Contributors to life satisfaction in parents of an adult child with Down syndrome

Aim: This study investigated: (1) concurrent relationships between measures of family life and parental satisfaction with life in parents of an adult with Down syndrome and (2) influence of early family functioning on current parental satisfaction. Method: Sixty-two families were interviewed using a semi-structured interview, and responded to a series of questionnaires related to family functioning when their child with Down syndrome was between 7 and 15 years. Fifteen years later parents were asked to provide data on their current situation, including mental health, and satisfaction and difficulties with respect to care-giving in relation to their adult child. Results: Over half the families provided data to the second phase of the study. Life circumstances were appreciably worse for a small group of families than had been the case 15 years previously; however, these changes were generally unrelated to their parenting role. Overall, parents reported experiencing satisfaction from their care-giving role and did not report high levels of difficulties emanating from this role. Conclusions: Most parents demonstrated good levels of personal functioning, although there was a small group for whom this was not the case. Earlier functioning did not make a strong contribution to current levels of life satisfaction.

Does metabolic compensation explain the majority of less-than-expected weight loss in obese adults during a short-term severe diet and exercise intervention?

Objective: We investigated to what extent changes in metabolic rate and composition of weight loss explained the less-than-expected weight loss in obese men and women during a diet-plus-exercise intervention. Design: 16 obese men and women (41 ± 9 years; BMI 39 ± 6 kg/m2) were investigated in energy balance before, after and twice during a 12-week VLED (565–650 kcal/day) plus exercise (aerobic plus resistance training) intervention. The relative energy deficit (EDef) from baseline requirements was severe (74-87%). Body composition was measured by deuterium dilution and DXA and resting metabolic rate (RMR) by indirect calorimetry. Fat mass (FM) and fat-free mass (FFM) were converted into energy equivalents using constants: 9.45 kcal/gFM and 1.13 kcal/gFFM. Predicted weight loss was calculated from the energy deficit using the '7700 kcal/kg rule'. Results: Changes in weight (-18.6 ± 5.0 kg), FM (-15.5 ± 4.3 kg), and FFM (-3.1 ± 1.9 kg) did not differ between genders. Measured weight loss was on average 67% of the predicted value, but ranged from 39 to 94%. Relative EDef was correlated with the decrease in RMR (R=0.70, P<0.01) and the decrease in RMR correlated with the difference between actual and expected weight loss (R=0.51, P<0.01). Changes in metabolic rate explained on average 67% of the less-than-expected weight loss, and variability in the proportion of weight lost as FM accounted for a further 5%. On average, after adjustment for changes in metabolic rate and body composition of weight lost, actual weight loss reached 90% of predicted values. Conclusion: Although weight loss was 33% lower than predicted at baseline from standard energy equivalents, the majority of this differential was explained by physiological variables. While lower-than-expected weight loss is often attributed to incomplete adherence to prescribed interventions, the influence of baseline calculation errors and metabolic down-regulation should not be discounted.

Examination of relationships and mediating effects of self-efficacy, locus of control, coping and the practice environment on caring efficacy and job satisfaction in Australian registered nurses

Background to the Problem: Improving nurses' self-efficacy and job satisfaction may improve the quality of nursing care to patients. Moreover, to work effectively and consistently with professional nursing standards, nurses have to believe they are able to make decisions about their practice. In order to identify what strategies and professional development programmes should be developed and implemented for registered nurses in the Australian context, a comprehensive profile of registered nurses and factors that affect nursing care in Australia needs to be available. However, at present, there is limited information available on a) the perceived caring efficacy and job satisfaction of registered nurses in Australia, and b) the relationships between the demographic variables general self-efficacy, work locus of control, coping styles, the professional nursing practice environment and caring efficacy and job satisfaction of registered nurses in Australia. This is the first study to 1) investigate relationships between caring efficacy and job satisfaction with factors such as general self-efficacy, locus of control and coping, 2) the nursing practice environment in the Australian context and 3) conceptualise a model of caring efficacy and job satisfaction in the Australian context. Research Design and Methods: This study used a two-phase cross-sectional survey design. A pilot study was conducted in order to determine the validity and reliability of the survey instruments and to assess the effectiveness of the participant recruitment process. The second study of the research involved investigating the relationships between the socio-demographic, dependent and independent variables. Socio-demographic variables included age, gender, level of education, years of experience, years in current job, employment status, geographical location, specialty area, health sector, state and marital status. Other independent variables in this study included general self-efficacy, work locus of control, coping styles and the professional nursing practice environment. The dependent variables were job satisfaction and caring efficacy. Results: A confirmatory factor analysis of the Brisbane Practice Environment Measure (B-PEM) was conducted. A five-factor structure of the B-PEM was confirmed. Relationships between socio-demographic variables, caring efficacy and job satisfaction, were identified at the bivariate and multivariable levels. Further, examination using structural equation modelling revealed general self-efficacy, work locus of control, coping style and the professional nursing practice environment contributed to caring efficacy and job satisfaction of registered nurses in Australia. Conclusion: This research contributes to the literature on how socio-demographic, personal and environmental variables (work locus of control, general self-efficacy and the nursing practice environment) influence caring efficacy and job satisfaction in registered nurses in Australia. Caring efficacy and job satisfaction may be improved if general self-efficacy is high in those that have an internal work locus of control. The study has also shown that practice environments that provide the necessary resources improve job satisfaction in nurses. The results have identified that the development and implementation of strategies for professional development and orientation programmes that enhance self-efficacy and work locus of control may contribute to better quality nursing practice and job satisfaction. This may further assist registered nurses towards focusing on improving their practice abilities. These strategies along with practice environments that provide the necessary resources for nurses to practice effectively may lead to better job satisfaction. This information is important for nursing leaders, healthcare organisations and policymakers, as the development and implementation of these strategies may lead to better recruitment and retention of nurses. The study results will contribute to the national and international literature on self-efficacy, job satisfaction and nursing practice.

