897 resultados para implementation strategy


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Background Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. Methods A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. Results The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. Conclusions Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise. Trial registration ClinicalTrials.gov Identifier: NCT01765387 Keywords: Hydrotherapy; Heart rate; Fatigue; Strength; Blood pressure; Body temperature

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Successful biodiversity conservation requires safeguarding viable populations of species. To work with this challenge Sweden has introduced a concept of Action Plans, which focus on the recovery of one or more species; while keeping in mind the philosophy of addressing ecosystems in a more comprehensive way, following the umbrella concept. In this paper we investigate the implementationprocess of the ActionPlanfor one umbrella species, the White-backed Woodpecker (WBW) Dendrocopos leucotos. We describe the plan's organisation and goals, and investigate its implementation and accomplishment of particular targets, based on interviewing and surveying the key actors. The achievement of the targets in 2005-2008 was on average much lower than planned, explained partially by the lack of knowledge/data, experienced workers, and administrative flexibility. Surprisingly, the perceived importance of particular conservation measures, the investment priority accorded to them, the money available and various practical obstacles all failed to kg? explain the target levels achieved. However qualitative data from both the interviews and the survey highlight possible implementation obstacles: competing interests with other conservation actions and the level of engagement of particular implementing actors. Therefore we suggest that for successful implementation of recovery plans, there is aneed for initial and inclusive scoping prior to embarking on the plan, where not only issues like ecological knowledge and practical resources are considered, but also possible conflicts and synergies with other conservation actions. An adaptive approach with regular review of the conservation process is essential, particularly in the case of such complex action plans as the one for the WBW.

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The National Curriculum is a current innovation in Australian schooling history which is likely to have a widespread and long-term impact on schools, teachers and students. This paper has investigated educational change during the early phase of curriculum implementation in a large secondary school, north of Brisbane, Australia. Specifically, this study explored teachers’ perceptions of the principal’s transformational leadership skills during an early stage of the curriculum’s implementation along with teachers’ perceptions of implementing a National Curriculum in their classroom. For this research, sixty-nine teachers were surveyed about their perceptions of their principal’s leadership and their perceptions of the difficulty of implementation of the new curriculum. Findings indicated that teachers with positive perceptions of their principal's leadership also had positive perceptions of their capacity to implement the new National Curriculum. Specifically, teachers who perceived the principal as holding high expectations and providing intellectual stimulation believed they had the capacity to successfully implement curriculum change.

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Ultrafine particles are particles that are less than 0.1 micrometres (µm) in diameter. Due to their very small size they can penetrate deep into the lungs, and potentially cause more damage than larger particles. The Ultrafine Particles from Traffic Emissions and Children’s Health (UPTECH) study is the first Australian epidemiological study to assess the health effects of ultrafine particles on children’s health in general and peripheral airways in particular. The study is being conducted in Brisbane, Australia. Continuous indoor and outdoor air pollution monitoring was conducted within each of the twenty five participating school campuses to measure particulate matter, including in the ultrafine size range, and gases. Respiratory health effects were evaluated by conducting the following tests on participating children at each school: spirometry, forced oscillation technique (FOT) and multiple breath nitrogen washout test (MBNW) (to assess airway function), fraction of exhaled nitric oxide (FeNO, to assess airway inflammation), blood cotinine levels (to assess exposure to second-hand tobacco smoke), and serum C-reactive protein (CRP) levels (to measure systemic inflammation). A pilot study was conducted prior to commencing the main study to assess the feasibility and reliably of measurement of some of the clinical tests that have been proposed for the main study. Air pollutant exposure measurements were not included in the pilot study.

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Biological systems are typically complex and adaptive, involving large numbers of entities, or organisms, and many-layered interactions between these. System behaviour evolves over time, and typically benefits from previous experience by retaining memory of previous events. Given the dynamic nature of these phenomena, it is non-trivial to provide a comprehensive description of complex adaptive systems and, in particular, to define the importance and contribution of low-level unsupervised interactions to the overall evolution process. In this chapter, the authors focus on the application of the agent-based paradigm in the context of the immune response to HIV. Explicit implementation of lymph nodes and the associated lymph network, including lymphatic chain structure, is a key objective, and requires parallelisation of the model. Steps taken towards an optimal communication strategy are detailed.

