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Local therapy facilitators working with children with developmental delay in rural and remote areas of western New South Wales,Australia: the ‘Outback’ service delivery model
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Angela Dew Kim Bulkeley Craig Veitch Anita Bundy Michelle Lincoln Hannah Glenn Gisselle Gallego Jennie Brentnall 《The Australian journal of social issues》2014,49(3):309-328
Australia's dispersed population in rural areas contributes to poor access to therapy services and the inability of the existing rural therapy workforce to meet demand. As a result, rural children with a developmental delay wait a long time for therapy. This paper describes participant perceptions of a therapy facilitation service model that has worked to improve access to therapy for children in these circumstances. The model, given the pseudonym ‘Outback’, operates in rural and remote areas of western New South Wales. ‘Outback’ employs local people to work under the guidance of therapists based in larger centres to provide preschool children with developmental delays with access to therapy interventions they might not otherwise receive. A two‐stage case study design involving focus groups and interviews with the director, four therapy facilitators, nine therapists, and seven carers was used. Three themes were identified as central to the service model: 1) being part of the local community; 2) developing therapy facilitator knowledge and skills; 3) improving access to therapy intervention for children in rural and remote areas. The ‘Outback’ model demonstrates that appropriately supported, local therapy facilitators provide a flexible workforce adjunct that expands the reach of therapists into rural and remote communities and enhances service access for children and their families. 相似文献
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Priddis H Dahlen H Schmied V 《Women and birth : journal of the Australian College of Midwives》2012,25(3):100-106
BackgroundFrom the historical literature it is apparent that birthing in an upright position was once common practice while today it appears that the majority of women within Western cultures give birth in a semi-recumbent position.AimTo undertake a review of the literature reporting the impact of birth positions on maternal and perinatal wellbeing, and the factors that facilitate or inhibit women adopting various birth positions throughout the first and second stages of labour.MethodsA search strategy was designed to identify the relevant literature, and the following databases were searched: CINAHL, CIAP, the Cochrane Database of Systematic Reviews, Medline, Biomed Central, OVID and Google Scholar. The search was limited to the last 15 years as current literature was sought. Over 40 papers were identified as relevant and included in this literature review.ResultsThe literature reports both the physical and psychological benefits for women when they are able to adopt physiological positions in labour, and birth in an upright position of their choice. Women who utilise upright positions during labour, have a shorter duration of the first and second stage of labour, experience less intervention, and report less severe pain and increased satisfaction with their childbirth experience than women in a semi recumbent or supine/lithotomy position. Increased blood loss during third stage is the only disadvantage identified but this may be due to increased perineal oedema associated with upright positions. There is a lack of research into factors and/or practices within the current health system that facilitate or inhibit women to adopt various positions during labour and birth. Upright birth positioning appears to occur more often within certain models of care, and birth settings, compared to others. The preferences for positions, and the philosophies of health professionals, are also reported to impact upon the position that women adopt during birth.ConclusionUnderstanding the facilitators and inhibitors of physiological birth positioning, the impact of birth settings and how midwives and women perceive physiological birth positions, and how beliefs are translated into practice needs to be researched. 相似文献
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Hannah Briony Thorne Matthew Justus Rockloff Erika Langham En Li 《Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming》2016,32(4):1101-1113
This paper presents the Hierarchy of Gambling Choices (HGC), which is a consumer-oriented framework for understanding the key environmental and contextual features that influence peoples’ selections of online and venue-based electronic gaming machines (EGMs). The HGC framework proposes that EGM gamblers make choices in selection of EGM gambling experiences utilising Tversky’s (Psychol Rev 79(4):281–299, 1972). Elimination-by-Aspects model, and organise their choice in a hierarchical manner by virtue of EGMs being an “experience good” (Nelson in J Polit Econ 78(2):311–329, 1970). EGM features are divided into three levels: the platform—including, online, mobile or land-based; the provider or specific venue in which the gambling occurs; and the game or machine characteristics, such as graphical themes and bonus features. This framework will contribute to the gambling field by providing a manner in which to systematically explore the environment surrounding EGM gambling and how it affects behaviour. 相似文献
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The affective dimensions of poverty, including the impact of wider policy discourses and services that ‘other’ and shame people in poverty, are increasingly recognized. In response, Lister [(2013). Power, not Pity: Poverty and Human Rights. Ethics and Social Welfare, 7(2), 109–123] advocates for ‘a politics of recognition&respect’ that centralizes the voices, participation and lived experiences of those who live in poverty. This paper considers how applying Lister’s theory could improve child protection (CP) social work in England, from a human rights and social justice perspective. The paper draws on findings from an ATD Fourth World participatory research project aimed at updating the course content for a pre-existing social worker training module on poverty awareness. The project brings together families with experience of poverty and CP interventions, social work practitioners and academics. 相似文献
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This is the second article of a two‐part review of the literature relating to family group conferences (FGCs); it explores outcomes and challenges in implementing FGCs. The complex data relating to outcomes, drawing on a range of national contexts, is presented. The challenges of researching outcomes and the role of longitudinal and randomized, controlled trials are considered. The article concludes with a discussion of the implementation of FGC policy and practice in the contemporary context. 相似文献
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