Weight management and its role in breast cancer rehabilitation

Overweight and obesity are risk factors for post-menopausal breast cancer, and many women diagnosed with breast cancer, irrespective of menopausal status, gain weight after diagnosis. Weight management plays an important role in rehabilitation and recovery since obesity and/or weight gain may lead to poorer breast cancer prognosis, as well as prevalent co-morbid conditions (e.g. cardiovascular disease and diabetes), poorer surgical outcomes (e.g., increased operating and recovery times, higher infection rates, and poorer healing), lymphedema, fatigue, functional decline, and poorer health and overall quality of life. Health care professionals should encourage weight management at all phases of the cancer care continuum as a means to potentially avoid adverse sequelae and late effects, as well as to improve overall health and possibly survival. Comprehensive approaches that involve dietary and behavior modification, and increased aerobic and strength training exercise have shown promise in either preventing weight gain or promoting weight loss, reducing biomarkers associated with inflammation and co-morbidity, and improving lifestyle behaviors, functional status, and quality of life in this high-risk patient population.

Knowledge management and Dublin Core

This paper is concerned with investigating existing and potential scope of Dublin Core metadata in Knowledge Management contexts. Modelling knowledge is identified as a conceptual prerequisite in this investigation, principally for the purpose of clarifying scope prior to identifying the range of tasks associated with organising knowledge. A variety of models is presented and relationships between data, information, and knowledge discussed. It is argued that the two most common modes of organisation, hierarchies and networks, influence the effectiveness and flow of knowledge. Practical perspective is provided by reference to implementations and projects providing evidence of how DC metadata is applied in such contexts. A sense-making model is introduced that can be used as a shorthand reference for identifying useful facets of knowledge that might be described using metadata. Discussion is aimed at presenting this model in a way that both validates current applications and points to potential novel applications.

Unpacking the connections between network and stakeholder management and their application to road infrastructure networks in Queensland

Since the late twentieth century, there has been a shift away from delivery of infrastructure, including road networks, exclusively by the state. Subsequently, a range of alternative delivery models including governance networks have emerged. However, little is known about how connections between these networks and their stakeholders are created, managed or sustained. Using an analytical framework based on a synthesis of theories of network and stakeholder management, three cases in road infrastructure in Queensland, Australia are examined. The paper finds that although network management can be used to facilitate stakeholder engagement, such activities in the three cases are mainly focused within the core network of those most directly involved with delivery of the infrastructure often to the exclusion of other stakeholder groups.

Risk management and injury prevention : competencies, behaviours, and attitudes to safety in the construction industry

Work in the Australian construction industry is fraught with risk and the potential for serious harm. The industry is consistently placed within the three most hazardous industries to work along with other industries such as mining and transport (National Occupational Health and Safety Commission, 2003). In the 2001 to 2002 period, construction work killed 39 people and injured 13,250 more. Hence, more effort is required to reduce the injury rate and maximise the value of the rehabilitation/back-to-work process.

Larger or broader : performance implications of size and diversity of the knowledge worker's egocentric network. [更多或更广：知识员工个人中心网络大小和 多样性对绩效的影响]

Management scholars and practitioners emphasize the importance of the size and diversity of a knowledge worker's social network. Constraints on knowledge workers’ time and energy suggest that more is not always better. Further, why and how larger networks contribute to valuable outcomes deserves further understanding. In this study, we offer hypotheses to shed insight on the question of the diminishing returns of large networks and the specific form of network diversity that may contribute to innovative performance among knowledge workers. We tested our hypotheses using data collected from 93 R&D engineers in a Sino-German automobile electronics company located in China. Study findings identified an inflection point, confirming our hypothesis that the size of the knowledge worker's egocentric network has an inverted U-shaped effect on job performance. We further demonstrate that network dispersion richness (the number of cohorts that the focal employee has connections to) rather than network dispersion evenness (equal distribution of ties across the cohorts) has more influence on the knowledge worker's job performance. Additionally, we found that the curvilinear effect of network size is fully mediated by network dispersion richness. Implications for future research on social networks in China and Western contexts are discussed.

