929 resultados para scope asymmetries


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This article explains the essence of the context-sensitive parameters and dimensions in play at the time of an intervention, through the application of Rog’s (2012) model of contextual parameters. Rog’s model offers evaluators a structured approach to examine an intervention. The initial study provided a systematic way to clarify the scope, variables, timing, and appropriate evaluation methodology to evaluate the implementation of a government policy. Given that the government implementation of an educational intervention under study did not follow the experimental research approach, nor the double cycle of action research approach, the application of Rog’s model provided an in-depth understanding of the context-sensitive environment; it is from this clear purpose that the broader evaluation was conducted. Overall, when governments or institutions implement policy to invoke educational change (and this intervention is not guided by an appropriate evaluation approach), then program evaluation is achievable post-implementation. In this situation, Rog’s (2012) model of contextual parameters is a useful way to achieve clarity of purpose to guide the program evaluation.

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Background The purpose of this study was to explore the workplace acceptance and experiences of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) paramedics. Methods A systematic search of academic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were research papers published in English, which focused on workplace acceptance and experiences of LGBTIQ health personnel. Results The initial focus of this systematic review was the workplace acceptance and experiences of LGBTIQ paramedics. However due to no published research specific to the paramedic profession the scope of the review was broadened to include of all LGBTIQ health personnel. Thirty-three papers were included in this review. Evidence indicated that LGBTIQ health professionals experienced discrimination from their patients, heterosexual colleagues and ‘closeted’ LGBTIQ peers. Positive contribution of LGBTIQ health professionals include improved patient care and role models for LGBTIQ peers. Inclusive policy is required for LGBTIQ health professional workforce retention. Conclusions The paramedic workforce is known to be a high risk occupational group for post-traumatic stress disorder and depression. Theoretically, LGBTIQ paramedics working in a heteronormative culture experience increased level of stress. While LGBTIQ health professionals receive legislative protection against discrimination, discrimination still exists in practice through lack of visibility. Effective and efficient integration of LGBTIQ health professionals could improve workplace satisfaction, workforce retention, and equity of access by marginalised groups. An inclusive workplace policy of LGBTIQ embraces and celebrates the value of diversity.

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Background Surgery is an example of expanded practice scope that enhances podiatry and incorporates inter-professional collaboration. By 2050 demand for foot and ankle procedures is predicted to rise nationally by 61.9%. Performance management of this increase motivated the development of an online audit tool. Developed in collaboration with the Australasian College of Podiatric Surgeons (ACPS), the ACPS audit tool provides real-time data capture and reporting. It is the first audit tool designed in Australia to support and improve the outcomes of foot and ankle surgery. Methods Audit activity in general, orthopaedic, plastic and podiatric surgery was examined using a case study design. Audit participation enablers and barriers were explored. Case study results guided a Delphi survey of international experts experienced or associated with foot and ankle surgery. Delphi survey-derived consensus informed modification of a generic data set from the Royal Australasian College of Surgeons (RACS). Based on the Delphi survey findings the ACPS online audit tool was developed and piloted. Reliability and validity of data entry and usability of this new tool was then assessed with an online survey. Results The case study found surgeon attitudes and behaviours positively impacted audit participation, and also indicated that audit data should be: (1) available in real time, (2) identify practice change, (3) applicable for safety and quality management, and; (4) useful for peer review discussion. The Delphi process established consensus on audit variables to be captured, including the modified RACS generic data set. 382 cases of foot and ankle surgery were captured across 3 months using the new tool. Data entry was found to be valid and reliable. Real-time outcome reporting and practice change identification impacted positively on safety and quality management and assisted peer review discussion. An online survey showed high levels of usability. Conclusions Surgeon contribution to audit tool development resulted in 100% audit participation. The data from the ACPS audit tool supported the ACPS submission to the Medical Services Advisory Committee to list podiatric surgery under Medicare, an outcome noted by the Federal Minister of Health.

