967 resultados para Nursing homes and assisted living facilities and reports


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This paper will report on a research project funded by the Australian Football League (AFL).The research mobilises Foucault's later work on the care of the Self to focus on the ways in which player identities are regulated; and the manner in which players conduct themselves in ways that can be characterised as professional - or not.

The paper explores the forms of risk management that Clubs use in the processes of talent identification that they engage in as a consequence of AFL rules. The paper discusses how psychological profiling is used to identify character traits prior to initial recruitment in the draft or trading processes - and reports on suggestions that risk management in this increasingly commerciaIised context may lead to recruitment practices that exclude certain types of persons. from
certain types of backgrounds.

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To be useful for policy simulation in the current climate of rapid structural change, inverse demand systems must remain regular over substanstial variations in quantities. The distance function is a convenient vehicle for generating such systems. It also allows convenient imposition of prior ideas about the structure of preferences required for realistic policy work. While the distance function directly yields Hicksian inverse demand functions via the Shepard-Hanoch lemma, they are usually explicit in the unobservable level of utility (u), but lack a closed-form representation in terms of the observable variables. Note however that the unobservability of u need not hinder estimation. A simple one-dimensional numerical inversion allows the estimation of the distance function via the parameters of the implied Marshallian inverse demand functions. This paper develops the formal theory for using distance functions in this context, and reports on initial trials on the operational feasibility of the method.

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This paper will report the findings from research conducted in Australia and New Zealand to inform development of standards for nurse practitioner education and practice competencies. In New Zealand and Australia the nurse practitioner is a new and unique level of health-care provider. The shifting boundaries caused by health-care reform have created impetus and demand for development of new models of health-care, but have also created some uncertainty regarding nurse practitioner standards, education and models of care. The title, Nurse Practitioner, is now legislated in New Zealand and most jurisdictions in Australia but there is scant research to inform development of nurse practitioner standards. This research, sponsored by the Australian Nursing Council and the Nursing Council of New Zealand, was conducted to develop generic standards that could be applied for the education, authorisation and practice of nurse practitioners in both countries. The study involved collection and triangulation of data from a range of sources across Australia and New Zealand including: in-depth interviews with 15 nurse practitioners from different geographical and clinical contexts; curriculum survey of all nurse practitioner courses in the two countries and interview with convenors of these courses; collation of the authorisation/registration processes and policies from states and territories in Australia, New Zealand and internationally. These data were analysed within and across the data modalities to provide information on standards for nurse practitioner practice and education. Findings from the study included identification of the core role of the nurse practitioner as it is expressed in New Zealand and Australia and generic standards for nurse practitioner competencies, education and authorisation. These findings will standardise expectations, support mutual recognition of nurse practitioner authorisation across the two countries and make an important contribution to the current international debate on nurse practitioner standards and scope of practice.

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Possums in urban areas can cause problems for residents when they live in the roof cavity of homes. The Victorian Living With Possums policy was implemented by the Department of Natural Resources and Environment (DNRE) in 1997 to address the ineffective, illegal and inhumane nature of possum management practices. Human-possum conflicts in urban areas can be difficult to resolve, and it is therefore important that the Living With Possums policy is effectively reaching the community and other stakeholders (e.g. vets, local councils).

This study represents Stage 1 of a two-part research project that aims to examine community awareness of and compliance with the policy and relevant legislation. A pilot questionnaire was designed and distributed to a sample of individuals who have recently hired possum traps from local councils or private organisations within metropolitan Melbourne. Preliminary findings indicate that although there is some level of awareness about the Living with Possums policy, there is evidence of non-compliance and a lack of understanding about the detailed policy guidelines. In Stage 2 of this project, questionnaires will be distributed to a larger sample of individuals who are experiencing conflicts with possums in order to examine just how widespread this lack of compliance and awareness is.

