122 research outputs found
Preparing Australian Special Educators: Courses and Content
: The characteristics and content of post-graduate courses in special and/or inclusive teacher education in Australian universities were examined using publicly available material on university websites. Content analysis was guided by a set of content area elements covering desirable skills and knowledge for special educators that were identified in the Australian literature. The presence or absence of these content elements in each course and in core or elective units was coded for 28 courses from 21 universities. All or most courses covered generic content such as teaching strategies and evaluating and using research. However, more specialist content, such as explicit teaching strategies and instruction in literacy and numeracy, was absent from over half the courses. The implications of these findings are discussed in the context of the limitations necessarily imposed by the inclusion of only publicly available online information
Beyond the iron triangle : the military-industrial complex as assemblage
The phrase “military-industrial complex” is at once both widely known and largely vague. Most people with some interest in national security matters will be familiar with the idea of the “iron triangle” — the relations between the three institutions of the military, the government, and industry — and the idea that there is some form of interaction between these three around matters of war and defence. However, there has been little comprehensive work on what the military-industrial complex actually is as a concept — how it should be defined, what its parts are, and how they interact in practice. This dissertation aims to answer these questions and provide both a thorough examination of and a theoretical basis for analysing the workings of the military-industrial complex.
The iron triangle concept as commonly applied implies a rigidity of structure that I argue that the military-industrial complex simply does not display in practice. Rather, it is a fluid and ever-changing system, and neither its parts nor their relations to each other are static over time. Furthermore, this kind of rigidity prevents us from comprehending how the military-industrial complex truly manifests and inhibits our understanding of its effects, making it more difficult to ameliorate the negative outcomes that it can produce for national security. I posit instead that the military-industrial complex is best understood as an assemblage, moving away from the rigidity of commonly held ideas like the iron triangle toward a conceptualisation that brings in the fluidity and change that the military-industrial complex exhibits in practice. I prompt scholars and policymakers to question what they mean by “the military-industrial complex” and offer a fresh and comprehensive way to conceptualise and understand it
A constructivist grounded theory of staff experiences relating to early mobilisation of mechanically ventilated patients in intensive care
From SAGE Publishing via Jisc Publications RouterEarly mobilisation of mechanically ventilated patients has been suggested to be effective in mitigating muscle weakness, yet it is not a common practice. Understanding staff experiences is crucial to gain insights into what might facilitate or hinder its implementation. In this constructivist grounded theory study, data from two Scottish intensive care units were collected to understand healthcare staff experiences relating to early mobilisation in mechanical ventilation. Data included observations of mobilisation activities, individual staff interviews and two focus groups with multidisciplinary staff. Managing Risks emerged as the core category and was theorised using the concept of risk. The middle-range theory developed in this study suggests that the process of early mobilisation starts by staff defining patient status and includes a process of negotiating patient safety, which in turn enables performing accountable mobilisation within the dynamic context of an intensive care unit setting.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is part of the first author’s PhD studies funded by Lembaga Pengelola Dana Pendidikan (LPDP) (Indonesia Endowment Fund for Education), grant number 20160222045521. The funder had no role in the design and conduct of the study nor the preparation of the publication manuscript. No other source of funding contributes to this study.9pubpu
Construction and evaluation of multisite recombinatorial (Gateway) cloning vectors for Gram-positive bacteria
<p>Abstract</p> <p>Background</p> <p>The Gateway recombinatorial cloning system allows easy and rapid joining of DNA fragments. Here we report the construction and evaluation of three different Gram-positive vectors that can be used with the Multisite Gateway cloning system to rapidly produce new gene arrangements in plasmid constructs for use in a variety of Gram-positive bacteria.</p> <p>Results</p> <p>Comparison of patterns of reporter gene expression with conventionally constructed clones show that the presence of residual recombination (att) sites does not have an effect on patterns of gene expression, although overall levels of gene expression may vary. Rapid construction of these new vectors allowed vector/gene combinations to be optimized following evaluation of plasmid constructs in different bacterial cells and demonstrates the benefits of plasmid construction using Gateway cloning.</p> <p>Conclusion</p> <p>The residual <it>att </it>sites present after Gateway cloning did not affect patterns of promoter induction in Gram-positive bacteria and there was no evidence of differences in mRNA stability of transcripts. However overall levels of gene expression may be reduced, possibly due to some post-transcriptional event. The new vectors described here allow faster, more efficient cloning in range of Gram-positive bacteria.</p
