905 resultados para Longitudinal Change
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The philosophical promise of community development to “resource and empower people so that they can collectively control their own destinies” (Kenny 1996:104) is no doubt alluring to Indigenous Australia. Given the historical and contemporary experiences of colonial control and surveillance of Aboriginal bodies, alongside the continuing experiences of socio-economic disadvantage, community development reaffirms the aspirational goal of Indigenous Australians for self-determination. Self-determination as a national policy agenda for Indigenous Australians emerged in the 1970s and saw the establishment of a wide range of Aboriginal community-controlled services (Tsey et al 2012). Sullivan (2010:4) argues that the Aboriginal community controlled service sector during this time has, and continues to be, instrumental to advancing the plight of Indigenous Australians both materially and politically. Yet community development and self-determination remain highly problematic and contested in how they manifest in Indigenous social policy agendas and in practice (Hollinsworth 1996; Martin 2003; McCausland 2005; Moreton-Robinson 2009). Moreton-Robinson (2009:68) argues that a central theme underpinning these tensions is a reading of Indigeneity in which Aboriginal and Torres Strait Islander people, behaviours, cultures, and communities are pathologised as “dysfunctional” thus enabling assertions that Indigenous people are incapable of managing their own affairs. This discourse distracts us from the “strategies and tactics of patriarchal white sovereignty” that inhibit the “state’s earlier policy of self-determination” (Moreton-Robinson 2009:68). We acknowledge the irony of community development espoused by Ramirez above (1990), that the least resourced are expected to be most resourceful.; however, we wish to interrogate the processes that inhibit Indigenous participation and control of our own affairs rather than further interrogate Aboriginal minds as uneducated, incapable and/or impaired...
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We propose the use of optical flow information as a method for detecting and describing changes in the environment, from the perspective of a mobile camera. We analyze the characteristics of the optical flow signal and demonstrate how robust flow vectors can be generated and used for the detection of depth discontinuities and appearance changes at key locations. To successfully achieve this task, a full discussion on camera positioning, distortion compensation, noise filtering, and parameter estimation is presented. We then extract statistical attributes from the flow signal to describe the location of the scene changes. We also employ clustering and dominant shape of vectors to increase the descriptiveness. Once a database of nodes (where a node is a detected scene change) and their corresponding flow features is created, matching can be performed whenever nodes are encountered, such that topological localization can be achieved. We retrieve the most likely node according to the Mahalanobis and Chi-square distances between the current frame and the database. The results illustrate the applicability of the technique for detecting and describing scene changes in diverse lighting conditions, considering indoor and outdoor environments and different robot platforms.
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Background The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual’s quality of life and healthcare costs. Objectives This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Design Secondary analysis of combined data collected from three previous prospective longitudinal studies. Setting The contributing studies’ participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Participants Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3 to 36 months). Methods Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. Results The median time to recurrence was 42 weeks (95% CI 31.9–52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07–2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84–10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003–1.01, p<0.001); while the protective factors were elevating legs for at least 30 minutes per day (HR 0.33, 95% CI 0.19–0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92–0.99, p=0.016), and walking around for at least three hours/day (HR 0.66, 95% CI 0.44–0.98, p=0.040). Conclusions Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence.
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Introduction Chest pain is common in emergency department (ED) patients and represents a considerable burden for rural health services. Health services reforms to improve access to care need appropriately skilled and supported clinicians in the delivery of safe and effective care, including the use of emergency nurse practitioners (ENPs). Despite increasing use of ENPs, little is known about the safety and quality of the service in the rural ED context. The aims of this study are (1) to examine the safety and quality of the ENP service model in the provision of care in the rural environment and (2) to evaluate the effectiveness of the service in the management of patients presenting with undifferentiated chest pain. Methods and analysis This is the protocol for a prospective longitudinal nested cohort study to compare the effectiveness of ENP service with that of standard care. Adults presenting to three rural EDs in Queensland, Australia with a primary presenting complaint of atraumatic chest pain will be eligible for enrolment. We will measure (1) clinician's use of evidence-based guidelines (2) diagnostic accuracy of ECG interpretation for the management of patients with suspected or confirmed ACS (3) service indicators of waiting times, length-of-stay and did-not-wait rates and (4) clinician's diagnostic accuracy as measured by rates of unplanned representation within 7 days (5) satisfaction with care, (6) quality-of-life and (7) functional status. To assess these outcomes we will use a combination of measures collected from routinely collected data, medical record review and questionnaires (with 30-day follow-up). Ethics and dissemination Queensland Health Human Research Ethics Committee (HREC) has approved this protocol. The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.