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School curriculum change processes have traditionally been managed internally. However, in Queensland, Australia, as a response to the current high-stakes accountability regime, more and more principals are outsourcing this work to external change agents (ECAs). In 2009, one of the authors (a university lecturer and ECA) developed a curriculum change model (the Controlled Rapid Approach to Curriculum Change (CRACC)), specifically outlining the involvement of an ECA in the initiation phase of a school’s curriculum change process. The purpose of this paper is to extend the CRACC model by unpacking the implementation phase, drawing on data from a pilot study of a single school. Interview responses revealed that during the implementation phase, teachers wanted to be kept informed of the wider educational context; use data to constantly track students; relate pedagogical practices to testing practices; share information between departments and professional levels; and, own whole school performance. It is suggested that the findings would be transferable to other school settings and internal leadership of curriculum change. The paper also strikes a chord of concern – Do the responses from teachers operating in such an accountability regime live their professional lives within this corporate and globalised ideology whether they want to or not?

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Overview The incidence of skin tears, pressure injuries and chronic wounds increases with age [1-4] and therefore is a serious issue for staff and residents in Residential Aged Care Facilities (RACFs). A pilot project funded in Round 2 of the Encouraging Best Practice in Residential Aged Care (EBPRAC) program by the then Australian Government Department of Health and Ageing found that a substantial proportion of residents in aged care facilities experienced pressure injuries, skin tears or chronic wounds. It also found the implementation of the evidence based Champions for Skin Integrity (CSI) model of wound care was successful in significantly decreasing the prevalence and severity of wounds in residents, improving staff skills and knowledge of evidence based wound management, increasing staff confidence with wound management, increasing implementation of evidence based wound management and prevention strategies, and increasing staff awareness of their roles in evidence based wound care at all levels [5]. Importantly, during the project, the project team developed a resource kit on evidence based wound management. Two critical recommendations resulting from the project were that: - The CSI model or a similar strategic approach should be implemented in RACFs to facilitate the uptake of evidence based wound management and prevention - The resource kit on evidence based wound management should be made available to all Residential Aged Care Facilities and interested parties A proposal to disseminate or rollout the CSI model of wound care to all RACFs across Australia was submitted to the department in 2012. The department approved funding from the Aged Care Services Improvement Healthy Ageing Grant (ACSIHAG) at the same time as the Round 3 of the Encouraging Better Practice in Aged Care (EBPAC) program. The dissemination involved two crucial elements: 1. The updating, refining and distribution of a Champions for Skin Integrity Resource Kit, more commonly known as a CSI Resource Kit and 2. The presentation of intensive one day Promoting Healthy Skin “Train the Trainer” workshops in all capital cities and major regional towns across Australia Due to demand, the department agreed to fund a second round of workshops focussing on regional centres and the completion date was extended to accommodate the workshops. Later, the department also decided to host a departmental website for a number of clinical domains, including wound management, so that staff from the residential aged care sector had easy access to a central repository of helpful clinical resource material that could be used for improving the health and wellbeing of their older adults, consumers and carers. CSI Resource Kit Upgrade and Distribution: At the start of the project, a full evidence review was carried out on the material produced during the EBPRAC-CSI Stage 1 project and the relevant evidence based changes were made to the documentation. At the same time participants in the EBPRAC-CSI Stage 1 project were interviewed for advice on how to improve the resource material. Following this the documentation, included in the kit, was sent to independent experts for peer review. When this process was finalised, a learning designer and QUT’s Visual Communications Services were engaged to completely refine and update the design of the resources, and combined resource kit with the goal of keeping the overall size of the kit suitable for bookshelf mounting and the cost at reasonable levels. Both goals were achieved in that the kit is about the same size as a 25 mm A4 binder and costs between $19.00 and $28.00 per kit depending on the size of the print run. The dissemination of the updated CSI resource kit was an outstanding success. Demand for the kits was so great that a second print run of 2,000 kits was arranged on top of the initial print run of 4,000 kits. All RACFs across Australia were issued with a kit, some 2,740 in total. Since the initial distribution another 1,100 requests for kits has been fulfilled as well as 1,619 kits being distributed to participants at the Promoting Healthy Skin workshops. As the project was winding up a final request email was sent to all workshop participants asking if they required additional kits or resources to distribute the remaining kits and resources. This has resulted in requests for 200 additional kits and resources. Feedback from the residential aged care sector and other clinical providers who have interest in wound care has been very positive regarding the utility of the kit, (see Appendix 4). Promoting Healthy Skin Workshops The workshops also exceeded the project team’s initial objective. Our goal of providing workshop training for staff from one in four facilities and 450 participants was exceeded, with overwhelming demand for workshop places resulting in the need to provide a second round of workshops across Australia. At the completion of the second round, 37 workshops had been given, with 1286 participants, representing 835 facilities. A number of strategies were used to promote the workshops ranging from invitations