319 results
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2. The experiences of home‐domiciled and international ethnic minority students on a pre‐registration speech and language therapy training programme: A qualitative study.
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Rees, Rachel, Smith, Christina, Loke, Asher, and Nightingale, Ruth
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SPEECH therapy education , *MINORITY students , *MINORITIES , *STUDENT speech , *OCCUPATIONAL therapy students , *SPEECH therapy - Abstract
Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on this subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Attainment inequalities exist for ethnic minority students graduating from higher education institutes (HEIs) in the UK. Previous research has investigated the outcomes and experiences of students from ethnic minority backgrounds on health and social care programmes. However, studies exploring ethnic minority speech and language therapy (SLT) students’ experiences have only focused on international students and were conducted in Australia. No known studies exploring the experiences of both home‐domiciled and international SLT students from ethnic minority backgrounds have been conducted in the UK.To explore the experiences of home‐domiciled and international ethnic minority students on a SLT training programme and to identify ways to improve these experiences.All SLT students attending a pre‐registration postgraduate course who identified as being from an ethnic minority background were invited to participate. Two focus groups, one for three international students and one for six home students, were conducted. Data were analysed using reflexive thematic analysis.Three themes were identified that illustrated students’ current experiences and how experiences could be improved: (1)
feeling an outsider , explores students’ sense of belonging in SLT education; (2)finding ways to manage , describes the strategies used by students to cope with their experiences of marginalization, and how adopting these strategies impact on their well‐being; and (3)promoting inclusion , explains how the training programme could be modified to improve the experience of ethnic minority students.A better understanding of the experiences of ethnic minority SLT students can help others to support them more effectively. The findings suggest that making changes to SLT training programmes could improve ethnic minority students’ outcomes and experiences. These include: more training for staff and students, support groups for ethnic minority students, sharing lived experiences of students and experienced SLTs from ethnic minority backgrounds, and clearer ways of reporting racist incidents. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. Previous studies have investigated the experiences of ethnic minority students on a range of HEI programmes, including those for students of physiotherapy and occupational therapy. The only studies investigating the experiences of ethnic minority SLT students are those exploring how international SLT students in Australia can be supported on professional placement. This study explores the experiences of home and international SLT students in the UK who identify as being from minority ethnic backgrounds. Findings suggest that these students feel like outsiders, affecting their sense of belonging. The need to find and implement strategies to manage their feelings of marginalization impacts on their well‐being. The findings suggest measures to promote the inclusion of ethnic minority SLT students to improve their experiences and support their well‐being. These include more training for all staff and students and the creation of a ‘lived experiences library’ where students and experienced SLTs from ethnic minority backgrounds could share positive experiences as well as ways of dealing with challenges. Clearer ways of reporting racist incidents would be beneficial for all students. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. It is important that ethnic minority SLT students are involved in developments that aim to improve their experiences. [ABSTRACT FROM AUTHOR]- Published
- 2024
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3. Service users' and carers' experiences of engaging with early intervention services: A meta‐synthesis review.
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Loughlin, Matthew, Bucci, Sandra, Brooks, Joanna, and Berry, Katherine
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THEMATIC analysis ,RELATIONSHIP quality ,ENVIRONMENTAL impact statements - Abstract
Aim: The provision and implementation of early intervention for psychosis services (early intervention services [EIS]) has received increasing attention over recent years. Maximizing engagement with EIS is of clinical and economic importance, and exploring the experiences of those who access EIS is vital. Although research has been conducted exploring the experiences of engaging with EIS from both a service user and carer/family member point of view, these data have not been systematically collated to generate new understanding. The primary aim of this study is to review, critically appraise and synthesize qualitative findings relating to the experiences of service users and/or carers and family members engaging with EIS. Methods: Four databases were systematically searched. Studies were analysed using an inductive thematic analysis approach, within a critical realist epistemological framework. Studies were critically appraised using the critical appraisal skills programme tool. Results: Fourteen papers were identified for inclusion. Three main themes were identified: the importance of a personal relationship with an EIS staff member, the impact of this relationship and consideration of life after EIS. The importance of a strong relationship with EIS staff was the most prominent theme throughout the papers reviewed. Conclusions: The quality of the therapeutic relationship with at least one EIS staff member was the single most important factor in determining whether the experience of accessing EIS was a positive or negative one. The majority of the studies reviewed were conducted in the United Kingdom or Australia. Therefore, more research across countries is needed to understand transferability of findings. [ABSTRACT FROM AUTHOR]
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- 2020
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4. A qualitative exploration of speech–language pathologists' approaches in treating spoken discourse post‐traumatic brain injury.
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Hoffman, Rhianne, Spencer, Elizabeth, and Steel, Joanne
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SPEECH therapy , *MEDICAL logic , *MEDICAL protocols , *QUALITATIVE research , *INTERVIEWING , *CONTENT analysis , *JUDGMENT sampling , *PHYSICIAN practice patterns , *RESEARCH methodology , *SOCIAL skills , *BRAIN injuries , *DISEASE complications - Abstract
Background: Spoken discourse impairments post‐traumatic brain injury (TBI) are well‐documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech–language pathologist (SLP) is recommended for adults with discourse impairments post‐TBI, with an emphasis on context‐sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice. Aims: To explore the under‐researched area of clinical practice for spoken discourse interventions with adults post‐TBI, including treatment components and clinician rationales, and to contribute towards a shared knowledge base. Methods & Procedures: Participants were recruited via purposeful sampling strategies. Six SLPs participated from Australia, the United Kingdom (UK) and the United States (US). Semi‐structured interviews were conducted via Zoom. Interviews were manually transcribed, coded and analysed via a qualitative content analysis approach. Outcomes & Results: :Participants described discourse treatment practices across various settings and TBI recovery stages. Results indicated that SLPs used numerous treatment activities, resources and outcome measures. Intervention approaches primarily targeted social communication skills, strategy development/utilization and insight‐building. Clinical practice conformed to available guidelines where possible, reflected best practice and incorporated components of the research literature. Participants reported using individualized treatment activities aimed at addressing client‐specific factors and rationales prioritized tailored, context‐sensitive and goal‐directed treatment. Conclusions & Implications: This study provided insight into a previously under‐researched area. It highlighted a wide range of treatment activities and factors informing current SLPs' treatment of spoken discourse impairment post‐TBI. Overall, clinical practice and rationales discussed in this study were aligned with best practice and emphasized a contextualized, individualized approach to discourse treatment across service settings and stages of recovery. Participants identified areas requiring further support, including access to training, resources and research, and the challenge of finding suitable outcome measures. Further investigation into discourse management post‐TBI, from initial assessment to outcome measurement, may help inform clinical decision‐making and the transfer of research to practice. WHAT THIS PAPER ADDS: What is already known on the subject: Spoken discourse impairments occur in dialogic and monologic productions post‐TBI. Interventions targeting both genres are detailed within the research literature; however, studies exploring clinical practice and decision‐making for discourse interventions post‐TBI are limited. What this paper adds to existing knowledge: This study provides new insight into the current treatment targets, activities, resources and outcome measures employed by clinicians supporting adults with discourse impairment post‐TBI. It details the factors that influence clinical decision‐making for this caseload and identifies an emphasis on client priorities and the value of clinician experience. What are the potential or actual clinical implications of this work?: This study identifies the broad and complex considerations required to deliver context‐sensitive discourse intervention post‐TBI. It indicates the need for an in‐depth review from assessment to treatment outcomes to better understand and support this area of practice and to direct future research. This study also highlighted the role of clinician experience in discourse intervention and the value of sharing clinical knowledge and resources within and across the profession to support all levels of clinician experience. [ABSTRACT FROM AUTHOR]
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- 2024
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5. A survey of speech pathologists' opinions about the prospective acceptability of an online implementation platform for aphasia services.
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Trebilcock, Megan, Shrubsole, Kirstine, Worrall, Linda, and Ryan, Brooke
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TELEREHABILITATION ,SPEECH therapy ,ATTITUDES of medical personnel ,INTERNET ,RESEARCH methodology ,MEDICAL care ,CONCEPTUAL structures ,SELF-efficacy ,REHABILITATION of aphasic persons ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,SPEECH therapists ,INTERNET service providers - Abstract
Background: Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far‐reaching dissemination of current evidence and best‐practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. Aims: To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. Methods & Procedures: A mixed‐methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. Outcomes & Results: A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. Conclusions & Implications: Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian‐based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS: What is already known on the subject: Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge: This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work?: Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in‐depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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6. Proffered papers 9.30–10.00 Monday 15 September 2003 2 Clinicopathologic significance of the ‘borderline nuclear change – high grade dyskaryosis not excluded’ report.
