Dissertations / Theses on the topic 'Preventive Victoria'

O risco de dano eventualmente provocado pela luz natural, em objectos de diversas naturezas, é uma questão frequentemente levantada em instituições onde a conservação tem um papel de destaque. Contudo, são mais raros os casos em que se faz uma avaliação profunda deste tipo de risco, avaliação esta que, podendo ser complexa, pode contribuir para a definição de medidas de prevenção da ocorrência acelerada de um tipo de dano que se caracteriza por ser cumulativo e irreversível. No Victoria and Albert Museum, em Londres, encontra-se em processo de preparação o projecto de uma nova exposição permanente de escultura. Tendo em conta a sensibilidade à luz referente a cada peça, assim como as especificidades dos espaços que virão a albergar o conjunto, parte das galerias incluídas no projecto foram alvo de uma avaliação profunda no que diz respeito ao risco de dano associado à luz solar. Neste contexto, foi monitorizada a iluminância externa e interna, tendo por objectivo a identificação das peças que estariam sob maior risco de dano acelerado e a proposta de medidas de mitigação de risco, a partir do cruzamento da informação sobre níveis de luz com o plano da distribuição prevista para as esculturas nas galerias. Este estudo incluiu a avaliação da eficácia da utilização de blackouts nas janelas. Os dados obtidos contribuíram para fundamentar argumentos defendidos pelo Departamento de Conservação, que visam a criação, aplicação e aperfeiçoamento de medidas de mitigação de risco de dano no conjunto de esculturas que se encontrará em exibição no V&A durante cerca de dez anos.

O risco de dano eventualmente provocado pela luz natural, em objectos de diversas naturezas, é uma questão frequentemente levantada em instituições onde a conservação tem um papel de destaque. Contudo, são mais raros os casos em que se faz uma avaliação profunda deste tipo de risco, avaliação esta que, podendo ser complexa, pode contribuir para a definição de medidas de prevenção da ocorrência acelerada de um tipo de dano que se caracteriza por ser cumulativo e irreversível. No Victoria and Albert Museum, em Londres, encontra-se em processo de preparação o projecto de uma nova exposição permanente de escultura. Tendo em conta a sensibilidade à luz referente a cada peça, assim como as especificidades dos espaços que virão a albergar o conjunto, parte das galerias incluídas no projecto foram alvo de uma avaliação profunda no que diz respeito ao risco de dano associado à luz solar. Neste contexto, foi monitorizada a iluminância externa e interna, tendo por objectivo a identificação das peças que estariam sob maior risco de dano acelerado e a proposta de medidas de mitigação de risco, a partir do cruzamento da informação sobre níveis de luz com o plano da distribuição prevista para as esculturas nas galerias. Este estudo incluiu a avaliação da eficácia da utilização de blackouts nas janelas. Os dados obtidos contribuíram para fundamentar argumentos defendidos pelo Departamento de Conservação, que visam a criação, aplicação e aperfeiçoamento de medidas de mitigação de risco de dano no conjunto de esculturas que se encontrará em exibição no V&A durante cerca de dez anos.