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In recent years, there have been significant developments in climate science relevant to agriculture and natural resource management. Assessing impacts of climate variability and use of seasonal climate forecasts have become increasingly important elements in the management "toolkit" for many Australian farmers. Consideration of climate change further increases the need for improved management strategies. While climate risk extension activities have kept pace with advances in climate science, a national review of the Vocational Education and Training system in Australia in relation to "weather and climate" showed that these topics were "poorly represented" at the management level in the Australian Qualifications Framework, and needed increased emphasis. Consequently, a new Unit of Competency concerning management of climatic risk was developed and accredited to address this deficiency. The objective of the unit was to build knowledge and skills for better management of climate variability via the elements of surveying climatic and enterprise data; analysing climatic risks and opportunities; and developing climatic risk management strategies. This paper describes establishment of a new unit for vocational education that is designed to harness recent developments in applied climate science for better management of Australia's highly variable climate. The main benefits of the new unit of competency, "Developing climatic risk management strategies,"were seen as improving decisions in climate and agriculture, and reducing climate risk exposure to enhance sustainable agriculture. The educational unit is now within the scope of agricultural colleges, universities, and registered training organisations as an accredited unit.

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The opportunities and challenges faced by litigants who strategically plead intentional torts are borne out by two recent medical cases. Both arose out of dental treatment. Dean v Phung established some key principles which were clarified in White v Johnston. Before considering those two cases it is worth examining the environment in which such intentional torts claims now exist. Following the Ipp Review of the Law of Negligence, non-uniform legislative changes to the law of negligence were introduced across Australia which have imposed limitations on liability and quantum of damages in cases where a person has been injured through the fault of another. While it seems that, given the limitation of the scope of the review and recommendations to negligently caused damage, the Ipp Review reforms were meant to be limited to injury resulting from negligent acts rather than intentional torts, the extent to which the civil liability legislation applies to intentional torts differs across Australia.

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Background Ensuring efficient and effective delivery of health care to an ageing population has been a major driver for a review of the health workforce in Australia. As part of this process a National Registration and Accreditation Scheme (NRAS) has evolved with one goal being to improve workforce flexibility within a nationally consistent model of governance. In addition to increased flexibility, there have been discussions about maintaining standards and the role of specialisation. This study aims to explore the association between practitioners’ self-perceptions about their special interest in musculoskeletal, diabetes related and podopaediatric foot care and the actual podiatry services they deliver in Australia. Methods A cross sectional on-line survey was administered on behalf of the Australasian Podiatry Council and its’ state based member associations. Self-reported data were collected over a 3-week interval and captured information about the practitioners by gender, years of clinical experience, area of work by state, work setting, and location. For those participants that identified with an area of special interest or specialty, further questions were asked regarding support for the area of special interest through education, and activities performed in treating patients in the week prior to survey completion. Queensland University of Technology Human Research Ethics approval was sought and confirmed exemption from review. Results 218 podiatrists participated in the survey. Participants were predominately female and worked in private practices. The largest area of personal interest by the podiatrists was related to the field of musculoskeletal podiatry (n = 65), followed closely by diabetes foot care (n = 61), and a third area identified was in the management of podopaediatric conditions (n = 26). Conclusions Health workforce reform in Australia is in part being managed by the federal government with a goal to meet the health care needs of Australians into the future. The recognition of a specialty registration of podiatric surgery and endorsement for scheduled medicines was established with this workforce reform in mind. Addition of new subspecialties may be indicated based on professional development, to maintain high standards and meet community expectations.