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Caroline, Brodie, Ritu, Kapur, Mary, Murray, Derek, Magee, Lesley, Turner, and David, Gibbons
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CYTOLOGICAL research ,ABSTRACTS - Abstract
Introduction Recent changes in terminology have recognized that cervical smears may contain cells with a high nuclear-cytoplasmic ratio, suspicious for high grade dyskaryosis, which are not definitively diagnostic. Aims The correlation of cyopathological features present in a prospective series of cervical smears diagnosed as ‘borderline nuclear change – high grade dyskaryosis not excluded’ (BNCH) with clinical and histological follow-up. Methods We have been using the BNCH diagnosis in our practice since June 1999. Cases of BNCH between June 1999 and June 2002 were retrieved from computerized laboratory records. Questionnaires were sent to referring clinicians regarding clinical follow-up, including results of colposcopy, histology and follow-up smears. Smears were reviewed for the presence of microbiopsies or single atypical cells. Numbers of atypical cells were quantified as less than/equal to or greater than 3. Results A total of 106 reports on conventional cervical smears diagnosed as BNCH from 1999 to 2002 were retrieved; they comprised of 0.098% of a total of 107 634 smears screened over that period. Clinical follow-up, with histology (n = 54), colposcopy (n = 26) or repeat cytology (n = 10), was available in 88 of 106 cases. Thirty-one (35%) showed a high grade abnormality (CIN2, CIN3 or invasive squamous or adenocarcinomas), 15 (17%) showed a borderline/low grade abnormality (repeat BNCH or CIN1) and 42 (48%) were negative. Eighty-seven of these were reviewed cytologically ( Table 1). Conclusions The BNCH category has a substantial yield of high grade abnormalities on follow-up, which may be greater in cases where atypical cells are pre-dominantly within microbiopsies. These findings support the introduction of the BNCH terminology. [ABSTRACT FROM AUTHOR]
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- 2003
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7. Advances and gaps in policy, practice, and research in transition for students with intellectual and developmental disabilities across four countries.
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Šiška, Jan, Beadle‐Brown, Julie, Tichá, Renáta, Stancliffe, Roger, Abery, Brian, and Káňová, Šárka
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EVIDENCE gaps , *RESEARCH funding , *AUTONOMY (Psychology) , *INDEPENDENT living , *HEALTH policy , *STUDENTS with disabilities , *INTELLECTUAL disabilities , *DEVELOPMENTAL disabilities , *TRANSITIONAL care , *SOCIAL integration , *MEDICAL research , *LITERATURE reviews , *CONCEPTUAL structures , *TRANSITIONAL programs (Education) , *SPECIAL education , *SOCIAL support , *HEALTH promotion , *PSYCHOSOCIAL factors , *EMPLOYMENT - Abstract
The difficulties faced by youth with intellectual and developmental disabilities (IDDs) and their families as they move into adulthood are widely documented. The aim of the paper is to explore the current situation in terms of transition processes and outcomes in four countries (the US, UK, Australia and Czech Republic) and identify commonalities and differences that help elucidate what might determine different outcomes. Two research methods—expert knowledge and rapid literature review—were combined to identify sources from which information on transition policy, processes, support practices and outcomes was extracted and synthesised. This review identified gaps in the research evidence including inadequate collection and use of data to drive policy and determine effectiveness, limited evidence‐based models or frameworks for successful transition. There was little transition research that included the voices of young people with IDD. More research is necessary to study the practices of highly successful programmes, and to explore the impact of transition programmes and disability support services on a broader range of outcomes, capturing the experiences of young people themselves and identifying factors that determine successful outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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8. International research into 22 years of use of chemical restraint: An evidence overview.
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Muir‐Cochrane, Eimear, Oster, Candice, and Grimmer, Karen
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ANXIETY prevention ,VIOLENCE prevention ,AGGRESSION (Psychology) ,HOSPITAL wards ,HOSPITAL emergency services ,INDUSTRIAL safety ,RESTRAINT of patients ,SYSTEMATIC reviews ,PSYCHIATRIC treatment - Abstract
Background: Chemical restraint (CR) (also known as rapid tranquilisation) is the forced (non‐consenting) administration of medications to manage uncontrolled aggression, anxiety, or violence in people who are likely to cause harm to themselves or others. Our population of interest was adults with mental health disorders (with/without substance abuse). There has been a growing international movement over the past 22 years towards reducing/eliminating restrictive practices such as CR. It is appropriate to summarise the research that has been published over this time, identify trends and gaps in knowledge, and highlight areas for new research to inform practice. Aims: To undertake a comprehensive systematic search to identify, and describe, the volume and nature of primary international research into CR published since 1995. Methods: This paper reports the processes and overall findings of a systematic search for all available primary research on CR published between 1 January 1996 and 31 July 2018. It describes the current evidence base by hierarchy of evidence, country (ies) producing the research, CR definitions, study purpose, and outcome measures. Results: This review identified 311 relevant primary studies (21 RCTs; 46 non‐controlled experimental or prospective observational studies; 77 cross‐sectional studies; 69 retrospective studies; 67 opinion pieces, position or policy statements; and 31 qualitative studies). The USA, UK, and Australia contributed over half the research, whilst cross‐country collaborations comprised 6% of it. The most common research settings comprised acute psychiatric wards (23.3%), general psychiatric wards (21.6%), and general hospital emergency departments (19.0%). Discussion A key lesson learnt whilst compiling this database of research into CR was to ensure that all papers described non‐consenting administration of medications to manage adults with uncontrolled aggression, anxiety, or violence. There were tensions in the literature between using effective CR without producing adverse events, and how to decide when CR was needed (compared with choosing non‐chemical intervention for behavioural emergencies), respecting patients' dignity whilst safeguarding their safety, and preserving safe workplaces for staff, and care environments for other patients. The range of outcome measures suggests opportunities to standardise future research. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Australian Consumption Expenditure and Real Income: 1900 to 2003–2004.
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HAIG, BRYAN and ANDERSSEN, JENNIFER
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CONSUMPTION (Economics) ,REAL income ,RESEARCH ,ESTIMATES ,PER capita ,ECONOMIC trends - Abstract
This paper provides new data of personal consumption expenditure at current and constant prices from 1900 to 1938–1939. The series is linked in with the official estimates, available from 1948–1949, to provide a broadly consistent series of estimates of consumers’ expenditure from Federation, based on new series of data. We comment on the differences in estimates often used to compare trends in real incomes, and attribute the differences as being mainly due to limitations of official data. We use the present results to describe the changes in the pattern of expenditure by main functional groupings, and compare the changes in real per capita expenditure in Australia with that in the UK and USA since the end of the nineteenth century. [ABSTRACT FROM AUTHOR]
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- 2007
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10. A survey of cognitive–communication difficulties following TBI: are families receiving the training and support they need?
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Grayson, Lynn, Brady, Marian C., Togher, Leanne, and Ali, Myzoon
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COGNITION disorders ,COMMUNICATIVE disorders ,CONTENT analysis ,STATISTICAL correlation ,COUNSELING ,FAMILY medicine ,HEALTH ,INTERPERSONAL relations ,SERVICES for caregivers ,NEEDS assessment ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,SOCIAL participation ,SPEECH therapy ,SURVEYS ,INFORMATION resources ,ACCESS to information ,REHABILITATION for brain injury patients ,DATA analysis software ,FAMILY attitudes ,DESCRIPTIVE statistics - Abstract
Background: Whilst research into the wide‐ranging needs of family members following traumatic brain injury (TBI) is well established, investigation into the specific needs of families in relation to supporting cognitive–communication difficulties, relationships and social participation is limited. Aims: To identify the family needs for cognitive‐communication difficulties following TBI and to explore whether current services are meeting these needs. Methods & Procedures: Following a successful pilot, family members from the UK and Australia were invited via posters, social media and e‐mail to take part in an anonymous, communication needs survey. Data arising from the thirty two closed questions (six eligibility, nine demographic and seventeen needs questions) were analysed using SPSS descriptive statistics. Data arising from one open question were analysed using qualitative content analysis. Outcomes & Results: A total of 102 family members from the UK (n = 89, 87%) and Australia (n = 13, 13%) completed the survey. The majority of respondents were female (n = 76; 75%), between the ages of 30 and 69 (n = 88; 87%), and either a parent or a partner of the person following TBI (n = 78;76%). Respondents rated information about expected recovery from cognitive‐communication difficulties and training in helpful strategies as their most important needs. The majority of respondents (more than 60%) were not satisfied that any of their cognitive–communication needs had been fully met and high levels of unmet need remained evident at three years or more post‐injury. Written information, communication partner training and counselling were identified as key supports. Conclusions & Implications: Families report high levels of unmet need for managing cognitive‐communication difficulties following TBI. Access to written information and communication partner training should be available to families at various time points following TBI and not just in the early stages. What this paper addsWhat is already known on this subjectAttempting to support a person who has cognitive‐communication difficulties following TBI has been found to be highly burdensome for family members. However, few studies have asked how families perceive their needs in relation to cognitive‐communication difficulties or measured how well current services are meeting their needs.What this paper adds to existing knowledgeThis study demonstrates that current speech and language therapy services are not yet meeting the needs of the relatives of individuals with cognitive‐communication difficulties following TBI. Important insights into the information, training and support families' rate as important are identified in addition to how these needs develop over time.What are the potential or actual clinical implications of this work?Speech and language therapy service design requires to reflect the ongoing nature of familial needs for cognitive‐communication difficulties following TBI. Families require access to appropriate literature, speech and language therapy support, and communication partner training in the longer term, not just in the acute phase. [ABSTRACT FROM AUTHOR]
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- 2020
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11. Perspectives of speech and language therapists in paediatric palliative care: an international exploratory study.