included in the kit, to postcard mail-outs, broadcast emailing to all facilities and aged care networks and to articles and paid advertising in aged care journals. The most effective method, by far, was directly phoning the facilities. This enabled the caller to contact the relevant staff member and enlist their support for the workshop. As this is a labour intensive exercise, it was only used where numbers needed bolstering, with one venue rising from 3 registrants before the calls to 53 registrants after. The workshops were aimed at staff who had the interest and the capability of implementing evidence-based wound management within their facility or organisation. This targeting was successful in that a large proportion (68%) of participants were Registered Nurses, Nurse Managers, Educators or Consultants. Twenty percent were Endorsed Enrolled Nurses with the remaining 12% being made up of Personal Care Workers or Allied Health Professionals. To facilitate long term sustainability, the workshop employed train-the-trainer strategies. Feedback from the EBPRAC-CSI Stage 1 interviews was used in the development of workshop content. In addition, feedback from the workshop conducted at the end of the EBPRAC-CSI Stage 1 project suggested that change management and leadership training should be included in the workshops. The program was trialled in the first workshop conducted in Brisbane and then rolled out across Australia. Participants were asked to complete pre and post workshop surveys at the beginning and end of the workshop to determine how knowledge and confidence improved over the day. Results from the pre and post surveys showed significant improvements in the level of confidence in attendees’ ability to implement evidence based wound management. The results also indicated a significant increase in the level of confidence in ability to implement change within their facility or organisation. This is an important indication that the inclusion of change management/leadership training with clinical instruction can increase staff capacity and confidence in translating evidence into practice. To encourage the transfer of the evidence based content of the workshop into practice, participants were asked to prepare an Action Plan to be followed by a simple one page progress report three months after the workshop. These reports ranged from simple (e.g. skin moisturising to prevent skin tears), to complex implementation plans for introducing the CSI model across the whole organisation. Outcomes described in the project reports included decreased prevalence of skin tears, pressure injuries and chronic wounds, along with increased staff and resident knowledge and resident comfort. As stated above, some organisations prepared large, complex plans to roll out the CSI model across their organisation. These plans included a review of the organisation’s wound care system, policies and procedures, the creation of new processes, the education of staff and clients, uploading education and resource material onto internal electronic platforms and setting up formal review and evaluation processes. The CSI Resources have been enthusiastically sought and incorporated into multiple health care settings, including aged care, acute care, Medicare Local intranets (e.g. Map of Medicine e-pathways), primary health care, community and home care organisations, education providers and New Zealand aged and community health providers. Recommendations: Recommendations for RACFs, aged care and health service providers and government  Skin integrity and the evidence-practice gap in this area should be recognised as a major health issue for health service providers for older adults, with wounds experienced by up to 50% of residents in aged care settings (Edwards et al. 2010). Implementation of evidence based wound care through the Champions for Skin Integrity model in this and the pilot project has demonstrated the prevalence of wounds, wound healing times and wound infections can be halved.  A national program and Centre for Evidence Based Wound Management should be established to: - expand the reach of the model to other aged care facilities and health service providers for older adults - sustain the uptake of models such as the Champions for Skin Integrity (CSI) model - ensure current resources, expertise and training are available for consumers and health care professionals to promote skin integrity for all older adults  Evidence based resources for the CSI program and similar projects should be reviewed and updated every 3 – 4 years as per NH&MRC recommendations  Leadership and change management training is fundamental to increasing staff capacity, at all levels, to promote within-organisation dissemination of skills and knowledge gained from projects providing evidence based training Recommendations for future national dissemination projects  A formal program of opportunities for small groups of like projects to share information and resources, coordinate activities and synergise education programs interactively would benefit future national dissemination projects - Future workshop programs could explore an incentive program to optimise attendance and reduce ‘no shows’ - Future projects should build in the capacity and funding for increased follow-up with workshop attendees, to explore the reasons behind those who are unable to translate workshop learnings into the workplace and identify factors to address these barriers.

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Alcohol-related mortality and morbidity represents a substantial financial burden on communities across the world. Adolescence and young adulthood is a peak period for heavy episodic alcohol consumption, with over a third of all people aged 14-19 years having been at risk of acute alcoholrelated harm at least once in the previous 12 months (Australian Institute of Health and Welfare [AIHW], 2011). Excessive alcohol consumption has long been seen as a male problem; however, a gradual shift towards a social acceptance of female drunkenness has narrowed the gap in drinking quantity and style between men and women (Grucza, Bucholz, Rice, & Bierut, 2008). The presented data point to the vulnerability of women to the consequences of acute alcohol intoxication and indicate that alcohol-related offending by women is on the rise. Taken together, these findings reveal that alcohol-related harms and aggression for young women are becoming more prevalent and problematic. This report addressed these issues from a policing perspective...

