authors draw upon data collected for a large-scale, mixed-methods research project focusing on literacy, learning and teaching with digital games in Australian classrooms, to focus explicitly on the attitudes, understandings and expectations held about digital games by diverse teachers at the beginning of the project. They seek to identify the beliefs about games that motivated teachers' participation in a digital games research project while focusing, as well, on concerns that teachers express about risks or limitations of such a project. The authors' aim is to develop a detailed picture of the mindsets that teachers bring to games-based learning environments, and the relevance of these mindsets to broader debates about the relationship between games, learning and school.

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This study aimed to highlight the praxis of various mainstream and alternative faith traditions in Australia with relation to environmental sustainability issues. A mixed methods approach (surveys, interviews, site visits) was used to investigate the levels of awareness and involvement of faith communities on issues including biodiversity protection, water conservation, energy efficiency, waste management and cultural property heritage. The aim of this chapter is to highlight a theme of integration (or lack thereof) that arose out of the interviews which formed a critical part of the participants’ worldview. A brief overview of the relationships of attitudes and behaviours to environmental issues and the importance placed on values and worldviews is provided. Individuals from 40 faith groups participated in the study; in this chapter, individuals and case studies from ten different groups are highlighted. These range from the conventional, mainstream Christian traditions to alternative Christian and Eastern traditions as well as the new age movement. The study found that mainstream traditions were making important attempts at integrating their worldview into appropriate environmental management strategies; however, the impact was marginal overall. The lesser known and alternative traditions, however, were at a significant leading edge of integrating praxis; yet, because these traditions are viewed with an element of suspicion, their efforts were marginalized by members of other faiths and the public. Thus, there are several points of convergence and divergence that faith traditions have with regard to environmental sustainability.

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The environmental sustainability (ES) of food systems is a critical challenge for policy makers. This is a highly contested policy area with differing views among stakeholders. The aim of the study was to develop a better understanding of how ES considerations are addressed in Australian food and nutrition policies and the way that consultation processes affect final policy outcomes. A mixed-methods study design combined a detailed chronology of key policy developments (2009-2015), a content analysis of written submissions obtained during the NFP's consultation period (2011-2013) and a frame analysis of the sustainability perspectives - efficiency, demand restraint, and system transformation - in the NFP's Issues, Green, and White Papers. There were 555 written submissions responding to two consultation papers. Stakeholders represented all sectors of Australia's food system including government, non-government organizations, the food supply chain, research and academic institutions, and members of the general public. Around 74% of submissions referred to ES considerations and ~65% supported their inclusion into the final policy. Efficiency frames were most dominant; emphasizing a production-oriented approach that regards the environment as a natural resource base for food production but overlooks consumption and equity concerns. Despite strong support for the inclusion of ES considerations in the NFP, the influence of Australia's socio-political context, powerful, industry-dominated stakeholders, and a reliance on traditional production-oriented perspectives delivered a business-as-usual approach to food policy making. It has since been replaced by an agricultural strategy that provides only cursory attention to ES. Our findings indicate that Australia's political environment is not sufficiently mature for ES considerations to be integrated into food and nutrition policies. We propose reforms to the current consultation process in Australia to better support this integration by promoting greater transparency and participation in the development of food and nutrition policy making.

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OBJECTIVES: This paper describes the longitudinal component of a larger mixed methods study into the processes and outcomes of chronic condition management and self-management strategies implemented in three Aboriginal communities in South Australia. The study was designed to document the connection between the application of structured systems of care for Aboriginal people and their longer-term health status. METHODS: The study concentrated on three diverse Aboriginal communities in South Australia; the Port Lincoln Aboriginal Health Service, the Riverland community, and Nunkuwarrin Yunti Aboriginal Health Service in the Adelaide metropolitan area. Repeated-measure clinical data were collected for individual participants using a range of clinical indicators for diabetes (type 1 and 2) and related chronic conditions. Clinical data were analysed using random effects modelling techniques with changes in key clinical indicators being modelled at both the individual and group levels. RESULTS: Where care planning has been in place longer than in other sites overall improvements were noted in BMI, cholesterol (high density and low density lipids) and HbA1c. These results indicate that for Aboriginal patients with complex chronic conditions, participation in and adherence to structured care planning and self-management strategies can contribute to improved overall health status and health outcomes. CONCLUSIONS: The outcomes reported here represent an initial and important step in quantifying the health benefits that can accrue for Aboriginal people living with complex chronic conditions such as diabetes, heart disease and respiratory disease. The study highlights the benefits of developing long-term working relationships with Aboriginal communities as a basis for conducting effective collaborative health research programs.