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Krikheli, Lillian, Erickson, Shane, Carey, Lindsay B., Carey‐Sargeant, Christa L., and Mathisen, Bernice A.
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CLINICAL competence ,PALLIATIVE treatment ,PEDIATRICS ,INDUSTRIAL psychology ,RESEARCH ,RESEARCH funding ,STATISTICAL sampling ,SPEECH evaluation ,SPEECH therapists ,PHYSICIAN practice patterns ,OCCUPATIONAL roles ,CROSS-sectional method ,ATTITUDES of medical personnel ,DESCRIPTIVE statistics - Abstract
Background: The involvement of speech and language therapists (SLTs) within paediatric palliative care (PPC) settings has been recognized within the extant literature. However, there is little understanding of SLT's specific roles and practices when working with this vulnerable cohort of children and their families. As part of a larger body of work to develop consensus‐based recommendations for SLTs working in PPC, it is important to investigate demographic and caseload characteristics. Aims: This exploratory study aimed to gather previously undocumented international demographic data pertaining to SLT service provision, caseload and training in PPC. Additionally, it sought to ascertain the current treatment and assessment approaches of SLTs, and if variations exist in beliefs and practices. Methods & Procedures: An anonymous cross‐sectional survey was designed and reported according to the Checklist for Reporting Results of Internet E‐Surveys (CHERRIES). The online survey consisted of 40 items spanning four domains: (1) demographic information, (2) caseload information, (3) service provision and (4) training and education. SLTs from Australia, Canada, New Zealand, the UK, Ireland and the United States were recruited using a purposive snowball sampling approach. Descriptive analysis of closed‐ended survey responses and content analysis of open‐ended responses are presented. Outcomes & Results: A total of 52 respondents completed the survey. SLTs worked in a variety of PPC settings, with patients of varying age and disease groups. Over 50% of participants reported working in PPC for ≤ 4 years. Genetic disorders (34%), oncology (27%) and neurological conditions (21%) made up a significant portion of respondents' caseloads. Reported treatments and assessment approaches used by SLTs are not unique to a PPC population. Barriers and enablers for practice were identified. A portion of participants did not feel trained and prepared to assess (19.2%) or treat (15.4%) PPC clients. Conclusions & Implications: This study confirms that SLTs internationally have a role in the management of communication and swallowing impairments in a PPC context. However, whether current training and resources adequately support SLTs in this role remains questionable. This paper helps to provide SLTs, administrators, professional associations and tertiary institutions with foundational data to help inform workforce planning, advocacy efforts and training priorities. What this paper addsWhat is already known on the subjectThe published multidisciplinary literature has identified that SLTs have a role in PPC. However, there has been no targeted research investigating the professional characteristics of clinicians in this context, nor any detailed information regarding associated clinician beliefs or management approaches.What this paper adds to existing knowledgeThis study is a snapshot of attributes, practice patterns and beliefs of SLTs who work with a PPC population. It highlights SLT perspectives of education and training, as well as meta‐perceptions of themselves within the multidisciplinary team.What are the potential or actual clinical implications of this work?Data presented in this paper will help to enable SLTs, organizations and associations to augment service provision and determine future professional development priorities within the field of PPC. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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12. Survey of hospital practitioners: common understanding of cardiopulmonary resuscitation definition and outcomes.
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Berry‐Kilgour, Niamh A. H., Paulin, Jono R., Psirides, Alex, and Pegg, Tammy J.
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CARDIOPULMONARY resuscitation , *HEALTH facility employees , *EVALUATION of medical care , *WORK experience (Employment) , *CLINICAL deterioration , *PROFESSIONS , *DO-not-resuscitate orders , *INDIVIDUALIZED medicine , *MEDICAL care research , *PSYCHOSOCIAL factors , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *SECONDARY care (Medicine) , *THEMATIC analysis , *ELECTRIC countershock , *DECISION making in clinical medicine , *EVALUATION - Abstract
Background: Cardiopulmonary resuscitation (CPR) is internationally defined as chest compressions and rescue breaths, and is a subset of resuscitation. First used for out‐of‐hospital cardiac arrest, CPR is now frequently used for in‐hospital cardiac arrest (IHCA) with different causes and outcomes. Aims: This paper aims to describe clinical understanding of the role of in‐hospital CPR and perceived outcomes for IHCA. Methods: An online survey of a secondary care staff involved in resuscitation was conducted, focussing on definitions of CPR, features of do‐not‐attempt‐CPR conversations with patients and clinical case scenarios. Data were analysed using a simple descriptive approach. Results: Of 652 responses, 500 were complete and used for analysis. Two hundred eleven respondents were senior medical staff covering acute medical disciplines. Ninety‐one percent of respondents agreed or strongly agreed that defibrillation is part of CPR, and 96% believed CPR for IHCA included defibrillation. Responses to clinical scenarios were dissonant, with nearly half of respondents demonstrating a pattern of underestimating survival and subsequently showing a desire to offer CPR in similar scenarios with poor outcomes. This was unaffected by seniority and level of resuscitation training. Conclusions: The common use of CPR in hospital reflects the broader definition of resuscitation. Recapturing the CPR definition for clinicians and patients as only chest compressions and rescue breaths may allow clinicians to better discuss individualised resuscitation care to aide meaningful shared decision‐making around patient deterioration. This may involve reframing current in‐hospital algorithms and uncoupling CPR from wider resuscitative measures. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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13. Down with falls! Paramedicine scope regarding falls amongst older adults in rural and remote communities: A scoping review.
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Peters, Aidan, Lim, David, and Naidoo, Navindhra
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CINAHL database ,RURAL health services ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,COMMUNITY health services ,RISK assessment ,ACCIDENTAL falls ,DESCRIPTIVE statistics ,MEDICAL practice ,LITERATURE reviews ,MEDLINE ,PARAMEDICINE ,EMERGENCY medicine ,OLD age - Abstract
Introduction: Australian rural and remote areas are faced with the double burden of an ageing population paired with inequitable access to health resources due to the paradigm of major city centred health care. This complicates fall management within this space. Paramedics are a registered health profession, which provides mobile, equitable health care. However, this resource is not being effectively utilised in rural and remote areas where primary care access barriers may cause patient needs to go unmet. Objective: To describe the existing literature and describe the international scope of current paramedicine practice in the out‐of‐hospital management of falls amongst older adults in rural and remote settings. Design: Joanna Briggs Institute scoping review methodology was employed. CINAHL (EBSCO), MEDLINE (Ovid), EMBASE (Ovid), SCOPUS (Elsevier), Google Scholar and These Global were searched and Australian, New Zealand and the UK ambulance service guidelines were sought. Findings: Two records met inclusion criteria. Currently, rural and remote paramedic fall management involves preventative health promotion through patient education, population‐based screening and referrals. Discussion: The use of paramedics to screen at‐risk populations and refer is vital, as many rural adults had screened positive to fall risks and other unmet needs. There is poor recollection of physically printed education material and low acceptance of further in‐home assessments following paramedic departure. Conclusion: This scoping review has highlighted a significant knowledge gap on this topic. Further research is needed to effectively utilise paramedicine within areas where access to primary care is not possible to achieve downstream, risk reducing care in the home. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Follow the policy: An actor network theory study of widening participation to medicine in two countries.
