999 resultados para Marc records problems


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As a strategy to identify child sexual abuse, most Australian States and Territories have enacted legislation requiring teachers to report suspected cases. Some Australian State and non-State educational authorities have also created policy-based obligations to report suspected child sexual abuse. Significantly, these can be wider than non-existent or limited legislative duties, and therefore are a crucial element of the effort to identify sexual abuse. Yet, no research has explored the existence and nature of these policy-based duties. The first purpose of this paper is to report the results of a three-State study into policy-based reporting duties in State and non-State schools in Australia. In an extraordinary coincidence, while conducting the study, a case of failure to comply with reporting policy occurred with tragic consequences. This led to a rare example in Australia (and one of only a few worldwide) of a professional being prosecuted for failure to comply with a legislative duty. It also led to disciplinary proceedings against school staff. The second purpose of this paper is to describe this case and connect it with findings from our policy analysis.

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There is a widespread recognition to the need of better manage municipal property in most cities in the world. Structural problems across regional, state, and territorial governments that have legal powers to own and maintain real property are similar, regardless of the level of development of each country. Start from a very basic level of property inventory records. The need for better manage to the local government owned property is the result of widespread decentralisation initiatives that often have devolved huge property portfolios from central to local governments almost “overnight”. At the same time municipal or regional governments were and continue to be unprepared to deal with multiple issues related to the role of property owners and managers. The lack of discussion of public asset management especially the elements that should be incorporated in the framework creates an important challenge to study the discipline of public asset management further. The aim of this paper is to study the practices of public asset management in developed countries, especially the elements of public asset management framework, and its transferability to developing countries. A case study was selected and conducted to achieve this aim. They involved interviews and a focus group. The study found that in public asset management framework, proper asset identification, public asset needs analysis, asset life cycle and performance measurements are an important element that should be incorporated in the framework. Those elements are transferable and applicable to developing countries’ local governments. Finally, findings from this study provide useful input for the local government policy makers, scholars and asset management practitioners to establish a public asset management framework toward more efficient and effective local governments in managing their assets as well as increasing public services quality.

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In normal child development, both individual and group pretense first emerges at approximately two years of age. The metarepresentational account of pretense holds that children already have the concept PRETEND when they first engage in early group pretense. A behavioristic account suggests that early group pretense is analogous to early beliefs or desires and thus require no mental state concepts. I argue that a behavioral account does not explain the actual behavior observed in children and it cannot explain how children come to understand that a specific action is one of pretense versus one of belief. I conclude that a mentalistic explanation of pretense best explains the behavior under consideration.

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Crash prediction models are used for a variety of purposes including forecasting the expected future performance of various transportation system segments with similar traits. The influence of intersection features on safety have been examined extensively because intersections experience a relatively large proportion of motor vehicle conflicts and crashes compared to other segments in the transportation system. The effects of left-turn lanes at intersections in particular have seen mixed results in the literature. Some researchers have found that left-turn lanes are beneficial to safety while others have reported detrimental effects on safety. This inconsistency is not surprising given that the installation of left-turn lanes is often endogenous, that is, influenced by crash counts and/or traffic volumes. Endogeneity creates problems in econometric and statistical models and is likely to account for the inconsistencies reported in the literature. This paper reports on a limited-information maximum likelihood (LIML) estimation approach to compensate for endogeneity between left-turn lane presence and angle crashes. The effects of endogeneity are mitigated using the approach, revealing the unbiased effect of left-turn lanes on crash frequency for a dataset of Georgia intersections. The research shows that without accounting for endogeneity, left-turn lanes ‘appear’ to contribute to crashes; however, when endogeneity is accounted for in the model, left-turn lanes reduce angle crash frequencies as expected by engineering judgment. Other endogenous variables may lurk in crash models as well, suggesting that the method may be used to correct simultaneity problems with other variables and in other transportation modeling contexts.

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A short discussion concerning the theory of endemic governance problems.

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This paper presents a Genetic Algorithms (GA) approach to search the optimized path for a class of transportation problems. The formulation of the problems for suitable application of GA will be discussed. Exchanging genetic information in the sense of neighborhoods will be introduced for generation reproduction. The performance of the GA will be evaluated by computer simulation. The proposed algorithm use simple coding with population size 1 converged in reasonable optimality within several minutes.