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Introduction Patients with dysphagia (PWDs) have been shown to be four times more likely to suffer medication administration errors (MAEs).1 2 Individualised medication administration guides (I-MAGs) which outline how each formulation should be administered, have been developed to standardise medication administration by nurses on the ward and reduce the likelihood of errors. This pilot study aimed to determine the recruitment rates, estimate effect on errors and develop the intervention to design a future full scale randomised controlled trial to determine the costs and effects of I-MAG implementation. Ethical approval was granted by local ethics committee. Method Software was developed to enable I-MAG production (based on current best practice)3 4 for all PWDs on two care of the older person wards admitted during a six month period from January to July 2011. I-MAGs were attached to the medication administration record charts to be utilised by nurses when administering medicines. Staff training was provided for all staff on the intervention wards. Two care of the older person wards in the same hospital were used for control purposes. All patients with dysphagia were recruited for follow up purposes at discharge. Four ward rounds at each intervention and control ward were observed pre and post I-MAG implementation to determine the level of medication administration errors. NHS ethical approval for the study was obtained. Results 164 I-MAGs were provided for 75 patients with dysphagia (PWDs) in the two intervention wards. At discharge, 23 patients in the intervention wards and 7 patients in the control wards were approached for recruitment of which 17 (74%) & 5 (71.5%) respectively consented. Discussion Recruitment rates were low on discharge due to the dysphagia remitting during hospitalisation. The introduction of the I-MAG demonstrated no effect on the quality of administration on the intervention ward and interestingly practice improved on the control ward. The observation of medication rounds at least one month post I-MAG removal may have identified a reversal to normal practice and ideally observations should have been undertaken with I-MAGs in place. Identification of the reason for the improvement in the control ward is warranted.

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Estimating the prevalence of drink driving is a difficult task. Self‐reported drink driving indicates that drink driving is far more common than official statistics suggest. In order to promote a responsible attitude towards alcohol consumption and drink driving within the Queensland community, the Queensland Police Service, Queensland Health and Queensland Transport developed the ‘Drink Rite’ program (Queensland Police Service information sheet, 2009). However, the feasibility of the program is now in doubt as the National Health and Medical Research Council’s guidelines for alcohol consumption changed in 2009 to state “For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol‐related injury arising from that occasion” (NHMRC Publication, 2009, p. 51). As such, adhering to the NHMRC guidelines places restrictions on how the existing Drink Rite program can be operated (i.e. by reducing the number of standard drinks provided to participants from eight to four). It is arguable that a reduction in the number of alcoholic drinks provided to participants in the program will result in a large reduction in observed BAC readings. This, in turn, will lead to a potential loss of message content when discussing the variation in the effects of alcohol.

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Nth-Dimensional Truncated Polynomial Ring (NTRU) is a lattice-based public-key cryptosystem that offers encryption and digital signature solutions. It was designed by Silverman, Hoffstein and Pipher. The NTRU cryptosystem was patented by NTRU Cryptosystems Inc. (which was later acquired by Security Innovations) and available as IEEE 1363.1 and X9.98 standards. NTRU is resistant to attacks based on Quantum computing, to which the standard RSA and ECC public-key cryptosystems are vulnerable to. In addition, NTRU has higher performance advantages over these cryptosystems. Considering this importance of NTRU, it is highly recommended to adopt NTRU as part of a cipher suite along with widely used cryptosystems for internet security protocols and applications. In this paper, we present our analytical study on the implementation of NTRU encryption scheme which serves as a guideline for security practitioners who are novice to lattice-based cryptography or even cryptography. In particular, we show some non-trivial issues that should be considered towards a secure and efficient NTRU implementation.

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In 2008 the Australian government introduced the National Rental Affordability Scheme (NRAS) to increase the supply of affordable rental in Australia. This Federal Government initiative was progressively rolled out through four different rounds over the years with fifth round to be announced some time in 2014. Although the scheme has been successful evident there have been numerous setbacks experienced. This paper focuses on understanding lessons learnt from the performance of the scheme to make recommendations for future government initiatives. This evaluation is based on the combination of document analysis, government officers as well as approved NRAS participants operating throughout Queensland. The most significant challenges for the NRAS participants is the involvement of three levels government which cause delays in the scheme approval process.