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Coyle M, Bullen J, Poobalan A, Sandover S, and Cleland J
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- Humans, Australia, United Kingdom, Policy, Schools, Medical, School Admission Criteria, Students, Medical
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Introduction: The slow pace of change in respect of increasing the diversity of medical students suggests powerful actors are reproducing practices to support the status quo. Opening up medicine to embrace diversity thus requires the deconstruction of entrenched processes and practices. The first step in doing so is to understand how the actor-network of widening participation and access to medicine (WP/WA) is constructed. Thus, here we examine how the connections among actors in WP/WA in two different networks are assembled., Methods: A comparative case study using documents (n = 7) and interviews with staff and students (n = 45) from two medical schools, one United Kingdom and one Australian, was used. We used Callon's moments of translation (problematisation, interessement/operationalisation, enrolment, mobilisation) to map the network of actors as they are assembled in relation to one another. Our main actant was institutional WP to medicine policy (actor-as-policy)., Results: Our actor-as-policy introduced five other actors: the medical school, medical profession, high schools, applicants and medical school staff. In terms of problematisation, academic excellence holds firm as the obligatory passage point and focal challenge for all actors in both countries. The networks are operationalised via activities such as outreach and admissions policy (e.g., affirmative action is apparent in Australia but not the UK). High schools play (at best) a passive role, but directed by the policy, the medical schools and applicants work hard to achieve WP/WA to medicine. In both contexts, staff are key mobilisers of WP/WA, but with little guidance in how to enact policy. In Australia, policy drivers plus associated entry structures mean the medical profession exerts significant influence., Conclusions: Keeping academic excellence as the obligatory passage point to medical school shapes the whole network of WP/WA and perpetuates inequality. Only by addressing this can the network reconfigure., (© 2023 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)
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- 2024
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15. The politics of audit: the federal Office of the Auditor General in comparative perspective.
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Sutherland, Sharon L.
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AUDITORS ,MERGERS & acquisitions ,LEGISLATION ,ACTIONS & defenses (Administrative law) ,LEGAL judgments ,POLICY sciences ,REPRESENTATIVE government - Abstract
Copyright of Canadian Public Administration is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 1986
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16. Spatial Variation of Extreme Rainfall Observed From Two Century‐Long Datasets.
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Wang, H. and Xuan, Y.
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SPATIAL variation ,CLIMATE change ,EXTREME value theory ,DISTRIBUTION (Probability theory) - Abstract
This paper presents the spatial variation of area‐orientated annual maximum daily rainfall (AMDR), represented by well‐fitted generalized extreme value (GEV) distributions, over the last century in Great Britain (GB) and Australia (AU) with respect to three spatial properties: geographic locations, sizes, and shapes of the region‐of‐interest (ROI). The results show that the spatial variation of GEV location‐scale parameters is dominated by geographic locations and area sizes. In GB, there is an eastward‐decreasing banded pattern compared with a concentrically increasing pattern from the middle to coasts in AU. The parameters tend to decrease with increased area sizes in both studied regions. Although the impact of the ROI shapes is insignificant, the round‐shaped regions usually have higher‐valued parameters than the elongated ones. These findings provide a new perspective to understand the heterogeneity of extreme rainfall distribution over space driven by the complex interactions between climate, geographical features, and the practical sampling approaches. Key Points: Rainfall series are extracted and processed from more than 11,000 regions of interest over the last 100 years in Great Britain and Australia.Spatial distribution of extreme rainfall modeled qualitatively and quantitatively shows impact from location, size, and shape of regions.Methods and findings provide new perspectives for understanding the heterogeneous nature of climate variability and climatic change impact. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
17. Physiotherapy Practice: Opportunities for International Collaboration on Workforce Reforms, Policy and Research.
- Author
-
Grimmer, K, Morris, J, Kim, S, Milanese, S, and Fletcher, W
- Subjects
LABOR supply ,RECORDING & registration ,WAGES ,MEDICAL specialties & specialists ,PHYSICAL therapy ,PHYSICAL therapy education ,PROFESSIONAL employee training ,RESPONSIBILITY ,WORK environment ,JOB performance ,OCCUPATIONAL roles ,PROFESSIONAL licenses - Abstract
Background and Purpose Physiotherapy or Physical Therapy (PT) is the most commonly practised allied health discipline globally. International PT workforce reforms are underway to deal with increasing patient numbers, shrinking medical and nursing workforces and lengthy waiting lists. It is timely to consider international differences in PT, with the aims of identifying opportunities for shared learning and forming stronger international alliances to support consistent and evidence-based workforce reforms. Methods This paper synthesizes freely available information on PT training and service delivery across the UK, Australia and United States (California). The paper considers differences in roles, workplaces, training, legislation and registration, continuing professional development, and accountability. Results There are similarities between UK, Australia and United States (California) in many areas of PT roles, training, registration, legislation and professional practice. However, none has a standard national mechanism by which to demonstrate PT accountability, patient safety or quality care. Moreover, there are different approaches to workforce reforms. There is considerable duplication in physiotherapy governance. Conclusion There are opportunities for targeted international collaborations regarding workforce reforms such as extending scope of practice, and determining and implementing internationally agreed ways of demonstrating PT accountability. The findings of this review have significant policy implications, and identify areas for collaborative research. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
18. The state of ethical decision‐making research in accounting: A retrospective assessment from 1987 to 2022.
- Author
-
Owusu, Godfred Matthew Yaw and Korankye, Gabriel
- Subjects
ETHICAL decision making ,BIBLIOMETRICS ,CLUSTER analysis (Statistics) ,DEVELOPED countries ,DATABASES ,BIBLIOTHERAPY ,ACCOUNTING education - Abstract
This study employs the bibliometric analysis approach to examine research on ethical decision‐making (EDM) of accountants from 1987 to 2022. The study specifically examines the developments in EDM research and evaluates the intellectual structure of the research field. Employing citation, co‐authorship, co‐occurrence and bibliographic coupling analyses, bibliometric data on 908 publications from the Scopus database was analysed. The results indicate that there has been a significant increase in the rate of publication on EDM of accountants following the spate of ethical breaches in the early 2000s. Further, we find that a large proportion of EDM in accounting research originates from developed countries like USA, Australia and UK. Our cluster analysis suggests that two main research streams have evolved over the period. Prior to 2012, researchers in this field mainly focused on individual level issues, particularly, on the determinants of the EDM process of individuals. Research, post 2012, however, has focused on firm‐level EDM issues including organisational ethics, culture, and corporate governance. The study further discusses the themes in detail andproposes a future research agenda. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
19. Dispelling the myths about major donor fundraising.
- Author
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Cluff, Angela
- Subjects
FUNDRAISING ,CHARITABLE uses, trusts, & foundations ,CHARITIES - Abstract
This paper explores some common weaknesses that occur when charities undertake major donor initiatives. It also explodes some common 'myths' that can stifle an organisation's major donor work. The basis for identifying these weaknesses and myths comprises of two sources: some original management centre (=mc) research among a number of leading major donor fundraising organisations, and our practical consulting experience over the last 3 years with not-for-profit fundraisers running major campaigns in UK, USA and Australia. In the paper, we also explore how by confronting these weaknesses and dispelling the myths within your organisation, you too can develop a successful major donor income stream. These lessons are now being applied in our consulting work in the UK, USA and South America, with some significant success. We believe they hold important general lessons for anyone running major donor-led capital campaigns. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
20. The Internet as a research site: establishment of a web-based longitudinal study of the nursing and midwifery workforce in three countries.
- Author
-
Huntington, Annette, Gilmour, Jean, Schluter, Philip, Tuckett, Anthony, Bogossian, Fiona, and Turner, Catherine
- Subjects
NURSING research ,MIDWIFERY ,INTERNET research ,MEDICAL research - Abstract
Title. The Internet as a research site: establishment of a web-based longitudinal study of the nursing and midwifery workforce in three countries. Aim. The aim of this paper is to describe the development of a web-based longitudinal research project, The Nurses and Midwives e-cohort Study. Background. The Internet has only recently been used for health research. However, web-based methodologies are increasingly discussed as significant and inevitable developments in research as Internet access and use rapidly increases worldwide. Method. In 2006, a longitudinal web-based study of nurses and midwives workforce participation patterns, health and wellbeing, and lifestyle choices was established. Participating countries are Australia, New Zealand and the United Kingdom. Data collection is handled through a dedicated website using a range of standardized tools combined into one comprehensive questionnaire. Internet-specific data collection and a range of recruitment and retention strategies have been developed for this study. Discussion. Internet-based technology can support the maintenance of cohorts across multiple countries and jurisdictions to explore factors influencing workforce participation. However, barriers to widespread adoption of web-based approaches include website development costs, the need for fast broadband connection for large data collection instruments, and varying degrees of Internet and computer literacy in the nursing and midwifery workforce. Conclusion. Many of the issues reported in this paper are transitional in nature at a time of rapid technological development. The development of on-line methods and tools is a major and exciting development in the world of research. Research via the world-wide web can support international collaborations across borders and cultures. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
21. Merkel cell carcinoma update: the case for two tumours.
- Author
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Nirenberg, A., Steinman, H., Dixon, J., and Dixon, A.