EPG monitoring of the probing behaviour of the common brown leafhopper Orosius orientalis on artificial diet and selected host plants

The common brown leafhopper Orosius orientalis (Hemiptera: Cicadellidae) is a polyphagous vector of a range of economically important pathogens, including phytoplasmas and viruses, which infect a diverse range of crops. Studies on the plant penetration behaviour by O. orientalis were conducted using the electrical penetration graph (EPG) technique to assist in the characterisation of pathogen acquisition and transmission. EPG waveforms representing different probing activities were acquired from adult O. orientalis probing in planta, using two host species, tobacco Nicotiana tabacum and bean Phaseolus vulgaris, and in vitro using a simple sucrose-based artificial diet. Five waveforms (O1–O5) were evident when O. orientalis fed on bean, whereas only four waveforms (O1–O4) and three waveforms (O1–O3) were observed when the leafhopper fed on tobacco and on the artificial diet, respectively. Both the mean duration of each waveform and waveform type differed markedly depending on the food substrate. Waveform O4 was not observed on the artificial diet and occurred relatively rarely on tobacco plants when compared with bean plants. Waveform O5 was only observed with leafhoppers probing on beans. The attributes of the waveforms and comparative analyses with previously published Hemipteran data are presented and discussed, but further characterisation studies will be needed to confirm our suggestions.

Examination of socio-demographics and job satisfaction in Australian registered nurses

Aims and Objectives To examine relationships between socio-demographic factors and job satisfaction and to identify if these factors predict job satisfaction levels in an Australian registered nurses. Background Reports indicate that in Australia there are 30,000 qualified nurses no longer working in the healthcare and that current nursing shortages vary as a result of certain socio-demographic variables including type of nurse, geographic, location, sector, service and organisation. Furthermore it has been revealed that there is not only a real shortage but also a pseudo-shortage (i.e. either there are not enough nurses are available, or not enough are willing to work under existing workplace conditions). International studies have found significant relationships exist between some socio-demographic factors and job satisfaction in registered nurses however there is limited information available on relationships between socio-demographic factors and job satisfaction in nurses in the Australian context. Design A cross sectional survey was undertaken of Australian registered nurses. Methods Two thousand Australian registered nurses who were members of an industrial and professional organisation were sent the questionnaire in 2008. They were stratified and randomised according to gender. Six hundred and thirty-nine registered nurses responded. Descriptive analyses, correlation analyses, one- way ANOVA tests, simple linear regression and multivariable analyses were conducted to examine further if any relationships existed between the variables. Results The majority of respondents showed positive job satisfaction scores. An ANOVA found significant positive relationships existed between job satisfaction, specialty area, health sector and Australian states. Multivariable analyses found relationships existed between specialty area, health sector, and job satisfaction. Conclusions The variables specialty area and health sector were found to be significantly associated with job satisfaction. The different specialty areas and health sectors in relation to job satisfaction should be investigated further. Clinical Relevance The study results have provided new knowledge for policy makers, organisational and nursing leaders of the socio-demographic variables that may affect job satisfaction in registered nurses in the Australian context.