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Urbanisation significantly changes the characteristics of a catchment as natural areas are transformed to impervious surfaces such as roads, roofs and parking lots. The increased fraction of impervious surfaces leads to changes to the stormwater runoff characteristics, whilst a variety of anthropogenic activities common to urban areas generate a range of pollutants such as nutrients, solids and organic matter. These pollutants accumulate on catchment surfaces and are removed and trans- ported by stormwater runoff and thereby contribute pollutant loads to receiving waters. In summary, urbanisation influences the stormwater characteristics of a catchment, including hydrology and water quality. Due to the growing recognition that stormwater pollution is a significant environmental problem, the implementation of mitigation strategies to improve the quality of stormwater runoff is becoming increasingly common in urban areas. A scientifically robust stormwater quality treatment strategy is an essential requirement for effective urban stormwater management. The efficient design of treatment systems is closely dependent on the state of knowledge in relation to the primary factors influencing stormwater quality. In this regard, stormwater modelling outcomes provide designers with important guidance and datasets which significantly underpin the design of effective stormwater treatment systems. Therefore, the accuracy of modelling approaches and the reliability modelling outcomes are of particular concern. This book discusses the inherent complexity and key characteristics in the areas of urban hydrology and stormwater quality, based on the influence exerted by a range of rainfall and catchment characteristics. A comprehensive field sampling and testing programme in relation to pollutant build-up, an urban catchment monitoring programme in relation to stormwater quality and the outcomes from advanced statistical analyses provided the platform for the knowledge creation. Two case studies and two real-world applications are discussed to illustrate the translation of the knowledge created to practical use in relation to the role of rainfall and catchment characteristics on urban stormwater quality. An innovative rainfall classification based on stormwater quality was developed to support the effective and scientifically robust design of stormwater treatment systems. Underpinned by the rainfall classification methodology, a reliable approach for design rainfall selection is proposed in order to optimise stormwater treatment based on both, stormwater quality and quantity. This is a paradigm shift from the common approach where stormwater treatment systems are designed based solely on stormwater quantity data. Additionally, how pollutant build-up and stormwater runoff quality vary with a range of catchment characteristics was also investigated. Based on the study out- comes, it can be concluded that the use of only a limited number of catchment parameters such as land use and impervious surface percentage, as it is the case in current modelling approaches, could result in appreciable error in water quality estimation. Influential factors which should be incorporated into modelling in relation to catchment characteristics, should also include urban form and impervious surface area distribution. The knowledge created through the research investigations discussed in this monograph is expected to make a significant contribution to engineering practice such as hydrologic and stormwater quality modelling, stormwater treatment design and urban planning, as the study outcomes provide practical approaches and recommendations for urban stormwater quality enhancement. Furthermore, this monograph also demonstrates how fundamental knowledge of stormwater quality processes can be translated to provide guidance on engineering practice, the comprehensive application of multivariate data analyses techniques and a paradigm on integrative use of computer models and mathematical models to derive practical outcomes.

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This paper discusses the emergence of assessment for learning (AfL) across the globe with particular attention given to Western educational jurisdictions. Authors from Australia, Canada, Ireland, Israel, New Zealand, Norway, and the USA explain the genesis of AfL, its evolution and impact on school systems, and discuss current trends in policy directions for AfL within their respective countries. The authors also discuss the implications of these various shifts and the ongoing tensions that exist between AfL and summative forms of assessment within national policy initiatives.

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Purpose Little is known about the adoption of mobile banking technologies in emerging Asian economies. This paper aims to empirically examine the motivators that influence a consumer’s intentions to use mobile banking. Design/methodology/approach A web-based survey was employed to collect data from 348 respondents, split across Thailand and Australia. Data were analyzed by employing exploratory and confirmatory factor analyses, path and invariance analyses. Findings The findings indicate that for Australian consumers, perceived ease of use, perceived usefulness and perceived risk were the primary determinants of mobile banking adoption. For Thai consumers, the main factors were perceived usefulness, perceived risk and social influence. National culture was found to impact key antecedents that lead to adoption of m-banking. Research limitations/implications The actual variance explained by our study’s model was higher in Australia (59.3%) than for Thailand (23.8%), suggesting future research of m-banking adoption in emerging Asian cultures. Practical implications We identify the important factors consumers consider when adopting m-banking. The findings of this research give banking organisations a foundational model that can be used to support m-banking implementation. Originality/value Our study is perhaps the first to examine and compare the intention to adopt m-banking across Thai and Australian consumers, and responds to calls for additional research that generalises m-banking and m-services acceptance across cultures. This study has proposed and validated additional constructs that are not present in the original SST Intention to Use model.