- Subjects
TUMORS ,SQUAMOUS cell carcinoma ,MERKEL cells ,VIRAL genomes ,STEM cells ,MERKEL cell carcinoma - Abstract
Merkel cell carcinoma (MCC) is an aggressive tumour with neuroendocrine differentiation. Clinically significant differences within the entity we know as MCC are apparent. This review aims to evaluate the evidence for differences in tumours within Merkel cell carcinoma and to stratify these. A literature search of research pertaining to various characteristics MCC was undertaken from 1972, when Merkel cell carcinoma was first described, to 2018, using PubMed and similar search engines. A total of 41 papers were analysed, including clinical trials, laboratory‐based research and reviews. A proportion of MCC has Merkel cell polyomavirus genome integrated (MCPyV+) while others do not (MCPyV−). Both types have a different mutation burden. MCPyV+ tumours are likely true neuroendocrine carcinomas, with a dermal origin, probably from fibroblasts which have been transformed by integration of the viral genome. MCPyV−tumours are likely derived from either keratinocytes or epidermal stem cells, are probably squamous cell carcinomas with neuroendocrine differentiation, and are related to sun damage. Prognostic factors (apart from tumour stage) include the MCPyV status, with MCPyV+ tumours having a better prognosis. P63 expression confers a worse prognosis in most studies. CD8+ lymphocytes play an important role, providing a possible target for PD1/PD‐L1 blockade treatment. The incidence of MCC varies from country to country. Countries such as Australia have a high rate and a far greater proportion of MCPyV− tumours than places such as the United Kingdom. MCC doubtlessly encompasses two tumours. The two tumours have demonstrated differences in prognosis and management. One is a neuroendocrine carcinoma related to MCPyV integration likely derived from fibroblasts, and the other is a UV‐related squamous cell carcinoma with neuroendocrine differentiation, presumptively derived from either keratinocytes or epidermal stem cells. We propose naming the former Merkel type sarcoma and the latter squamous cell carcinoma, Merkel type. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
22. Research Quality Assessment and Geography in Australia: Can Anything be Learned from the UK Experience?
- Author
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Johnston, Ron
- Subjects
GEOGRAPHY ,PHYSICAL sciences ,UNIVERSITIES & colleges ,ENVIRONMENTAL sciences - Abstract
The assessment of research activity in universities is now undertaken regularly in a number of countries, with resources then being allocated according to the results of those evaluations. Such an exercise (a Research Quality Framework – RQF) has recently been proposed for Australia. This paper suggests likely consequences of such an exercise for geography in Australian universities, given its current situation there, on the basis of experience with the Research Assessment Exercises undertaken in the UK since 1986. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
23. Asylum, children's rights and social work.
- Author
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Cemlyn, Sarah and Briskman, Linda
- Subjects
CHILDREN'S rights ,SOCIAL services ,FAMILIES ,HUMAN rights - Abstract
Although it is only a minority of displaced and persecuted people globally who seek refuge in 'Western' countries, they meet an increasingly hostile reception. This paper focuses on the situation facing children seeking asylum with or without their families in Britain and Australia, and the implications for children's rights and for social work. The policy background and its racist foundations in both countries are outlined. Despite geopolitical differences, there are unnerving parallels. Legislative changes and policy complexity signal increasingly punitive attitudes towards asylum seekers. The situation of children and families in the community is discussed in terms of the exclusion of asylum seekers from basic rights, and specific issues for separated children. Even more damaging is the incarceration of children and families in detention centres, and the emerging research is explored. In both countries there is widespread flouting of children's rights, and children also feature as pawns in ideological contests. However, they also act autonomously and illustrate an inclusive model of citizenship. The role of social workers in the statutory and voluntary sectors is considered, and the paper concludes with a discussion of the challenges for social work of avoiding collusion with repressive policies and actively promoting human rights. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF
24. Vulnerable workers in insecure jobs: A critical meta‐synthesis of qualitative findings.
- Author
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Bazzoli, Andrea and Probst, Tahira M.
- Subjects
EMPLOYEE psychology ,IMMIGRANTS ,META-synthesis ,EMPLOYEE attitudes ,PSYCHOLOGY of men ,SYSTEMATIC reviews ,JOB stress ,PRACTICAL politics ,SOCIAL change ,JOB security ,APPLIED psychology ,CONCEPTUAL structures ,THEMATIC analysis ,WOMEN employees ,POWER (Social sciences) ,CONTROL (Psychology) - Abstract
Job insecurity is a widespread workplace stressor that has been extensively investigated using quantitative approaches. With the use of a critical organisational psychology framework, we conducted a meta‐synthesis of 20 qualitative studies to investigate the experience of job insecurity among vulnerable employee groups (i.e., women and immigrants). The qualitative meta‐synthesis results suggest that there are meaningful differences. Specifically, whereas women were more concerned with and exposed to deteriorating working conditions, men experienced job insecurity as a threat to their identity. Among immigrants, the experience of job insecurity is viewed as largely intersecting with the legal system, impacting their ability to remain in their country and making them feel powerless. Thematic evidence also emerged regarding individual actions that participants use to attain security in contrast to corporate strategies that enhance job insecurity. We contribute to the critical organisational psychology literature by discussing how these results test common academic theories and neoliberal assumptions pervasive within the job insecurity literature: We highlight how organisations manufacture job insecurity, question the existence of harmonious social exchanges, discuss the use of job insecurity as a form of worker control, consider the role of the legal context in aiding worker exploitation and argue for an intersectional view of job insecurity. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
25. How Different Are Higher Education Institutions in the UK, US and Australia? The Significance of Government Involvement.
- Author
-
Moodie, Gavin
- Subjects
COMPARATIVE education ,HIGHER education & state ,FOREIGN students ,UNIVERSITY & college admission ,DOCTORAL degree ,ADULTS ,YOUNG adults ,HIGHER education - Abstract
Governments in the UK and many other countries have long sought to promote the diversity of their higher education institutions. However, diversity is hard to define, harder to measure and even more difficult to compare between countries. Most empirical analyses of the diversity of higher education systems use categorical variables, which shape the extent of diversity found. This study examines continuous variables of institutions' enrolment size and proportions of postgraduate, fulltime and international students to find the extent of variation amongst doctoral granting and all higher education institutions in the United Kingdom, United States and Australia. The study finds that there is less variety amongst all higher education institutions in the United Kingdom than in Australia, which in turn has much less variety than the United States. The paper argues that the extent of government involvement in higher education is not so important for institutional variety as the form that it takes. More tentatively, the paper suggests that the more limited the range of institutions for which government funding is available the stronger government involvement is needed to have variety among the limited range of institutions for which government financial support is available. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
26. Editors' Introduction to Special Issue of the Manchester School on Structural Breaks and Monetary Policy.
- Author
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Hall, Alastair R., Osborn, Denise R., and Orme, Chris
- Subjects
STRUCTURAL break (Economics) ,MONETARY policy - Abstract
An introduction is presented in which the editor discusses various topics within the issue including structural breaks, monetary policy in Great Britain and Australia and the effect of financial crisis of 2007-2009 on the interest rate spread of the European Central Bank (ECB).
- Published
- 2013
- Full Text
- View/download PDF
27. Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change.
- Author
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Appleton, Jane V. and Sidebotham, Peter
- Subjects
CHILD welfare ,CAREGIVERS ,DOMESTIC violence ,FOOD habits ,PARENTING ,PRENATAL care ,PROFESSIONAL employee training ,SERIAL publications ,PHYSICAL activity - Abstract
An introduction to the journal is presented on topics including abuse of women and their children during post-separation contact; post-separation co-parenting from fathers; and history of domestic violence.