This study undertook an evaluation of six alternative education programs provided by St Augustine's Education and Training in the Barwon region of Victoria. The impetus for the study has come from the staff of St Augustine's who bravely opened up their programs to closer scrutiny in order to gain a clearer understanding about the needs of the students attending their programs, the theoretical basis of their work and the outcomes of program intervention. A utilisation-focused approach was used and incorporated the following components: a needs analysis using a variety of measures to identify the characteristics of the students and to describe the experiences of students and parents, a qualitative process to articulate the model of psycho-education intervention and issues in service delivery and an impact evaluation to assess the effectiveness of intervention. There were 158 students aged between 6 and 15 years enrolled in programs over a two year period. The results of the needs analysis found that programs were appropriately targeting a marginalised and disadvantaged group of students that typically came from a low socioeconomic background, were significantly behind in their academic achievement, had poor adaptive functioning skills, exhibited a low level of social-emotional development (social-emotional competencies and negative attitudes towards learning) and a high level of psychopathology (mental health symptoms). Using the Survey of Student Assets (Bernard, 2002), the impact evaluation found that programs were successful in increasing the students' social-emotional capabilities and positive attitudes towards learning but did not impact significantly on the students' presenting mental health symptoms and adaptive functioning as measured by the Teachers Report Form (Achenbach and Rescoria, 2001). However, these results are to be interpreted with caution given the small sample sizes used in the analysis. Across the six programs it was found that a total of 89 students (56.3%) experienced a positive outcome destination immediately post-program and these students were maintained in, or transitioned back to mainstream school (n=71) or entered vocational training, education or employment (n= 18). Negative outcome destinations were experienced by 35 students (22.1 %) either because they were excluded (n=3), not engaged (n= 15) or withdrew from program (n= 17). At the end of the study, the remaining 25 students (15.8%) were either referred internally onto another program (n=16) or remained in program (n=9). In predicting outcome destinations, students with positive outcomes, were those that presented with less serious mental health symptoms, in particular they had lower rule-breaking and externalising scores on the Teachers Report Form at referral and a higher level of adaptive functioning in the area of 'working hard'. Students experiencing positive outcome destinations were also those that attended program regularly and for a fewer number of months and were involved in fewer critical incidents whilst attending. The qualitative process evaluation found that the model delivered was grounded in the principles of exemplary practice found in the psycho-educational literature and focused on building positive relationships and a sense of belonging, the provision of hands-on learning activities and rewarding individual achievement. Parents and students generally provided positive feedback however the theme analysis of staff, student and parent interviews and the case study scenarios did identify a number of critical areas to be addressed. These included clarifying the target group and the length and intensity of intervention, improving assessment, planning and transition processes, better collaboration with other services and mainstream schools, the on-site delivery of auxiliary services to meet specific student needs, work to better support and involve parents and to develop a sense of community across the school. A strategic planning process involving key stakeholders to systematically address these areas was recommended.

This study undertook an evaluation of six alternative education programs provided by St Augustine's Education and Training in the Barwon region of Victoria. The impetus for the study has come from the staff of St Augustine's who bravely opened up their programs to closer scrutiny in order to gain a clearer understanding about the needs of the students attending their programs, the theoretical basis of their work and the outcomes of program intervention. A utilisation-focused approach was used and incorporated the following components: a needs analysis using a variety of measures to identify the characteristics of the students and to describe the experiences of students and parents, a qualitative process to articulate the model of psycho-education intervention and issues in service delivery and an impact evaluation to assess the effectiveness of intervention.

[Truncated abstract] The aim of the research was to explore the association between wrist guard use and wrist fracture risk in snowboarders in Australia. During the study, the opportunity was also taken to examine the relationship between wearing wrist guards and the severity of wrist and elbow injury. A case-control study was conducted at the Mount Buller Medical Centre, Victoria, Australia. A total of 494 participants was recruited during the 2004 and 2005 ski seasons. Cases were defined as any snowboarder seen at the Clinic with a fractured wrist (N = 119), and controls as any snowboarder seen at the clinic for any reasons other than a fractured wrist (N = 375). Severity of forearm injuries were defined and analysed separately. Study participants completed a questionnaire consisting of: basic demographics (age and sex only); wrist guard use on the day of presentation; normal use of protective equipment; the number of days spent snowboarding that season; the ability of the snowboarder; and ski run difficulty. Risk taking behaviour was assessed by a history of any previous fracture or joint injury and psychometric questions. Clinic medical staff recorded site and severity of fractures and soft tissue injuries. Logistic regression was used to obtain adjusted odds ratios for these risk factors against the main outcome measure. Presence of wrist fracture and injury in snowboarders with and without wrist guards. ... There was a significant association between wrist guard use and soft tissue elbow injuries (adjusted odds ratio = 17.6, p = 0.011, 95% CI: 1.93 – 160.2), but no significant association with elbow fractures (adjusted odds ratio = 1.84, p = 0.385, 95% CI: 0.46 – 7.30). There was thus no evidence in this study that wrist guards increase the occurrence of other severe injuries in the forearm by transferring the impact force away from the protected wrist up the arm. No evidence was found for compensatory risk taking behaviour in participants wearing protective equipment. A local injury prevention strategy was implemented in schools in the Mt Buller district during the course of this study. Education about the protective effects of wrist guards enabled a policy change in the local secondary college so that wrist guard use is now mandatory for all snowboarders in the school ski programme: That policy states:

El objetivo fue determinar los conocimientos de las medidas preventivas de los adolescentes de la ESNPCT del Centro de Salud Materno Infantil El Porvenir. Material y Método. El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población estuvo constituida por 22, la técnica fue la encuesta y el instrumento un cuestionario aplicado previo consentimiento informado. Resultados. Del 100% (22), 55% (12) conoce y 45% (10) no conoce. Respecto a la dimensión tratamiento 55% (12) conoce y 45% (10) no conoce; en la dimensión alimentación 50% (11) conoce y 50% (11) no conoce; en la dimensión eliminación de secreciones 82% (18) conoce y 18% (04) no conoce; en la dimensión descanso y sueño 82% (18) conoce y 18% (04) no conoce; en la dimensión higiene personal 77% (17) conoce y 23% (05) no conoce ; y en la dimensión saneamiento de la vivienda 64% (14) conoce y 36% (08) no conoce. Conclusiones. El mayor porcentaje de los adolescentes de la ESNPCT del Centro de Salud Materno Infantil El Porvenir conocen las medidas preventivas referido a que se debe consumir 3 litros de agua al día, realizar la higiene personal diariamente, realizarse el lavado de manos antes y después de comer e ir al baño, no se debe de compartir la habitación con otra persona, se debe cubrir la boca con pañuelos o papel higiénicos cuando tose, estornuda o habla, si utiliza papel higiénico para eliminar secreciones colocarlo en una bolsa y arrojarlo al carro de basurero, descansar en promedio de 8 a 10 horas diaria, mientras que un porcentaje significativo no conocen aspectos acerca de que debe abrirse las ventanas y cortinas del dormitorio para iluminarlo y ventilarlo, por lo que ello influye negativamente en la salud del adolescente con tuberculosis.
Trabajo académico

Otitis media and consequent hearing loss are known to be high in Koori communities. Previous research on otitis media in Koori communities has focused on its identification, treatment and management. Little research has focused on the prevention of otitis media. Victorian Aboriginal communities often have small populations which result in small sample sizes for research projects. Consequently use of traditional quantitative methods to measure of change arising from health interventions can be problematic. The aim of the research was to describe Koori children’s otitis media risk factors using a Koori research method in order to develop, implement and evaluate preventative interventions.

Introduction: In the Archives of the University of Melbourne there are two black notebooks containing the handwritten reminiscences of William Tyson Kendall, the “founder of the veterinary profession in Australia”. In fact, Kendall makes very little reference to the veterinary college that he founded, his teaching or the trials that he was to confront, but out of that chance encounter with his notebooks I became interested in the early years of the profession in Victoria; the profession to which Kendall devoted so much of his incredible energy and enthusiasm. Further inquiry only served to enhance this interest, but revealed that there was a paucity not only of primary source material, but also of recorded history. During the course of conversations with both retired and active practitioners, I have frequently been told, and can verify, that veterinarians are great talkers, and many of them are keen to preserve their historical heritage, but are the worst procrastinators when it comes to the written word. (For complete introduction open document).

Chronic diseases have increased dramatically in Australia and around the world over the past decade, causing pain, suffering, disability, psychosocial problems, early mortality and economic and public health crisis. However, many chronic diseases and conditions could be prevented with better evidence based and community based health promotion strategies. Guided by a philosophy of idealism, the aim of this thesis was to develop a community centred health promotion strategy to assist the improvement of health and the prevention of chronic disease in an Australian context. More specifically, the research was concerned with exploring the potentiality of statistical or epidemiological evidence and community collaboration as pathways to chronic disease prevention and improvement of health at an individual, community and system level. The research utilised a praxis paradigm and action research design over three stages. Stage One included in depth quantitative analysis of health and epidemiological data and addressed the question: What is the current evidence/knowledge about health status, determinants and inequalities in Victorian communities and the broader Victorian and Australian context? Stage Two involved qualitative participatory action research methods to engage a small group of community members from the Brimbank region of Melbourne (Victoria, Australia) in the community governance of health promotion and disease prevention. The questions addressed were: What are the benefits of community based health promotion and prevention? What ideas for health promotion action does the community have to offer? Stage Three involved a minor evaluation of the strategy as a whole and addressed the question: In what ways, can health evidence and community involvement in health promotion contribute to better health outcomes? Stage One identified various determinants that impact on health status and result in inequalities. Stage Two revealed six major benefits for community based health promotion and prevention and generated a number of useful ideas for health promotion action in the community. Stage Three showed positive evaluations by the participants and identified numerous indicators of success of the health promotion strategy as a whole.