Preparing for a Northwest Passage: A Workshop on the Role of New England in Navigating the New Arctic
Preparing for a Northwest Passage: A Workshop on the Role of New England in Navigating the New Arctic (March 25 - 27, 2018 -- The University of New Hampshire) paired two of NSF\u27s 10 Big Ideas: Navigating the New Arctic and Growing Convergence Research at NSF. During this event, participants assessed economic, environmental, and social impacts of Arctic change on New England and established convergence research initiatives to prepare for, adapt to, and respond to these effects. Shipping routes through an ice-free Northwest Passage in combination with modifications to ocean circulation and regional climate patterns linked to Arctic ice melt will affect trade, fisheries, tourism, coastal ecology, air and water quality, animal migration, and demographics not only in the Arctic but also in lower latitude coastal regions such as New England. With profound changes on the horizon, this is a critical opportunity for New England to prepare for uncertain yet inevitable economic and environmental impacts of Arctic change
An evaluation of advanced access in general practice
Aims: To evaluate ‘Advanced Access’ in general practice, and assess its impact on patients, practice organisation, activity, and staff.Objectives:
To describe the range of strategies that general practices have employed to
improve access to care
To determine the impact of Advanced Access on the wait for an appointment,
continuity of care, practice workload, and demand on other NHS services. To explore the perceptions of different groups of patients, including both
users and non-users of services, about the accessibility of care and their
satisfaction with access to care in relation to different models of organisation.
To explore the trade-offs that patients make between speed of access,
continuity of care and other factors when making an appointment in general
practice.
To explore the perceptions of general practitioners and receptionists about
working with the NPDT and implementing changes to practice arrangements
to improve access.
To assess the impact of the above changes in practice organisation on staff
job satisfaction and team climate.Method and results:
This research was based on a comparison of 48 general practices, half of
which operated Advanced Access appointment systems and half of which did
not (designated ‘control’ practices). These practices were recruited from 12
representative Primary Care Trusts (PCTs). From within these 48 practices,
eight (four Advanced Access and four control) were selected for in-depth case
study using an ethnographic approach.
The research was comprised of several component studies. These included:
• A survey of all practices in 12 PCTs. Based on this we recruited the 24
Advanced Access and 24 control practices and the 8 case study practices.
• An assessment of appointments available and patients seen, based on
appointments records
• An assessment of continuity of care based on patients’ records
• Random phone calls to practices to assess ability to make an appointment
by telephone
• A questionnaire survey of patients attending the practices
• A postal survey of patients who had not attended the surgery in the
previous 12 months
• A discrete choice experiment to explore trade-offs patients make between
access and other factors
• A survey of practice staff
• Qualitative case studies in 8 practices
• Interviews with PCT access facilitators
The methods and results for each of these studies are described below, in
relation to each of the research objectives.<br/
Telehealth for patients at high risk of cardiovascular disease: pragmatic randomised controlled trial
Objective: To assess whether non-clinical staff can effectively manage people at high risk of cardiovascular disease using digital health technologies.
Design: Pragmatic, multicentre, randomised controlled trial.
Setting: 42 general practices in three areas of England.
Participants: Between 3 December 2012 and 23 July 2013 we recruited 641 adults aged 40 to 74 years with a 10 year cardiovascular disease risk of 20% or more, no previous cardiovascular event, at least one modifiable risk factor (systolic blood pressure ≥140 mm Hg, body mass index ≥30, current smoker), and access to a telephone, the internet, and email. Participants were individually allocated to intervention (n=325) or control (n=316) groups using automated randomisation stratified by site, minimised by practice and baseline risk score.
Interventions: Intervention was the Healthlines service (alongside usual care), comprising regular telephone calls from trained lay health advisors following scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use online resources to reduce risk factors, and sought to optimise drug use, improve treatment adherence, and encourage healthier lifestyles. The control group comprised usual care alone.
Main outcome measures: The primary outcome was the proportion of participants responding to treatment, defined as maintaining or reducing their cardiovascular risk after 12 months. Outcomes were collected six and 12 months after randomisation and analysed masked. Participants were not masked.
