Factors contributing to nurse job satisfaction in the acute hospital setting : a review of recent literature

Aim  To explore and discuss from recent literature the common factors contributing to nurse job satisfaction in the acute hospital setting. Background  Nursing dissatisfaction is linked to high rates of nurses leaving the profession, poor morale, poor patient outcomes and increased financial expenditure. Understanding factors that contribute to job satisfaction could increase nurse retention. Evaluation  A literature search from January 2004 to March 2009 was conducted using the keywords nursing, (dis)satisfaction, job (dis)satisfaction to identify factors contributing to satisfaction for nurses working in acute hospital settings. Key issues  This review identified 44 factors in three clusters (intra-, inter- and extra-personal). Job satisfaction for nurses in acute hospitals can be influenced by a combination of any or all of these factors. Important factors included coping strategies, autonomy, co-worker interaction, direct patient care, organizational policies, resource adequacy and educational opportunities. Conclusions  Research suggests that job satisfaction is a complex and multifactorial phenomenon. Collaboration between individual nurses, their managers and others is crucial to increase nursing satisfaction with their job. Implications for nursing management  Recognition and regular reviewing by nurse managers of factors that contribute to job satisfaction for nurses working in acute care areas is pivotal to the retention of valued staff.

Action inquiry into the use of standardized evaluation tools for music therapy : a real life journey within a parent-child community program

Sing & Grow is an early intervention music therapy project that provides community group music therapy programs to families with young children who encounter risk factors that may impact on parenting and optimal child develop variety of evaluation tools were devised and used over the first 3 years of the project. Upon the subsequent funding and expansion of the project at the end of this period, it was necessary to find, test and devise more rigorous, valid and reliable measures to withstand the scrutiny of researchers, and to combat the concerns and criticisms associated with the previous methods of data collection. An action inquiry project was therefore undertaken with two groups of project participants to trial the use of the Parenting Stress Index and Depression, Anxiety and Stress Scales, both recommended by leading psychologists. Key findings that will be discussed include the friction between the deficit-focussed nature of many psychometric tools and the strengths-based approach taken in service delivery, the level of difficulty in terms of literacy and comprehension for vulnerable respondents, and the lack of one tool with the ability to comprehensively measure all aspects of a broad scoping program. Keywords: music therapy, evaluation, PSI, DASS, action inquiry.

From go to woe : how a not-for-profit managed the change to accrual accounting

Purpose – The aim of this paper is to examine the process of change in an Australian not-for-profit organization, from a cash-based to an accrual-based accounting system. Its particular focus is the relationship between the image portrayed by accrual accounting adoption and the technical realities of the new system. Design/methodology/approach – Data were gathered from interviews, documents and meetings, and were contextualized and interpreted using institutional theory. Findings – The decision to change to accrual accounting was made at the top of the organizational hierarchy in response to institutional pressure to present a corporate image. The implementation of the new system was poorly conceived, inadequately resourced, and hampered by an authoritarian structure that effectively ignored the technical incompetence and training needs of many accounting staff. This resulted in an accounting system half way between cash and accrual, and very different from the system as it had been promoted. The process caused conflict at all levels of the organizational hierarchy. Research limitations/implications – Accounting in not-for-profit organizations is an under-researched area offering potential for fruitful research in a changing institutional landscape. This institutional approach, while offering just one interpretation of the qualitative data gathered in this project, provides valuable insights about the process of change. Practical implications – Not-for-profit organizations play a vital economic and social role, and need carefully to assess their responses to ongoing institutional pressures. In implementing change, they face the challenge of balancing the promotion of an institutionally acceptable image and the need for technical efficiencies. Originality/value – The examination of change in an organization provides a rich context for the exploration of the dynamic, problematic process by which a new accounting practice is embedded and institutionalized. Keywords Institutional theory, Not-for-profit organizations, Accrual accounting, Change process, Qualitative research, Change management, Decision making, Training needs, Australia Paper type Research paper

Obligatory dangerousness criteria in the involuntary commitment and treatment provisions of Australian mental health legislation