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Background Enteral tubes are frequently inserted as part of medical treatment in a wide range of patient situations. Patients with an enteral tube are cared for by nurses in a variety of settings, including general and specialised acute care areas, aged care facilities and at home. Regardless of the setting, nurses have the primary responsibility for administering medication through enteral tubes. Medication administration via an enteral tube is a reasonably common nursing intervention that entails a number of skills, including preparing the medication, verifying the tube position, flushing the tube and assessing for potential complications. If medications are not given effectively through an enteral tube, harmful consequences may result leading to increased morbidity, for example, tube occlusion, diarrhoea and aspiration pneumonia. There are resultant costs for the health-care system related to possible increased length of stay and increased use of equipment. Presently what is considered to be best practice to give medications through enteral tubes is unknown.

Objectives The objective of this systematic review was to determine the best available evidence on which nursing interventions are effective in minimising the complications associated with the administration of medications via enteral tubes in adults. Nursing interventions and considerations related to medication administration included form of medication, verifying tube placement before administration, methods used to give medication, methods used to flush tubes, maintenance of tube patency and specific practices to prevent possible complications related to the administration of enteral medications.

Search strategy The following databases were searched for literature reported in English only: CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO. There was no date restriction applied. In addition, the reference lists of all included studies were scrutinised for other potentially relevant studies.

Selection criteria Systematic reviews of randomised controlled trials (RCTs) and RCTs that compared the effectiveness of nursing interventions and considerations used in the administration of medications via enteral tubes. Other research methods, such as non-randomised controlled trials, longitudinal studies, cohort and case control studies, were also included. Exclusion criteria included studies investigating drug–nutrient interactions or the bioavailability of specific medications.

Data collection and analysis Initial consideration of potential relevance to the review was carried out by the primary author (NP). Two reviewers independently assessed study eligibility for inclusion. A meta-analysis could not be undertaken, as there were no comparable RCTs identified. All data were presented in a narrative summary.

Results There is very limited evidence regarding the effectiveness of nursing interventions in minimising the complications associated with enteral tube medication administration in adults. The review highlights a lack of high quality research on many important nursing issues relating to enteral medication administration. There is huge scope for further research. Some of the evidence that was identified included that nurses should consider the use of liquid form medications as there may be fewer tube occlusions than with solid forms in nasoenteral tubes and silicone percutaneous endoscopic gastronomy tubes. Nurses may need to consider the sorbitol content of some liquid medications, for example, elixirs, as diarrhoea has been attributed to the sorbitol content of the elixir, not the drug itself. In addition, the use of 30 mL of water for irrigation when administering medications or flushing small-diameter nasoenteral tubes may reduce the number of tube occlusions.

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Background: The aim of this study was to evaluate active support (AS) training and to investigate changes to perceived engagement in domestic tasks, opportunities for choice, frequency of challenging behaviour, and level of support needs.

Method: Participants were 12 adults with ID aged 27–57 years (M = 37 years) residing in three group homes, and their support workers. The support workers completed assessments on three occasions (at baseline, post-training, and at follow-up).

Results: Residents' engagement in domestic tasks increased over time, and overall choice increased, although perceived choice in two life domains initially increased, but decreased to baseline levels at follow-up. Residents exhibited an overall decrease in anxiety, self-absorbed behaviour, disruptive behaviour, and problem behaviour in general. There was also an overall decrease in perceived support needs for five activity domains, with no change for one domain.

Conclusions: The results contribute to a growing body of evidence demonstrating favourable outcomes of AS in terms of engagement and challenging behaviour in people with ID. Surprising results are presented for choice and perceived support needs, warranting further investigation.

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Aim: Active Support, an evidence-based intervention developed in the UK and tested in Australia, enables direct support professionals to engage people with high support needs in meaningful and rewarding every day activities. This paper outlines the practical details of adapting the Active Support curriculum for service providers in the US and outlines an evaluation methodology that will inform both service delivery and future developments of Active Support.

Method: Active Support curricula developed in the UK and Australia were adapted for implementation the US.Train-the-trainer activities were conducted in early 2008 in three group homes serving 12 people with intellectual or developmental disabilities. A formative evaluation process was used to identify changes in the materials and training design needed to support a randomized controlled trial of the intervention in 20 small group homes.

Results: Modifications in the delivery of training are needed to account for differences in scheduling patterns and high turnover rates in US group homes, and to adjust British/Australian terminology to the U.S. context.

