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Search Results: 1 - 10 of 1881 matches for " Nick Bretland "
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Factors Associated with Self and Informant Ratings of the Quality of Life of People with Dementia Living in Care Facilities: A Cross Sectional Study
Christopher Beer,Leon Flicker,Barbara Horner,Nick Bretland,Samuel Scherer,Nicola T. Lautenschlager,Frank Schaper,Osvaldo P. Almeida
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0015621
Abstract: There is no consensus regarding the optimal approach to assessment of the quality of life of people with dementia. We undertook the present study to describe and determine the factors associated with ratings of the quality of life of a cohort of people with dementia living in a residential care facility.
A Cluster-Randomised Trial of Staff Education to Improve the Quality of Life of People with Dementia Living in Residential Care: The DIRECT Study
Christopher Beer, Barbara Horner, Leon Flicker, Samuel Scherer, Nicola T. Lautenschlager, Nick Bretland, Penelope Flett, Frank Schaper, Osvaldo P. Almeida
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0028155
Abstract: Background The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. Methodology/Principal Findings This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. Conclusion The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. Trial Registration ANZCTR.org.au ACTRN12607000417482
Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities
Christopher Beer, Barbara Horner, Osvaldo P Almeida, Samuel Scherer, Nicola T Lautenschlager, Nick Bretland, Penelope Flett, Frank Schaper, Leon Flicker
BMC Geriatrics , 2009, DOI: 10.1186/1471-2318-9-36
Abstract: A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey) and 202 GPs (19% of metropolitan GPs). Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically.Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern, communication, knowledge regarding dementia, aspects of person centred care, system factors and the multidisciplinary team were consistently and frequently cited. Small group education which is flexible, individualized, practical and case based was sought.The effectiveness and sustainability of an educational intervention based on these findings needs to be tested. In addition, future interventions should focus on supporting cultural change to facilitate sustainable improvements in care.Dementia is estimated to affect 0.9% of Australians and is now the leading cause of non-fatal disease burden among older Australians. [1,2] Prevalence is strongly age-related, with estimated prevalence rates of 6.5% in people aged 65 years a
Dementia in residential care: education intervention trial (DIRECT); protocol for a randomised controlled trial
Christopher D Beer, Barbara Horner, Osvaldo P Almeida, Samuel Scherer, Nicola T Lautenschlager, Nick Bretland, Penelope Flett, Frank Schaper, Leon Flicker
Trials , 2010, DOI: 10.1186/1745-6215-11-63
Abstract: A prospective randomised controlled trial conduced in residential aged care facilities in the metropolitan area of Perth, Western Australia. Participants are care facility residents, aged 65 years and older and with mini-mental state examination scores less than 25. GPs and care facility staff have been independently randomised to intervention or control groups. An education programme, designed to meet the perceived needs of learners, will be delivered to GPs and care staff in the intervention groups. The primary outcome of the study will be quality of life of the people with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) and Alzheimer Disease Related QOL Scale (ADRQL), 4 weeks and 6 months after the conclusion of the education intervention.Recruitment of 351 people with dementia, cared for by staff in 39 residential facilities and 55 GPs, was undertaken between May 2007 and July 2008. Collection of baseline data is complete. Education has been delivered to GPs and Care staff between September 2008 and July 2009. Follow- up data collection is underway.The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.These trial methods have been prospectively registered (ACTRN12607000417482).Many Australians with dementia, nearly half, live in residential care [1]. A large proportion of RCF residents have dementia, the majority with moderate-severe dementia [2-4]. However only a small proportion of beds are dementia-specific, and these have usually been designed to deal with specific behavioural and psychological challenges associated with dementia, such as frequent wandering [1].Little is known about the subjective experience of people with dementia living in residential care. The available data suggest that people with moderate to severe dementia frequently experience distressing
Reducing workplace burnout: The relative benefits of cardiovascular and resistance exercise
Rachel J Bretland,Einar B Thorsteinsson
PeerJ , 2015, DOI: 10.7287/peerj.preprints.659v1
Abstract: Objectives. With 43% of Australians experiencing occupational burnout therapies for burnout reduction are paramount to organisational efficiency. Exercise has potential to provide a multilevel and cost effective burnout intervention. The current study aims to extend the literature by comparing cardiovascular with resistance exercise to assess their relative effectiveness against well-being, perceived stress, and burnout. Design. Participants were 49 (36 females and 13 males) previously inactive volunteers ranging in age from 19 to 68 that completed a four week exercise program of either cardiovascular, resistance, or no exercise (control). Method. Participants were measured against the Subjective Exercise Experience Scale, the Perceived Stress Scale, and the Maslach Burnout Inventory. Results. After four weeks of exercise participants had greater positive well-being and personal accomplishment, and concomitantly less psychological distress, perceived stress, and emotional exhaustion. Cardiovascular exercise was found to increase well-being and decrease psychological distress, perceived stress, and emotional exhaustion. Resistance training was noticeably effective in increasing well-being and personal accomplishment and to reduce perceived stress. Our preliminary findings revealed large effect sizes suggesting that exercise may be an effective treatment for burnout. However, given a small sample size further research needs to be conducted. Conclusion. Different types of exercise may thus help protect against burnout as exercise seems to increase well-being and personal accomplishment while decreasing psychological distress, perceived stress, and emotional exhaustion. Organisations that want to address burnout can assist by improving their employees’ access to regular exercise programs.
Mapping Software Metrics to Module Complexity: A Pattern Classification Approach  [PDF]
Nick John Pizzi
Journal of Software Engineering and Applications (JSEA) , 2011, DOI: 10.4236/jsea.2011.47049
Abstract: A desirable software engineering goal is the prediction of software module complexity (a qualitative concept) using automatically generated software metrics (quantitative measurements). This goal may be couched in the language of pattern classification; namely, given a set of metrics (a pattern) for a software module, predict the class (level of complexity) to which the module belongs. To find this mapping from metrics to complexity, we present a classification strategy, stochastic metric selection, to determine the subset of software metrics that yields the greatest predictive power with respect to module complexity. We demonstrate the effectiveness of this strategy by empirically evaluating it using a publicly available dataset of metrics compiled from a medical imaging system and comparing the prediction results against several classification system benchmarks.
Deviants or Consenting Adults: A Human Rights Approach to Defining and Controlling Deviant Behavior  [PDF]
Einar Nick Larsen
Sociology Mind (SM) , 2013, DOI: 10.4236/sm.2013.31001

