An investigation of factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam

Background: In diabetes care, health care professionals need to provide support for their patients. In order to provide good diabetes self-management support for adults with type 2 diabetes in Vietnam, it is important that health care professionals in Vietnam understand the factors influencing diabetes self-management among these people. However, knowledge about factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam is limited. Objectives: This study aimed to investigate factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam. Methodology: A cross-sectional survey with convenience sampling was conducted on 198 adults with type 2 diabetes in VietnamData collection was administeted via interview. Descriptive statistics, simple correlation statistics and structural equation modelling statistics were used for data analysis. Results: Adults with type 2 diabetes in Vietnam had limited diabetes knowledge (Median = 6.0). The majority of the study participants (72.7%) believed that performing diabetes self-management activities was very important or extremely important for controlling their blood glucose levels and for preventing complications from diabetes; about half usually received support from their family and friends’ (48.5%), and around two thirds rarely received support from their health care providers (68.2%). Many of the participants (41.4%) had limited confidence to perform diabetes management activities. The practices of diabetes self-management were limited among the study population (Mean = 96.7, SD = 19.4). Diabetes knowledge (β = 0.17, p < .001), belief in treatment effectiveness (β = 0.13, p < .01), family and friends’ support (β = 0.13, p < .001), health care providers’ support (β = 0.27, p < .001) and diabetes management self-efficacy (β = 0.43, p < .001) directly influenced their diabetes self-management. Diabetes knowledge, and family and friends’ support also indirectly influenced diabetes self-management among these people through their belief in treatment effectiveness and their diabetes management self-efficacy (p < .05). Conclusion: Findings in this study indicated that health care professionals should provide diabetes self-management support for adults with type 2 diabetes in Vietnam in the future. The adapted theory-based model of factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam found in this study could be a useful framework to develop this supporting program.

Sleepy driving and pulling over for a rest : investigating individual factors that contribute to these driving behaviours

Driver sleepiness is a substantial crash risk factor and as such, is a major contributor to crash statistics. A number of individual factors (i.e., psychological factors) have been suggested to influence driving while sleepy. However, few studies have examined the influence of these individual factors for sleepy driving in combination. The current study sought to examine how various demographic factors, attitudes, perceived legitimacy, personality constructs, and risk taking variables were associated with self-reported likelihood of driving sleepy and pulling over and resting when sleepy. The results show that being a younger driver, having positive attitudes towards driving sleepy, and high levels of emotional stability were related to self-reported likelihood of driving sleepy. Whereas, being an older driver and having negative attitudes towards driving sleepy were associated with self-reported likelihood of pulling over and resting when sleepy. Overall, the obtained results suggest that the age and attitudes of the driver have greater influence than personality traits or risk taking factors. Campaigns focused on changing attitudes to reflect the dangerousness of sleepy driving could be important for road safety outcomes.

Study protocol : establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

Abstract Background: Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design: This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous) and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion: This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient-clinician exchange. This approach may provide a way forward to reduce the appalling health disadvantage experienced within the Indigenous Australian communities. Keywords: Patient-clinician engagement, Qualitative, Cardiovascular disease, Focus groups, Indigenous

