A taxonomic approach to understanding managerial ethical decision making approaches of clinically and non-clinically trained healthcare managers in Australia

Objective To understand differences in the managerial ethical decision-making styles of Australian healthcare managers through the exploratory use of the Managerial Ethical Profiles (MEP) Scale. Background Healthcare managers (doctors, nurses, allied health practitioners and non-clinically trained professionals) are faced with a raft of variables when making decisions within the workplace. In the absence of clear protocols and policies healthcare managers rely on a range of personal experiences, personal ethical philosophies, personal factors and organizational factors to arrive at a decision. Understanding the dominant approaches to managerial ethical decision-making, particularly for clinically trained healthcare managers, is a fundamental step in both increasing awareness of the importance of how managers make decisions, but also as a basis for ongoing development of healthcare managers. Design Cross-sectional. Methods The study adopts a taxonomic approach that simultaneously considers multiple ethical factors that potentially influence managerial ethical decision-making. These factors are used as inputs into cluster analysis to identify distinct patterns of influence on managerial ethical decision-making. Results Data analysis from the participants (n=441) showed a similar spread of the five managerial ethical profiles (Knights, Guardian Angels, Duty Followers, Defenders and Chameleons) across clinically trained and non-clinically trained healthcare managers. There was no substantial statistical difference between the two manager types (clinical and non-clinical) across the five profiles. Conclusion This paper demonstrated that managers that came from clinical backgrounds have similar ethical decision-making profiles to non-clinically trained managers. This is an important finding in terms of manager development and how organisations understand the various approaches of managerial decision-making across the different ethical profiles.

Threats and Promises: The Promotion of Artificial Lighting to Women Consumers in the United States, 1880s – 1960s

This article examines the development of a specific gendered discourse in the United States in the first half of the twentieth century that united key beliefs about feminine beauty, identity, and the domestic interior with particular electric lighting technologies and effects. Largely driven by the electrical industry’s marketing rhetoric, American women were encouraged to adopt electric lighting as a beauty aid and ally in a host of domestic tasks. Drawing evidence from a number of primary texts, including women’s magazines, lighting and electrical industry trade journals, manufacturer-generated marketing materials, and popular home decoration and beauty advice literature, this study shifts the focus away from lighting as a basic utility, demonstrating the ways in which modern electric illumination was culturally constructed as a desirable personal and environmental beautifier as well as a means of harmonizing the domestic interior.

Sitting-time and 9-year all-cause mortality in older women

Background Studies of mid-aged adults provide evidence of a relationship between sitting-time and all-cause mortality, but evidence in older adults is limited. The aim is to examine the relationship between total sitting-time and all-cause mortality in older women. Methods The prospective cohort design involved 6656 participants in the Australian Longitudinal Study on Women's Health who were followed for up to 9 years (2002, age 76–81, to 2011, age 85–90). Self-reported total sitting-time was linked to all-cause mortality data from the National Death Index from 2002 to 2011. Cox proportional hazard models were used to examine the relationship between sitting-time and all-cause mortality, with adjustment for potential sociodemographic, behavioural and health confounders. Results There were 2003 (30.1%) deaths during a median follow-up of 6 years. Compared with participants who sat <4 h/day, those who sat 8–11 h/day had a 1.45 times higher risk of death and those who sat ≥11 h/day had a 1.65 times higher risk of death. These risks remained after adding sociodemographic and behavioural covariates, but were attenuated after adjustment for health covariates. A significant interaction (p=0.02) was found between sitting-time and physical activity (PA), with increased mortality risk for prolonged sitting only among participants not meeting PA guidelines (HR for sitting ≥8 h/day: 1.31, 95% CI 1.07 to 1.61); HR for sitting ≥11 h/day: 1.47, CI 1.15 to 1.93). Conclusions Prolonged sitting-time was positively associated with all-cause mortality. Women who reported sitting for more than 8 h/day and did not meet PA guidelines had an increased risk of dying within the next 9 years.