This article examines the concept of deviance within a human rights perspective. The current debate over the need for consent, and the difficulty inherent in attempting to reach a consensus regarding definitions of deviance, are discussed. The positivist and subjectivist-constructionist approaches to defining deviance are outlined and critiqued. It is concluded that both of these models are inadequate for defining deviance and that a more objective approach is required which reflects society’s interests, while also protecting individuals from the tyranny of the majority. This conclusion leads to the development of a new model of deviance which incorporates human rights into the method for defining deviance. This model rests on the argument that there is a crucial difference between behaviors which are undesirable and those which are unacceptable. It is further argued that only unacceptable behaviors should be prohibited and that behaviors which are merely undesirable should be tolerated and regulated. A model is elaborated in which five criteria are posited as a methodology for determining whether particular behavior is deviant and/or whether it should be controlled through criminal sanctions.

Integration of Lean Approaches to Manage a Manual Assembly System  [PDF]
Qian Wang, Nick Bennett
Open Journal of Social Sciences (JSS) , 2014, DOI: 10.4236/jss.2014.29038

Today, importance of flexibility and reconfigurability needs to be addressed when designing and implementing a cost-effective and responsive manufacturing system. Such a system should be able to accommodate dynamic changes of product varieties and production volumes by maximizing its production capability and minimizing its production costs, this is particularly useful for a SME (small and medium-sized enterprises) to remain competitive in the market. For a manual assembly line, it is always a good practice using a highly skilled workforce that each assembly worker is capable of performing multiple tasks. Ideally, each worker is fully trained to complete assigned tasks of a unit from start to finish. This paper presents a case study of incorporating 5S management rules into an assembly system using so-called skillful and dynamic walking workers as a combination of lean management approaches to improve productivity and efficiency of a shop floor production line at a local plant.

Advances by Selective Breeding for Aquatic Species: A Review  [PDF]
Trygve Gjedrem, Nick Robinson
Agricultural Sciences (AS) , 2014, DOI: 10.4236/as.2014.512125
Abstract: During the last 40 years it has been shown that well planned family-based breeding programs yield high rates of genetic improvement for aquatic species. The genetic gain has been greater than 12% per generation for growth rate and for disease resistance when challenge tests are applied. The main reasons for the large genetic gains observed for aquatic species are their relatively high fertility and the natural existence of broad genetic variation for economically important traits, both of which allows a very high selection intensity to be applied. However, the genetic improvement of species grown in aquaculture is far behind that achieved for animals and plants. In 2010 less than 10% of aquaculture production was based on genetically improved stocks. Breeding programs for aquatic species should be family based and include new biotechnologies like genomic selection.
Co-Existence of Local Limit Cycles from Degenerate and Weak Foci in Cubic Systems  [PDF]
Nick Schoonover, Terence Blows
Applied Mathematics (AM) , 2016, DOI: 10.4236/am.2016.716158
Abstract: In this paper, we investigate the existence of local limit cycles obtained by perturbing degenerate and weak foci of two-dimensional cubic systems of differential equations. In particular, we consider a specific class of such systems where the origin is a degenerate focus. By utilizing a Liapunov function method and the stability results that follow, we first determine constraints on the system to maximize the number of local limit cycles that can be obtained by perturbing the degenerate focus at the origin. Once this is established, we add on the additional assumption that the system has a weak focus at \"\", where \"\", and determine conditions to maximize the number of additional local limit cycles that can be obtained near this fixed point. We will ultimately achieve an example of a cubic system with three local limit cycles about the degenerate focus and one local limit cycle about the weak focus.
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