Nursing research : the Australian College of Nursing position statement

Background Nursing perspectives play an important role in addressing the health priorities of today’s society. The Australian College of Nursing (ACN) acknowledges the significant contribution that nursing research has made since the first nurse researcher, Florence Nightingale, documented the factors that affected the morbidity and mortality of soldiers wounded in the Crimean war in the 1800s. The nursing profession continues to celebrate the significant contribution nursing research made to improving nursing practice and health outcomes. These significant contributions over recent years include, but are not limited to: 1. Health services research that has demonstrated the importance of nursing services and how such services are designed/organised to ensure safety and quality of care (Duffield, et al., 2011; Fernandez, et al., 2012; Middleton, et al., 2011); 2. Clinical research that has demonstrated the value of specific nursing interventions to improved health outcomes, including enhanced survival, reduced morbidity, and improved quality of life and consumer engagement (Cancer Australia and Cancer Voices Australia, 2011; Kitson, et al., 2013; Middleton, et al., 2012; Rickard, et al., 2012; Zeitz, et al., 2011); 3. Basic science research that has advanced discoveries in terms of understanding the biological mechanisms underpinning nursing interventions (Illi, et al., 2012; Kim, et al., 2012; Miaskowski, et al., 2010; Simonova, et al., 2012); 4. Epidemiological research that has advanced understanding about how individuals and populations respond to health problems (Carrington, et al., 2012); 5. Qualitative research that has advanced understanding about experiences of and responses to health and illness and the processes of care that are important to optimal outcomes (Schulman-Green, et al., 2012; Scott, et al., 2011).

What are the offence and offender risk factors for Indigenous repeat drink drivers in Queensland?

In Australia and internationally, there is scant information about Indigenous repeat drink drivers. The aim was to identify the risk factors associated with repeat offending. De-identified data on drink driving convictions by offenders identifying as Indigenous in Queensland between 2006 and 2010 were examined. A range of univariate analyses were used to compare first time and repeat offenders on gender, age, court location and region (based on the accessibility/remoteness index of Australia), blood alcohol concentration and sentencing severity. Multivariate logistic regression adjusted for confounding variables. Convictions for repeat offenders were more likely from locations other than ‘major cities’ with the association strongest for courts in the ‘very remote’ region (OR=2.75, 2.06-3.76, p<.001). Indigenous offenders 40 years or older were found to be at reduced risk in comparison to offenders aged 15-24 years (OR=0.68, 0.54-0.86, p=0.01). After controlling for confounding factors, gender, sentencing severity and blood alcohol concentration levels were not significantly associated with recidivism. The association of recidivism and remoteness is consistent with higher rates of alcohol-related transport accidents involving Indigenous Australians in isolated areas. This study provides a platform for future research and allows for early attempts to address the need for intervention to reduce Indigenous drink driving recidivism.

Identification of molecular genetic factors that influence migraine

Migraine is a common neurological disorder with a strong genetic basis. However, the complex nature of the disorder has meant that few genes or susceptibility loci have been identified and replicated consistently to confirm their involvement in migraine. Approaches to genetic studies of the disorder have included analysis of the rare migraine subtype, familial hemiplegic migraine with several causal genes identified for this severe subtype. However, the exact genetic contributors to the more common migraine subtypes are still to be deciphered. Genome-wide studies such as genome-wide association studies and linkage analysis as well as candidate genes studies have been employed to investigate genes involved in common migraine. Neurological, hormonal and vascular genes are all considered key factors in the pathophysiology of migraine and are a focus of many of these studies. It is clear that the influence of individual genes on the expression of this disorder will vary. Furthermore, the disorder may be dependent on gene–gene and gene–environment interactions that have not yet been considered. In addition, identifying susceptibility genes may require phenotyping methods outside of the International Classification of Headache Disorders II criteria, such as trait component analysis and latent class analysis to better define the ambit of migraine expression.

What are the offence and offender risk factors for Indigenous repeat drink drivers in Queensland Australia?

Background Road crashes contribute to high injury rates in Indigenous population in Aust, NZ, Canada and USA Alcohol one of the leading risk factors for road crashes: 31.5% Indigenous drivers in remote areas over 0.05mg/100ml, compared to 7.4 percent of non-Indigenous counterparts 17.5% Indigenous drivers in regional areas over 0.05mg/100ml compared to 3.8 percent of non-Indigenous counterparts Indigenous peoples are overrepresented in alcohol-related fatality rates, with this group 40% more likely to be killed

Community college faculty's teaching social networks and their implications for librarians