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We analyse warps in the nearby edge-on spiral galaxies observed in the Spitzer/Infrared Array Camera (IRAC)4.5-mu m band. In our sample of 24 galaxies, we find evidence of warp in 14 galaxies. We estimate the observed onset radii for the warps in a subsample of 10 galaxies. The dark matter distribution in each of these galaxies are calculated using the mass distribution derived from the observed light distribution and the observed rotation curves. The theoretical predictions of the onset radii for the warps are then derived by applying a self-consistent linear response theory to the obtained mass models for six galaxies with rotation curves in the literature. By comparing the observed onset radii to the theoretical ones, we find that discs with constant thickness can not explain the observations; moderately flaring discs are needed. The required flaring is consistent with the observations. Our analysis shows that the onset of warp is not symmetric in our sample of galaxies. We define a new quantity called the onset-asymmetry index and study its dependence on galaxy properties. The onset asymmetries in warps tend to be larger in galaxies with smaller dis scalelengths. We also define and quantify the global asymmetry in the stellar light distribution, that we call the edge-on asymmetry in edge-on galaxies. It is shown that in most cases the onset asymmetry in warp is actually anticorrelated with the measured edge-on asymmetry in our sample of edge-on galaxies and this could plausibly indicate that the surrounding dark matter distribution is asymmetric.

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Hamstring strains in the Australian Football League (AFL) have a high incidence (15%) and recurrence rate (34%) with lateral hamstring injuries most common (83%). Retrospective studies have found significant muscle volume asymmetries ≤23 months post hamstring injury; however examination of the association between hamstring strains and muscle asymmetry has not been investigated prospectively. This study presents baseline data from a longitudinal study focusing on individual hamstring morphometry in uninjured and injured semi-elite AFL players.

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Associations between injury and muscle asymmetries, as determined with magnetic resonance (MR) imaging, have been investigated in a number of sports medicine-based studies. For interventional or prospective studies into musculoskeletal injuries, it is important to determine the repeatability of the morphometric procedures used for quantifying muscle asymmetries. This study examines the intra-observer repeatability of manual segmentation for determining bilateral volumes of the individual hamstring muscles.

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In their recent Review, Walter Zingg and colleagues1 presented the findings of a mixed methods systematic review done to describe the most effective elements of infection control programmes. We believe the inclusion of both qualitative and quantitative research in this Article is commendable, particularly because qualitative research contributes important context for clinicians, researchers, and policy makers when designing, implementing, and assessing interventions. However, in view of the large scope covered by the systematic review, and difficulties associated with a mixed methods synthesis approach,2 we would like to seek further information from the authors...

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Weed management is complicated by the presence of soil seed banks. The complexity of soil-seed interactions means that seed persistence in the field is often difficult to measure, let alone predict. Field trials, although accurate in their context, are time-consuming and expensive to conduct for individual species. Some ex situ techniques for estimating seed life expectancy have been proposed, but these fail to simulate the environmental complexity of the field. Also, it has been questioned whether techniques such as the controlled aging test (CAT) are useful indicators of field persistence. This study aimed to test the validity of the standard CAT (seed aging at 45 C and 60% relative humidity) in use at the Royal Botanic Gardens, Kew, U.K., for predicting field seed-persistence. Comparison of seed persistence and CAT data for 27 northwest European species suggested a significant positive correlation of 0.31. Subsequently, 13 species of emerging and common weeds of Queensland were assessed for their seed longevity using the CAT. The seed longevity data of these species in the CAT were linked with field seed-persistence data according to three broad seed-persistence categories: <1 yr, 1 to 3 yr, and >3 yr. We discuss the scope for using the CAT as a tool for rapid assignment of species to these categories. There is a need for further studies that compare predictions of seed persistence based on the CAT with seed persistence in the field for a larger range of species and environments.