Conclusions: The translation of active support into the U.S. context requires modifications to support successful implementation. Research is planned to document the success of the modified curriculum in improving outcomes for persons with disabilities.

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An enormous amount of research in the conceptual change tradition has shown the difficulty of learning fundamental science concepts, yet conceptual change schemes have failed to convincingly demonstrate improvements in supporting significant student learning. Recent work in cognitive science has challenged this purely conceptual view of learning, emphasising the role of languages, and the importance of personal and contextual aspects of  understanding science. The research described in this paper is designed around the notion that learning involves the recognition and development of students’ representational resources. In particular, we argue that difficulties with the concept of force are fundamentally representational in nature. The paper describes the planning and implementation of a classroom sequence in force that focuses on representations and their negotiation, and reports on the effectiveness of this perspective in guiding teaching and learning. Classroom sequences involving three teachers 158 2008 NARST Annual International Conference were videotaped using a combined focus on the teacher and groups of students. Video analysis software was used to code the variety of representations used, and sequences of representational negotiation. Stimulated recall interviews were conducted with teachers and students. The paper will report on the effect of this approach on teacher knowledge and pedagogy, and on student learning of force.

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Depression is a significant public health issue among Australian adolescents. A number of family, school and community level factors have been identified as important determinants of adolescent's health and well-being, including depression. This study examines associations between measures of the social and physical environment and adolescent mental health, specifically depressive symptomotology using data from the Healthy Neighbourhoods study, a large observational study carried out in 231 Australian schools stratified by socioeconomic quartiles and urban/non-urban geography, which focuses on adolescent health and well-being. Participants were 8256 year 6 and 8
students (48% male), aged 11-16 years (M = 11.6, SD = 0.8 years) from schools across Victoria,Queensland and Western Australia who completed a comprehensive on-line survey. Data collected included the Short Mood and Feeling Questionnaire (SMFQL a tool for assessing depressive symptomotology in adolescents. Results showed that the mean total depression score (possible range 0-26 with total scores;:: 8 used as the cutoff for depression symptomotology) was 6.4 (SD = 5.9), with scores for females (M = 6.8, SD = 6.3) higher than those for males (M = 5.9, SD = 5.5), and scores for year 8 students (M = 6.7,SD = 6.1) higher than those for year 6 students (M = 6.2, SD = 5.8) (p < .001). Greater access to sporting and play equipment, local parks, and more functional neighbourhoods for walking and jogging reduced the odds for depressive symptomotology (p < .05L while increased levels of abandoned homes, and higher levels of fighting within the neighbourhood, and fewer scout/guide clubs, local teams to play sport, and adults in the neighbourhood to talk with, as well as reduced neighbourhood safety increased the odds for depressive symptomotology (p < .05). These findings support the important role of physical and social environments in influencing adolescent health and well-being. Modifications to particular aspects of these environments at the community level may assist in providing adolescents some protection from depression.

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Why is it that some people respond in a more negative way to procedural injustice than do others, and why is it that some people go on to defy authority while others in the same situation do not? Personality theorists suggest that the psychological effect of a situation depends on how a person interprets the situation and that such differences in interpretation can vary as a function of individual difference factors. For example, affect intensity—one’s predisposition to react more or less emotionally to an event—is one such individual difference factor that has been shown to influence people’s reactions to events. Cross-sectional survey data collected from (a) 652 tax offenders who have been through a serious law enforcement experience (Study 1), and (b) 672 citizens with recent personal contact with a police officer (Study 2), showed that individual differences in ‘affect intensity’ moderate the effect of procedural justice on both affective reactions and compliance behavior. Specifically, perceptions of procedural justice had a greater effect in reducing anger and reports of non-compliance among those lower in affect intensity than those higher in affect intensity. Both methodological and theoretical explanations are offered to explain the results, including the suggestion that emotions of shame may play a role in the observed interaction.