Collaboration between faculty and librarians is an important topic of discussion and research among academic librarians. These partnerships between faculty and librarians are vital for enabling students to become lifelong learners through their information literacy education. This research developed an understanding of academic collaborators by analyzing a community college faculty's teaching social networks. A teaching social network, an original term generated in this study, is comprised of communications that influence faculty when they design and deliver their courses. The communication may be formal (e.g., through scholarly journals and professional development activities) and informal (e.g., through personal communication) through their network elements. Examples of the elements of a teaching social network may be department faculty, administration, librarians, professional development, and students. This research asked 'What is the nature of faculty's teaching social networks and what are the implications for librarians?' This study moves forward the existing research on collaboration, information literacy, and social network analysis. It provides both faculty and librarians with added insight into their existing and potential relationships. This research was undertaken using mixed methods. Social network analysis was the quantitative data collection methodology and the interview method was the qualitative technique. For the social network analysis data, a survey was sent to full-time faculty at Las Positas College, a community college, in California. The survey gathered the data and described the teaching social networks for faculty with respect to their teaching methods and content taught. Semi-structured interviews were conducted following the survey with a sub-set of survey respondents to understand why specific elements were included in their teaching social networks and to learn of ways for librarians to become an integral part of the teaching social networks. The majority of the faculty respondents were moderately influenced by the elements of their network except the majority of the potentials were weakly influenced by the elements in their network in their content taught. The elements with the most influence on both teaching methods and content taught were students, department faculty, professional development, and former graduate professors and coursework. The elements with the least influence on both aspects were public or academic librarians, and social media. The most popular roles for the elements were conversations about teaching, sharing ideas, tips for teaching, insights into teaching, suggestions for ways of teaching, and how to engage students. Librarians' weakly influenced faculty in their teaching methods and their content taught. The motivating factors for collaboration with librarians were that students learned how to research, students' research projects improved, faculty saved time by having librarians provide the instruction to students, and faculty built strong working relationships with librarians. The challenges of collaborating with librarians were inadequate teaching techniques used when librarians taught research orientations and lack of time. Ways librarians can be more integral in faculty's teaching social networks included: more workshops for faculty, more proactive interaction with faculty, and more one-on-one training sessions for faculty. Some of the recommendations for the librarians from this study were develop a strong rapport with faculty, librarians should build their services in information literacy from the point of view of the faculty instead of from the librarian perspective, use staff development funding to attend conferences and workshops to improve their teaching, develop more training sessions for faculty, increase marketing efforts of the librarian's instructional services, and seek grant opportunities to increase funding for the library. In addition, librarians and faculty should review the definitions of information literacy and move from a skills based interpretation to a learning process.

Child-related factors that influence teacher-child relationships using an Australian national sample

This study assessed the extent to which child-related factors had an impact on teacher-child relationships in Australian childcare settings. Analyses used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC). The sample consisted of 1577 two to three year old children (M= 33.9 months, SD=2.93; 51.5% male). Two separate hierarchical multiple regression analyses were conducted to examine the relation between teachers’ perceptions of their relationships with children and (a) gender, (b), indigenous status, (c), language background other than English, (d), socio-economic position, (e) special health care needs, (f) expression and receptive language concerns, (g) psychosocial competence and problems and (h) temperament factors (approach, persistence and reactivity). Results indicated that special health care needs, receptive language concerns and all three temperament scales (approach, persistence and reactivity) significantly predicted conflict in teacher-child relationships. Close relationships were predicted by being female, indigenous status, higher socio-economic position, not having a special health care need and no expressive language concerns.

The role of psychological and physiological factors in decision making under risk and in a dilemma

We study the difference in the result of two different risk elicitation methods by linking estimates of risk attitudes to gender, age, personality traits, a decision in a dilemma situation, and physiological states measured by heart rate variability (HRV). Our results indicate that differences between the methods can partly be explained by gender, but not by personality traits. Furthermore, HRV is linked to risktaking in the experiment for at least one of the methods, indicating that more stressed individuals display more risk aversion. Finally, we and that risk attitudes are not predictive of the ability to decide in a dilemma, but personality traits are. Surprisingly, there is also no apparent relationship between the physiological state during the dilemma situation and the ability to make a decision.

