992 resultados para more doctors


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After much hesitation, discussion, and power brokering, Australia adopted digital TV for its Free-to air broadcasting on January 1, 2001. However, by December 2002, only a few thousand homes had adopted the technology. This paper examines the implementation and regulation of digital TV in Australia from the point of view of the ‘established base’ the new technology will replace, theories on diffusion and innovation of new technologies, and the Justification Model, which sees technology choice as social gambling. It then evaluates the various protectionist regulations and limitations imposed on the technology to safeguard the various stakeholders, the implementation strategies used, lack of digital content, marketing efforts, negative media coverage, and the economic realities of the technology, and argues that if consumers reject the technology altogether, it would lead to Australia missing the future applications of digital technology and the opportunity to address the issue of the ‘digital divide’ in the 21st century.

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The development of the Internet has boosted prosperity of the World Wide Web, which is now a huge information source. Because of characteristics of the web, in most cases, traditional databasebased technologies are no longer suitable for web information retrieval and management. To effectively manage web information, it is necessary to reveal intrinsic relationships/structures among web information objects by eliminating noise factors. This paper proposes a mechanism that could be widely used in information processing, including web information processing and noise factor elimination for getting more intrinsic relationships. As an application case of this mechanism, one relevant web page finding algorithm is proposed to uncover intrinsic relationship among web pages from their hyperlink patterns, and find more semantic relevant web pages. The experimental evaluation shows the feasibility and effectiveness of the algorithm and demonstrates the potential of the proposed mechanism in web applications.

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This study reports the cognitive processing of a Year 8 female student (Kerri) during a test, and during her subsequent homework as she consolidated as part of abstracting; a topic of recent research interest. This case adds to the body of knowledge about how constructing and consolidating can occur simultaneously. The analysis captured the complexity of the cognitive processing, and their intertwined nature. Data was captured through lesson video, and post-lesson, video-stimulated reconstructive student interviews. It was found that Kerri’s constructing and consolidating included characteristics previously identified by others, and an additional feature. Her constructing included “branching” (Kidron & Dreyfus, 2004, p. 159); but unlike the case cited, one of these branches related to a new goal.

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This paper backgrounds the current approach to ecologically sustainable design (ESD) while outlining the prevailing technological zeitgeist within which architecture operates. In differentiating between ecology and ecosophy a quantum shift in attitude is explored. This allows the psychodynamics behind the act of commitment to be brought up for discussion and places the designer within a more holistic understanding of ESD.

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The impact of prior learning on new learning is highlighted by the case of Dean, a Year 8 student who developed his own method to find the sum of the interior angles of a polygon without knowing why his method worked. Enriched transcripts and visual displays of the cognitive, social (Dreyfus, Hershkowitz, & Schwarz, 2001) and affective elements (Williams, 2002) of Dean's interrupted abstraction process informed the identification of factors that inhibited Dean's constructing process. It was found Dean possessed an empirical, not theoretical, generalization (Davydov, 1990) about sums of interior angles of triangles that was an inadequate cognitive artifact for constructing the new more complex theoretical generalization. The study suggests use of tasks designed with the opportunity develop assumed knowledge in conjunction with new concepts.

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• Pain assessment and management are complex issues that embrace physiological, emotional, cognitive, and social dimensions.

• This observational study sought to investigate nurse–patient interactions associated with pain assessment and management in hospitalized postsurgical patients in clinical practice settings.

• Twelve field observations were carried out on Registered Nurses' activities relating to pain with their assigned patients. All nurses were involved in direct patient care in one surgical unit of a metropolitan teaching hospital in Melbourne, Australia. Six observation times were identified as key periods for activities relating to pain, which included change of shift and high activity periods. Each observation period lasted 2 hours and was examined on two occasions.

• Four major themes were identified as barriers to effective pain management: nurses' responses to interruptions of activities relating to pain, nurses' attentiveness to patient cues of pain, nurses' varying interpretations of pain, and nurses' attempts to address competing demands of nurses, doctors and patients.