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Construction waste generation has been identified as one of the major issues in the construction industry due to its direct impacts on the environment as well as the efficiency of the construction industry. As the industry cannot continue to practice if the environmental resources on which it depends are depleted, the significance of waste management needs to be understood in order to encourage stakeholders to achieve related goals. Therefore, this research aims to determine effective approaches to eliminate and/or minimise waste generation in construction projects. Mixed methods were adopted by combining qualitative and quantitative research approaches. Interviews and a questionnaire survey were conducted as the primary data collection methods. The findings reveal twenty six critical solutions for waste management. Five factors of solutions for waste management were extracted from the exploratory factor analysis. These factors were: team building and supervision; strategic guidelines in waste management; proper design and documentation; innovation in waste management decisions; and lifecycle management. The evidence from this study suggests that both technologies and attitudinal approaches require improvement to eliminate/minimise waste generation in construction projects. Similarly, attention should be paid to being mindful of the environmental effects of waste generation and avoiding waste generation as early as possible in construction projects.

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BACKGROUND: The surge in the incidence of obesity and being overweight demands new options to extend the reach of weight-loss interventions. Mobile phones provide a medium for reaching large numbers of people in a cost-effective manner. The present study aimed to explore the potential for weight-loss interventions to be delivered via mobile phone. METHODS: A mixed methods approach was employed. A telephone survey was conducted with 306 randomly selected participants, and 10 focus groups were undertaken with 54 purposively selected participants. The telephone survey comprised questions exploring the nature and acceptability of any potential weight-loss programme that might be delivered via mobile phones. The focus groups were conducted to explore issues of acceptability in more depth than was possible in the survey. RESULTS: Two-thirds of participants reported support for a mobile phone weight-loss intervention, with greater levels of support amongst younger age groups and rural Māori (the indigenous population in New Zealand). Participants liked the idea of ready access to weight-loss information, and associated feedback and encouragement. The results suggest that interventions would need to include aspects of social support, use tailored and personalised content, and be practical and relevant so that they appeal to consumers. Appropriate methods of providing social support using a mobile phone require further exploration. CONCLUSIONS: Mobile phones may provide a novel but acceptable way to deliver a weight-loss intervention. They have the potential to be automatically personalised and tailored to the needs of the individual, at the same time as being delivered at a population level.

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Introduction: Occupational therapy in forensic settings has developed in recent decades, leading to an increasing amount of research being conducted in this field. There have been two previous attempts to provide overviews of this body of evidence and future directions for research; however, the rate of research has accelerated in recent years. This critical review addresses the following question: what evidence has been published about occupational therapy in forensic psychiatry over the past 7 years? Method: A mixed methods approach was adopted, with four databases and a search engine consulted (OTDBase, CINAHL, AMED, PSYCHInfo, Google Scholar). The inclusion criteria were: (a) articles published in peer reviewed journals since 2007 and (b) authored by at least one occupational therapist. Twenty-five studies were identified for review, and the four dimensions of occupation - doing, being, becoming and belonging - were used to provide a theoretical context for the subsequent discussion. Findings: The recent evidence base in forensic psychiatry focuses on doing and being, with fewer articles addressing becoming and belonging. Conclusion: This review has identified increasing numbers of studies about forensic occupational therapy, which may reflect growth in both interest and the worldwide workforce.

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OBJECTIVE: To explore the role of women in fishing industry organisations and communities in promoting best-practice health behaviours among fishers in Australia. DESIGN: This paper reports aspects of research that examined how the fishing industry can best support physical health and mental well-being of fishers. The study employed a mixed-methods, multisite case study approach. Data were gathered from face-to-face and phone interactions. SETTING: Two sites in Victoria and one in Western Australia. PARTICIPANTS: Thirty-one male fishers, including commercial licence owners, skippers, deckhands, three female family members, three fishing association representatives, one local government representative, two health care providers, and three regional health planning and funding bodies. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: Often unrecognised, women associated with the fishing industry are integral to the promotion of good health for fishers. They are key to identifying health issues (particularly mental health issues) and proposing community-based health and well-being strategies. They often do so by incorporating health information and activities into 'soft entry points' - informal, non-health service mechanisms by which fishers can access health information and health services. CONCLUSIONS: While not working at the industry coalface, women have a stake, and are key players, in the commercial fishing industry. Their knowledge of, and credibility within, fishing enterprises makes them valuable sources of information about health issues facing the industry and effective strategies to address them. This expertise should be applied in conjunction with industry associations and health providers to achieve better health outcomes for fishers and their families.

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BACKGROUND: Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity - defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire - of the streamed simulations. DESIGN AND METHODS: In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. RESULTS: Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. CONCLUSIONS: Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals' learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training. Significance for public healthThere are significant health inequalities for migrant populations. They commonly have poorer access to health services and poorer health outcomes than the Australian-born population. The factors are multiple, complex and include language and cultural barriers. To address these disparities, culturally competent patient-centred care is increasingly recognised to be critical to improving care quality, patient satisfaction, patient compliance and patient outcomes. Yet there is a lack of quality in the teaching and learning of cultural competence in healthcare education curricula, particularly in rural settings where qualified trainers and resources can be limited. The Cultural Respect Encompassing Simulation Training (CREST) program offers opportunities to health professional students and practitioners to learn and develop communication skills with professionally trained culturally and linguistically diverse simulated patients who contribute their experiences and health perspectives. It has already been shown to contribute to health professionals' learning and is effective in improving cultural competency in urban settings. This study demonstrates that CREST when delivered via live video-streaming and simulation can achieve similar results in rural settings.

