955 resultados para Public Hospitals


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A quasi-experimental design (N=517) was used to investigate the effect on audience response to a supported charity if corporate support is featured in an advertisement. The results indicate that corporate support of a charity appears not to influence audience attitudes and donation intentions for the charity. A small portion of the audience may be motivated to donate when learning of a large corporate donation to the charity. The level of individual's favourability for the charity was the strongest predictor of their attitudes and intentions. Gender was also a predictor of more positive charity attitudes, with females reporting more positive attitudes than males for three of four charities. Managerial implications and areas for future research are discussed.

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The affective communication patterns of conversations on Twitter can provide insights into the culture of online communities. In this paper we apply a combined quantitative and qualitative approach to investigate the structural make-up and emotional content of tweeting activity around the hashtag #auspol (for Australian politics) in order to highlight the polarity and conservativism that characterise this highly active community of politically engaged individuals. We document the centralised structure of this particular community, which is based around a deeply committed core of contributors. Through in-depth content analysis of the tweets of participants to the online debate we explore the communicative tone, patterns of engagement and thematic drivers that shape the affective character of the community and their effect on its cohesiveness. In this way we provide a comprehensive account of the complex techno-social, linguistic and cultural factors involved in conversations that are shaped in the Twittersphere.

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An increasing number of countries are faced with an aging population increasingly needing healthcare services. For any e-health information system, the need for increased trust by such clients with potentially little knowledge of any security scheme involved is paramount. In addition notable scalability of any system has become a critical aspect of system design, development and ongoing management. Meanwhile cryptographic systems provide the security provisions needed for confidentiality, authentication, integrity and non-repudiation. Cryptographic key management, however, must be secure, yet efficient and effective in developing an attitude of trust in system users. Digital certificate-based Public Key Infrastructure has long been the technology of choice or availability for information security/assurance; however, there appears to be a notable lack of successful implementations and deployments globally. Moreover, recent issues with associated Certificate Authority security have damaged trust in these schemes. This paper proposes the adoption of a centralised public key registry structure, a non-certificate based scheme, for large scale e-health information systems. The proposed structure removes complex certificate management, revocation and a complex certificate validation structure while maintaining overall system security. Moreover, the registry concept may be easier for both healthcare professionals and patients to understand and trust.

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Balancing the demands of research and ethics is always challenging and even more so when recruiting vulnerable groups. Within the context of current legislation and international human rights declarations, it is strongly advocated that research can and must be undertaken with all recipients of health care services. Research in the field of intellectual disability presents particular challenges in regard to consenting processes. This paper is a critical reflection and analysis of the complex processes undertaken and events that occurred in gaining informed consent from people with intellectual disability to participate in a study exploring their experiences of being an inpatient in mental health hospitals within Aotearoa/New Zealand. A framework based on capacity, information and voluntariness is presented with excerpts from the field provided to explore consenting processes. The practical implications of the processes utilised are then discussed in order to stimulate debate regarding clearer and enhanced methods of gaining informed consent from people with intellectual disability.

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Public sector organisations (PSOs) operate in information-intensive environments often within operational contexts where efficiency is a goal. What's more, the rapid adoption of IT is expected to facilitate good governance within public sector organisations but it often clashes with the bureaucratic culture of these organisations. Accordingly, models such as IT Governance (ITG) and government reform -in particular the new public management (NPM)- were introduced in PSOs in an effort to address the inefficiencies of bureaucracy and under performance. This work explores the potential effect of change in political direction and policy on the stability of IT governance in Australian public sector organisations. The aim of this paper is to examine implications of a change of government and the resulting political environment on the effectiveness of the audit function of ITG. The empirical data discussed here indicate that a number of aspects of audit functionality were negatively affected by change in political direction and resultant policy changes. The results indicate a perceived decline in capacity and capability which in turn disrupts the stability of IT governance systems in public sector organisations.

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IT resources are indispensable in the management of Public Sector Organizations (PSOs) around the world. We investigate the factors that could leverage the IT resources in PSOs in developing economies. While research on ways to leverage IT resources in private sector organizations of developed countries is substantial, our understanding on ways to leverage the IT resources in the public sector in developing countries is limited. The current study aspires to address this gap in the literature by seeking to determine the key factors required to create process value from public sector IT investments in developing countries. We draw on the resource-centric theories to imply the nature of factors that could leverage the IT resources in the public sector. Employing an interpretive design, we identified three factors necessary for IT process value generation in the public sector. We discuss these factors and state their implications to theory and practice.