Comparing population attributable risks for heart disease across the adult lifespan in women

Background Recent estimates suggest that high body mass index (BMI), smoking, high blood pressure (BP) and physical inactivity are leading risk factors for the overall burden of disease in Australia. The aim was to examine the population attributable risk (PAR) of heart disease for each of these risk factors, across the adult lifespan in Australian women. Methods PARs were estimated using relative risks (RRs) for each of the four risk factors, as used in the Global Burden of Disease Study, and prevalence estimates from the Australian Longitudinal Study on Women's Health, in 15 age groups from 22–27 (N=9608) to 85–90 (N=3901). Results RRs and prevalence estimates varied across the lifespan. RRs ranged from 6.15 for smoking in the younger women to 1.20 for high BMI and high BP in the older women. Prevalence of risk exposure ranged from 2% for high BP in the younger women to 79% for high BMI in mid-age women. In young adult women up to age 30, the highest population risk was attributed to smoking. From age 31 to 90, PARs were highest for physical inactivity. Conclusions From about age 30, the population risk of heart disease attributable to inactivity outweighs that of other risk factors, including high BMI. Programmes for the promotion and maintenance of physical activity deserve to be a much higher public health priority for women than they are now, across the adult lifespan.

Nine year changes in sitting time in young and mid-aged Australian women: Findings from the Australian longitudinal study for women's health

- Objective To examine changes in sitting time (ST) in women over nine years and to identify associations between life events and these changes. - Methods Young (born 1973–78, n = 5215) and mid-aged (born 1946–51, n = 6973) women reported life events and ST in four surveys of the Australian Longitudinal Study on Women's Health between 2000 and 2010. Associations between life events and changes in ST between surveys (decreasers ≥ 2 h/day less, increasers ≥ 2 h/day more) were estimated using generalized estimating equations. - Results Against a background of complex changes there was an overall decrease in ST in young women (median change − 0.48 h/day, interquartile range [IQR] = − 2.54, 1.50) and an increase in ST in mid-aged women (median change 0.43 h/day; IQR = − 1.29, 2.0) over nine years. In young women, returning to study and job loss were associated with increased ST, while having a baby, beginning work and decreased income were associated with decreased ST. In mid-aged women, changes at work were associated with increased ST, while retiring and decreased income were associated with decreased ST. - Conclusions ST changed over nine years in young and mid-aged Australian women. The life events they experienced, particularly events related to work and family, were associated with these changes.

Assessing the effectiveness of High Intensity Interval Training (HIIT) for smoking cessation in women: HIIT to quit study protocol

Background: Smoking and physical inactivity are major risk factors for heart disease. Linking strategies that promote improvements in fitness and assist quitting smoking has potential to address both these risk factors simultaneously. The objective of this study is to compare the effects of two exercise interventions (high intensity interval training (HIIT) and lifestyle physical activity) on smoking cessation in female smokers. Method/design: This study will use a randomised controlled trial design. Participants: Women aged 18–55 years who smoke ≥ 5 cigarettes/day, and want to quit smoking. Intervention: all participants will receive usual care for quitting smoking. Group 1 - will complete two gym-based supervised HIIT sessions/week and one home-based HIIT session/week. At each training session participants will be asked to complete four 4-min (4 × 4 min) intervals at approximately 90 % of maximum heart rate interspersed with 3- min recovery periods. Group 2 - participants will receive a resource pack and pedometer, and will be asked to use the 10,000 steps log book to record steps and other physical activities. The aim will be to increase daily steps to 10,000 steps/day. Analysis will be intention to treat and measures will include smoking cessation, withdrawal and cravings, fitness, physical activity, and well-being. Discussion: The study builds on previous research suggesting that exercise intensity may influence the efficacy of exercise as a smoking cessation intervention. The hypothesis is that HIIT will improve fitness and assist women to quit smoking.

Physical activity in mid-age and older women: Lessons from the Australian longitudinal study on women’s health

The Australian Longitudinal Study on Women’s Health (ALSWH) commenced in Australia in 1996 when researchers recruited approximately 40,000 women in three birth cohorts: 1973–1978, 1946–1951, and 1921–1926. Since then participants have completed surveys on a wide range of health issues, at approximately three-year intervals. This overview describes changes in physical activity (PA) over time in the mid-age and older ALSWH cohorts, and summarizes the findings of studies published to date on the determinants of PA, and its associated health outcomes in Australian women. The ALSWH data show a significant increase in PA during mid-age, and a rapid decline in activity levels when women are in their 80s. The study has demonstrated the importance of life stages and key life events as determinants of activity, the additional benefits of vigorous activity for mid-age women, and the health benefits of ‘only walking’ for older women. ALSWH researchers have also drawn attention to the benefits of activity in terms of a wide range of physical and mental health outcomes, as well as overall vitality and well-being. The data indicate that maintaining a high level of PA throughout mid and older age will not only reduce the risk of premature death, but also significantly extend the number of years of healthy life.