Abstract Objective Involuntary commitment and treatment (IC&T) of people affected by mental illness may have reference to considerations of dangerousness and/or need for care. While attempts have been made to classify mental health legislation according to whether IC&T has obligatory dangerousness criteria, there is no standardised procedure for making classification decisions. The aim of this study was to develop and trial a classification procedure and apply it to Australia's mental health legislation. Method We developed benchmarks for ‘need for care’ and ‘dangerousness’ and applied these benchmarks to classify the mental health legislation of Australia's 8 states and territories. Our focus was on civil commitment legislation rather than criminal commitment legislation. Results One state changed its legislation during the course of the study resulting in two classificatory exercises. In our initial classification, we were able to classify IC&T provisions in legislation from 6 of the 8 jurisdictions as being based on either ‘need for care’ or ‘dangerousness’. Two jurisdictions used a terminology that was outside the established benchmarks. In our second classification, we were also able to successfully classify IC&T provisions in 6 of the 8 jurisdictions. Of the 6 Acts that could be classified, all based IC&T on ‘need for care’ and none contained mandatory ‘dangerousness’ criteria. Conclusions The classification system developed for this study provided a transparent and probably reliable means of classifying 75% of Australia's mental health legislation. The inherent ambiguity of the terminology used in two jurisdictions means that further development of classification may not be possible until the meaning of the terms used has been addressed in case law. With respect to the 6 jurisdictions for which classification was possible, the findings suggest that Australia's mental health legislation relies on ‘need for care’ and not on ‘dangerousness’ as the guiding principle for IC&T. Keywords: Involuntary commitment; Mental health legislation; Dangerousness; Australia

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers

Objective: In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. Method: A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. Results: The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Conclusion: Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy. Keywords: case management, caseload, stress

Attachment Security and Alexithymia in a Heavy Drinking Population

Attachment difficulties have been proposed as a key risk factor for the development of alexithymia, a multifaceted personality trait characterised by difficulties identifying and describing feelings, a lack of imagination and an externally oriented thinking style. The present study investigated the relationship between attachment and alexithymia in an alcohol dependent population. Participants were 210 outpatients in a Cognitive Behavioural Treatment Program assessed on the Toronto Alexithymia Scale (TAS-20) and the Revised Adult Attachment Scale (RAAS). Significant relationships between anxious attachment and alexithymia factors were confirmed. Furthermore, alexithymic alcoholics reported significantly higher levels of anxious attachment and significantly lower levels of closeness (secure attachment) compared to non-alexithymic alcoholics. These findings highlight the importance of assessing and targeting anxious attachment among alexithymic alcoholics in order to improve alcohol treatment outcomes. Keywords: Attachment, alexithymia, alcohol dependence.

Information Behavior: A Socio-Cognitive Ability

Abstract: How has human information behavior evolved? Our paper explores this question in the form of notions, models and theories about the relationship between information behavior and human evolution. Alexander’s Ecological Dominance and Social Competition/Cooperation (EDSC) model currently provides the most comprehensive overview of human traits in the development of a theory of human evolution and sociality. His model provides a basis for explaining the evolution of human socio-cognitive abilities, including ecological dominance, and social competition/cooperation. Our paper examines the human trait of information behavior as a socio-cognitive ability related to ecological dominance, and social competition/cooperation. The paper first outlines what is meant by information behavior from various interdisciplinary perspectives. We propose that information behavior is a socio-cognitive ability that is related to and enables other sociocognitive abilities such as human ecological dominance, and social competition/cooperation. The paper reviews the current state of evolutionary approaches to information behavior and future directions for this research . Keywords: information behavior, socio-cognitive ability, ecological dominance, social competition, social cooperation.

Linking perceived value of mobile marketing with the experiential consumption of mobile phones

Purpose – This study examines the nature of consumers’ perceptions of the value they derive from the everyday experiential consumption of mobile phones and how mobile marketing (m-marketing) can potentially enhance these value perceptions. Methodology – Q methodology is used to examine how consumers’ subjective perceptions and opinions are shared at a collective level. Forty participants undertook two Q sorts and the data was analysed using PQ-method. Findings – The first Q sort identified three profiles of perceived value: the Mobile Pragmatists, the Mobile Connectors and the Mobile Revellers. The second Q sort identified two profiles of perceived value of m-marketing: one emerging from the shared opinions of the Mobile Pragmatists and the Mobile Connectors, and the second from the Mobile Revellers. Implications/limitations – The findings show how consumers can be segmented based on their contextualised perceived value of consuming mobile phones and how the potential for m-marketing is perceived in ways that can enhance these value perceptions. Limitations relate to deriving statements for the Q sorts and the generalisability of the results. Practical implications – The findings highlight ways to tailor m-marketing strategies to complement consumers’ perceptions of the value offered through their mobile phones. Originality/value of paper – The study contributes to the literature through using Q methodology to examine two subjective areas of consumer behaviour, experiential consumption and consumer perceived value. Keywords mobile phones, mobile phone marketing, consumer perceived value, Q methodology, experiential consumption Classification Research paper