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There is growing awareness of the benefits of rehabilitation both in Australia and overseas. While the provision of rehabilitation services is not new, recognition of this type of health service as an integral part of health care has been linked to changes in the provision of acute care services, advances in medical technology, improvements in the management of trauma and an ageing population. Despite this, little attention has been paid to nursing's contribution to patient rehabilitation in Australia. The aim of this grounded theory study, therefore, was to collect and analyse nurses' reports of their contributions to patient rehabilitation and to describe and analyse contextual factors influencing that contribution. Data were collected during interviews with registered and enrolled nurses working in five inpatient rehabilitation units in New South Wales and during observation of the nurses' everyday practice. A total of 53 nurses participated in the study, 35 registered nurses and 18 enrolled nurses. Grounded theory, informed by the theoretical perspective of symbolic interactionism, was used to guide data analysis, the ongoing collection of data and the generation of a substantive theory. The findings revealed six major categories. One was an everyday problem labelled incongruence between nurses' and patients' understandings and expectations of rehabilitation. Another category, labelled coaching patients to self-care, described how nurses independently negotiated the everyday problem of incongruence. The remaining four categories captured conditions in the inpatient context which influenced how nurses could contribute to patient rehabilitation. Two categories, labelled segregation: divided and dividing work practices between nursing and allied health and role ambiguity, were powerful in shaping nursing's contribution as they acted individually and synergistically to constrain nursing's contribution to patient rehabilitation. The other two categories, labelled distancing to manage systemic constraints and grasping the nettle to realise nursing's potential, represent the mutually exclusive strategies nurses used in response to segregation and role ambiguity. From exploration of the relationship between the six categories, the core category and an interactive grounded theory called opting in and opting out emerged. In turn, this grounded theory reveals nursing's contribution to inpatient rehabilitation as well as contextual conditions constraining that contribution. The significance of these findings is made manifest through their contribution to the advancement of nursing knowledge and through implications for nursing practice and education, rehabilitation service delivery and research.

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This thesis is an exploration of women's domestic crafts in the Geelong region, between 1900 and I960, Through analysing oral testimony and the women's handicraft artefacts, the nature of the domestic production of handicrafts and the meanings the makers have constructed around their creations and their lives is illuminated. The thesis is organised around the themes of work, space, the construction of femininity, memory, time and meaning. The thesis argues that until recently, the discipline of history has privileged the experiences of men over those of women. It challenges the trivialising of women’s handicrafts. It also argues that within the restrictive social structures around them and within the confined nature of their situations, the women of my study asserted themselves to transform their environments and to improve their situations through labour in the home. In ‘making do’, recycling materials and creating functional and decorative needlework items for their homes and families, the women were often finding solutions to pressing practical and economic problems. Doing handicrafts was rarely just a passive way of filling in time. Rather, making and creating was for these women a multi-layered activity that similtaneously fulfilled a complex range of needs for themselves and their families. A multiplicity of deeply personal, aesthetic, familial, social, practical and economic needs were met in the making of domestic craft artefacts, whose symbolism reflected the values and meanings of the women's cultures, homes and families.