Prospective relationships between physical activity and optimism in young and mid-aged women

BACKGROUND: There is growing evidence that regular physical activity (PA) reduces the risk of poor mental health. Less research has focused on the relationship between PA and positive wellbeing. The study aims were to assess the prospective associations between PA and optimism, in both young and mid-aged women. METHODS: 9688 young women (born 1973-1978) completed self-report surveys in 2000 (age 22 to 27), 2003, 2006, and 2009; and 11,226 mid-aged women (born 1946-1951) completed surveys in 2001 (age 50-55) 2004, 2007, and 2010, as part of the Australian Longitudinal Study on Women's Health. Generalized estimating equation models (with 3-year time lag) were used to examine the relationship between PA and optimism in both cohorts. RESULTS: In both cohorts, women reporting higher levels of PA had greater odds of reporting higher optimism over the 9-year period, (young, OR = 5.04, 95% CI: 3.85-6.59; mid-age, OR = 5.77, 95% CI: 4.76-7.00) than women who reported no PA. Odds were attenuated in adjusted models, with depression accounting for a large amount of this attenuation (young, OR = 2.00, 95% CI: 1.57-2.55; mid-age, OR = 1.64 95% CI: 1.38-1.94). CONCLUSIONS: Physical activity can promote optimism in young and mid-aged women over time, even after accounting for the negative effects of other psychosocial indicators such as depression.

Barriers to and facilitators of cervical screening practice among African immigrant women from refugee and non-refugee backgrounds living in Brisbane

This thesis investigated and compared barriers and facilitators of cervical screening among African-born refugee and non-refugee women living in Brisbane. Refugee women were more likely to have limited or no knowledge about cervical cancer and the screening test and also less likely to use Pap smear services than non-refugee women. The analysis identified belief systems, lack of knowledge about cervical cancer and screening practices, and lack of culturally appropriate screening programs as major barriers. In the context of health promotion interventions, these findings will contribute to addressing major differential screening needs among African immigrant refugee and non-refugee women.

Online learning an effective means for developing small business owner-managers’ capabilities?

Purpose If owner-managers engage in management development activities then chances of success may be improved for small businesses. But small business owner-managers (SBOMs) are a difficult group to engage in management development activities. While practitioners worry about timing, content and location of development activities, the purpose of this paper is to examine what drives SBOMs to participate in an online discussion forum (ODF) as a form of management development. An ODF was run with SBOMs and the factors affecting their participation are reported from this exploratory study. Design/methodology/approach A qualitative methodology was used where data gathered from three sources, the ODF posts, in-depth interviews with participants and a focus group with non-participants. These were analysed to evaluate factors affecting participation of SBOMs in an ODF. Findings The findings point to the importance of owner-managers’ attitudes. Attitudes that positively affected SBOMs participation in the ODF included; appreciating that learning leads to business success; positive self-efficacy developed through prior online experience; and an occupational identity as a business manager. Research limitations/implications Few SBOMs participated in the ODF, which is consistent with research finding that they are a difficult group to engage in management development learning activities. Three forms of data were analysed to strengthen results. Practical implications Caution should be exercised when considering investment in e-learning to develop the managerial capabilities of SBOMs. Originality/value Evidence of the factors important for participation in an informal voluntary ODF. The findings suggest greater emphasis should be placed on changing attitudes if SBOMs are to be encouraged to participate in management development activities.

Small firm internationalisation and the objective characteristics of managers: An importer's relationship marketing perspective

As a result of competitive pressures, firms are transitioning to international sourcing and initiating complex relationships with suppliers. Despite a lack of inward internationalisation research, there is progressive support for the importance of importing. Heavier focus has been placed on downstream efforts in past years, despite the fact that many factors affecting exporting also influence importing. For small and medium sized enterprises (SME), the psychic distance construct is especially important for internationalisation behaviour but there is little evidence on how perceptual psychic distance, that is the individual’s experiences, influences the buyer-seller relationship. This study draws on internationalisation process theory and commitment-trust theory, in an effort to describe the relationship between objective characteristics (i.e. language, cultural background, education and international experience) and relationship marketing (trust and commitment). The study utilises a holistic, multiple case study design to gain a deeper understanding of the inherent complexities of the relationships in dyads and how objective characteristics, which reduce psychic distance, can facilitate trust and commitment development between importers and exporters.

