967 resultados para 63-468
Resumo:
This paper is a detailed case narrative on how a Faculty of a leading Australian University conducted a rigorous process improvement project, applying fundamental Business Process Management (BPM) concepts. The key goal was to increase the efficiency of the faculty’s service desk. The decrease of available funds due to reducing student numbers and the ever increasing costs associated with service desk prompted this project. The outcomes of the project presented a set of recommendations which leads to organizational innovation having information technology as an enabler for change. The target audience includes general BPM practitioners or academics who are interested in BPM related case studies, and specific organisations who might be interested in conducting BPM within their service desk processes.
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Cholesterol-lowering treatment by statins is an important and costly issue; however, its role in stroke has not been well documented. The aim of the present study was to review literature and current practice regarding cholesterol-lowering treatment for stroke patients. A literature review was conducted on lipids in stroke and their management with both statins and diet, including the cost-effectiveness of medical nutrition therapy. Qualifying criteria and prescription procedures of the Pharmaceutical Benefits Scheme (PBS) were also reviewed. Data on lipid levels and statin prescriptions were analysed for 468 patients admitted to a stroke unit. The literature shows that management with both medication and diet can be effective, especially when combined; however, 60% of patients with an ischaemic event had fasting total cholesterol measures ≥4 mmol/L (n = 231), with only 52% prescribed statins on discharge (n = 120). Hypercholesterolaemia is an underdiagnosed and undertreated risk factor within the stroke population. It appears that the PBS has not kept pace with advances in the evidence in terms of statin use in the stroke population, and review is needed. The present review should address the qualifying criteria for the stroke population and recommendations on referral to dietitians for dietary advice. Cholesterol-lowering treatment for both stroke patients and the wider population is an area that needs awareness raising and review by the PBS, medical practitioners and dietitians. The role of dietary and pharmacological treatments needs to be clearly defined, including adjunct therapy, and the cost-effectiveness of medical nutrition therapy realised.
The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting
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Objective: To compare the effectiveness of the STRATIFY falls tool with nurses’ clinical judgments in predicting patient falls. Study Design and Setting: A prospective cohort study was conducted among the inpatients of an acute tertiary hospital. Participants were patients over 65 years of age admitted to any hospital unit. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive values (NPV) of the instrument and nurses’ clinical judgments in predicting falls were calculated. Results: Seven hundred and eighty-eight patients were screened and followed up during the study period. The fall prevalence was 9.2%. Of the 335 patients classified as being ‘‘at risk’’ for falling using the STRATIFY tool, 59 (17.6%) did sustain a fall (sensitivity50.82, specificity50.61, PPV50.18, NPV50.97). Nurses judged that 501 patients were at risk of falling and, of these, 60 (12.0%) fell (sensitivity50.84, specificity50.38, PPV50.12, NPV50.96). The STRATIFY tool correctly identified significantly more patients as either fallers or nonfallers than the nurses (P50.027). Conclusion: Considering the poor specificity and high rates of false-positive results for both the STRATIFY tool and nurses’ clinical judgments, we conclude that neither of these approaches are useful for screening of falls in acute hospital settings.
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Pitch discrimination skills are important for general musicianship. The ability to name musical notes or produce orally any named note without the benefit of a known reference is called Absolute Pitch (AP) and is comparatively rare. Relative Pitch (RP) is the ability to name notes when a known reference is available. AP has historically been regarded as being innate. This paper will examine the notion that pitch discrimination skill is based on knowledge constructed through a suite of experiences. That is, it is learnt. In particular, it will be argued that early experiences promote the development of AP. Second it will argue that AP and RP represent different types of knowledge, and that this knowledge emerges from different experiences. AP is a unique research phenomenon because it spans the fields of cognition and perception, in that it links verbal labels with physiological sensations, and because of its rarity. It may provide a vantage for investigating the nature/nurture of musicianship; expertise; knowledge structure development; and the role of knowledge in perception. The study of AP may inform educational practice and curriculum design both in music and cross-curriculur. This paper will report an initial investigation into the similarities and differences between the musical experiences of AP possessors and the manifestation of their AP skill. Interview and questionnaire data will be used for the development and proposal of a preliminary model for AP development.
