2,247 research outputs found
How to tell an impact story? the building blocks you need
No full textAt a loss for how to demonstrate impact? Laura Meagher and David Edwards outline a dynamic understanding of impact evaluation comprised of ‘building blocks’. These building blocks are five types of impacts; five broad categories of stakeholders; and eight causal factors, along with a set of over-arching reflective questions
The genus Cololejeunea (Spruce) Steph. (Marchantiophyta: Lejeuneaceae) on Lord Howe Island
No full textCololejeunea elizabethae Meagher & Pócs is described as a species new to science from Lord Howe Island, Australia. This is the second Cololejeunea species known from the island, along with the widespread temperate Australasian Cololejeunea laevigata (Mitt.) R.M. Schust. The new species is distinguished from Cololejeunea laevigata (Mitt.) R.M. Schust. by its hyaline lobe margin, 2–3 lobule teeth and by the large, often confluent trigones and intermediate thickenings of the lobe cells. Differences from other similar species in the region are tabulated. Cololejeunea hebridensis Tixier is considered to be a new synonym of Cololejeunea laevigata
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Geology of the Whetstone Ridge area, Meagher County, Montana
No full textThe thesis area consists of 65 square miles located in the southeastern part of Meagher County, Montana. Ranging in age from Precambrian to Quaternary, the strata exposed in the area have a total thickness of about 11,100 feet. Low grade metamorphic rocks, mainly slates, and limestones represent the estimated 2,000 foot thick Precambrian unit. Paleozoic rocks, about 2,600 feet in thickness, consist mainly of carbonates but include marine sandstones, some of which were metamorphosed into quartzites. Ordovician, Silurian, and Permian strata are absent. The Mesozoic rocks are dominantly marine, continental, and lacustrjne sandstones, siltstones, and shales. Rocks of Triassic age are not present in this 6, 500 foot thick sequence of sedimentary rocks. Intrusive and extrusive igneous rocks, glacial deposits, and unconsolidated alluvium represent the Cenozoic Period. The major structures in the thesis area are the result of the Lararnide Revolution and date from Late Cretaceous to Early Tertiary
Voters and the Senate
No full textOver half of all voters believe that government control of the Senate is a bad thing, report DAVID DENEMARK, SHAUN WILSON and GABRIELLE MEAGHER in this extract from Australian Social Attitudes 2: Citizenship, Work and Aspirations, a collection of essays based on the Australian Survey of Social Attitudes 2005 IN JULY 2005, a federal government won control of the Senate for the first time since 1981, after the Howard-led Coalition secured a higher than expected vote in the elections of October 2004. With this new majority in both parliamentary houses, the government can pass its legislative agenda without the need to consult with opposition parties - effectively eliminating what has become an important aspect of the Senate’s role. The Australian Survey of Social Social Attitudes 2005 asks respondents about their knowledge of who controls the Senate, and about their attitudes toward who controls it. The first thing to say is that most voters (79 per cent) know that the Coalition parties have a majority in the upper house, with few (1 per cent) saying Labor. But almost one in five citizens did not know (19 per cent responded “Can’t choose”). Overall, voters who did not know had lower levels of formal education and lower incomes, which suggests that voters affected by Senate decisions (such as changes to welfare provisions) may be unaware of this new legislative power.
The survey finds that, overall, 57 per cent of voters disapprove of the Senate majority (they say it’s “a bad thing”) with just 14 per cent saying it’s “a good thing.” Quite a few say “it’s too early to say” but very few think ‘it will make no difference’ anyway (just 8 per cent). It’s not surprising that Labor, Democrat and Green voters are strongly opposed to Howard’s majority (all above 80 per cent). What is more surprising is the low number of Coalition voters willing to say the majority is a good thing - 29 per cent for Liberal and 28 per cent of National identifiers respectively. More conservative voters have adopted a “wait and see” attitude, which may have some implications for strategic voters in the 2007 elections...
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The development and evaluation of a palliative care admission assessment tool
No full textEffective palliative care intervention is contingent upon a comprehensive multidimensional assessment of the patient’s experience of illness. Assessment in palliative care settings must be focused, sensitive, specific and effective in order to minimise discomfort to vulnerable and often highly morbid patients. Optimal assessment can be facilitated by careful choice of tools that allow systematic standardised assessment, are feasible within clinical practice and acceptable to patients.