Evaluating stakeholder satisfaction during public participation in major infrastructure and construction projects : a fuzzy approach

Numerous different and sometimes discrepant interests can be affected, both positively and negatively, throughout the course of a major infrastructure and construction (MIC) project. Failing to address and meet the concerns and expectations of the stakeholders involved has resulted in many project failures. One way to address this issue is through a participatory approach to project decision making. Whether the participation mechanism is effective or not depends largely on the client/owner. This paper provides a means of systematically evaluating the effectiveness of the public participation exercise, or even the whole project, through the measurement of stakeholder satisfaction. Since the process of satisfaction measurement is complicated and uncertain, requiring approximate reasoning involving human intuition, a fuzzy approach is adopted. From this, a multi-factor hierarchical fuzzy comprehensive evaluation model is established to facilitate the evaluation of satisfaction in both single stakeholder group and overall MIC project stakeholders.

Diet-induced obesity : when does consumption become overconsumption?

Overconsumption is commonly implicated in the aetiology of obesity; however there is a lack of consensus on a definition and the most appropriate methodology for assessing it. The aim of this communication is to highlight the need for theoretical consensus on the assessment of overconsumption, which may lead to improved methodological standards in obesity research. In laboratory studies, overconsumption is most frequently inferred from the comparison of food intake within or between individuals against a single control. Measurement often relies on a single eating episode with limited consideration of preceding or subsequent intake. An alternative approach is to consider food intake in the context of energy requirements, within an energy balance framework. One such marker of chronic overconsumption is body weight. There is a need for agreement on the definition and measurement of overconsumption, so that its role in weight gain and obesity can be more precisely delineated.

Diet, physical activity and substrate oxidation : implications for appetite control, weight loss and body composition

In many countries, governments and health agencies are strongly promoting physical activity as a means to prevent the accumulation of fatness that leads to weight gain and obesity. However, there is often a resistance to respond to health promotion initiatives. For example, in the UK, the Chief Medical Officer has recently reported that 71% of women and 61% of men fail to carry out even the minimal amount of physical activity recommended in the government’s guidelines. Similarly, the Food safety Agency has promoted reductions in the intake of fat, sugar and salt but with very little impact on the pattern of consumption. Why is it that recommendations to improve health are so difficult to implement, and produce the desired outcome?

Developing a predictive contractor satisfaction model (CoSMo) for construction projects

Over the last few decades, construction project performance has been evaluated due to the increase of delays, cost overruns and quality failures. Growing numbers of disputes, inharmonious working environments, conflict, blame cultures, and mismatches of objectives among project teams have been found to be contributory factors to poor project performance. Performance measurement (PM) approaches have been developed to overcome these issues, however, the comprehensiveness of PM as an overall approach is still criticised in terms of the iron triangle; namely time, cost, and quality. PM has primarily focused on objective measures, however, continuous improvement requires the inclusion of subjective measures, particularly contractor satisfaction (Co-S). It is challenging to deal with the two different groups of large and small-medium contractor satisfaction as to date, Co-S has not been extensively defined, primarily in developing countries such as Malaysia. Therefore, a Co-S model is developed in this research which aims to fulfil the current needs in the construction industry by integrating performance measures to address large and small-medium contractor perceptions. The positivist paradigm used in the research was adhered to by reviewing relevant literature and evaluating expert discussions on the research topic. It yielded a basis for the contractor satisfaction model (CoSMo) development which consists of three elements: contractor satisfaction (Co-S) dimensions; contributory factors and characteristics (project and participant). Using valid questionnaire results from 136 contractors in Malaysia lead to the prediction of several key factors of contractor satisfaction and to an examination of the relationships between elements. The relationships were examined through a series of sequential statistical analyses, namely correlation, one-way analysis of variance (ANOVA), t-tests and multiple regression analysis (MRA). Forward and backward MRAs were used to develop Co-S mathematical models. Sixteen Co-S models were developed for both large and small-medium contractors. These determined that the large contractor Malaysian Co-S was most affected by the conciseness of project scope and quality of the project brief. Contrastingly, Co-S for small-medium contractors was strongly affected by the efficiency of risk control in a project. The results of the research provide empirical evidence in support of the notion that appropriate communication systems in projects negatively contributes to large Co-S with respect to cost and profitability. The uniqueness of several Co-S predictors was also identified through a series of analyses on small-medium contractors. These contractors appear to be less satisfied than large contractors when participants lack effectiveness in timely authoritative decision-making and communication between project team members. Interestingly, the empirical results show that effective project health and safety measures are influencing factors in satisfying both large and small-medium contractors. The perspectives of large and small-medium contractors in respect to the performance of the entire project development were derived from the Co-S models. These were statistically validated and refined before a new Co-S model was developed. Developing such a unique model has the potential to increase project value and benefit all project participants. It is important to improve participant collaboration as it leads to better project performance. This study may encourage key project participants; such as client, consultant, subcontractor and supplier; to increase their attention to contractor needs in the development of a project. Recommendations for future research include investigating other participants‟ perspectives on CoSMo and the impact of the implementation of CoSMo in a project, since this study is focused purely on the contractor perspective.