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Many forces are driving the global demand for assurance that fruit and vegetables are safe to eat and of the right quality, and are produced and handled in a manner that does not cause harm to the environment and the health, safety and welfare of workers. The impact of these driving forces is that retailer requirements for suppliers to comply with Good Agricultural Practice (GAP) is increasing and governments are strengthening legal requirements for food safety, environmental protection, and worker health, safety and welfare. The implementation of GAP programs currently within the ASEAN (Association of South East Asian Nations) region varies, with some countries having government certified systems and others beginning the journey with awareness programs for farmers. Under a project funded by the ASEAN Australia Development Cooperation Program, a standard for ASEAN GAP has been developed to harmonise GAP Programs in the region. The goal is to facilitate trade between ASEAN countries and to global markets, improve viability for farmers, and help sustain a safe food supply and the environment. ASEAN GAP is an umbrella standard that individual member countries will benchmark their national programs against to gain equivalence. The scope of ASEAN GAP covers the production, harvesting and postharvest handling of fresh fruit and vegetables on farm and postharvest handling in locations where produce is packed for sale. ASEAN GAP consists of four modules covering food safety, environmental management, worker health, safety and welfare, and produce quality. Each module can be used alone or in combination with other modules. This enables progressive implementation of ASEAN GAP, module by module based on individual country priorities.

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For decades psychoanalysis was the discipline studying the unconscious, and other branches of study lacked competence to take a stand on the issues concerning the unconscious. From 1980s onwards intense study of the unconscious has been taken place in the scope of cognitive orientation. Thus, nowadays it is talked about both pyschoanalytic and cognitive unconscious. The aim of this thesis is to integrate psychoanalytic and cognitive views. When the "Freudian" conception of the unconscious is considered, there are four entangled issues: 1) what is the unconscious like, 2) how does the unconsciuos give rise to psychic disorders 3) why and how certain contents are missing from consciousness (repression of contents), 4) the emergence of those contents (becoming conscious of the repressed). The conventional psychoanalytic answer to the first question - and "the cornerstone of psychoanalysis" - is "the unconscious is mental". The issues 2)-4) depend radically on the answer given to the 1): "psychoanalytic" conceptualizations on them rest on the "cornerstone". That ground was challended in study I: it was argued that it has never been clear what does it mean that the unconscious is mental. Thus, it was stated that in the current state of art psychoanalysis should drop out the ephitet "mental" before the term unconscious. That claim creates a pressure to reappraise the convential "psychoanalytic" answers to the other questions, and that reappraisal was the aim of studies II and III. In study II the question 2) is approached in terms of implicit knowledge. Study III focuses on mechanisms, which determine which contents appear in the scope of consciousness, and also cause missing of contents from there (the questions 3) and 4)). In the core of study III there are distinctions concerning the processess occuring in the levels of the brain, consciousness, self-consciousness, and narrative self-consciousness. Studies I-III set "psychoanalytic" topics in the frames of cognitive view. The picture emerging from those studies is not especially useful for a clinican (psychotherapist). Studies IV and V focused that issue. Study IV is a rather serious critique toward neuropsychoanalysis. In it it was claimed that repressive functions of conscious states are in the core of clinical psychoanalysis, and functions in general cannot be reduced to neurophysiological terminology. Thus, the limits of neuropsychoanalysis are more strict than it has been realized: crucial clinical issues remain outside its scope. In study V it was focused on the confusing state of things that although unconscious fantasies do not exist, the idea on them has been an important conceptual tool for clinicans. When put in a larger context, the aim of study V is similar to that of study IV: to determine the relation between psychotherapists' and neuroscientists' terminologies. Studies III, IV and V apply the philosopher Daniel Dennett's model on different levels of explanation.

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In Radich v Kenway [2014] QDC 60 McGinness DCJ considered issues relating to the assessment of costs under the Legal Profession Act 2007 (Qld). This recent costs assessment case from the District Court clearly illustrates the interplay between the relevant elements of the Legal Profession Act 2007 and Uniform Civil Procedure Rules 1999.

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This thesis explores perspectives on the accountability of Private Ancillary Funds (PAFs), a type of Australian endowed philanthropic foundation. Privately established for a public benefit purpose, with limited formal accountability requirements, there are differing and sometimes conflicting perspectives on the nature and scope of PAF accountability. Through in-depth interviews with managers and trustees of 10 PAFs, forms and relationships of PAF accountability are uncovered. Findings reveal accountability for PAFs does not necessarily include public disclosure or transparency. However, engagement with accountability for a PAF results in greater impact and satisfaction for those involved.