- Published
- 2018
- Full Text
- View/download PDF
28. In‐person interventions to reduce social isolation and loneliness: An evidence and gap map.
- Author
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Welch, Vivian, Ghogomu, Elizabeth Tanjong, Dowling, Sierra, Barbeau, Victoria I., Al‐Zubaidi, Ali A. A., Beveridge, Ella, Bondok, Mostafa, Desai, Payaam, Doyle, Rebecca, Huang, Jimmy, Hussain, Tarannum, Jearvis, Alyssa, Jahel, Fatima, Madani, Leen, Choo, Wan Yuen, Yunus, Raudah M., Tengku Mohd, Tengku A. M., Wadhwani, Arpana, Ameer, Abdulah Al, and Ibrahim, Rayan
- Subjects
PSYCHOTHERAPY ,MEDICAL information storage & retrieval systems ,MIDDLE-income countries ,CINAHL database ,LONELINESS ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,INDIVIDUALIZED medicine ,SOCIAL isolation ,LOW-income countries - Abstract
Background: Social isolation and loneliness can occur in all age groups, and they are linked to increased mortality and poorer health outcomes. There is a growing body of research indicating inconsistent findings on the effectiveness of interventions aiming to alleviate social isolation and loneliness. Hence the need to facilitate the discoverability of research on these interventions. Objectives: To map available evidence on the effects of in‐person interventions aimed at mitigating social isolation and/or loneliness across all age groups and settings. Search Methods: The following databases were searched from inception up to 17 February 2022 with no language restrictions: Ovid MEDLINE, Embase, EBM Reviews—Cochrane Central Register of Controlled Trials, APA PsycInfo via Ovid, CINAHL via EBSCO, EBSCO (all databases except CINAHL), Global Index Medicus, ProQuest (all databases), ProQuest ERIC, Web of Science, Korean Citation Index, Russian Science Citation Index, and SciELO Citation Index via Clarivate, and Elsevier Scopus. Selection Criteria: Titles, abstracts, and full texts of potentially eligible articles identified were screened independently by two reviewers for inclusion following the outlined eligibility criteria. Data Collection and Analysis: We developed and pilot tested a data extraction code set in Eppi‐Reviewer. Data was individually extracted and coded. We used the AMSTAR2 tool to assess the quality of reviews. However, the quality of the primary studies was not assessed. Main Results: A total of 513 articles (421 primary studies and 92 systematic reviews) were included in this evidence and gap map which assessed the effectiveness of in‐person interventions to reduce social isolation and loneliness. Most (68%) of the reviews were classified as critically low quality, while less than 5% were classified as high or moderate quality. Most reviews looked at interpersonal delivery and community‐based delivery interventions, especially interventions for changing cognition led by a health professional and group activities, respectively. Loneliness, wellbeing, and depression/anxiety were the most assessed outcomes. Most research was conducted in high‐income countries, concentrated in the United States, United Kingdom, and Australia, with none from low‐income countries. Major gaps were identified in societal level and community‐based delivery interventions that address policies and community structures, respectively. Less than 5% of included reviews assessed process indicators or implementation outcomes. Similar patterns of evidence and gaps were found in primary studies. All age groups were represented but more reviews and primary studies focused on older adults (≥60 years, 63%) compared to young people (≤24 years, 34%). Two thirds described how at‐risk populations were identified and even fewer assessed differences in effect across equity factors for populations experiencing inequities. Authors' Conclusions: There is growing evidence that social isolation and loneliness are public health concerns. This evidence and gap map shows the available evidence, at the time of the search, on the effectiveness of in‐person interventions at reducing social isolation and loneliness across all ages and settings. Despite a large body of research, with much of it published in more recent years, it is unevenly distributed geographically and across types of interventions and outcomes. Most of the systematic reviews are of critically low quality, indicating the need for high quality reviews. This map can guide funders and researchers to consider the areas in which the evidence is lacking and to address these gaps as future research priorities. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
29. Towards Learning Standards in Economics in Australia.
- Author
-
Guest, Ross
- Subjects
LEARNING ,ECONOMICS ,HIGHER education ,POSTSECONDARY education ,EDUCATIONAL quality standards ,NOMINATIONS for public office - Abstract
This paper discusses the development of learning standards in higher education economics in Australia. The motivation is twofold. The creation of Tertiary Education Quality Standards Agency in 2011, along with the revised Australian Qualifications Framework specifications published in July 2011, have given the learning standards agenda a new impetus in Australia. Work has been done overseas on learning standards in economics through the UK Benchmarking Statement and the OECD's Assessment of Higher Education Learning Outcomes study. However, a key finding from learning standards projects in Australia in other disciplines is that the Australian academic community needs to take ownership of the standards agenda as a pre-condition for general acceptance and successful implementation. Second, the development of learning standards in economics is an opportunity to drive an evidence-based process of curriculum renewal, including critical reflection on core knowledge, skills and assessment methods. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
30. Forestry as imperial careering: New Zealand as the end and edge of empire in the 1920s-1940s.
- Author
-
Roche, Michael
- Subjects
FORESTS & forestry ,BRITISH colonies - Abstract
Forestry is interestingly situated within British imperial networks of the 19th and early 20th centuries whereby India was arguably the main node. Drawing on Lambert and Lester's concept of 'imperial careering' as a way of exploring imperial networks, this paper further extends its application to foresters as a group of middle-level technical experts as well as carrying it into the 20th century when the British Empire was by some measures at its zenith. The forestry careers of Owen Jones and Hugh Corbin, principally in Australia and New Zealand, are used to illustrate the discussion which concludes with some more general observations about imperial careerists. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
31. Asymmetric Dynamics in Stock Market Volatility.
- Author
-
Karunanayake, Indika and Valadkhani, Abbas
- Subjects
STOCK exchanges ,MARKET volatility ,ECONOMETRICS ,MATHEMATICAL models ,GLOBALIZATION ,INTERNATIONAL trade - Abstract
This paper provides some insight into the asymmetric effects of stock market volatility transmission using weekly stock market return data (January 1992-June 2010) of four countries, namely, Australia, Singapore, the United Kingdom and the United States within a MGARCH (multivariate generalised autoregressive conditional heteroskedasticity) framework. Our results indicate that negative shocks in each market play a more important role in increasing both volatility and covolatilities than positive shocks. In addition, as expected, we identified that all markets (particularly Australia and Singapore) exhibit significant positive mean and volatility spillovers from the US stock market returns, but not the other way around. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
32. The Role of Universities in the ‘Cultural Health’ of their Regions: universities' and regions' understandings of cultural engagement.
- Author
-
DOYLE, LESLEY
- Subjects
UNIVERSITIES & colleges ,CULTURE ,PARTICIPATION ,CULTURAL activities ,ECONOMIC development - Abstract
As Arbo and Benneworth (2007) have alerted us, higher education institutions are now expected not only to conduct education and research, but also to play an active role in the development of their economic, social and cultural surroundings. They call this the ‘regional mission’ of HEIs. This paper is concerned with cultural engagement. Research on universities’ cultural engagement in their regions and the impact of that engagement is still in its infancy, partly because there are different understandings of ‘culture’ and of what ‘engagement’ entails. In this paper, qualitative data from the reports of mixed teams of academics and regional administrators involved in a large international project designed to improve universities’ regional engagement are analysed and discussed. The on-going study — PASCAL Universities' Regional Engagement (PURE) — investigates the role of HEIs in their regions across in a variety of fields such as the economy, community development, the environment and others. This article analyses the data from the study to identify the different perspectives universities and regions have of cultural engagement. The aim here is to demonstrate the value of PURE in facilitating the development of mutual understanding both between universities through a common language and between universities and their regions in respect of mutual expectations. For example, particularly difficult to de-construct is universities’ engagement with disadvantaged communities (Doyle, 2007) but Powell's (2009) work suggests that universities might engage more broadly and effectively ‘through better knowledge sharing and co-creation with business and community partners’ to become ‘real drivers of creative change in developing socially inclusive projects’. Others have written about the educational role of universities in developing a ‘lifelong learning culture’ in their region (European Universities’ Charter on Lifelong Learning, 2008). [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
33. The shaping of organisational routines and the distal patient in assisted reproductive technologies.
- Author
-
Allan H, de Lacey S, and Payne D
- Subjects
OCCUPATIONAL roles ,INFERTILITY treatment ,HEALTH insurance reimbursement ,HUMAN reproductive technology ,NURSES ,GYNECOLOGIC nursing ,PATIENT-professional relations ,GOVERNMENT aid ,TECHNOLOGY ,SCIENCE ,TELEMEDICINE - Abstract
In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines in ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
34. Establishing the criterion validity of the Graduate Medical School Admissions Test (GAMSAT).
- Author
-
Coates, Hamish
- Subjects
MEDICAL College Admission Test ,MEDICAL school admission ,RANKING (Statistics) ,MEDICAL education - Abstract
Context This paper examines the criterion validity of the Graduate Medical School Admissions Test (GAMSAT), which has been used since 1996 in Australia and more recently in the UK and Ireland. The study provides evidence on the extent to which GAMSAT, in combination with grade point average (GPA) and interview scores, adds value to determining an individual’s capability for medical study. The study responds to increasing demand for information on the validity of selection processes. Criterion validity is important because it helps to empirically situate selection tests within their broader contexts by, for instance, providing an assurance to educators and the public that test results are valid and add value to selection decisions. Methods After introducing the rationale and focus of the study, the paper summarises the data and research methods, presents statistical results and draws conclusions that advance current insight into medical school admissions processes. The results are based on data from six institutions and 351 students. Results Analyses of GAMSAT, interview and GPA scores show, in summary, that: there are fairly high levels of divergence between these three measures; that relationships between the measures and Year 1 marks vary across institutions, and that a combination of GAMSAT and GPA scores provides the best means of predicting Year 1 performance. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