The aim of this research was the development and testing of evidence based, multidisciplinary, specialist palliative care assessment; accompanying guidelines and training package (the intervention). The tools included in the admission assessment were chosen further to extensive literature review. Mixed methods were utilised to facilitate a comprehensive evaluation pre and post-intervention to test the effectiveness, feasibility and acceptability of the intervention in a busy clinical environment.
Results demonstrated an increase in evidence of assessment across the palliative care domains and in particular in relation to assessment of the patient’s psychosocial distress and assessment of carer’s needs. Post-intervention increased concordance of outcome of clinical assessment with the patients self-rating of pain, nausea, breathlessness and distress is evident in comparison to pre-intervention. Referrals to other disciplines occurred earlier in the admission post-intervention. Staff reported that there was an increase in the assessment of palliative care domains, less need for training and an increased likelihood of assessment of carers needs.
Significant improvement with regard to assessment of patient needs were reported. The admission assessment should be tested in other clinical environments to determine the degree to which the results can be replicated and to investigate concordance with the finding presented here. An adapted version of the assessment should also be developed for the home care and day care services
Detection and diagnosis of delirium: a study of the application of computer-assisted technologies
No full textDelirium is a common, severe and life threatening neuropsychiatric disorder. Encountered in all healthcare settings, delirium affects approximately one in five general hospital inpatients (Ryan et al., 2013, Siddiqi et al., 2006) with delirium incidence and prevalence rates likely to rise substantially in the coming years as healthcare services provide for our increasingly aged society. Delirium impacts negatively upon morbidity, length of stay in hospital, cognitive impairment and mortality (Witlox et al., 2010), along with substantial social and healthcare costs (Leslie and Inouye, 2011).
Despite its clinical importance in terms of frequency and impact, delirium is underdiagnosed and inadequately treated. This may be related to factors such as the complex and heterogenous clinical presentation of delirium, as well as the frequent mis-assumption that cognitive impairment is an expected and normal state for older inpatients, thus missing out on opportunities to identify potentially reversible and modifiable causative factors. This is further compounded by the lack of brief, objective and effective bed-side tests that are acceptable to patients and healthcare workers alike. At a service-planning level, the importance of delirium and cognitive friendly hospital initiatives are frequently neglected (O\u27Connell et al., 2014).
Prior to DSM III (APA, 1980) and ICD10 (WHO, 1992), the lack of operationalized diagnostic criteria for delirium hampered detection and diagnosis: the emphasis in DSM 5 (APA, 2013) on the critical importance of attentional deficits, especially deficits in sustained attention, has brought clarity to the area of delirium screening, diagnosis and assessment
Towards early intervention for youth mental health in primary care: a mixed methods investigation
No full textIn Ireland, psychological morbidity has been reported in 21-27% of young people and
recent data has indicated that the youth suicide rate in Ireland is now the second highest
(of 26 countries) in the European Union, for 0-19 year olds. Early intervention in youth
mental health is increasingly viewed as easier, cheaper and more effective than
traditional approaches to care. GPs, as the health care professional most often consulted
by young people, have a central role in early detection of youth mental health and
substance use problems. However, there is a dearth of evidence regarding the
experiences and attitudes of young people and health care workers towards screening
and treatment for mental and substance use disorders in primary care in Ireland.
The overarching aim of this thesis was to examine the role of primary care (with a
particular focus on the role of the GP) in providing early intervention and treatment for
mental health and substance use problems in young people. It was a mixed methods
study that involved qualitative interviews with health care workers (n=37) and young
people (n=20) from primary care, secondary care and community agencies in two of
Ireland’s most socio-economically disadvantaged areas, Limerick City and Dublin
South Inner City and a national cross-sectional survey of GPs (n=175).
The research found that while addressing youth mental health problems was a priority
for most participants, a number of barriers to the identification and management of such
issues were identified: access to services, flaws in traditional mental health services for
young people under eighteen years, fragmentation between services and limited
resources. The research outlined potential implications for clinical practice, research and
education such as promoting awareness of mental health and the role of the GP in
helping these issues, education of practitioners and improving access to psychological
treatments for young people
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