989 resultados para motivational enhancement therapy


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Aligning the motivation of contractors and consultants to perform better than ‘business-as-usual’ (BAU) on a construction project is a complex undertaking and the costs of failure are high as misalignment can compromise project outcomes. Despite the potential benefits of effective alignment, there is still little information about optimally designing procurement approaches that promote motivation towards ‘above BAU’ goals. The paper contributes to this knowledge gap by examining the negative drivers of motivation in a major construction project that, despite a wide range of performance enhancing incentives, failed to exceed BAU performance. The paper provides a case study of an iconic infrastructure project undertaken in Australia between 2002 and 2004. It is shown that incentives provided to contractors and consultants to achieve above BAU performance can be compromised by a range of negative motivation drivers including: • inequitable contractual risk allocation; • late involvement of key stakeholders; • inconsistency between contract intentions and relationship intentions; • inadequate price negotiation; • inconsistency between the project performance goals and incentive goals; •unfair and inflexible incentive performance measurement processes. Future quantitative research is planned to determine the generalisability of these results.

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This naturalistic study investigated the mechanisms of change in measures of negative thinking and in 24-h urinary metabolites of noradrenaline (norepinephrine), dopamine and serotonin in a sample of 43 depressed hospital patients attending an eight-session group cognitive behavior therapy program. Most participants (91%) were taking antidepressant medication throughout the therapy period according to their treating Psychiatrists' prescriptions. The sample was divided into outcome categories (19 Responders and 24 Non-responders) on the basis of a clinically reliable change index [Jacobson, N.S., & Truax, P., 1991. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.] applied to the Beck Depression Inventory scores at the end of the therapy. Results of repeated measures analysis of variance [ANOVA] analyses of variance indicated that all measures of negative thinking improved significantly during therapy, and significantly more so in the Responders as expected. The treatment had a significant impact on urinary adrenaline and metadrenaline excretion however, these changes occurred in both Responders and Non-responders. Acute treatment did not significantly influence the six other monoamine metabolites. In summary, changes in urinary monoamine levels during combined treatment for depression were not associated with self-reported changes in mood symptoms.

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This paper summarises results from an evaluation of the adequacy and utility of the Australian Competency Standards for Entry-Level Occupational Therapists © (OT AUSTRALIA, 1994a). It comprised a two-part study, incorporating an online survey of key national stakeholders (n = 26), and 13 focus groups (n = 152) conducted throughout Australia with occupational therapy clinicians, academics, OT AUSTRALIA association and Occupational Therapy Registration Board representatives, as well as university program accreditors. The key recommendations were that: (i) urgent revision to reflect contemporary practice, paradigms, approaches and frameworks is required; (ii) the standards should exemplify basic competence at graduation (not within two years following); (iii) a revision cycle of five years is required; (iv) the Australian Qualifications Framework should be retained, preceded by an introduction describing the scope and nature of occupational therapy practice in the national context; (v) access to the standards should be free and unrestricted to occupational therapists, students and the public via the OT AUSTRALIA (national) website; (vi) the standards should incorporate a succinct executive summary and additional tools or templates formatted to enable occupational therapists to develop professional portfolios and create working documents specific to their workplace; and (vii) language must accommodate contextual variation while striking an appropriate balance between providing instruction and encouraging innovation in practice.

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With increasing pressure to provide environmentally responsible infrastructure products and services, stakeholders are putting significant foci on the early identification of financial viability and outcome of infrastructure projects. Traditionally, there has been an imbalance between sustainable measures and project budget. On one hand, the industry tends to employ the first-cost mentality and approach to developing infrastructure projects. On the other, environmental experts and technology innovators often push for the ultimately green products and systems without much of a concern for cost. This situation is being quickly changed as the industry is under pressure to continue to return profit, while better adapting to current and emerging global issues of sustainability. For the infrastructure sector to contribute to sustainable development, it will need to increase value and efficiency. Thus, there is a great need for tools that will enable decision makers evaluate competing initiatives and identify the most sustainable approaches to procuring infrastructure projects. In order to ensure that these objectives are achieved, the concept of life-cycle costing analysis (LCCA) will play significant roles in the economics of an infrastructure project. Recently, a few research initiatives have applied the LCCA models for road infrastructure that focused on the traditional economics of a project. There is little coverage of life-cycle costing as a method to evaluate the criteria and assess the economic implications of pursuing sustainability in road infrastructure projects. To rectify this problem, this paper reviews the theoretical basis of previous LCCA models before discussing their inability to determinate the sustainability indicators in road infrastructure project. It then introduces an on-going research aimed at developing a new model to integrate the various new cost elements based on the sustainability indicators with the traditional and proven LCCA approach. It is expected that the research will generate a working model for sustainability based life-cycle cost analysis.

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Aims To identify self-care activities undertaken and determine relationships between self-efficacy, depression, quality of life, social support and adherence to compression therapy in a sample of patients with chronic venous insufficiency. Background Up to 70% of venous leg ulcers recur after healing. Compression hosiery is a primary strategy to prevent recurrence, however, problems with adherence to this strategy are well documented and an improved understanding of how psychosocial factors influence patients with chronic venous insufficiency will help guide effective preventive strategies. Design Cross-sectional survey and retrospective medical record review. Method All patients previously diagnosed with a venous leg ulcer which healed between 12–36 months prior to the study were invited to participate. Data on health, psychosocial variables and self-care activities were obtained from a self-report survey and data on medical and previous ulcer history were obtained from medical records. Multiple linear regression modelling was used to determine the independent influences of psychosocial factors on adherence to compression therapy. Results In a sample of 122 participants, the most frequently identified self-care activities were application of topical skin treatments, wearing compression hosiery and covering legs to prevent trauma. Compression hosiery was worn for a median of 4 days/week (range 0–7). After adjustment for all variables and potential confounders in a multivariable regression model, wearing compression hosiery was found to be 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). Conclusion In this sample, depression, self-efficacy and knowledge were found to be significantly related to adherence to compression therapy. Relevance to clinical practice These findings support the need to screen for and treat depression in this population. In addition, strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy.

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Traditional speech enhancement methods optimise signal-level criteria such as signal-to-noise ratio, but these approaches are sub-optimal for noise-robust speech recognition. Likelihood-maximising (LIMA) frameworks are an alternative that optimise parameters of enhancement algorithms based on state sequences generated for utterances with known transcriptions. Previous reports of LIMA frameworks have shown significant promise for improving speech recognition accuracies under additive background noise for a range of speech enhancement techniques. In this paper we discuss the drawbacks of the LIMA approach when multiple layers of acoustic mismatch are present – namely background noise and speaker accent. Experimentation using LIMA-based Mel-filterbank noise subtraction on American and Australian English in-car speech databases supports this discussion, demonstrating that inferior speech recognition performance occurs when a second layer of mismatch is seen during evaluation.

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Traditional speech enhancement methods optimise signal-level criteria such as signal-to-noise ratio, but such approaches are sub-optimal for noise-robust speech recognition. Likelihood-maximising (LIMA) frameworks on the other hand, optimise the parameters of speech enhancement algorithms based on state sequences generated by a speech recogniser for utterances of known transcriptions. Previous applications of LIMA frameworks have generated a set of global enhancement parameters for all model states without taking in account the distribution of model occurrence, making optimisation susceptible to favouring frequently occurring models, in particular silence. In this paper, we demonstrate the existence of highly disproportionate phonetic distributions on two corpora with distinct speech tasks, and propose to normalise the influence of each phone based on a priori occurrence probabilities. Likelihood analysis and speech recognition experiments verify this approach for improving ASR performance in noisy environments.

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