Standardising practices improves ambulatory diabetic foot management and reduces amputations : the Queensland Diabetic Foot Innovation Project, 2006 – 2009

Background Diabetic foot complications are recognised as the most common reason for diabetic related hospitalisation and lower extremity amputations. Multi-faceted strategies to reduce diabetic foot hospitalisation and amputation rates have been successful. However, most diabetic foot ulcers are managed in ambulatory settings where data availability is poor and studies limited. The project aimed to develop and evaluate strategies to improve the management of diabetic foot complications in three diverse ambulatory settings and measure the subsequent impact on ospitalisation and amputation. Methods Multifaceted strategies were implemented in 2008, including: multi-disciplinary teams, clinical pathways and training, clinical indicators, telehealth support and surveys. A retrospective audit of consecutive patient records from July 2006 – June 2007 determined baseline clinical indicators (n = 101). A clinical pathway teleform was implemented as a clinical record and clinical indicator analyser in all sites in 2008 (n = 327) and followed up in 2009 (n = 406). Results Prior to the intervention, clinical pathways were not used and multi-disciplinary teams were limited. There was an absolute improvement in treating according to risk of 15% in 2009 and surveillance of the high risk population of 34% and 19% in 2008 and 2009 respectively (p < 0.001). Improvements of 13 – 66% (p < 0.001) were recorded in 2008 for individual clinical activities to a performance > 92% in perfusion, ulcer depth, infection assessment and management, offloading and education. Hospitalisation impacts recorded reductions of up to 64% in amputation rates / 100,000 population (p < 0.001) and 24% average length of stay (p < 0.001) Conclusion These findings support the use of multi-faceted strategies in diverse ambulatory services to standardise practice, improve diabetic foot complications management and positively impact on hospitalisation outcomes. As of October 2010, these strategies had been rolled out to over 25 ambulatory sites, representing 66% of Queensland Health districts, managing 1,820 patients and 13,380 occasions of service, including 543 healed ulcer patients. It is expected that this number will rise dramatically as an incentive payment for the use of the teleform is expanded.

Promotion and succession management and associated retention issues in Australian law firms