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Background and Significance Venous leg ulcers are a significant cause of chronic ill-health for 1–3% of those aged over 60 years, increasing in incidence with age. The condition is difficult and costly to heal, consuming 1–2.5% of total health budgets in developed countries and up to 50% of community nursing time. Unfortunately after healing, there is a recurrence rate of 60 to 70%, frequently within the first 12 months after heaing. Although some risk factors associated with higher recurrence rates have been identified (e.g. prolonged ulcer duration, deep vein thrombosis), in general there is limited evidence on treatments to effectively prevent recurrence. Patients are generally advised to undertake activities which aim to improve the impaired venous return (e.g. compression therapy, leg elevation, exercise). However, only compression therapy has some evidence to support its effectiveness in prevention and problems with adherence to this strategy are well documented. Aim The aim of this research was to identify factors associated with recurrence by determining relationships between recurrence and demographic factors, health, physical activity, psychosocial factors and self-care activities to prevent recurrence. Methods Two studies were undertaken: a retrospective study of participants diagnosed with a venous leg ulcer which healed 12 to 36 months prior to the study (n=122); and a prospective longitudinal study of participants recruited as their ulcer healed and data collected for 12 months following healing (n=80). Data were collected from medical records on demographics, medical history and ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer history, compression and other self-care activities. Follow-up data for the prospective study were collected every three months for 12 months after healing. For the retrospective study, a logistic regression model determined the independent influences of variables on recurrence. For the prospective study, median time to recurrence was calculated using the Kaplan-Meier method and a Cox proportional-hazards regression model was used to adjust for potential confounders and determine effects of preventive strategies and psychosocial factors on recurrence. Results In total, 68% of participants in the retrospective study and 44% of participants in the prospective study suffered a recurrence. After mutual adjustment for all variables in multivariable regression models, leg elevation, compression therapy, self efficacy and physical activity were found to be consistently related to recurrence in both studies. In the retrospective study, leg elevation, wearing Class 2 or 3 compression hosiery, the level of physical activity, cardiac disease and self efficacy scores remained significantly associated (p<0.05) with recurrence. The model was significant (p <0.001); with a R2 equivalent of 0.62. Examination of relationships between psychosocial factors and adherence to wearing compression hosiery found wearing compression hosiery was significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Analysis of data from the prospective study found there were 35 recurrences (44%) in the 12 months following healing and median time to recurrence was 27 weeks. After adjustment for potential confounders, a Cox proportional hazards regression model found that at least an hour/day of leg elevation, six or more days/week in Class 2 (20–25mmHg) or 3 (30–40mmHg) compression hosiery, higher social support scale scores and higher General Self-Efficacy scores remained significantly associated (p<0.05) with a lower risk of recurrence, while male gender and a history of DVT remained significant risk factors for recurrence. Overall the model was significant (p <0.001); with an R2 equivalent 0.72. Conclusions The high rates of recurrence found in the studies highlight the urgent need for further information in this area to support development of effective strategies for prevention. Overall, results indicate leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence. In addition, optimal management of depression and strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy. This research provides important information for development of strategies to prevent recurrence of venous leg ulcers, with the potential to improve health and decrease health care costs in this population.

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This paper is concerned with some plane strain and axially symmetric free surface problems which arise in the study of static granular solids that satisfy the Coulomb-Mohr yield condition. Such problems are inherently nonlinear, and hence difficult to attack analytically. Given a Coulomb friction condition holds on a solid boundary, it is shown that the angle a free surface is allowed to attach to the boundary is dependent only on the angle of wall friction, assuming the stresses are all continuous at the attachment point, and assuming also that the coefficient of cohesion is nonzero. As a model problem, the formation of stable cohesive arches in hoppers is considered. This undesirable phenomena is an obstacle to flow, and occurs when the hopper outlet is too small. Typically, engineers are concerned with predicting the critical outlet size for a given hopper and granular solid, so that for hoppers with outlets larger than this critical value, arching cannot occur. This is a topic of considerable practical interest, with most accepted engineering methods being conservative in nature. Here, the governing equations in two limiting cases (small cohesion and high angle of internal friction) are considered directly. No information on the critical outlet size is found; however solutions for the shape of the free boundary (the arch) are presented, for both plane and axially symmetric geometries.