Remote measurement of diesel locomotive emission factors and particle size distributions

A technique for analysing exhaust emission plumes from unmodified locomotives under real world conditions is described and applied to the task of characterizing plumes from railway trains servicing an Australian shipping port. The method utilizes the simultaneous measurement, downwind of the railway line, of the following pollutants; particle number, PM2.5 mass fraction, SO2, NOx and CO2, with the last of these being used as an indicator of fuel combustion. Emission factors are then derived, in terms of number of particles and mass of pollutant emitted per unit mass of fuel consumed. Particle number size distributions are also presented. The practical advantages of the method are discussed including the capacity to routinely collect emission factor data for passing trains and to thereby build up a comprehensive real world database for a wide range of pollutants. Samples from 56 train movements were collected, analyzed and presented. The quantitative results for emission factors are: EF(N)=(1.7±1)×1016 kg-1, EF(PM2.5)= (1.1±0.5) g·kg-1, EF(NOx)= (28±14) g·kg-1, and EF(SO2 )= (1.4±0.4) g·kg-1. The findings are compared with comparable previously published work. Statistically significant (p<α, α=0.05) correlations within the group of locomotives sampled were found between the emission factors for particle number and both SO2 and NOx.

Identifying important success factors in new venture creation

This paper seeks to uncover the factors that lead to a successful entrepreneurial experience and or venture. Findings of interest in this paper include: • A venture’s initial aspirations are a double edged sword. Ambition may lead to improved performance by striving to reach harder goals. Harder goals are more difficult therefore this may lead to some dissatisfaction, and possibly abandonment of the venture. • Venture legitimacy is important to establish where possible. Firms that formalize their legal form are more successful, as are those set up a shop-front in order to makes sales. • Increased use of technology and higher levels of novelty does not guarantee success early on. Firms of this nature have longer processes, and attempting to create brand new markets is difficult to achieve. At the same time developing your own technology and securing this intellectual property is important for success. • Having goals to work towards and business planning may be useful, but only if the plan is actively revised. Just having a business plan does not matter. Business plans are more useful as a thinking tool than as a blueprint for action. It is the process of thinking through while reviewing the plan that provides the benefit, not following its instruction to the letter.

Prospective imaging study of asymptomatic patellar tendinopathy in elite junior basketball players

To evaluate the ability of ultrasonography to predict eventual symptoms in an at-risk population, 52 elite junior basketball players' patellar tendons were studied at baseline and again 16 months later. The group consisted of 10 study tendons (ultrasonographically hypoechoic at baseline) and 42 control tendons (ultrasonographically normal at baseline). By design, all tendons were asymptomatic at baseline. No differences were noted between subjects and controls at baseline for age, height, weight, training hours, and vertical jump. Functional (P < 0.01) and symptomatic outcome (P < 0.05) were poorer for subjects' tendons than for controls. Relative risk for developing symptoms of jumper's knee was 4.2 times greater in case tendons than in control tendons. Men were more likely to develop ultrasonographic changes than women (P < 0.025), and they also had significantly increased training hours per week (P < 0.01) in the study period. Half (50%) of abnormal tendons in women became ultrasonographically normal in the study period. Our data suggest that presence of an ultrasonographic hypoechoic area is associated with a greater risk of developing jumper's knee symptoms. Ultrasonographic patellar tendon changes may resolve, but this is not necessary for an athlete to become asymptomatic. Qualitative or quantitative analysis of baseline ultrasonographic images revealed it was not possible to predict which tendons would develop symptoms or resolve ultrasonographically.