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OBJECTIVES: To examine quality and safety in inter-professional clinical handovers in Post Anaesthetic Care Units (PACUs) and make recommendations for tools to standardize handover processes.
DESIGN: Mixed methods combining data from observations and focus groups.
SETTING: Three PACUs, one public tertiary hospital and two private hospitals.
PARTICIPANTS: Observations were made of 185 patient handovers from anaesthetists to nurses. Eight focus groups were conducted with 62 staff (15 anaesthetists and 47 nurses) across the study sites.
INTERVENTION: Inter-professional clinical handovers in PACU's.
MAIN OUTCOME MEASURES: Characteristics of the structure and processes that support safe inter-professional PACU handover practice.
RESULTS: Characteristics of the process, content, activities and risks during anaesthetist to nurse patient handover into the PACU were integrated into four steps in the PACU handover process summarized by the acronym COLD (Connect, Observe, Listen and Delegate), a verbal communication tool (ISoBAR), a checklist of critical information for safe patient transfer into PACU and a matrix of factors perceived to increase handover risk.
CONCLUSIONS: The standard structure and checklists for optimal content of patient handovers were derived from existing practices and consensus, hence, expected to provide ecologically valid and practical resources to improve quality and safety during clinical handovers in the PACU.

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Introduction: Major health-care reforms have extended across all Australian public hospitals in recent years. Improving emergency department (ED) access has been a focus of these reforms.

Objective: This study evaluates how the national reforms have led to improvement in ED access in a regional hospital in remote Australia.Methods: Assessing a complex scenario such as national reforms and the challenges faced by the regional hospital to implement these reforms requires in-depth analysis. A realist evaluation theory-based approach was employed, allowing investigation of what, how, why, and for whom change occurred. A case study mixed methods design was adopted within the realist framework to answer these questions about change.

Results and Conclusion: The study identified moderate improvement in ED access as a result of the reforms (investment in infrastructure and workforce and the introduction of ED targets). Clinical leadership and support from management were essential for the improvement. Without ongoing investment and clinical redesign activities, however, sustainability of the improvement may prove difficult.

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AIM: To conduct an integrative review on how nurses prepare families for and support families during withdrawal of life-sustaining treatments in intensive care.

BACKGROUND: End-of-life care is widely acknowledged as integral to the practice of intensive care. However, little is known about what happens after the decision to withdraw life-sustaining treatments has been made and how families are prepared for death and the dying process.

DESIGN: Integrative literature review.

DATA SOURCES: MEDLINE, CINAHL Plus, PsychINFO, PUBMED, Scopus, EMBASE and Web of Knowledge were searched for papers published between 2000 - May 2015.

REVIEW METHODS: A five stage review process, informed by Whittemore and Knafl's methodology was conducted. All papers were reviewed and quality assessment performed. Data were extracted, organised and analysed. Convergent qualitative thematic synthesis was used.

RESULTS: From an identified 479 papers, 24 papers were included in this review with a range of research approaches: qualitative (n=15); quantitative (n=4); mixed methods (n=2); case study (n=2); and discourse analysis (n=1). Thematic analysis revealed the nurses: equipped families for end of life through information provision and communication; managed the withdrawal of life-sustaining treatments to meet family need; and continued care to build memories.

CONCLUSION: Greater understanding is needed of the language that can be used with families to describe death and dying in intensive care. Clearer conceptualisation of the relationship between the medically focussed withdrawal of life-sustaining treatments and patient/family centred end-of-life care is required making the nursing contribution at this time more visible.

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This article reports on and discusses the findings of an investigationcarried out to explore the expectations of an English language enhancementcourse (ELEC) held by a group of undergraduate students at anAustralian university. For the study, a mixed-methods approach was utilised,with two instruments: a survey with a combination of closed- andopen-ended questions and semi-structured interviews. The research wasguided by the following three questions: (1) What do the students expectto learn on the course? (2) How are they developing their expectations?(3) Are the students’ expectations being met? The literature concerningstudent expectations foregrounds the complexity and multi-faceted natureof the concept, the satisfaction of which can impact on student engagement,satisfaction, performance, retention and attrition. Findings showthat the participants’ expectations of the course content and teachingstaff were largely met; nonetheless, a lack of class attendance was notedthroughout. Expectations were reported to have been developed largelythrough consultation with previous students of the course (43 per cent)and information materials provided by the university (42 per cent). Thearticle concludes with a discussion regarding the implications of thefindings for universities and education providers both in Australia andabroad.