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Despite ongoing ‘boom’ conditions in the Australian mining industry, women remain substantially and unevenly under-represented in the sector, as is the case in other resource-dependent countries. Building on the literature critiquing business-case rationales and strategies as a means to achieve women’s equality in the workplace, we examine the business case for employing more women as advanced by the Australian mining industry. Specifically, we apply a discourse analysis to seven substantial, publically-available documents produced by the industry’s national and state peak organizations between 2005 and 2013. Our study makes two contributions. First, we map the features of the business case at the sectoral rather than firm or workplace level and examine its public mobilization. Second, we identify the construction and deployment of a normative identity – ‘the ideal mining woman’ – as a key outcome of this business-case discourse. Crucially, women are therein positioned as individually responsible for gender equality in the workplace.

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Background: International epidemic clones (ribotypes 027 and 078) of Clostridium difficile have been associated with death, toxic megacolon and other adverse outcomes in North America and Europe. In 2010, the first local transmission of an epidemic strain (027) of C. difficile was reported in the state of Victoria, Australia, but no cases of infection with this strain were reported in the state of Queensland. In 2012, a prevalence study was undertaken in all public and selected private hospitals to examine the epidemiology of CDI and determine the prevalence of epidemic C. difficile strains in Queensland. Methods: Enhanced surveillance was undertaken on all hospital identified CDI cases aged over 2 years between 10 April and 15 June 2012. Where available, patient samples were cultured and isolates of C. difficile ribotyped. The toxin profile of each isolate was determined by PCR. Results: In total, 168 cases of CDI were identified during the study period. A majority (58.3%) of cases had onset of symptoms in hospital. Of the 62 patients with community onset of symptoms, most (74%) had a hospital admission in the previous 3 months. Only 4 of 168 patients had onset of symptoms within a residential care facility. Thirteen out of the 168 (7.7%) patients included in the study had severe disease (ICU admission and/or death within 30 days of onset). Overall 136/168 (81%) of cases had been prescribed antibiotics in the last month. Of concern was the emergence of a novel ribotype (244) which has recently been described in other parts of Australia and is genetically related to ribotype 027. Seven patients were infected with C. difficile ribotype 244 (8% of 83 samples ribotyped), including one patient requiring ICU admission and one patient who died. Ribotype 244 was tcdA, tcdB and CDT positive and contained a tcdC mutation at position 117. Conclusion: Ongoing surveillance is required to determine the origin and epidemiology of C. difficile ribotype 244 infections in Australia.

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Design-build (DB) is regarded as an effective means of delivering high performance green buildings, and the selection of DB contractors is of critical importance. The objective of this study is to evaluate the selection of design-builders for public buildings seeking Leadership in Energy and Environmental Design (LEED) certification and compare the selection practices involved with those of non-LEED-seeking DB projects through a robust content analysis of 74 DB request for proposals (RFPs) for public DB projects. The results of the content analysis reveal that the level of LEED certification is the dominant means of conveying the sustainability requirements in RFPs for contractor selection, with the majority of RFPs (60%) including sustainability requirements as part of the contractor evaluation package. With the exception of contractors' past performance, there is no statistically significant difference in the importance weightings of selection criteria between LEED-seeking and non-LEED-seeking buildings, and DB owners tend to place more emphasis on innovative technical solutions rather than the past performance of DB contractors. Additionally, the research findings also indicate that owners of LEED-seeking building projects tend to provide less design decisions in RFPs in order to solicit innovative design alternatives from potential DB contractors. This study provides DB owners with a number of practical implications for selecting appropriate design-builders for green DB projects.

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The design-build (DB) system is regarded as an effective means of delivering sustainable buildings. Specifying clear sustainability requirements to potential contractors is of great importance to project success. This research investigates the current state-of-the-practice for the definition of sustainability requirements within the public sectors of the U.S. construction market using a robust content analysis of 49 DB requests for proposals (RFPs). The results reveal that owners predominantly communicate their desired level of sustainability through the LEED certification system. The sustainability requirement has become an important dimension for the best-value evaluation of DB contractors with specific importance weightings of up to 25%. Additionally, owners of larger projects and who provide less design information in their RFPs generally allocate significantly higher importance weightings to sustainability requirements. The primary knowledge contribution of this study to the construction industry is the reveal of current trend in DB procurement for green projects. The findings also provide owners, architects, engineers, and constructors with an effective means of communicating sustainability objectives in solicitation documents.