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This chapter investigates the phenomenon of fashion from the perspective of ‘the look.’ This is achieved by the wearer (as opposed to the designer) and also forms the basis of fashion media, where it represents the ‘decisive moment’ of photography. The chapter argues that the evolving ‘look’ of fashion can be analysed to identify tensions between novelty and emulation, the unique and the universal, in contemporary consumer culture and status-based social-network markets. It explores the work of fashion photographer Corinne Day and artist Olga Tobreluts to identify the theme of ‘risk culture.’
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This chapter starts from the observation that new sporting attributes are growing up unnoticed in popular entertainment and ‘reality’ TV. They celebrate not individual heroics but spectator-oriented teamwork which must look effortless and stylish. Instead of objective measurements – ‘faster, higher, stronger’ – winners are picked by voting and consumer choice. Sport and media are converging and integrating. As they do so, what counts as sport, why it is valued, and what it symbolises for contemporary culture, are all changing. I take these changes to be emblematic of something emergent in the culture at large as the modernist paradigm shifts towards a new consumerist paradigm. This is symbolised in new sports, of which the paradigm example is synchronised swimming. The chapter traces these changes via the career and legacy of the Australian swimming and fashion pioneer Annette Kellerman.
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The paper examines the decision by Australian Real Estate Trusts (A-REITs) to issue seasoned equity offerings from 2000 - 2008 and stock market reaction to the offerings using panel data and event study methodologies, respectively. The global financial crisis has resulted in freezing of the Australian bond markets, with several A-REITs left with seasoned equity issuance and asset sales as the only viable modes of raising additional capital. The findings review that leverage and operating risk are negative significant determinants of seasoned equity offerings; profitability and growth opportunities are positive significant determinants. Of the structure and type of properties held by the A-REIT, only stapled management structure and international operations are significant determinants. Type of properties held by A-REITs show inconsistent results. Similar to previous studies of seasoned equity offerings, we find a significant negative abnormal return associated with their announcement and no evidence of excessive leakage of information. Cross-sectional regressions show that the issued amount raised and leverage are significant factors affecting abnormal returns.
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Background The accurate measurement of Cardiac output (CO) is vital in guiding the treatment of critically ill patients. Invasive or minimally invasive measurement of CO is not without inherent risks to the patient. Skilled Intensive Care Unit (ICU) nursing staff are in an ideal position to assess changes in CO following therapeutic measures. The USCOM (Ultrasonic Cardiac Output Monitor) device is a non-invasive CO monitor whose clinical utility and ease of use requires testing. Objectives To compare cardiac output measurement using a non-invasive ultrasonic device (USCOM) operated by a non-echocardiograhically trained ICU Registered Nurse (RN), with the conventional pulmonary artery catheter (PAC) using both thermodilution and Fick methods. Design Prospective observational study. Setting and participants Between April 2006 and March 2007, we evaluated 30 spontaneously breathing patients requiring PAC for assessment of heart failure and/or pulmonary hypertension at a tertiary level cardiothoracic hospital. Methods SCOM CO was compared with thermodilution measurements via PAC and CO estimated using a modified Fick equation. This catheter was inserted by a medical officer, and all USCOM measurements by a senior ICU nurse. Mean values, bias and precision, and mean percentage difference between measures were determined to compare methods. The Intra-Class Correlation statistic was also used to assess agreement. The USCOM time to measure was recorded to assess the learning curve for USCOM use performed by an ICU RN and a line of best fit demonstrated to describe the operator learning curve. Results In 24 of 30 (80%) patients studied, CO measures were obtained. In 6 of 30 (20%) patients, an adequate USCOM signal was not achieved. The mean difference (±standard deviation) between USCOM and PAC, USCOM and Fick, and Fick and PAC CO were small, −0.34 ± 0.52 L/min, −0.33 ± 0.90 L/min and −0.25 ± 0.63 L/min respectively across a range of outputs from 2.6 L/min to 7.2 L/min. The percent limits of agreement (LOA) for all measures were −34.6% to 17.8% for USCOM and PAC, −49.8% to 34.1% for USCOM and Fick and −36.4% to 23.7% for PAC and Fick. Signal acquisition time reduced on average by 0.6 min per measure to less than 10 min at the end of the study. Conclusions In 80% of our cohort, USCOM, PAC and Fick measures of CO all showed clinically acceptable agreement and the learning curve for operation of the non-invasive USCOM device by an ICU RN was found to be satisfactorily short. Further work is required in patients receiving positive pressure ventilation.