35. Shifting Identities and Blurring Boundaries: the Emergence of Third Space Professionals in UK Higher Education.
- Author
-
Whitchurch, Celia
- Subjects
HIGHER education ,EMPLOYEE empowerment ,EMPLOYEE training ,GRADUATE study in education ,ACADEMIC programs ,PROFESSIONAL employees ,LEADERSHIP - Abstract
This paper adds to earlier reviews by the author of the changing roles and identities of contemporary professional staff in UK higher education, and builds on a categorisation of professional staff identities as having bounded, cross-boundary and unbounded characteristics. Drawing on a study of 54 professional managers in the United Kingdom, Australia and the United States, it describes a further category of blended professionals, who have mixed backgrounds and portfolios, comprising elements of both professional and academic activity. The paper goes on to introduce the concept of third space as an emergent territory between academic and professional domains, which is colonised primarily by less bounded forms of professional. The implications of these developments for institutions and for individuals are considered, and some international comparisons drawn. Finally, it is suggested that third space working may be indicative of future trends in professional identities, which may increasingly coalesce with those of academic colleagues who undertake project- and management-oriented roles, so that new forms of third space professional are likely to continue to emerge. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
36. Generational justice in aged care policy in Australia and the United Kingdom.
- Author
-
Howe, Anna and Healy, Judith
- Subjects
ELDER care ,MEDICAL care ,SERVICES for older people ,HEALTH policy - Abstract
This paper traces the emergence of the theme of generational justice in aged care policy in Australia and the United Kingdom. Debate about the balance to be struck between inter- and intragenerational funding in the two countries took somewhat different courses before and after the crossover in the political persuasion of national governments that occurred in 1996–1997, but both continue to grapple with the question as to whether housing assets of the elderly are a resource for private, intergenerational transfers, or a source of intragenerational funding for aged care. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
37. 'The Worst Thing is the Screwing' (1): Consumption and the Management of Identity in Sex Work.
- Author
-
Brewis, Joanna and Linstead, Stephen
- Subjects
SEX work ,SEX industry ,SEX workers ,SELF-esteem ,CONSUMPTION (Economics) - Abstract
This paper reviews qualitative data from academic research into prostitution, accounts from prostitutes themselves in the UK and Australia, and data from one of the authors' own research in New South Wales to analyse the ways in which female sex workers negotiate and construct their sense of themselves. This analysis is informed by the suggestion that, in the act of commercial sex, the prostitute's own body is being consumed by the client, which can be seen to place certain pressures on the relationship between sex workers' professional and personal identities. Our review suggests that individual workers' tactics for managing the contradictions of working as a prostitute and preserving self-esteem are both similar and different, even within two broadly culturally commensurable contexts, and, moreover, that not all prostitutes necessarily want to maintain a strict divide between work sex and non-work sex in every encounter. Moreover, even for those who do, the trials of maintaining the divide are considerable, as is the permeability of boundaries between work and intimate sex. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
- View/download PDF
38. From questions to answers: Examining the role of pediatric surveillance units in eating disorder research.
- Author
-
Katzman, Debra K., Madden, Sloane, Nicholls, Dasha, Mawjee, Karizma, and Norris, Mark L.
- Subjects
AGE factors in disease ,EATING disorders ,EATING disorders in adolescence ,EATING disorders in children ,HEALTH policy ,MEDICAL research ,PUBLIC health surveillance - Abstract
Pediatric Surveillance Units (PSUs) provide a unique model for the study of pediatric eating disorders (EDs). Australia, Britain, and Canada have surveillance programs that have generated valuable epidemiological and clinical data on early-onset eating disorders (EOED). The PSUs represent an important collaborative tool that has helped shape our understanding of EOEDs and offers potential to contribute to decisions regarding health resource allocation and public health policy. This paper reviews the role of PSUs as a unique model to study pediatric EDs and its success in translating the knowledge generated by these programs into improving the health of children and adolescents with EDs worldwide. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
39. The cost of convict transportation from Britain to Australia, 1796-1810.
- Author
-
Lewis, Frank
- Subjects
FORMERLY incarcerated people ,PRISONERS ,IMPRISONMENT ,POLICY sciences - Abstract
The article deals with the costs and risks involved in the decision of the British government in 1786 to transport convicts to Australia. The British government's decision, taken in 1786, to transport convicts to Australia has been the subject of a lively debate among historians for the past 35 years. Until 1952 nearly all historians agreed that the colony in New South Wales and Norfolk Island was established for only one purpose: as a receptacle for convicts. The British authorities were averse to building new penitentiaries, and were unable to find alternative destinations for British convicts, consequently they chose Australia as a suitable place to which they should be removed. The question posed at the beginning of this paper was: "Why did Britain transport convicts to Australia"? Although it is impossible to answer definitively, in the sense that it is impossible to read the minds of policymakers, past or current, both the documentary evidence and the statistical evidence tell a remarkably similar story. According to the traditional interpretation of contemporary documents, Australia was seen as a low-cost alternative to new British prisons.
- Published
- 1988
- Full Text
- View/download PDF
40. A STRATEGIC CHOICE-RESOURCE DEPENDENCE ANALYSIS ON UNION MERGERS IN THE BRITISH AND AUSTRALIAN BROADCASTING AND FILM INDUSTRIES.
- Author
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CAMPLING, JOHN T. and MICHELSON, GRANT
- Subjects
ORGANIZATIONAL change ,LABOR union mergers ,ORGANIZATIONAL behavior ,STRATEGIC planning ,MOTION picture industry ,DEPENDENCY theory (International relations) ,RESOURCE management ,ADAPTABILITY (Personality) - Abstract
Since the late 1980s there has been a marked increase in the rate of union restructuring and merger in both Britain and Australia. This has been particularly prevalent in the film and broadcasting industries in both countries. This organizational change has largely been triggered by environmental turbulence which has altered the availability and control of resources required for organizational survival. Accepting the concept from strategic choice theory that trade unions are able to exercise a degree of choice over the way in which they manage and adapt to changes in their external and internal environments, the paper demonstrates how an integration of strategic choice and resource dependence perspectives can explain why organizations behave in different ways and, in particular, why trade union mergers in the film and broadcasting industries have occurred. Further, the perspective also explains why some trade unions chose not to merge. An integration of resource dependence theory with strategic choice theory explains why trade unions make particular strategic decisions. Conversely, strategic choice explains how organizations acquire resources and manage dependencies. The paper concludes by making the case for an integration of the two perspectives for future studies of organizational behaviour and change. [ABSTRACT FROM AUTHOR]
- Published
- 1998
- Full Text
- View/download PDF
41. INTERNATIONAL COMPARISONS OF AUSTRALIAN GDP IN THE 19TH CENTURY.
- Author
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Haig, Bryan
- Subjects
AUSTRALIAN economy ,ECONOMIC conditions in Great Britain ,PRICE deflation ,GROSS domestic product ,CONSUMPTION (Economics) - Abstract
This paper summarises the results of a new comparison of the level of Australian and U.K. real product in the 1890s, obtained by the direct deflation of money values of GDP by relative prices. The object of the study was to provide a check on the existing comparisons, obtained by extrapolation of time series of real GDP, as shown, for example, in Maddison (1982). Existing estimates imply that in the 1890s Australian GDP per capita was about 50 percent higher in the U.K. and U.S.A. and more than twice that for the average of 12 other western countries. The present study suggests these results probably overstate Australia's real GDP, and that Australian real GDP per capita was 36 percent higher than the U.K.'s in 1891 and 3 percent higher in 1900. Personal consumption per capita was 15 percent higher in Australia than in the U.K. in 1891, but about the same level in 1900. Although this study compares prices and GDP in the colony of New South Wales with those in the U.K., the colony may be token as representative of Australia as a whole. [ABSTRACT FROM AUTHOR]