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This thesis examines the nature, extent and impact of multiple forms of maltreatment (multi-type maltreatment) from within a developmental victimological framework. The interrelationships between sexual abuse, physical abuse, psychological maltreatment, neglect, and witnessing family violence are assessed. The role of family variables in predicting maltreatment and the relative contribution of child maltreatment and family variables to adjustment are evaluated. Risk factors for multi-type maltreatment, and the relationship between multi-type maltreatment and adjustment are explored. The major theories of child development are reviewed. As well as exploring the relevance of developmental theories to understanding the impact of child maltreatment, factors influencing the emergence of child psychopathology are reviewed from a developmental psychopathology perspective. Ecological and developmental perspectives on how child maltreatment translates into the behavioural and emotional adjustment problems of children are integrated in the Child Maltreatment: Risk and Protection Model. After exploring some of the relevant conceptual issues, the literature on the prevalence and impact of each maltreatment type is reviewed, and the literature on multi-type maltreatment critiqued. Methodological and ethical concerns with the conduct of research in the field of child maltreatment using direct assessment of children led to the need for an instrument to assess parent perceptions of each of the types of abuse and neglect, as well as adult retrospective reports. Data are presented from two cross-sectional questionnaire-based studies using the Parent and Adult versions of the Family and Life Experiences Questionnaire which was designed to assess perceptions of children's experiences of sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence. Problems with the isolated focus of research on single forms of child maltreatment are addressed by the inclusion of each of these forms of child maltreatment within a single research design. Respondents for both studies were volunteers recruited from counselling agencies, medical, community health, child care and fitness centres and a first year psychology course. Parents (N=50) described their perceptions of primary school children's family characteristics, experiences of maltreatment and adjustment. Children's behavioural adjustment (internalising and externalising), sexual behaviours, emotions, self-esteem, gender identity, family adaptability and cohesion, parental traditionality, parental sexual punitiveness, interparental relationship satisfaction, and demographic characteristics are assessed in the study of Parents' perceptions. A large degree of overlap between the different types of abuse and neglect was found, with a high proportion of parents describing children's experiences of multiple forms of child maltreatment. Using both maltreatment and family characteristics to predict internalising behaviour problems, neglect and family cohesion were the only unique predictors. Family adaptability and cohesion were the only unique predictors of externalising behaviour problems. Physical and sexual abuse were not predicted from family characteristics; neglect was predicted, but no variables provided unique prediction. Unique predictors of psychological maltreatment were family cohesion, parental sexual punitiveness and divorce. Divorce was the only variable with significant unique prediction of the child witnessing family violence. Family background and family functioning were found to predict some forms of maltreatment, but to also be important factors mediating the adjustment of children, independent of maltreatment. The results are interpreted within an ecological framework, integrating risk factors for maltreatment with experiences of abuse and neglect and subsequent adjustment in childhood. Retrospective reports of adults' (N=175) own childhood family characteristics, experiences of maltreatment, and reports of their current adjustment are also studied. Included with the adult version of the FLEQ were the Trauma Symptom Checklist-40, Rosenberg's Self-esteem Scale, and the Family and Adaptability and Cohesion Evaluation Scale-II. Similar results were found in the in the Adult Study. As hypothesised, adult retrospective reports of the five different types of child maltreatment were found to be highly intercorrelated. Family characteristics predicted maltreatment and adjustment scores and discriminated between single and multi-type maltreatment. Maltreatment scores also predicted adult adjustment. As the number of maltreatment types increased, there was an increase in the number of adjustment problems reported. Alternate hypotheses regarding the possible operation of mediating and moderating processes in the relationships between family characteristics, maltreatment and the adjustment of adults were assessed. Finally, the results of these investigations are discussed and interpreted in the light of extant findings previously reviewed. Data from the two major empirical studies are used to demonstrate the overlap between different child maltreatment categories, and the extent and impact of multi-type maltreatment. The results show that children are vulnerable to more than one type of maltreatment. Individuals who experience a number of different forms of maltreatment had greater adjustment problems than those experiencing only one or two different types of abuse or neglect. Dysfunctional families place children at risk of child maltreatment. Negative family characteristics lead to adjustment problems in children and adults. The type of maltreatment having the most damaging effect on children was neglect, and in the long-term, sexual abuse. A multi-dimensional approach to prevention and intervention needs to be adopted, based on the co-morbidity of maltreatment types, and the likelihood of children experiencing further abuse or neglect of a different type. Dysfunctional family dynamics which place children at risk of multi-type maltreatment, and mediate the effects of maltreatment on adjustment, need to be specifically targeted with support and family intervention strategies. Risk-assessment measures used by Child Protection workers must include adequate knowledge of the inter-relationships between maltreatment types, and the particularly negative impact on adjustment of experiencing many forms of abuse or neglect. Suggestions for future clinical and research work in the area of child maltreatment are developed. The importance of assessing all forms of maltreatment when examining the relationships of maltreatment to adjustment is emphasised. It is recommended that prevention and intervention strategies acknowledge the interrelationships between maltreatment types.

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This research reports on the experiences of Canadian nursing students as they coped with learning online, exploring the strategies that they used to learn effectively. The findings identified aspects of course design and online facilitation that will help students cope with the lack of social presence in the online environment.