Results: 50% (148/295) of participants in the intervention group responded to treatment compared with 43% (124/291) in the control group (adjusted odds ratio 1.3, 95% confidence interval 1.0 to 1.9; number needed to treat=13); a difference possibly due to chance (P=0.08). The intervention was associated with reductions in blood pressure (difference in mean systolic −2.7 mm Hg (95% confidence interval −4.7 to −0.6 mm Hg), mean diastolic −2.8 (−4.0 to −1.6 mm Hg); weight −1.0 kg (−1.8 to −0.3 kg), and body mass index −0.4 (−0.6 to −0.1) but not cholesterol −0.1 (−0.2 to 0.0), smoking status (adjusted odds ratio 0.4, 0.2 to 1.0), or overall cardiovascular risk as a continuous measure (−0.4, −1.2 to 0.3)). The intervention was associated with improvements in diet, physical activity, drug adherence, and satisfaction with access to care, treatment received, and care coordination. One serious related adverse event occurred, when a participant was admitted to hospital with low blood pressure.
Conclusions: This evidence based telehealth approach was associated with small clinical benefits for a minority of people with high cardiovascular risk, and there was no overall improvement in average risk. The Healthlines service was, however, associated with improvements in some risk behaviours, and in perceptions of support and access to care
Rapid climate-driven circulation changes threaten conservation of endangered north atlantic right whales
As climate trends accelerate, ecosystems will be pushed rapidly into new states, reducing the potential efficacy of conservation strategies based on historical patterns. In the Gulf of Maine, climate-driven changes have restructured the ecosystem rapidly over the past decade. Changes in the Atlantic meridional overturning circulation have altered deepwater dynamics, driving warming rates twice as high as the fastest surface rates. This has had implications for the copepod Calanus finmarchicus, a critical food supply for the endangered North Atlantic right whale (Eubalaena glacialis). The oceanographic changes have driven a deviation in the seasonal foraging patterns of E. glacialis upon which conservation strategies depend, making the whales more vulnerable to ship strikes and gear entanglements. The effects of rapid climate-driven changes on a species at risk undermine current management approaches.publishedVersio
Person-centered healthcare practice in a pandemic context: An exploration of people's experience of seeking healthcare support
Eleanor Curnow - ORCID: 0000-0001-9332-8248
https://orcid.org/0000-0001-9332-8248Vaibhav Tyagi - ORCID: 0000-0003-2756-1513
https://orcid.org/0000-0003-2756-1513Lisa Salisbury - ORCID: 0000-0002-1400-3224
https://orcid.org/0000-0002-1400-3224Brendan McCormack - ORCID: 0000-0001-8525-8905
https://orcid.org/0000-0001-8525-8905Background: The recent COVID-19 pandemic increased pressure upon healthcare resources resulting in compromised health services. Enforced national lockdown led to people being unable to access essential services in addition to limiting contact with social support networks. The novel coronavirus, and subsequent condition known as long covid were not well-understood and clinicians were not supported by existing guidelines or pathways. Our study explored people's experiences of healthcare during this period with a person-centered “lens.”Methods: Ninety-seven people participated in our online survey about their experiences of the pandemic, particularly while socially isolated and their experiences of healthcare. Following completion of the survey, 11 of these participants agreed to further semi-structured interviews to explore this further in their own words. Interview conversations were transcribed, checked; together with the responses to open questions in the survey. The data were then analyzed thematically by members of the research team. We conducted framework analysis from a post-positivist perspective, using the Person-centered Practice Framework to explore participants' experiences.Results: There were few examples of people describing person-centered care. People experienced barriers to accessing support, and negative experiences of care that represented complexities enacting person-centered care at each level of the framework (processes, practice environment, prerequisites, and macro context). These barriers were influenced greatly by the pandemic, for example, with health professionals being harder to access. Some experiences related to the ways in which health professionals responded to the context, for example, positive examples included active listening, recognition of people's experiences, seeking to find out more, and engaging in collaborative problem-solving.Discussion: People want to feel heard, supported to navigate healthcare systems, source trustworthy information, find appropriate services, and collaborate in learning and problem-solving with healthcare professionals. There have been enormous challenges to the provision of healthcare throughout the pandemic. Moving forward is crucial with emphasis on overcoming barriers to person-centered healthcare. This should focus on steps now and also in planning for the possibility of further rapid changes in the demand for and provision of healthcare.This study received funding from Queen Margaret University, Edinburgh through the Scottish Funding Council Research Funding to Mitigate the effects COVID 19 on the Research. It built on previous work which was funded by Chief Scientist Office, Scotland (Rapid Research in Covid−19 programme: COV/QMU/20/04).https://doi.org/10.3389/fresc.2021.7262102pubpu
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