Diabetes MILES - Australia (Management and Impact for Long-Term Empowerment and Success) : methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study is an international collaborative. Diabetes MILES-Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures.

Methods The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years) with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS) database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4%) completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES-Australia (58.8% versus 41.2%). Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas.

Discussion A potential limitation of the study is the under-representation of respondents from culturally and linguistically diverse backgrounds (including Aboriginal and Torres Strait Islander origin). Diabetes MILES-Australia represents a major achievement in the study of diabetes in Australia, where for the first time, the focus is on psychosocial and behavioural aspects of this condition at a national level.

Reduced graphene oxide/ZnO composite : reusable adsorbent for pollutant management

Reduced graphene oxide (RGO) coated with ZnO nanoparticles (NPs) was synthesized by a self-assembly and in situ photoreduction method, and then their application for removing organic pollutant from water was investigated. The RGO@ZnO composite nanomaterial has unique structural features including well-dispersed NPs on the surface and dense NPs loading. This composite exhibited a greatly improved Rhodamine B (RhB) adsorption capacity and an improved photocatalytic activity for degrading RhB compared to neat ZnO NPs. These properties made RGO@ZnO reusable for pollutant adsorbent. The composite showed an excellent cycling performance for organic pollutant removal up to 99% recovery over several cycles via simulated sunlight irradiation.

Barriers to the detection and management of depression by palliative care professional carers among their patients : perspectives from professional carers and patients' family members

Introduction: Clinical depression is highly prevalent yet underdetected and poorly managed within palliative care settings.

Objectives: This qualitative study explored the identification, monitoring, and management of symptoms of depression in patients receiving palliative care from 2 juxtaposed perspectives that are of care providers and care recipients' family members. Examining the barriers that restrict professional carers detecting and managing depression in their patients was a central focus of the study.

Methods: Focus groups were held with 18 professional carers, including 8 holding managerial positions, across 2 palliative care services, 1 regional and 1 metropolitan, which provided both inpatient and community-based care. Individual interviews were conducted with 10 family members of patients who had received or were receiving palliative care through these services.

Results: Thematic analysis of these data identified that both professional carers and family members perceived that depression is a wide-spread concern for patients receiving palliative care; however, numerous barriers were identified that affect professional carers’ ability to identify depression. These included knowledge and training deficits, low self-efficacy, prioritization of physical concerns and time constraints, patient/family characteristics, and system/process issues. These themes (and related subthemes) are discussed in this article.

Conclusions: Specialized training in depression is recommended for professional carers in order to improve their depression-related knowledge, detection skills, and self-efficacy. The ultimate goal of such training is to increase the rate of recognition of depression that in turn will lead to appropriate treatment for depressed patients.

Internet cognitive behavioural therapy for panic disorder : does the inclusion of stress management information improve end-state functioning?

Previous research has established Internet-based cognitive behavioural therapy (CBT) for panic disorder (PD) as effective in reducing panic severity and frequency. There is evidence, however, that such programs are less effective at improving overall end-state functioning, defined by a PD clinician severity rating of ≤2 and panic free. In order to test the effect on end-state functioning of the incorporation of stress management material within a CBT program for PD, 32 people with PD were randomised to either Internet-based CBT (PO1), Internet-based CBT plus stress management (PO2) or an Internet-based information-only control condition (IC). Both CBT treatments were more effective at posttreatment assessment than the control condition in reducing PD severity, panic and agoraphobia-related cognition, negative affect and self-ratings of health. PO2 was more effective than PO1 at posttreatment assessment on PD severity and general anxiety, although at 3-month follow-up these differences were no longer apparent. This study provides further support for the efficacy of Internet-based CBT for PD and suggests that although the incorporation of stress management material confers short-term advantages over a standard program, it is not associated with any longer term improvements on panic severity and related cognitions, negative affect, general wellbeing and end-state functioning.

Concept definition in knowledge management : the development of an organizational memory scale

Theorists and researchers in the field of Knowledge Management are frequently frustrated by issues with concept definition, as illustrated by the following comment "there remains disagreement on methodologies, definitions and processes" from the summary article "Issues Raised at ECKM, 2008". How can we clearly define constructs of interest? How can we further research and understanding in the field if we are speaking with different vocabularies? This paper illustrates some of these issues by describing the concept definition process involved in the development of an organizational memory scale. The example being used to illustrate these issues was a self-report scale of organizational memory developed to survey experienced workers' attitudes to mentoring others to pass on their knowledge. The current research sought to differentiate between the types of organizational knowledge that experienced workers have and the possible relationships these have with attitudes pertaining to knowledge transfer via mentoring. Defining the construct to be measured is the vital first ingredient in scale development. Many researchers lament that the concept of organizational memory is a "rather loosely defined and under-developed concept" (e.g. Johnson & Paper, 1998, p.504), and this hints at the challenges that concept definition can entail. Furthermore, in the early stages of this particular project it became clear that the organizational memory scale had similar aims, and was able to borrow from, an existing sale of organizational socialization (Chao, O'Leary-Kelly, Woolf, Klein & Gardner, 1994). This paper describes the concept definition process involved in the development of the scale along with results from the exploratory factor analysis. There is a discussion of the relative contribution that the organizational memory scale makes alongside the existing measure of socialization (Chao et al., 1994), along with goals for further development.

Young adults' management of type 1 diabetes during life transitions

Aim. To identify life transitions likely to impact diabetes self-care among young adults with Type 1 diabetes and their coping strategies during transition events.

Background. Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects individuals’ problem-solving, coping abilities and blood glucose levels.

Design. A qualitative interpretive inquiry.

Method. Semi-structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR_ NVIVO 7 software.