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Background: Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods: A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results: In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most ‘under-coded’ by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Conclusion: Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

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Research is indicating that individuals who present for DUI treatment may have competing substance abuse and mental health needs. This study aimed to examine the extent of such comorbidity issues among a sample of Texas DUI offenders. Method: Records of 36,372 DUI clients and 308,695 non-DUI clients admitted to Texas treatment programs between 2005 and 2008 were obtained from the State's administrative dataset. The data were analysed to identify the relationship between substance use, psychiatric problems, program completion and recidivism rates. Results: Analysis indicated that while non-DUI clients were more likely to present with more severe illicit substance use problems, DUI clients were more likely to have a primary problem with alcohol. Additionally, a cannabis use problem was also found to be significantly associated with DUI recidivism in the last year. In regards to mental health needs, a major finding was that depression was the most common psychiatric condition reported by DUI clients, including those with more than one DUI offence in the past year. This group were also more at risk of being diagnosed with Bipolar Disorder compared to the general population, and such a diagnosis was also associated with an increased likelihood of not completing treatment. Interestingly, female DUI and non-DUI clients were also more likely to be diagnosed with mental health problems compared to males, as well as more likely to be placed on medications at admission and have problems with methamphetamine, cocaine, and opiates. Conclusion: The findings highlight the complex competing needs of some DUI offenders who enter treatment. The results also suggest that there is a need to utilise mental health and substance abuse screening methods to ensure DUI offenders are directed towards appropriate treatment pathways as well as ensure that such interventions adequately cater for complex substance abuse and psychiatric needs.

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Objective: To understand the levels of substance abuse and dependence among impaired drivers by comparing the differences in patients in substance abuse treatment programs with and without a past-year DUI arrest based on their primary problem substance at admission (alcohol, cocaine, cannabis, or methamphetamine). Method: Records on 345,067 admissions to Texas treatment programs between 2005 and 2008 have been analyzed for differences in demographic characteristics, levels of severity, and mental health problems at admission, treatment completion, and 90-day follow-up. Methods will include t-tests,??, and multivariate logistic regression. Results: The analysis found that DUI arrestees with a primary problem with alcohol were less impaired than non-DUI alcohol patients, had fewer mental health problems, and were more likely to complete treatment. DUI arrestees with a primary problem with cannabis were more impaired than non-DUI cannabis patients and there was no difference in treatment completion. DUI arrestees with a primary problem with cocaine were less impaired and more likely to complete treatment than other cocaine patients, and there was little difference in levels of mental health problems. DUI arrestees with a primary problem with methamphetamine were more similar to methamphetamine non-arrestees, with no difference in mental health problems and treatment completion. Conclusions: This study provides evidence of the extent of abuse and dependence among DUI arrestees and their need for treatment for their alcohol and drug problems in order to decrease recidivism. Treatment patients with past-year DUI arrests had good treatment outcomes but closer supervision during 90 day follow-up after treatment can lead to even better long-term outcomes, including reduced recidivism. Information will be provided on the latest treatment methodologies, including medication assisted therapies and screening and brief interventions, and ways impaired driving programs and substance dependence programs can be integrated to benefit the driver and society.

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Mechanical control systems have become a part of our everyday life. Systems such as automobiles, robot manipulators, mobile robots, satellites, buildings with active vibration controllers and air conditioning systems, make life easier and safer, as well as help us explore the world we live in and exploit it’s available resources. In this chapter, we examine a specific example of a mechanical control system; the Autonomous Underwater Vehicle (AUV). Our contribution to the advancement of AUV research is in the area of guidance and control. We present innovative techniques to design and implement control strategies that consider the optimization of time and/or energy consumption. Recent advances in robotics, control theory, portable energy sources and automation increase our ability to create more intelligent robots, and allows us to conduct more explorations by use of autonomous vehicles. This facilitates access to higher risk areas, longer time underwater, and more efficient exploration as compared to human occupied vehicles. The use of underwater vehicles is expanding in every area of ocean science. Such vehicles are used by oceanographers, archaeologists, geologists, ocean engineers, and many others. These vehicles are designed to be agile, versatile and robust, and thus, their usage has gone from novelty to necessity for any ocean expedition.