Enriching students’ intellectual diet through inquiry based learning

Traditionally, Science education has stressed the importance of teaching students to conduct ‘scientific inquiry’, with the main focus being the experimental model of inquiry used by real world scientists. Current educational approaches using constructivist pedagogy recognise the value of inquiry as a method for promoting the development of deep understanding of discipline content. A recent Information Learning Activity undertaken by a Grade Eight Science class was observed to discover how inquiry based learning is implemented in contemporary Science education. By analysing student responses to questionnaires and assessment task outcomes, the author was able to determine the level of inquiry inherent in the activity and how well the model supported student learning and the development of students’ information literacy skills. Although students achieved well overall, some recommendations are offered that may enable teachers to better exploit the learning opportunities provided by inquiry based learning. Planning interventions at key stages of the inquiry process can assist students to learn more effective strategies for dealing with cognitive and affective challenges. Allowing students greater input into the selection of topic or focus of the activity may encourage students to engage more deeply with the learning task. Students are likely to experience greater learning benefit from access to developmentally appropriate resources, increased time to explore topics and multiple opportunities to undertake information searches throughout the learning activity. Finally, increasing the cognitive challenge can enhance both the depth of students’ learning and their information literacy skills.

Patient expectations, outcomes and satisfaction : related, relevant or redundant?

Abstract Study design: A prospective investigation of patients undergoing lumbar spine surgery. Objective: Is there a correlation between patient’s expectations before lumbar surgery, postoperative outcomes and satisfaction levels? Methods: A prospective study of 145 patients undergoing primary, single-level surgery for degenerative lumbar conditions was conducted. Oswestry Disability Index (ODI), back visual analogue scale (VAS) and leg VAS were assessed pre-operatively and at 6 weeks and 6 months post-surgery. Patients’ expectations were measured pre-operatively by asking them to score the level of pain and disability that would be least acceptable for them to undergo surgery and be satisfied. Satisfaction was assessed six weeks post-operatively with a Likert scale. Differences in patient expectations between actual and expected improvements were quantified. Results: Most patients had a clinically relevant improvement, but only about half achieved their expectation. Satisfaction did not correlate with pre-operative pain or disability, or with patient expectation of improvement. Instead, satisfaction correlated with positive outcomes. Conclusions Patient expectations have little bearing on final outcome and satisfaction.

Associations exist between food insecurity, poor diet, chronic illness and obesity among an Australian population

Food insecurity is the limited availability of, or access to, sufficient amounts of nutritious, culturally-appropriate and safe foods, or the inability to access such foods by socially-acceptable means. Evidence from the United States and Canada suggests that food insecurity may be associated with poor dietary intakes, obesity, and chronic disease including depression and diabetes, thus constituting a significant public health issue. Currently, no existing studies have investigated the dietary and health factors associated with food insecurity among the general Australian population. The current study investigated the potential associations between food insecurity, diet and health among Australian adults (18 years and over) participating in the cross-sectional National Health Survey (n = 19,500). Data were analysed by logistic regression adjusting for sociodemographic covariates. Those from food insecure households were 50% less likely to consume the recommended number of servings of fruit, 60% more likely to report poor health and experienced a 6-fold increase in the risk of severe depressive disorders, compared to their food secure counterparts. Furthermore, food insecurity was associated with a 50% increase in the risk of being diagnosed with ‘high sugar levels’. Finally, women from food insecure households were 30% more likely to be obese compared to their food secure counterparts. These findings suggest that food insecurity may play an important role in preventing adherence with national dietary recommendations, and may increase the risk of obesity and chronic illness. This has important implications for both clinical practice, and the development of interventions and policy to address food insecurity.

Job satisfaction in haemodialysis nurses : results from a two country study

• Australian nurses report lower levels of job satisfaction than the broader working population and perceive they have limited influence over important workplace decisions. • Higher levels of nurse job satisfaction is positively linked to improved quality of care, patient outcomes and staff retention. • Identifying factors that contribute to job satisfaction can improve retention of highly skilled and specialised haemodialysis nurses. • Contributors to job satisfaction and current levels of job satisfaction are poorly understood in the Australia and New Zealand context.