A review of commuter exposure to ultrafine particles and its health effects

Ultrafine particles (UFPs, <100 nm) are produced in large quantities by vehicular combustion and are implicated in causing several adverse human health effects. Recent work has suggested that a large proportion of daily UFP exposure may occur during commuting. However, the determinants, variability and transport mode-dependence of such exposure are not well-understood. The aim of this review was to address these knowledge gaps by distilling the results of ‘in-transit’ UFP exposure studies performed to-date, including studies of health effects. We identified 47 exposure studies performed across 6 transport modes: automobile, bicycle, bus, ferry, rail and walking. These encompassed approximately 3000 individual trips where UFP concentrations were measured. After weighting mean UFP concentrations by the number of trips in which they were collected, we found overall mean UFP concentrations of 3.4, 4.2, 4.5, 4.7, 4.9 and 5.7 × 10^4 particles cm^-3 for the bicycle, bus, automobile, rail, walking and ferry modes, respectively. The mean concentration inside automobiles travelling through tunnels was 3.0 × 10^5 particles cm^-3. While the mean concentrations were indicative of general trends, we found that the determinants of exposure (meteorology, traffic parameters, route, fuel type, exhaust treatment technologies, cabin ventilation, filtration, deposition, UFP penetration) exhibited marked variability and mode-dependence, such that it is not necessarily appropriate to rank modes in order of exposure without detailed consideration of these factors. Ten in-transit health effects studies have been conducted and their results indicate that UFP exposure during commuting can elicit acute effects in both healthy and health-compromised individuals. We suggest that future work should focus on further defining the contribution of in-transit UFP exposure to total UFP exposure, exploring its specific health effects and investigating exposures in the developing world. Keywords: air pollution; transport modes; acute health effects; travel; public transport

Sri Lanka in global medical research: a scientific analysis of the Sri Lankan research output during 2000-2009

Background Scientific research is an essential component in guiding improvements in health systems. There are no studies examining the Sri Lankan medical research output at international level. The present study evaluated the Sri Lankan research performance in medicine as reflected by the research publications output between years 2000-2009. Methods This study was based on Sri Lankan medical research publication data, retrieved from the SciVerse Scopus® from January 2000 to December 2009. The process of article selection was as follows: Affiliation - 'Sri Lanka' or 'Ceylon', Publication year - 'January 2000 to December 2009' and Subject area - 'Life and Health Sciences'. The articles identified were classified according to disease, medical speciality, institutions, major international collaborators, authors and journals. Results Sri Lanka's cumulative medical publications output between years 2000-2009 was 1,740 articles published in 160 different journals. The average annual publication growth rate was 9.1%. Majority of the articles were published in 'International' (n = 950, 54.6%) journals. Most articles were descriptive studies (n = 611, 35.1%), letters (n-345, 19.8%) and case reports (n = 311, 17.9%). The articles were authored by 148 different Sri Lankan authors from 146 different institutions. The three most prolific local institutions were Universities of; Colombo (n = 547), Kelaniya (n = 246) and Peradeniya (n = 222). Eighty four countries were found to have published collaborative papers with Sri Lankan authors during the last decade. UK was the largest collaborating partner (n = 263, 15.1%). Malaria (n = 75), Diabetes Mellitus (n = 55), Dengue (n = 53), Accidental injuries (n = 42) and Lymphatic filariasis (n = 40) were the major diseases studied. The 1,740 publications were cited 9,708 times, with an average citation of 5.6 per paper. The most cited paper had 203 citations, while there were 597 publications with no citations. The Sri Lankan authors' contribution to the global medical research output during the last decade was only 0.086%. Conclusion The Sri Lankan medical research output during the last decade is only a small fraction of the global research output. There it is a necessity to setup an enabling environment for research, with a proper vision, support, funds and training. In addition, collaborations across the region need to be strengthened to face common regional health challenges. Keywords: Sri Lanka, Medical research, Publication, Analysis