CXCL10, CXCL11, HLA-A and IL-1β are induced in peripheral blood mononuclear cells from women withChlamydia trachomatisrelated infertility

Chlamydia trachomatis infections can result in the development of serious sequelae such as pelvic inflammatory disease and tubal infertility. In this study, peripheral blood mononuclear cells from women who were undergoing or had recently undergone IVF treatment were cultured ex vivo with C. trachomatis to identify the immune responses associated with women who had serological evidence of a history of Chlamydia infection. Cytokines secreted into the supernatant from the cultures were measured using ELISA, and the level of IL-1β was found to be significantly higher in Chlamydia positive women than Chlamydia negative women. qRT-PCR analysis of the expression of 88 immune-related genes showed trends towards an upregulation of CXCL10, CXCL11 and HLA-A in Chlamydia positive women compared with Chlamydia negative women. These findings support that some women launch a more marked proinflammatory response upon infection with C. trachomatis and this may be associated with why C. trachomatis induces infertility in some infected women.

8-13 Hz fluctuations in rectal pressure are an objective marker of clitorally-induced orgasm in women

Orgasm is a subjective experience accompanied by involuntary muscle contractions. We hypothesized that orgasm in women would be distinguishable by frequency analysis of a perineal muscle-derived signal. Rectal pressure, an index of perineal muscle activity, was measured continuously in 23 healthy women during different sexual tasks: receiving clitoral stimulation, imitation of orgasm, and attempt to reach orgasm, in which case the women were asked to report whether orgasm had been reached ("orgasm") or not ("failed orgasm attempt"). We performed spectral analysis on the rectal pressure data and calculated the spectral power in the frequency bands delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), and beta (13-25 Hz). The most significant and most important difference in spectral power between orgasm and both control motor tasks (imitation of orgasm and failed orgasm attempt) was found in the alpha band. An objective rule based on spectral power in the alpha band recognized 94% (29/31) of orgasms and correctly labeled 69% (44/64) of all orgasm attempts as either successful or failed. Because outbursts of alpha fluctuations in rectal pressure only occurred during orgasm and not during voluntary imitation of orgasm or failed attempts, we propose that they represent involuntary contractions of muscles in the rectal vicinity. This is the first objective and quantitative measure that has a strong correspondence with the subjective experience of orgasm.

Human and pathogen factors associated with chlamydia trachomatis-related infertility in women

Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen worldwide. Infection can result in serious reproductive pathologies, including pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. However, the processes that result in these reproductive pathologies have not been well defined. Here we review the evidence for the human disease burden of these chlamydial reproductive pathologies. We then review human-based evidence that links Chlamydia with reproductive pathologies in women. We present data supporting the idea that host, immunological, epidemiological, and pathogen factors may all contribute to the development of infertility. Specifically, we review the existing evidence that host and pathogen genotypes, host hormone status, age of sexual debut, sexual behavior, coinfections, and repeat infections are all likely to be contributory factors in development of infertility. Pathogen factors such as infectious burden, treatment failure, and tissue tropisms or ascension capacity are also potential contributory factors. We present four possible processes of pathology development and how these processes are supported by the published data. We highlight the limitations of the evidence and propose future studies that could improve our understanding of how chlamydial infertility in women occurs and possible future interventions to reduce this disease burden.

Gendering and racialising self-determination: Indigenous women and patriarchal whiteness

Indigenous peoples have the right of self-determination, in accordance with international law by virtue of which tehy may freely determine their political status and institutions and freely pursue their economic, social and cultural development. an integral part of this is the right to autonomy and self-government. The essential feature of racism is not hostility or misperception, but rather the defense [sic] of a system from which advantage is derived on the basis of race. The manner in which the defense [sic] is articulated - either as hostility or subtlety - is not nearly as important as the fact that it insures the continuation of a privileged relationship.