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Aim: To quantify the consequences of major threats to biodiversity, such as climate and land-use change, it is important to use explicit measures of species persistence, such as extinction risk. The extinction risk of metapopulations can be approximated through simple models, providing a regional snapshot of the extinction probability of a species. We evaluated the extinction risk of three species under different climate change scenarios in three different regions of the Mexican cloud forest, a highly fragmented habitat that is particularly vulnerable to climate change. Location: Cloud forests in Mexico. Methods: Using Maxent, we estimated the potential distribution of cloud forest for three different time horizons (2030, 2050 and 2080) and their overlap with protected areas. Then, we calculated the extinction risk of three contrasting vertebrate species for two scenarios: (1) climate change only (all suitable areas of cloud forest through time) and (2) climate and land-use change (only suitable areas within a currently protected area), using an explicit patch-occupancy approximation model and calculating the joint probability of all populations becoming extinct when the number of remaining patches was less than five. Results: Our results show that the extent of environmentally suitable areas for cloud forest in Mexico will sharply decline in the next 70 years. We discovered that if all habitat outside protected areas is transformed, then only species with small area requirements are likely to persist. With habitat loss through climate change only, high dispersal rates are sufficient for persistence, but this requires protection of all remaining cloud forest areas. Main conclusions: Even if high dispersal rates mitigate the extinction risk of species due to climate change, the synergistic impacts of changing climate and land use further threaten the persistence of species with higher area requirements. Our approach for assessing the impacts of threats on biodiversity is particularly useful when there is little time or data for detailed population viability analyses. © 2013 John Wiley & Sons Ltd.
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Despite being used since 1976, Delusions-Symptoms-States-Inventory/states of Anxiety and Depression (DSSI/sAD) has not yet been validated for use among people with diabetes. The aim of this study was to examine the validity of the personal disturbance scale (DSSI/sAD) among women with diabetes using Mater-University of Queensland Study of Pregnancy (MUSP) cohort data. The DSSI subscales were compared against DSM-IV disorders, the Mental Component Score of the Short Form 36 (SF-36 MCS), and Center for Epidemiologic Studies Depression Scale (CES-D). Factor analyses, odds ratios, receiver operating characteristic (ROC) analyses and diagnostic efficiency tests were used to report findings. Exploratory factor analysis and fit indices confirmed the hypothesized two-factor model of DSSI/sAD. We found significant variations in the DSSI/sAD domain scores that could be explained by CES-D (DSSI-Anxiety: 55%, DSSI-Depression: 46%) and SF-36 MCS (DSSI-Anxiety: 66%, DSSI-Depression: 56%). The DSSI subscales predicted DSM-IV diagnosed depression and anxiety disorders. The ROC analyses show that although the DSSI symptoms and DSM-IV disorders were measured concurrently the estimates of concordance remained only moderate. The findings demonstrate that the DSSI/sAD items have similar relationships to one another in both the diabetes and non-diabetes data sets which therefore suggest that they have similar interpretations.
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Background Symptoms of depression can be recurrent or limited to one episode. This study discusses the prospective association between psychological health, measured as change in depression symptoms, and the risk of diabetes mellitus in Australian women. Methods Data obtained from the Mater-University of Queensland Study of Pregnancy. Depression was measured using the Delusions-Symptoms: States Inventory. To examine possible transitions over time, depression was grouped into four categories and assessed at different phases over the 21-year period. Multiple logistic regression models and sensitivity analysis to assess the robustness of our analytical strategy were performed. Results Three hundred and one women reported diabetes 21 years after the index pregnancy. Almost one-third of the women who reported depression symptoms continued to report these at a subsequent follow-up (FU) phase. About 1 in 20 women who had not reported depression symptoms at the 5-year FU did so at the subsequent 14-year FU. In prospective analyses, we did not find a significant association between diabetes and negative change (not depressed to depressed, at subsequent phase); however, for women with positive history of symptoms of depression and women with persistent symptoms, there was a 1.97-fold (95% confidence interval [CI]: 1.14–3.40) to 2.23-fold (95% CI: 1.09–4.57) greater risk of diabetes. Conclusions Our study suggests that an increased risk of diabetes is significantly associated with persistent depression symptoms. It highlights the importance of recognizing depression symptoms in terms of women's psychological wellbeing and thus provides a basis for targeting those most at risk.
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Changing environments pose a serious problem to current robotic systems aiming at long term operation under varying seasons or local weather conditions. This paper is built on our previous work where we propose to learn to predict the changes in an environment. Our key insight is that the occurring scene changes are in part systematic, repeatable and therefore predictable. The goal of our work is to support existing approaches to place recognition by learning how the visual appearance of an environment changes over time and by using this learned knowledge to predict its appearance under different environmental conditions. We describe the general idea of appearance change prediction (ACP) and investigate properties of our novel implementation based on vocabularies of superpixels (SP-ACP). Our previous work showed that the proposed approach significantly improves the performance of SeqSLAM and BRIEF-Gist for place recognition on a subset of the Nordland dataset under extremely different environmental conditions in summer and winter. This paper deepens the understanding of the proposed SP-ACP system and evaluates the influence of its parameters. We present the results of a large-scale experiment on the complete 10 h Nordland dataset and appearance change predictions between different combinations of seasons.