• These findings provide some understanding of the complexities impacting on nurses' assessment and management of postoperative pain. Further research using this observational methodology is indicated to examine these influences in more depth. This knowledge may form the basis for developing and evaluating strategic intervention programmes that analyse nurses' management of postoperative pain and, in particular, their administration of opioid analgesics.


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We analyze a principal-agent model with moral hazard in which the principal has private information about the technology. We characterize Perfect Bayesian Equilibria of the contracting game that possess the following properties: (i) a principal with a more informative technology ends up earning less profits than a principal with a less informative one does; (ii) compared to the complete information case, the actions implemented by the privately informed principal can be distorted; (iii) the agent can end up being better off when the principal has private information.

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In the field of environment-related education, the period from the early 70s to the present is marked by continuity and contestation. There has been a remarkable continuity of environmentrelated practice; and there has also been contestation in the language of the field, with terms like ecology education, environmental education and education for sustainable development becoming highly visible at different times. Presently, the environment-related work formerly known as ‘environmental education’ (EE) is being aggressively and extensively ‘re-badged’ as ‘education for sustainable development’ (ESD). This paper explores the role of slogans in the fields of environmental education and education for sustainable development.

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The rapid development of network technologies has made the web a huge information source with its own characteristics. In most cases, traditional database-based technologies are no longer suitable for web information processing and management. For effectively processing and managing web information, it is necessary to reveal intrinsic relationships/structures among concerned web information objects such as web pages. In this work, a set of web pages that have their intrinsic relationships is called a web page community. This paper proposes a matrix-based model to describe relationships among concerned web pages. Based on this model, intrinsic relationships among pages could be revealed, and in turn a web page community could be constructed. The issues that are related to the application of the model are deeply investigated and studied. The concepts of community and intrinsic relationships, as well as the proposed matrix-based model, are then extended to other application areas such as biological data processing. Some application cases of the model in a broad range of areas are presented, demonstrating the potentials of this matrix-based model.

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Research across various countries and relationship contexts suggests that attachment anxiety and avoidance are associated with people’s prosocial feelings, tendencies, and behaviors (e.g., Gillath et al., 2005; Karantzas, Evans, & Foddy, 2007). In the present paper we extend the two dimensional model of attachment to include a series of nested facets. Doing so allowed us to examine whether the multifaceted nested factor model provides a better explanation of the associations between attachment and the components of prosocial personality as compared to the bi-factor model (attachment anxiety and avoidance). Three hundred and eighty participants, aged 18 to 33 years completed self-report measures of adult attachment and prosocial personality. Data were fitted to various models – as expected the nested model provided a better fit to the data and explained a significantly larger proportion of the variance in prosocial tendencies than the bi-factor model. The attachment facets were found to make distinct contributions to prosocial personality beyond the broad attachment dimensions (e.g., the preoccupied facet was uniquely associated with personal distress). Implications for the revised attachment structure across various prosocial contexts are discussed, as are the limitations of using the Experience in Close Relationships Scale (ECR; Brennan et al., 1998) to test a multifaceted attachment model.

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Certificate verification in PKI is a complex and time consuming process. In the classical PKI methodology, in order to obtain a public key and to accept a certificate as valid, a verifier needs to extract a certificate path from the PKI and to verify the certificates on this path recursively. Levi proposed a nested certificate model vvith the aim to simplify and speed up certificate verification. Such a nested certificate-based PKI significantly improves certificate verification, but it also requires a large increase in the number of issued certificates, which makes this model impractical for real life deployment. In order to solve this drawback of nested PKI, while retaining its speed in certificate verification, we propose in this paper the innovative concept of a compressed nested certificate, which is a significantly modified version of the nested certificate model. Compressed nested certificate PKI deploys compressed nested certificates which speed up and simplify certificate verification while keeping certificate load to a minimum, thus providing implementers the option of integrating it into the existing PKI model or building it separately as an independent model.

