7 research outputs found
Spirituality and attitudes towards nature in the Pacific Islands: insights for enabling climate - change adaptation
Get PDFA sample of 1226 students at the University of the South Pacific, the premier tertiary institution in the Pacific Islands, answered a range of questions intended to understand future island decision-makers’ attitudes towards Nature and concern about climate change. Questions asking about church attendance show that the vast majority of participants have spiritual values that explain their feelings of connectedness to Nature which in turn may account for high levels of pessimism about the current state of the global/Pacific environment. Concern about climate change as a future livelihood stressor in the Pacific region is ubiquitous at both societal and personal levels. While participants exhibited a degree of understanding matching objective rankings about the vulnerability of their home islands/countries, a spatial optimism bias was evident in which ‘other places’ were invariably regarded as ‘worse’. Through their views on climate change concern, respondents also favoured a psychological distancing of environmental risk in which ‘other places’ were perceived as more exposed than familiar ones. Influence from spirituality is implicated in both findings. Most interventions intended to reduce exposure to environmental risk and to enable effective and sustainable adaptation to climate change in the Pacific Islands region have failed to acknowledge influences on decision making of spirituality and connectedness to Nature. Messages that stress environmental conservation and stewardship, particularly if communicated within familiar and respected religious contexts, are likely to be more successful than secular ones
The relationship between patient data and pooled clinical management decisions
No full textA strong relationship between patient data and preoperative clinical decisions could potentially be used to support clinical decisions in preoperative management. The aim of this exploratory study was to determine the relationship between key patient data and pooled clinical opinions on management. Ina previous study, panels of anaesthetists compared the quality of computer-assisted patient health assessments with outpatient consultations and made decisions on the need for preoperative tests, no preoperative outpatient assessment, possible postoperative intensive care unit/high dependency unit requirements and aspiration prophylaxis. In the current study, the relationship between patient data and these decisions was examined using binomial logistic regression analysis. Backward stepwise regression was used to identify independent predictors of each decision (at P <0.15), which were then incorporated into a predictive model. The number of factors related to each decision varied: blood picture (four factors), biochemistry (six factors), coagulation studies (three factors), electrocardiography (eight factors), chest X-ray (seven factors), preoperative outpatient assessment (17 factors), intensive care unit requirement (eight factors) and aspiration prophylaxis (one factor). The factor types also varied, but included surgical complexity, age, gender, number of medications or comorbidities, body mass index, hypertension, central nervous system condition, heart disease, sleep apnoea, smoking, persistent pain and stroke. Models based on these relationships usually demonstrated good sensitivity and specificity, with receiver operating characteristics with the following areas under curve: blood picture (0.75), biochemistry (0.86), coagulation studies (0.71), electrocardiography (0.90), chest X-ray (0.85), outpatient assessment (0.85), postoperative intensive care unit requirement (0.88) and aspiration prophylaxis (0.85). These initial results suggest modelling of patient data may have utility supporting clinicians' preoperative decisions.G. L. Ludbrook, E. J. O'loughlin, C. Grant, T B. Corcora