Results. Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes-related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes camps. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self-negotiation to minimise risks’; ‘managing diabetes using previous experiences’; ‘connecting with others with diabetes’; ‘actively seeing information to ‘patch’ knowledge gaps’; and ‘putting diabetes into perspective’.

Conclusions. Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions.

Relevance to clinical practice. It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, individualised and collaborative treatment.

Self-conscious emotion: how two teachers explore the emotional work of teaching

Teachers are constantly involved in emotional management. This chapter focuses on two second year teachers and the self-conscious emotional work of teaching. Both teachers were working in a prep ( 5-year-olds) class. The teachers engaged in The Participatory Inquiry Program (PIP), which is framed by active and critical reflections on classroom practices. The teachers collaborated with each other, firstly filming the other's practice, and then acting as a critical peer when reviewing the other's film. Teachers also examined internal feelings and thought processes that influenced their actions. The teachers concluded their participation in PIP by narrating their experience and learning. These narratives were then analysed by focusing on how they became cognisant of emotion and emotion regulation that enhances practice and learning outcomes. Emotion work for these two teachers revolved around three key themes: the emotion work with regard to colleagues; the emotional work that arises in relation to students (feelings of love; annoyance, anger), and emotion and self-awareness.

A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings

Background: 

The impact of a team-based intervention on the lifestyle risk factor management practices of community nurses: outcomes of the community nursing SNAP trial

Background
Lifestyle risk factors like smoking, nutrition, alcohol consumption, and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care is an appropriate setting to address these risk factors in individuals. Generalist community health nurses (GCHNs) are uniquely placed to provide lifestyle interventions as they see clients in their homes over a period of time. The aim of the paper is to examine the impact of a service-level intervention on the risk factor management practices of GCHNs.

Methods
The trial used a quasi-experimental design involving four generalist community nursing services in NSW, Australia. The services were randomly allocated to either an intervention group or control group. Nurses in the intervention group were provided with training and support in the provision of brief lifestyle assessments and interventions. The control group provided usual care. A sample of 129 GCHNs completed surveys at baseline, 6 and 12 months to examine changes in their practices and levels of confidence related to the management of SNAP risk factors. Six semi-structured interviews and four focus groups were conducted among the intervention group to explore the feasibility of incorporating the intervention into everyday practice.

Results
Nurses in the intervention group became more confident in assessment and intervention over the three time points compared to their control group peers. Nurses in the intervention group reported assessing physical activity, weight and nutrition more frequently, as well as providing more brief interventions for physical activity, weight management and smoking cessation. There was little change in referral rates except for an improvement in weight management related referrals. Nurses’ perception of the importance of ‘client and system-related’ barriers to risk factor management diminished over time.

Conclusions
This study shows that the intervention was associated with positive changes in self-reported lifestyle risk factor management practices of GCHNs. Barriers to referral remained. The service model needs to be adapted to sustain these changes and enhance referral.

Motivation, self-assessment and tacit knowledge in e-learning context selection

Formal consideration of the links between students' Motivation, Self-Assessment abilities and Tacit Knowledge is shown in this paper to provide a useful model (MSATK) for planning postgraduate, Web-based education. The design of effective e-Learning courses requires a Learning Framework that emphasizes contextanalysis within knowledge-mediated processes. Contextual analysis ensures that self-assessment will be effective in complex domains that rely on Web sources of experiential knowledge, usually accessible as Professional practice models that employ diagnostic tools for scenario simulation processes. Demographic trends now facing Japan and Western countries, and the knowledge management support requirements of global e-Learning initiatives are challenging the value of current selfassessment processes. Building a Culture of Critique is highly desirable, but the lack of an Learning Framework that reflects student ownership of their learning process has obscured the need for tools to correctly interpret domain contexts, or for student freedom to drive the need for modified scenarios. The value of a Learning Framework that links motivation, tacit knowledge, selfassessment practice and contextual analysis is examined in this paper with consequential implications for Web support.

A randomized head to head trial of MoodSwings.net.au: an internet based self-help program for bipolar disorder.

Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design.

Hume's humanity: a nexus for global management

This chapter explains the development of the Human Nexus, being an original interpretation of ethics based on David Hume's exploration of morality. Recognizing the current moral malaise in global business practice, and searching for a contemporary approach to relational ethics, his elegant reasoning is concisely adapted for global managers. The Human Nexus is proposed as a tool for conveying humanism in global business decision-making today. A matrix of Humean variables from Hume's moral treatise counterbalances usefulness and agreeableness with considerations of self-interest, selflessness and the human connection with ecology. The analysis explores the interaction of variables, relationships and decision processes common in global management. A longitudinal reflective study underpins the research. The resultant construct is presented in context with foundational and emerging literature about the challenge of abstract moral perspectives for global managers, highlighting the desire for something more practical. The Human Nexus shows potential for pragmatically encouraging and enhancing humanistic engagement in ethical decision-making.

The role of a self-report measure in athlete preparation

Athlete self-report measures (ASRM) are a common and cost-effective method of athlete monitoring. It is purported that ASRM be used to detect athletes at risk of overtraining, injury or illness, allowing intervention through training modification. However it is not known whether ASRM are actually being used for or are achieving these objectives in the applied sport setting. Therefore the aim of this study was to better understand how ASRM are being used in elite sports and their role in athletic preparation. Semi-structured interviews were conducted one-on-one with athletes, coaches and sports science and medicine staff (n=30) at a national sporting institute. Interview recordings were transcribed and analysed for emergent themes. Twelve day-to-day and seven longer-term practices were identified which contributed to a four-step process of ASRM use (record data, review data, contextualize, act). In addition to the purported uses, ASRM facilitated information disclosure and communication amongst athletes and staff and between staff, and improved the understanding and management of athlete preparation. These roles of ASRM are best achieved through engagement of athletes, coaches and support staff in the systematic, cyclic process.