The focus of this research was promotion and succession management in Australian law firms. Two staff retention issues currently faced by the Australian legal industry were identified as suggesting possible failures in this area: 1) Practitioners are leaving law firms early in their careers, 2) Female representation is disproportionally low at partnership level. The research described current Australian law firm promotion and succession practices and then explained their possible relevance to the two retention issues. The overall aim of the research was to uncover key findings and present practical recommendations to law firm managers and partners ready for incorporation into their future promotion and succession planning practice. In so doing the research aimed to benefit the Australian legal community as a whole. Four areas of literature relevant to the topic were reviewed, 1) law firm governance concluding that the fundamental values of the P²-Form remained constant (Cooper, Hinings, Greenwood & Brown, 1996; Morris & Pinnington, 1998) with ownership and strategic control of law firms remaining in the hands of partners; 2) the importance of individual practitioners to law firms concluding that the actual and opportunity costs relating to practitioner turnover were significant due to the transient nature of knowledge as a key asset of law firms (Gottschalk & Khandelwal, 2004; Rebitzer & Taylor, 2007); 3) generational differences concluding with support for the work of Finegold, Mohrman and Spreitzer (2002), Davis, Pawlowski and Houston (2006), Kuhnreuther (2003), and Avery, McKay, and Wilson (2007) which indicated that generational cohort differences were of little utility in human resources management practice; and 4) previous research relating to law firm promotion and succession practices indicating that five practices were relevant in law firm promotion outcomes; 1) firm billing requirements (Gorman & Kmec, 2009; Phillips, 2001; Noonan & Corcoran, 2004; Webley & Duff, 2007); 2) mentoring programs (Phillips, 2001; Noonan & Corcoran, 2004); 3) the existence of female partners (Gorman & Kmec, 2009; Beckman & Phillips, 2005); 4) non-partner career paths (Phillips, 2001; Corcoran & Noonan, 2004); and 5) the existence of family friendly policies (Gorman & Kmec, 2009; Phillips, 2001; Noonan & Corcoran, 2004; Webley & Duff, 2007.) The research was carried out via a sequential mixed method approach. The initial quantitative study was based upon a theoretical framework grounded in the literature and provided baseline information describing Australian law firm promotion and succession practices. The study was carried out via an on-line survey of Australian law firm practitioners. The results of the study provided the basis for the second qualitative study. The qualitative study further explained the statistically generated results and focused specifically on the two identified retention issues. The study was conducted via one-on-one interviews with Australian law firm partners and experienced law firm managers. The results of both studies were combined within the context of relevant literature resulting in eight key findings: Key findings 1) Organisational commitment levels across generational cohorts are more homogenous than different. 2) Law firm practitioners are leaving law firms early in their careers due to the heavy time commitment behaviour demanded of them, particularly by clients. 3) Law firm promotion and succession practices reinforce practitioner time commitment behaviour marking it as an indicator of practitioner success. 4) Law firm practitioners believe that they have many career options outside law firms and are considering these options. 5) Female practitioners are considering opting out of law firms due to time commitment demands related to partnership conflicting with family commitment demands. 6) A masculine, high time commitment culture in law firms is related to the decision by female practitioners to leave law firms. 7) The uptake of alternative work arrangements by female practitioners is not fatal to their partnership prospects particularly in firms with supportive policies, processes and organisational culture. 8) Female practitioners are less inclined than their male counterparts to seek partnership as an ultimate goal and are more likely to opt out of law firms exhibiting highly competitive, masculine cultures. Practical recommendations Further review of the data collected in relation to the key findings provided the basis for nine practical recommendations specifically geared towards implementation by law firm managers and partners. The first recommendation relates to the use of generational differences in practitioner management. The next six relate to recommended actions to reduce the time commitment demands on practitioners. The final two recommendations relate to the practical implementation of these actions both at an individual and organisational level. The recommendations are as follows: 1) "Generationally driven," age based generalisations should not be utilised in law firm promotion and succession management practice. 2) Expected levels of client access to practitioners be negotiated on a client by client basis and be included in client retention agreements. 3) Appropriate alternative working arrangements such as working off-site, flexible working hours or part-time work be offered to practitioners in situations where doing so will not compromise client serviceability. 4) The copying of long working hour behaviours of senior practitioners should be discouraged particularly where information technology can facilitate remote client serviceability. 5) Refocus the use of timesheets from an employer monitoring tool to an employee empowerment tool. 6) Policies and processes relating to the offer of alternative working arrangements be supported and reinforced by law firm organisational culture. 7) Requests for alternative working arrangements be determined without regard to gender. 8) Incentives and employment conditions offered to practitioners to be individualised based on the subjective need of the individual and negotiated as a part of the current employee performance review process. 9) Individually negotiated employment conditions be negotiated within the context of the firm’s overall strategic planning process. Through the conduct of the descripto-explanatory study, a detailed discussion of current law firm promotion and succession practices was enabled. From this discussion, 7 eight key findings and nine associated recommendations were generated as well as an insight into the future of the profession being given. The key findings and recommendations provide practical advice to law firm managers and partners in relation to their everyday promotion and succession practice. The need to negotiate individual employee workplace conditions and their integration into overall law firm business planning was put forward. By doing so, it was suggested that both the individual employee and the employing law firm would mutually benefit from the arrangement. The study therefore broadened its practical contribution from human resources management to a contribution to the overall management practice of Australian law firms. In so doing, the research has provided an encompassing contribution to the Australian legal industry both in terms of employee welfare as well as firm and industry level success.