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This article presents the findings of a study of the psychological variables that discriminate between high and low omitters on a high-stakes achievement test using a short-response format. Data were obtained from a questionnaire administered to a random sample (N = 1,908) of students prior to sitting the 1997 Queensland Core Skills (QCS) Test (N = 29,273). Fourteen psychological variables were measured including test anxiety (four subscales), emotional stability, achievement motivation, self-esteem, academic self-concept, self-estimate of ability, locus of control (three subscales), and approaches to learning (two subscales). The results were analyzed using descriptive discriminant analysis and suggested that the psychological predictors of the propensity to omit short-response items include test-irrelevant thinking and academic self-concept, with sex of candidate being a mediating variable.
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Talk is the foundation for thought and understanding, and the key to literacy learning. Research demonstrates that powerful meta-cognitive strategies can be taught to help students self-monitor their comprehension when reading print and digital texts. This paper provides a repertoire of motivating speaking and listening tips to develop the meta-cognitive thinking of students in the elementary years.
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This article reviews an exhibition of art works at the Institute for Modern Art that dealt with the idea of history. The review suggests that history is an unstable product of our collective imaginations and is constantly open to revisions and individual perspectives. Each of the artists deal with these issues by reinterpreting past events. The artists were Pierre Huyghe, Thomas Demand, Mike Kelley, paul McCarthy, Jeremy Deller, Danius Kesminas, Gerard Byrne, Emma Kay, and Omer Fast.
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Previous research examining players of Massively-Multiplayer Online Games (MMOGs) suggests that players form meaningful relationships with each other. Other research indicates that people may derive social support from online sources and this social support has been associated with greater wellbeing. This study used an online survey of players (N = 206) of the MMOG “World of Warcraft” (WoW) to examine if social support can be derived from MMOGs, and to examine its relationship with negative psychological symptoms. Players of WoW were found to derive social support from playing and a positive relationship was found between game engagement and levels of in-game social support. Higher levels of in-game social support were associated with fewer negative psychological symptoms, although this effect was not maintained after accounting for social support derived from the offline sources. Additionally, a small subsample of players (N = 21) were identified that played for between 44 and 82 hours per week (M = 63.33). These players had significantly lower levels of offline social support and higher levels of negative symptoms compared to the rest of the sample. This study provides evidence that social support can be derived from MMOGs and the associated potential to promote well being, but also highlights the potential harm from spending excessive hours playing.
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Primary science education is a concern around the world and quality mentoring within schools can develop preservice teachers’ practices. A five-factor model for mentoring has been identified, namely, personal attributes, system requirements, pedagogical knowledge, modelling, and feedback. Final-year preservice teachers (mentees, n=211) from three Turkish universities were administered a previously validated instrument to gather perceptions of their mentoring in primary science teaching. ANOVA indicated that each of these five factors was statistically significant (p<.001) with mean scale scores ranging from 3.36 to 4.12. Although mentees perceived their mentors to provide evaluation feedback (95%), model classroom management (88%), guide their preparation (96%), and outline the science curriculum (92%), the majority of mentors were perceived not to assist their mentees in 10 of the 34 survey items. Professional development programmes that target the specific needs of these mentors may further enhance mentoring practices for advancing primary science teaching.