The study explored, described and explained the current models of voluntary counselling and testing services delivery and analysed the extent to which a given VCT model had influenced uptake of VCT services in the fishing communities along the shores of Lake Victoria, in Wakiso District, with an aim of designing optimal VCT service delivery strategies. The study was therefore exploratory, descriptive and explanatory, and collected both qualitative and quantitative data in a three-phased approach. Phase I involved the Kasenyi fishing community respondents, while phases II and III involved VCT managers and VCT counsellors at the Entebbe and Kisubi Hospitals. The findings indicated that VCT services are generally available onsite at health facilities, and in the field through mobile VCT outreach or home-based VCT services provided at clients’ homes. Both client-initiated and health provider-initiated VCT services are available and services are integrated with other health services. Despite the availability of VCT, only about half of the respondents in phase I had accessed VCT services although almost all indicated a willingness to undergo HIV testing in the near future. The main challenges to service delivery and utilisation included limited funding and staffing as well as limited awareness in target communities. The strategies drawn are based on the need to increase availability, accessibility, acceptability and utilisation of VCT services.
Health Studies
D. Litt. et Phil. (Health Studies)

This thesis addresses the question of why work stress prevention has not been adopted systemically in organisations, despite some research findings that it is effective, that it has been mandated by legislative regulations and that it has the potential for significant cost savings. Work stress is recognised as an increasing and global problem in terms of negative economic, health and social outcomes. Its significant costs related to work injury compensation have resulted in growing pressure from governmental health and safety jurisdictions for organisations to manage and prevent stress through systemic risk management approaches.