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There are limited studies that describe patient meal preferences in hospital; however this data is critical to develop menus that address satisfaction and nutrition whilst balancing resources. This quality study aimed to determine preferences for meals and snacks to inform a comprehensive menu revision in a large (929 bed) tertiary public hospital. The method was based on Vivanti et al. (2008) with data collected by two final year dietetic students. The first survey comprised 72 questions, achieved a response rate of 68% (n = 192), with the second more focused at 47 questions achieving a higher response rate of 93% (n = 212). Findings showed over half the patients reporting poor or less than normal appetite, 20% describing taste issues, over a third with a LOS >7 days, a third with a MST _ 2 and less than half eating only from the general menu. Soup then toast was most frequently reported as eaten at home when unwell, and whilst most reported not missing any foods when in hospital (25%), steak was most commonly missed. Hot breakfasts were desired by the majority (63%), with over half preferring toast (even if cold). In relation to snacks, nearly half (48%) wanted something more substantial than tea/coffee/biscuits, with sandwiches (54%) and soup (33%) being suggested. Sandwiches at the evening meal were not popular (6%). Difficulties with using cutlery and meal size selection were identified as issues. Findings from this study had high utility and supported a collaborative and evidenced based approach to a successful major menu change for the hospital.

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Information on foods patients like and dislike is the essential basis for planning menus which are acceptable to patients and promote adequate consumption. The aim of this study was to obtain quantitative data on the food preferences of inpatients at a large metropolitan public hospital for use in menu planning. Methodology was based on a study by Williams et al (1988), and included additional questions about appetite and taste changes. The survey used a 9 point hedonic scale to rate foods listed in random order and was modified to incorporate more contemporary foods than those used in the originalWilliams study. Surveys were conducted by final year University of Queensland dietetics students on Food Service Practicum at the Royal Brisbane and Women’s Hospital (929 beds) in 2012. The first survey (220 questions, n = 157) had a response rate of 61%. The second included more sandwich fillings and salads (231 questions, n = 219, response rate 67%). Total number surveyed was 376. Results showed the most preferred foods were roast potato, grilled steak, ice cream, fresh strawberries, roast lamb, roast beef, grapes and banana. The least preferred foods were grapefruit, soybeans, lentils, sardines, prune juice and grapefruit juice. Patients who reported taste changes (10%) had similar food preferences to those who didn’t report taste changes. Patients who reported poor/very poor appetite (10%) generally scored foods lower than those who reported OK (22%), good/very good appetite (65%). The results of this study informed planning for a new patient menu at the RBWH in December 2012.

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Purpose Pharmaceuticals have played an important role in improving the quality of life of the human population in modern times. However, it must also be acknowledged that both the production and use of pharmaceuticals have a significant, negative impact on the environment and consequently, a negative impact on the health of humans and wildlife. This negative impact is due to the embedded carbon in pharmaceuticals' manufacture and distribution and the waste generated in their manufacture, consumption and disposal. Pharmaceutical waste is comprised of contaminated waste (unwanted pharmaceuticals and their original containers) and non-contaminated waste (non-hazardous packaging waste). The paper aims to discuss these issues. Design/methodology/approach The article is a literature review. Findings The article identified a gap in the literature around pharmacist attitudes and behaviour toward the environmentally responsible handling of pharmaceutical waste. Originality/value Pharmacists, with their professional commitment to the quality use of medicines and their active participation in the medicines management pathway, already play an important role in the more sustainable use of pharmaceuticals. Even so, they have the potential to play an even greater role with the environmentally responsible disposal of pharmaceutical waste (including packaging waste) and the education of other health professionals and the general public on this topic.

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The trust and credibility gap between institutional regulators and the public is based on fundamental social and cultural differences related to power and authority. It is also associated with the 'distance' of a bureaucracies from those whom they serve. The nature of public concern about risk may be investigated by considering specific cognitive decision making 'rules' such as 'familiarity' of a hazard or 'voluntariness' of exposure. A more complete appreciation of the 'how' and 'why' of public response to danger from industrial hazards can be gained by appreciating these 'rules' within the broader context of mis-communication between 'elite' regulators and a highly diverse public. If the results of risk assessments are expressed in technical terms alone, it is unlikely that any real communication will occur. Further, if issues related to the 'remote' nature of much institutional decision making are not addressed, closure of the 'gap' may be difficult to bring about.