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While hybrid governance arrangements have been a major element of organisational architecture for some time, the contemporary operating environment has brought to the fore new conditions and expectations for the governance of entities that span conventional public sector departments, private firms and community organisations or groups. These conditions have resulted in a broader array of mixed governance configurations including Public Private Partnerships, alliances, and formal and informal collaborations. In some such arrangements, market based or ‘complete’ contractual relationships have been introduced to replace or supplement existing traditional ‘hierarchical’ and/or newer relational ‘network-oriented’ institutional associations. While there has been a greater reliance on collaborative or relational contracts as an underpinning institutional model, other modes of hierarchy and market may remain in operation. The success of these emergent hybrid forms has been mixed. There are examples of hybrids that have been well adopted, achieving the desired goals of efficiency, effectiveness and financial accountability; while others have experienced implementation problems which have undermined their results. This paper postulates that the cultural and institutional context within which hybrids operate may contribute to the implementation processes employed and the level of success attained. The paper explores hybrid arrangements through three cases of the use of inter-organisational arrangements in three different national contexts. Distilling the various elements of hybrids and the impact of institutional context will provide important insights for those charged with the responsibility for the formation and key infrastructure and public value development.

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A key concern in the field of contemporary fashion/textiles design is the emergence of ‘fast fashion’: best explained as "buy it Friday, wear it Saturday and throw it away on Sunday" (O'Loughlin, 2007). In this contemporary retail atmosphere of “pile it high: sell it cheap” and “quick to market”, even designer goods have achieved a throwaway status. This modern culture of consumerism is the antithesis of sustainability and is proving a dilemma surrounding sustainable practice for designers and producers in the disciplines (de Blas, 2010). Design researchers including those in textiles/fashion have begun to explore what is a key question in the 21st century in order to create a vision and reason for their disciplines: Can products be designed to have added value to the consumer and hence contribute to a more sustainable industry? Fashion Textiles Design has much to answer for in contributing to the problems of unsustainable practices on a global scale in design, production and waste. However, designers within this field also have great potential to contribute to practical ‘real world’ solutions. ----- ----- This paper provides an overview of some of the design and technological developments from the fashion/textiles industry, endorsing a model where designers and technicians use their transferrable skills for wellbeing rather than desire. Smart materials in the form of responsive and adaptive fibres and fabrics combined with electro active devices, and ICT are increasingly shaping many aspects of society particularly in the leisure industry and interactive consumer products are ever more visible in healthcare. Combinations of biocompatible delivery devices with bio sensing elements can create analyse, sense and actuate early warning and monitoring systems which can be linked to data logging and patient records via intelligent networks. Patient sympathetic, ‘smart’ fashion/textiles applications based on interdisciplinary expertise utilising textiles design and technology is emerging. An analysis of a series of case studies demonstrates the potential of fashion textiles design practitioners to exploit the concept of value adding through technological garment and textiles applications and enhancement for health and wellbeing and in doing so contribute to a more sustainable future fashion/textiles design industry.

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One of our most pressing needs in creating a more sustainable world is the explicit development of holistic policy. This is becoming increasingly apparent as we are faced with more and more ‘wicked problems', the most difficult class of problems that we can conceptualize. Such problems consist of ‘clusters’ of problems, and include socio-political and moral-spiritual issues. This paper articulates a methodology that can be applied to the analysis and design of underlying organizational structures and processes that will consistently and effectively address wicked problems while being consistent with the advocated 'learning by doing' approach to change management and policy making. This transdisciplinary methodology—known as the institutionalist policymaking framework—has been developed from the perspective of institutional economics synthesized with perspectives from ecological economics and system dynamics. In particular it draws on the work first presented in Hayden’s 1993 paper ‘Institutionalist Policymaking’—and further developed in his 2006 book, at the heart of which lies the SFM—and the applicability of this approach in tackling complex and wicked problems.