Healthcare is a complex arena of multi-skilled interaction. In recent years, it has grown extensively out of the simple act of treating the sick by a noble healer to taking measures of preventing illness not only of the clients but also of the community. It is no more a deal between two persons: the sick and the healer (like a doctor). Community healthcare is regulated by several agencies including legislative agencies (like government, international health organisations), professional bodies, industrial regulators, consumer advocates and commercial entities (such as insurance companies and pharmaceuticals). Healthcare service providers or professionals are not the sole regulators rather their actions need to balance the legal obligations to the client (such as client satisfaction), to staff (such as workplace safety) and to business (to maintain competitive advantage in the industry). Current healthcare service provision is challenged by many factors including diversification of the task, diversity of workforce characteristics due to globalisation and increased service demand by knowledgeable customers searching proactive healthcare and not just curative care. To overcome these challenges along with maintaining quality service, organisations need skilled staff. This, however, is threatened by occupational hazards like occupational violence against staff (OVAS) which is well documented globally and across Australia. The impact of OVAS is not limited only to disruption of service but also to the quality of service and shortage of human resources in some cases. Regulatory agencies like the Department of Health, Comcare, Safe Work Australia and Worksafe Victoria (VAGO, 2013) are providing guidelines on OVAS management. Most healthcare providers are considering some actions, but not with any universal consensus. According to the hierarchy of control in Work Health and Safety Management System (WHSMS) a hazard could best be controlled by eliminating it, but if not then training of staff is an option. Training will always be needed whether or not other measures of hazard and risk control are implemented. This encourages research to develop effective training in terms of trainers’ perspective (in delivery), learners’ perspective (of appreciating the sessions) and management’ perspective (of the outcome of hazard control). Literature shows that the workforce training in hospitals to control OVAS lacks consistency and uniformity across Australian hospitals. ‘Management of Violence and Aggression International Training’ (MSVT) is one training programme run by the BN123 Health, Victoria, since 1990. With that background the main aim of this qualitative case study research project was to “identify the effectiveness of the existing training programme (MSVT) in prevention of occupational violence against staff (OVAS) “. Occupational violence is a part of work health and safety issue. So, the research intended to enquire: ‘Is the existing MSVT in prevention of OVAS achieving its purpose, particularly in the current WHSMS setting of the hospital?’ The literature review assisted in identifying the causes of OVAS, types, prevalence and the factors associated with it. It also helped to analyse the published incidents. Among different training evaluation methods, the Kirkpatrick’s model was found most suitable to evaluate MSVT. Analysis attempted to correlate the outcome of the training against existing objectives. Limited access to information meant that I could not perform in-depth analyses, but the findings of this study are expected to guide future research on the effectiveness of MSVT at BN123 Health with more integration to the WHSMS and other safety programmes This research used a qualitative case study with Actor-Network Theory (ANT) to fulfil the goal. The limited access to health facilities both due to obstacle in sensitive data collection and accessing busy participants of different sections of the hospital in a limited time frame. This study explored actors related to OVAS and suggested adoption of an innovative approach to improve workplace safety through the formation of new networks. It did this by looking through the lens of Actor-Network Theory (ANT). The present vision of the government in digitalising the health sector in Australia is a prime opportunity to re-align the network in the WHSMS of the hospital for better impact of training on the OVAS situation. Limited guidance from top management was an issue. MSVT was under the control of the Psychiatric Department at its inception but was then moved under Human Resources (HR), which seems to have reduced its importance and resource management ability. Hospitals are dominated by clinical priorities rather than HR issues. Being a part of the general training programme administered by HR has limited the ability of MSVT as it struggled to receive funding to recruit enough full-time trainers to undertake research on OVAS incidents, promote the programme across the whole organisation, publish materials to create awareness to all staff and develop resources to help retain the knowledge of the participants in the post-training period. Limited flow of information on OVAS was another issue. Even though BN123 Health invests in innovation like RSKSOFT, for reporting it did not purchase all the modules of that programme to improve the flow of information to the trainers of MSVT. BN123 Health demonstrated a proactive attitude in managing OVAS by procuring and trademarking MSVT but is lacking continuity of efforts in it, maybe due to its commitment to clinical aspects of the service. This could be verified by further research. The research identified scope for innovation. Firstly, the training programme could be strengthened by incorporating recent updates on organisational objectives and legislative changes and standardisation with industry practices. It could also be strengthened by incorporation of an improved audio-visual component, distance learning facilities for beginners and refreshers, updating resources including books and journals, inter-organisation exchange programmes and inclusion of regular research results in booklets and handouts. Targeted delivery would also assist, with constant vigilance on incidents and inclusion of vulnerable groups in training. Another worthwhile innovation would be to change the focus from staff only programmes to involve customer or client interest. This could include arranging training for clients and carers as they are a party in the conflict. Management training would be useful to prepare resources for the population of the catchment area, bringing together all healthcare providers (including GPs) who refer clients to the hospital. Updating real-time information collection, storage and analysis by professionals as well as information access to trainers would also be a worthwhile innovation. With the availability of mobile technology, BN123 Health has scope to improve its ability to get real-time information from the incident spot and to develop better management to control events. This could also provide arrangements for easy data entry by general staff.

Community interventions are a recent development in the field of prevention. This study sought to address the current gap in this area, between scientific knowledge and community practice, through an understanding of practitioners’ experiences of implementation. A case study was undertaken to explore the context and complexity of implementation processes. Data was collected concurrently with the implementation of a community intervention located in rural Victoria, Australia, which aimed to reduce early school leaving. Implementers’ perspectives on a guide to best practice, developed from the academic literature, were sought. Concepts from systems theory and ecological approaches were combined to create a framework suitable for the analysis of the data. The intervention was viewed as an open system. Its progression from being a subsystem of the funded organization to a subsystem of both the funded organization and the community was examined. Factors such as meeting community needs and community members as program staff were found to facilitate community acceptance. The interactions within and between the subsystems of the intervention and the community were also explored. School retention rates were suggestive of some level of impact on school leaving. Additional positive outcomes were the facilitation and/or strengthening of links between community subsystems, and a perceived change within the funded organization. This thesis goes some way towards bridging the gap between science and practice in this field. Findings contribute to the debate regarding flexibility versus fidelity and a greater understanding of the unique challenges faced by rural interventions.