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Background: Debate about testing for prostate cancer using prostate-specific antigen (PSA) and digital rectal examination (DRE) continues. The evidence of benefit from screening for prostate cancer using PSA tests is inconclusive, and it is unclear how PSA can be used most effectively in the detection of prostate cancer. Given the lack of consensus, it is important that consumers understand the issues in a way that will permit them to decide whether or not to have a test and, if symptomatic, how their condition is managed.

Aims: To compare prostate cancer knowledge, attitudes and testing experiences reported by male doctors and men in the community, despite the lack of evidence of a benefit.

Methods : The primary method for ascertaining the attitudes of male doctors (MD) was a telephone survey, with some doctors electing to complete a written survey. Each MD was selected, at random, from a register of male practitioners aged ≥ 49 years of age. A total of 266 MD participated in the survey. The community sample (CS) was accessed using a telephone survey. Five hundred male Victorian residents aged ≥ 49 years of age participated in the study.

Results:
Knowledge − Overall, 55% of the CS indicated ­correctly that prostate disease is sometimes cancer, compared to 83% of MD.

Attitudes − Fifty-five per cent of MD believed men should be tested for prostate disease at least every 2 years, compared to 68% of men in the CS.

Testing experience − Forty-five per cent of MD had been tested for prostate cancer in the past, and 92% of those tests were reported as negative. In the CS, 56% had been tested for prostate cancer in the past, and 78% of the results were reported as negative. The ­significant independent predictors of having had a prostate test among MD were: (i) age (≥ 60 years; odds ratio (OR): 1.59; 95% confidence intervals (CI): 1.30−1.88) and (ii) positive attitudes towards regular testing for prostate cancer (OR: 2.27; 95% CI: 1.98−2.56). The significant independent predictors for the CS were: (i) age (≥ 60 years; OR: 1.65; 95% CI: 1.40−1.89), (ii) being married (OR: 1.30; 95% CI: 1.00−1.60), (iii) knowledge that prostate disease was sometimes cancer (OR: 1.46; 95% CI: 1.26−1.66) and (iv) positive attitudes towards regular testing for prostate cancer (OR: 2.12; 95% CI: 1.90−2.34).

Conclusions: The results highlight that testing for prostate cancer is widespread in the community and in the medical profession. Further research should be undertaken to identify how to help men make fully informed decisions about prostate cancer testing.

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Objective: The aim of this study was to investigate the effects of prior general practice training in mental health and practice location on general practitioner (GP) attitudes toward depression, self-confidence in assessing and treating depressed patients, identification of doctor, patient and practice barriers to the effective care of depressed patients in general medical practice and GP-reported current clinical practice.

Method: Fifty-two (out of 123) Divisions of General Practice that responded to an invitation to participate in the study distributed 608 anonymous surveys to a representative sample of GPs; 420 (69%) were returned. The questionnaire focused on current clinical practice, perceived barriers to care of depressed patients and doctors' self-efficacy for assessing and treating depressed patients. It also consisted of two scales, based upon previous research, designed to assess doctors' attitudes towards depression and depressed patients.

Results: General practitioners who had undertaken mental health education and training more often used non-pharmacological treatments (p = 0.00), as did female GPs (p = 0.00). Male GPs (p = 0.00) and those in rural settings (p = 0.01) more often prescribed medication for depression. Those without mental health training more often identified incomplete knowledge about depression as a barrier to its effective management (p = 0.00). Urban-based GPs (p = 0.04) and those with prior mental health training (p = 0.00) were more confident in the use of non-pharmacological treatments. Female GPs without mental health training were the least confident in the use of these methods (p = 0.01). Overall, GPs with mental health training were more positive in their attitudes toward depression and their treatment of these patients (p = 0.00). Female GPs appeared more positive in their attitudes toward depression than male GPs (p = 0.01), although the results were not entirely consistent.

Conclusions: Participation in mental health training by GPs appears to be related to their attitudes toward depressed patients and to their confidence and abilities to diagnose and manage the common mental disorders effectively.