Sporadic childhood Burkitt lymphoma incidence in the United States during 1992-2005

Background The risk factors and co-factors for sporadic childhood BL are unknown. We investigated demographic and age-specific characteristics of childhood BL (0–14 years) in the U.S. Procedure BL age-standardized incidence rates (2000 U.S. standard population), were calculated using data obtained from 12 registries in the NCI’s Surveillance, Epidemiology, and End Results program for cases diagnosed from 1992 through 2005. Incidence rate ratios and 95% confidence intervals (95% CI) were calculated by gender, age-group, race, ethnicity, calendar-year period, and registry. Results Of 296 cases identified, 56% were diagnosed in lymph nodes, 21% in abdominal organs, not including retroperitoneal lymph nodes, 14% were Burkitt cell leukemia, and 9% on face/head structures. The male-to-female case ratio was highest for facial/head tumors (25:1) and lowest for Burkitt cell leukemia (1.6:1). BL incidence rate was 2.5 (95% CI 2.3–2.8) cases per million person-years and was higher among boys than girls (3.9 vs. 1.1, p<0.001) and higher among Whites and Asians/Pacific Islanders than among Blacks (2.8 and 2.9 vs.1.2, respectively, p<0.001). By ethnicity, BL incidence was higher among non-Hispanic Whites than Hispanic Whites (3.2 vs. 2.0, p=0.002). Age-specific incidence rate for BL peaked by age 3–5 years (3.4 cases per million), then stabilized or declined with increasing age, but it did not vary with calendar-year or registry area. Conclusions Our results indicate that early childhood exposures, male-sex, and White race may be risk factors for sporadic childhood BL in the United States. Keywords: epidemiology, pediatric cancer, non-Hodgkin lymphoma, HIV/AIDS

Timing of births and endometrial cancer risk in Swedish women

While a protective long-term effect of parity on endometrial cancer risk is well established, the impact of timing of births is not fully understood. We examined the relationship between endometrial cancer risk and reproductive characteristics in a population-based cohort of 2,674,465 Swedish women, 20–72 years of age. During follow-up from 1973 through 2004, 7,386 endometrial cancers were observed. Compared to uniparous women, nulliparous women had a significantly elevated endometrial cancer risk (hazard ratio [HR] = 1.32, 95% confidence interval [CI], 1.22–1.42). Endometrial cancer risk decreased with increasing parity; compared to uniparous women, women with ≥4 births had a HR=0.66 (95% CI, 0.59–0.74); p-trend < 0.001. Among multiparous women, we observed no relationship of risk with age at first birth after adjustment for other reproductive factors. While we initially observed a decreased risk with later ages at last birth, this appeared to reflect a stronger relationship with time since last birth, with women with shorter times being at lowest risk. In models for multiparous women that included number of births, age at first and last birth, and time since last birth, age at last birth was not associated with endometrial cancer risk, while shorter time since last birth and increased parity were associated with statistically significantly reduced endometrial cancer risks. The HR was 3.95 (95%CI; 2.17–7.20; p-trend=<0.0001) for women with ≥25 years since a last birth compared to women having given birth within 4 years. Our findings support that clearance of initiated cells during delivery may be important in endometrial carcinogenesis. Keywords: endometrial carcinoma, parity, registry, reproductive factors

Incidence and geographic distribution of endemic Burkitt lymphoma in northern Uganda revisited