Role of hydraulic factors in constructed wetland and bioretention basin treatment performance

This research project contributed to the in-depth understanding of the influence of hydrologic and hydraulic factors on the stormwater treatment performance of constructed wetlands and bioretention basins in the "real world". The project was based on the comprehensive monitoring of a Water Sensitive Urban Design treatment train in the field and underpinned by complex multivariate statistical analysis. The project outcomes revealed that the reduction in pollutant concentrations were consistent in the constructed wetland, but was highly variable in the bioretention basin to a range of influential factors. However, due to the significant amount retention within the filter media, all pollutant loadings were reduced in the bioretention basin.

A systematic approach for selecting lean strategies and assessing leanness in manufacturing organizations

Lean strategies have been developed to eliminate or reduce manufacturing waste and thus improve operational efficiency in manufacturing processes. However, implementing lean strategies requires a large amount of resources and, in practice, manufacturers encounter difficulties in selecting appropriate lean strategies within their resource constraints. There is currently no systematic methodology available for selecting appropriate lean strategies within a manufacturer's resource constraints. In the lean transformation process, it is also critical to measure the current and desired leanness levels in order to clearly evaluate lean implementation efforts. Despite the fact that many lean strategies are utilized to reduce or eliminate manufacturing waste, little effort has been directed towards properly assessing the leanness of manufacturing organizations. In practice, a single or specific group of metrics (either qualitative or quantitative) will only partially measure the overall leanness. Existing leanness assessment methodologies do not offer a comprehensive evaluation method, integrating both quantitative and qualitative lean measures into a single quantitative value for measuring the overall leanness of an organization. This research aims to develop mathematical models and a systematic methodology for selecting appropriate lean strategies and evaluating the leanness levels in manufacturing organizations. Mathematical models were formulated and a methodology was developed for selecting appropriate lean strategies within manufacturers' limited amount of available resources to reduce their identified wastes. A leanness assessment model was developed by using the fuzzy concept to assess the leanness level and to recommend an optimum leanness value for a manufacturing organization. In the proposed leanness assessment model, both quantitative and qualitative input factors have been taken into account. Based on program developed in MATLAB and C#, a decision support tool (DST) was developed for decision makers to select lean strategies and evaluate the leanness value based on the proposed models and methodology hence sustain the lean implementation efforts. A case study was conducted to demonstrate the effectiveness of these proposed models and methodology. Case study results suggested that out of 10 wastes identified, the case organization (ABC Limited) is able to improve a maximum of six wastes from the selected workstation within their resource limitations. The selected wastes are: unnecessary motion, setup time, unnecessary transportation, inappropriate processing, work in process and raw material inventory and suggested lean strategies are: 5S, Just-In-Time, Kanban System, the Visual Management System (VMS), Cellular Manufacturing, Standard Work Process using method-time measurement (MTM), and Single Minute Exchange of Die (SMED). From the suggested lean strategies, the impact of 5S was demonstrated by measuring the leanness level of two different situations in ABC. After that, MTM was suggested as a standard work process for further improvement of the current leanness value. The initial status of the organization showed a leanness value of 0.12. By applying 5S, the leanness level significantly improved to reach 0.19 and the simulation of MTM as a standard work method shows the leanness value could be improved to 0.31. The optimum leanness value of ABC was calculated to be 0.64. These leanness values provided a quantitative indication of the impacts of improvement initiatives in terms of the overall leanness level to the case organization. Sensitivity analsysis and a t-test were also performed to validate the model proposed. This research advances the current knowledge base by developing mathematical models and methodologies to overcome lean strategy selection and leanness assessment problems. By selecting appropriate lean strategies, a manufacturer can better prioritize implementation efforts and resources to maximize the benefits of implementing lean strategies in their organization. The leanness index is used to evaluate an organization's current (before lean implementation) leanness state against the state after lean implementation and to establish benchmarking (the optimum leanness state). Hence, this research provides a continuous improvement tool for a lean manufacturing organization.