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Climate change and solar ultraviolet radiation may affect vaccine-preventable infectious diseases (VPID), the human immune response process and the immunization service delivery system. We systematically reviewed the scientific literature and identified 37 relevant publications. Our study shows that climate variability and ultraviolet radiation may potentially affect VPID and the immunization delivery system through modulating vector reproduction and vaccination effectiveness, possibly influencing human immune response systems to the vaccination, and disturbing immunization service delivery. Further research is needed to determine these affects on climate-sensitive VPID and on human immune response to common vaccines. Such research will facilitate the development and delivery of optimal vaccination programs for target populations, to meet the goal of disease control and elimination.
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Urban green infrastructure can help cities adapt to climate change. Spatial planning can play an important role in utilizing green infrastructure for adaptation. Yet climate change risks represent a different sort of challenge for planning institutions. This paper aims to address two issues arising from this challenge. First, it defines the concept of green infrastructure within the context of climate adaptation. Second, it identifies and puts into perspective institutional barriers to adopting green infrastructure for climate adaptation, including path dependence. We begin by arguing that there is growing confusion among planners and policy makers about what constitutes green infrastructure. Definitional ambiguity may contribute to inaction on climate change adaptation, because it muddies existing programs and initiatives that are to do with green-space more broadly, which in turn feeds path dependency. We then report empirical findings about how planners perceive the institutional challenge arising from climate change and the adoption of green infrastructure as an adaptive response. The paper concludes that spatial planners generally recognize multiple rationales associated with green infrastructure. However they are not particularly keen on institutional innovation and there is a tendency for path dependence. We propose a conceptual model that explicitly recognizes such institutional factors. This paper contributes to the literature by showing that agency and institutional dimensions are a limiting factor in advancing the concept of green infrastructure within the context of climate change adaptation.
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Global climate change will affect all domains of person-environment relations. Tackling climate change will require social change that can be motivated by people’s imaginings of the future of their society where such social change has occurred. We use the “collective futures” framework to examine whether beliefs about the future of society are related to present-day intentions to take climate change action. Participants from two Brazilian samples imagined their society in 2050 where climate change was mitigated and then rated how this future society would differ from Brazilian society today in terms of societal-level dysfunction and development and personal-level traits and values. To the extent that participants believed preventing climate change would result in societal development and more competence traits, they were more willing to engage in environmental citizenship activities. Individual differences in future time perspective also impacted environmental citizenship intention. Societal development and consideration of future consequences seem to be distinct routes by which future thinking influence climate change action.
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We identified the active ingredients in people’s visions of society’s future (“collective futures”) that could drive political behavior in the present. In eight studies (N = 595), people imagined society in 2050 where climate change was mitigated (Study 1), abortion laws relaxed (Study 2), marijuana legalized (Study 3), or the power of different religious groups had increased (Studies 4-8). Participants rated how this future society would differ from today in terms of societal-level dysfunction and development (e.g., crime, inequality, education, technology), people’s character (warmth, competence, morality), and their values (e.g., conservation, self-transcendence). These measures were related to present-day attitudes/intentions that would promote/prevent this future (e.g., act on climate change, vote for a Muslim politician). A projection about benevolence in society (i.e., warmth/morality of people’s character) was the only dimension consistently and uniquely associated with present-day attitudes and intentions across contexts. Implications for social change theories, political communication, and policy design are discussed.
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A sizeable (and growing) proportion of the public in Western democracies deny the existence of anthropogenic climate change. It is commonly assumed that convincing deniers that climate change is real is necessary for them to act pro-environmentally. However, the likelihood of ‘conversion’ using scientific evidence is limited because these attitudes increasingly reflect ideological positions. An alternative approach is to identify outcomes of mitigation efforts that deniers find important. People have strong interests in the welfare of their society, so deniers may act in ways supporting mitigation efforts where they believe these efforts will have positive societal effects. In Study 1, climate change deniers (N D 155) intended to act more pro-environmentally where they thought climate change action would create a society where people are more considerate and caring, and where there is greater economic/technological development. Study 2 (ND347) replicated this experimentally, showing that framing climate change action as increasing consideration for others, or improving economic/technological development, led to greater pro-environmental action intentions than a frame emphasizing avoiding the risks of climate change. To motivate deniers’ pro-environmental actions, communication should focus on how mitigation efforts can promote a better society, rather than focusing on the reality of climate change and averting its risks.