- Published
- 1989
- Full Text
- View/download PDF
42. Mismatch between conservation higher education skills training and contemporary conservation needs.
- Author
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Slater, Helena, Fisher, Janet, Holmes, George, and Keane, Aidan
- Subjects
HIGHER education ,COMMUNICATIVE competence ,TEACHING methods ,EDUCATIONAL objectives ,EDUCATORS ,CONTENT analysis - Abstract
Scholars have detailed the range of skills required for conservation and voiced concerns that training is not fit for purpose. Still, we have little understanding of what skills conservation education aims to teach. This study uses survey data and content analysis of online module descriptions to examine skills and methods teaching in conservation higher education across the United Kingdom and Australia. We found most conservation‐specific modules aimed to develop disciplinary and communication skills, but fewer than half aimed to develop interpersonal or project management skills. Social science methods training was absent from the core offering of over half of the conservation degrees reviewed. To prepare students for conservation careers and the complex problems they will encounter, the conservation education sector should further focus on building essential nonacademic skills and provide training on the breadth of methods that contribute to effective conservation science. This analysis can help educators to reflect on teaching aims and forge a curriculum that will best prepare students for contemporary conservation challenges. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
43. Peopled landscapes: Questions of coexistence in invasive plant management and rewilding.
- Author
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Atchison, Jennifer, Pickerill, Jenny, Arnold, Crystal, Gibbs, Leah M., Gill, Nicholas, Hubbard, Ella, Lorimer, Jamie, and Watson, Matt
- Subjects
INVASIVE plants ,LANDSCAPES ,SOCIAL action ,HUMAN behavior ,BIODIVERSITY conservation ,SOCIAL processes - Abstract
The concept of 'peopled landscapes' is based on the notion that it is not possible, nor socially or politically desirable, to remove people from the environment in the era of the Anthropocene. As such, it is necessary to document and develop ways to coexist and flourish.This review examines emergent scholarship about peopled landscapes and biodiversity conservation by considering invasive plant management and rewilding as social processes. While invasive plant management and rewilding are often understood as separate, thinking through social scientific research and examples from Australia and the UK, we demonstrate how both forms of human action in landscapes can be more usefully understood as social relations with nature involving social change and social action.Drawing attention to agency, practices and capacity, we show how diverse forms of human and nonhuman actions are recognised, attributed or acknowledged in biodiversity conservation in peopled landscapes.In practice, centring the idea of peopled landscapes (rather than conceiving of the environment as where the impact of people is minimised) shows how invasive plant management and rewilding can be understood as related responses to environmental problems.Flourishing and coexistence in peopled landscapes require recognition of the diverse human and nonhuman agencies that shape the politics of acceptable action, and illustrate the inseparability of environmental and social justice. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
44. An exploratory international study into occupational therapy students' perceptions of professional identity.
- Author
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Ashby, Samantha E., Adler, Jessica, and Herbert, Lisa
- Subjects
CHI-squared test ,CONFIDENCE intervals ,CURRICULUM ,FIELDWORK (Educational method) ,SENSORY perception ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH ,SOCIALIZATION ,SURVEYS ,CLINICAL competence ,JUDGMENT sampling ,PROFESSIONAL identity ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics ,KRUSKAL-Wallis Test ,OCCUPATIONAL therapy students ,EDUCATION - Abstract
Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
45. An Invidious Position? The Public Dance of the Promiscuous Partisan.
- Author
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GRUBE, DENNIS
- Subjects
PUBLIC officers ,CIVIL service ,MANAGEMENT - Abstract
Public service mandarins were once largely anonymous, diligently wielding their great power behind the scenes while their political masters performed on the front stage. Things have changed. Today, civil service leaders are appearing publicly more often, in more places and to a wider range of audiences than ever before. This article examines the extent to which this decline in anonymity impacts on traditions of civil service impartiality within the Westminster system. It draws on the late Peter Aucoin's concept of 'promiscuous partisanship' to examine how contemporary mandarins in the United Kingdom, Canada and Australia face accusations of having compromised their impartiality by advocating for the policy agenda of the government of the day. The article argues that what has changed is not that civil service leaders have suddenly become partisan, but rather that they have become more 'public', allowing for perceptions of partisanship to emerge. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
46. Adolescent food literacy programmes: A review of the literature.
- Author
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Brooks, Natalie and Begley, Andrea
- Subjects
BEHAVIOR modification ,COOKING ,FOOD handling ,EVALUATION of medical care ,MEDLINE ,NUTRITION education ,ONLINE information services ,RESEARCH funding ,SYSTEMATIC reviews ,TEACHING methods ,HUMAN services programs - Abstract
Aim The aim of this study was to explore what is known about food literacy programmes targeting adolescents, including identification of the constituents of food literacy addressed, assessment of programme effectiveness, and description of programme design or delivery specific to adolescents. Methods A review of the peer-reviewed literature surrounding adolescent food literacy was conducted using scholarly electronic databases. Programme reports were identified in the grey literature using online searching and cross-referencing to support the research aim. Programmes from 2000 to 2012 targeting adolescents aged 13-17 years were included. Results A total of 19 peer-reviewed papers and four grey literature programmes met the search criteria. Interventions focused on practical cooking and/or food preparation skills and targeted younger adolescent age groups. Programmes were most commonly held in schools and community settings. The majority of programmes (n = 16/23) did not use a theoretical basis for their development. Programme evaluation encompassed the use of pre- and post-intervention questionnaires and focus groups. Only nine studies included a dietary behaviour-based outcome measure. Although 19 of the 23 studies reviewed reported positive changes related to the intervention, these did not include significant changes in diet quality or cooking frequency at home. Conclusions Few existing adolescent food literacy programmes have demonstrated a positive impact on dietary behaviours to date. Adolescent target groups present unique challenges in programme development and delivery. However, the physical, social and emotional health needs of this age group and potential to influence lifelong behaviours highlight the need to design effective and age-appropriate adolescent food literacy programmes. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
47. 'Meritocracy' and 'fairness' in medical student selection: Comparing UK and Australia.
- Author
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Razack, Saleem
- Subjects
GOVERNMENT policy ,MEDICAL education ,SCHOOL entrance requirements - Abstract
Razack compares the discourse of widening access in the UK and Australia, raising incisive questions about the nature of meritocracy and constructs of fairness in student selection. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
48. Meta Taylor Rules for the UK and Australia; Accommodating Regime Uncertainty in Monetary Policy Analysis Using Model Averaging Methods.
- Author
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Lee, Kevin, Olekalns, Nilss, and Shields, Kalvinder
- Subjects
MONETARY policy ,ECONOMIC policy ,ECONOMIC models ,REGRESSION analysis - Abstract
This paper provides a characterization of UK and Australian monetary policy within a Taylor rule framework, accommodating uncertainties about the nature and duration of policy regimes in a flexible but easy-to-implement analysis. Our approach involves estimation and inference based on a set of Taylor rules obtained through linear regression methods, but combined into a 'meta' rule using model averaging techniques. Using data that were available in real time, the estimated version of the meta Taylor rule provides a useful and detailed characterization of monetary policies in the UK and Australia over the last 30 years. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
49. Confidence in receiving medical care when seriously ill: a seven-country comparison of the impact of cost barriers.
- Author
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Wendt, Claus, Mischke, Monika, Pfeifer, Michaela, and Reibling, Nadine
- Subjects
INSURANCE -- History ,HEALTH insurance reimbursement ,CONFIDENCE ,CONFIDENCE intervals ,EPIDEMIOLOGY ,HEALTH services accessibility ,HEALTH status indicators ,MEDICAID ,HEALTH policy ,MEDICALLY uninsured persons ,MEDICARE ,RESEARCH funding ,STATISTICS ,DATA analysis ,EMPIRICAL research ,MULTIPLE regression analysis ,SECONDARY analysis ,SEVERITY of illness index ,DATA analysis software ,PATIENTS' attitudes ,DESCRIPTIVE statistics - Abstract
Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
50. Mental health: Knowledge, attitudes and training of professionals on dual diagnosis of intellectual disability and psychiatric disorder.
- Author
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Werner, S. and Stawski, M.
- Subjects
CLINICAL competence ,ATTITUDE (Psychology) ,CINAHL database ,DUAL diagnosis ,ERIC (Information retrieval system) ,MEDICAL information storage & retrieval systems ,INTELLECT ,MEDICAL personnel ,MEDLINE ,MENTAL health ,MENTAL illness ,INTELLECTUAL disabilities ,PSYCHIATRISTS ,RESEARCH funding ,SYSTEMATIC reviews - Abstract
Background Dual diagnosis (DD) refers to the coexistence of intellectual disability and psychiatric disorder. In order to provide individuals with DD with adequate care, it is essential for mental health workers to have adequate knowledge and positive attitudes. These may be achieved through proper training. Aims To summarise the available literature examining the knowledge, attitudes and training of psychiatrists and other professional caregivers in regard to serving people with DD. Methods A search strategy was developed to find manuscripts published in English since 1995. Results Twenty-seven studies on knowledge, attitudes and training in the field of DD were identified and reviewed in this paper. Conclusion The findings of this review stress the need to improve the knowledge, competence and attitudes of practitioners within the DD field via training and practice opportunities. In light of this review, recommendations for improving training opportunities and for conducting future research are made. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
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