Endemic Burkitt lymphoma (BL) is etiologically associated with Epstein-Barr virus (EBV) and ecologically linked to Plasmodium falciparum malaria. However, these infections imperfectly correlate with BL epidemiology. To obtain recent epidemiological data, we studied district- and county-specific BL incidence and standardized incidence ratios using data collected from 1997 through 2006 at Lacor Hospital in northern Uganda, where studies were last done more than 30 years ago. Among 500 patients, median age was 6 years (inter-quartile range 5-8) and male-to-female ratio was 1.8:1. Among those known, most presented with abdominal (56%, M: F 1.4:1) vs. only facial tumors (35%, M: F 3.0:1). Abdominal tumors occurred in older (mean age: 7.0 vs. 6.0 years; p<0.001) and more frequently in female children (68% vs. 50%; OR 2.2, 95% CI 1.5-3.5). The age-standardized incidence was 2.4 per 100,000, being 0.6 in 1-4 year olds, 4.1 in 5-9 year olds and 2.8 in 10-14 year olds and varied 3-4-fold across districts. The incidence was lower in districts that were far from Lacor and higher in districts that were close to Lacor. While districts close to Lacor were also more urbanized, the incidence was higher in the nearby perirural areas. We highlight high BL incidence and geographic variation in neighboring districts in northern Uganda. While distance from Lacor clearly influenced the patterns, the incidence was lower in municipal than in surrounding rural areas. Jaw tumors were characterized by young age and male gender, but presentation has shifted away from facial to mostly abdominal. Keywords: Africa, cancer, malaria, Epstein-Barr virus, clustering, epidemiology

Pass the scissors : consumers close in on the fashion industry

The fashion ecosystem is at boiling point as consumers turn up the heat in all areas of the fashion value, trend and supply chain. While traditionally fashion has been a monologue from designer brand to consumer, new technology and the virtual world has given consumers a voice to engage brands in a conversation to express evolving needs, ideas and feedback. Product customisation is no longer innovative. Successful brands are including customers in the design process and holding conversations ‘with’ them to improve product, manufacturing, sales, distribution, marketing and sustainable business practices. Co-creation and crowd sourcing are integral to any successful business model and designers and manufacturers are supplying the technology or tools for these creative, active, participatory ‘prosumers’. With this collaboration however, there arises a worrying trend for fashion professionals. The ‘design it yourself’, ‘indiepreneur’ who with the combination of technology, the internet, excess manufacturing capacity, crowd funding and the idea of sharing the creative integrity of a product (‘copyleft’ not copyright) is challenging the notion that the fashion supply chain is complex. The passive ‘consumer’ no longer exists. Fashion designers now share the stage with ‘amateur’ creators who are disrupting every activity they touch, while being motivated by profit as well as a quest for originality and innovation. This paper examines the effects this ‘consumer’ engagement is having on traditional fashion models and the fashion supply chain. Crowd sourcing, crowd funding, co-creating, design it yourself, global sourcing, the virtual supply chain, social media, online shopping, group buying, consumer to consumer marketing and retail, and branding the ‘individual’ are indicative of the new consumer-driven fashion models. Consumers now drive the fashion industry - from setting trends, through to creating, producing, selling and marketing product. They can turn up the heat at any time _ and any point _ in the fashion supply chain. They are raising the temperature at each and every stage of the chain, decreasing or eliminating the processes involved: decreasing the risk of fashion obsolescence, quantities for manufacture, complexity of distribution and the consumption of product; eliminating certain stages altogether and limiting the brand as custodians of marketing. Some brands are discovering a new ‘enemy’ – the very people they are trying to sell to. Keywords: fashion supply chain, virtual world, consumer, ‘prosumers’, co-creation, fashion designers

Post-graduate health promotion students assess their information literacy

Purpose - The purpose of this paper is to examine post-graduate health promotion students’ self-perceptions of information literacy skills prior to, and after completing PILOT, an online information literacy tutorial. Design/methodology/approach – Post graduate students at Queensland University of Technology enrolled in PUP038 New Developments in Health Promotion completed a pre- and post- self-assessment questionnaire. From 2008-2011 students were required to rate their academic writing and research skills before and after completing the PILOT online information literacy tutorial. Quantitative trends and qualitative themes were analysed to establish students’ self-assessment and the effectiveness of the PILOT tutorial. Findings – The results from four years of post-graduate students’ self-assessment questionnaires provide evidence of perceived improvements in information literacy skills after completing PILOT. Some students continued to have trouble with locating quality information and analysis as well as issues surrounding referencing and plagiarism. Feedback was generally positive and students’ responses indicated they found the tutorial highly beneficial in improving their research skills. Originality/value - This paper is original because it describes post-graduate health promotion students’ self-assessment of information literacy skills over a period of four years. The literature is limited in the health promotion domain and self-assessment of post-graduate students’ information literacy skills. Keywords – Self-assessment, Post-graduate, Information literacy, Library instruction, Higher education, Health promotion, Evidence-based practice Paper Type - Research paper