Australian new graduate experiences during their transition program in a rural/regional acute setting

The transition process from student to Registered Nurse has been recognised as an important yet challenging time for newly graduated nurses. Knowledge about this experience from the nurse’s perspective, particularly in a rural setting, is limited. This paper reports the findings of a qualitative study of the experiences of newly graduated nurses working in a rural acute care facility in New South Wales. The study examined, from the perspective of the new nurse, the orientation and support which can help to facilitate the transition from student to registered nurse. Four themes emerged which were being supported, being challenged, reflections on being a new graduate, and reflections on a rural new graduate program. These findings contribute to what is know about the transition of new graduates in a rural facility and have implications for program improvements, specifically within the rural acute care environment. The findings are also relevant to students considering rural employment on graduation and for the recruitment and retention of New Graduate Registered Nurses in rural areas.

Identifying key enablers to improve business performance in Taiwanese electronic manufacturing companies

Purpose – Integrated supplier management (ISM), new product development (NPD) and knowledge sharing (KS) practices are three primary business activities utilised to enhance manufacturers' business performance (BP). The purpose of this paper is to empirically investigate the relationships between these three business activities (i.e. ISM, NPD, KS) and BP in a Taiwanese electronics manufacturing context. Design/methodology/approach – A questionnaire survey is first administered to a sample of electronic manufacturing companies operating in Taiwan to elicit the opinions of technical and managerial professionals regarding business activities and BP within their companies. A total of 170 respondents from 83 companies respond to the survey. Factor, correlation and path analysis are undertaken on this quantitative data set to derive the key factors which leverage business outcomes in these companies. Following empirical analysis, six semi-structured interviews are undertaken with manufacturing executives to provide qualitative insights into the underlying reasons why certain business activity factors are the strongest predictors of BP. Findings – The investigation shows that the ISM, NPD and KS constructs all play an important role in the success of company operations and creating business outcomes. Specifically, the key factors within these constructs which influenced BP are: supplier evaluation and selection; design simplification and modular design; information technology infrastructure and systems and open communication. Accordingly, sufficient financial and human resources should be allocated to these important activities to derive accelerated rates of improved BP. These findings are supported by the qualitative interviews with manufacturing executives. Originality/value – The paper depicts the pathways to improved manufacturing BP, through targeting efforts into the above-mentioned factors within the ISM, NPD and KS constructs. Based on the empirical path model, and the specific insights derived from the explanatory interviews with manufacturing executives, the paper also provides a number of practical implications for manufacturing companies seeking to enhance their BP through improved operational activities.

Empirical study to identify the key business activities contributing to manufacturing business performance

Purpose: Within the context of high global competitiveness, knowledge management (KM) has proven to be one of the major factors contributing to enhanced business outcomes. Furthermore, knowledge sharing (KS) is one of the most critical of all KM activities. From a manufacturing industry perspective, supply chain management (SCM) and product development process (PDP) activities, require a high proportion of company resources such as budget and manpower. Therefore, manufacturing companies are striving to strengthen SCM, PDP and KS activities in order to accelerate rates of manufacturing process improvement, ultimately resulting in higher levels of business performance (BP). A theoretical framework along with a number of hypotheses are proposed and empirically tested through correlation, factor and path analyses. Design/methodology/approach: A questionnaire survey was administered to a sample of electronic manufacturing companies operating in Taiwan to facilitate testing the proposed relationships. More than 170 respondents from 83 organisations responded to the survey. The study identified top management commitment and employee empowerment, supplier evaluation and selection, and design simplification and modular design as the key business activities that are strongly associated with the business performance. Findings: The empirical study supports that key manufacturing business activities (i.e., SCM, PDP, and KS) are positively associated with BP. The findings also evealed that some specific business activities such as SCMF1,PDPF2, and KSF1 have the strongest influencing power on particular business outcomes (i.e., BPF1 and BPF2) within the context of electronic manufacturing companies operating in Taiwan. Practical implications: The finding regarding the relationship between SCM and BP identified the essential role of supplier evaluation and selection in improving business competitiveness and long term performance. The process of forming knowledge in companies, such as creation, storage/retrieval, and transfer do not necessarily lead to enhanced business performance; only through effectively applying knowledge to the right person at the right time does. Originality/value: Based on this finding it is recommended that companies should involve suppliers in partnerships to continuously improve operations and enhance product design efforts, which would ultimately enhance business performance. Business performance depends more on an employee’s ability to turn knowledge into effective action.

Have we misinterpreted the study of Hoogerheide et al. (1971)?

In 1971, Rempt et al. reported peripheral refraction patterns (skiagrams) along the horizontal visual field in 442 people. Later in the same year, Hoogerheide et al. used skiagrams in combination with medical records to relate skiagrams in emmetropes and hyperopes to progression of myopia in young adults. The two articles have spurred interest in peripheral refraction in the past decade. We challenge the understanding that their articles provide evidence that the peripheral refraction pattern along the horizontal visual field is predictive of whether or not a person develops myopia. First, although it has been generally assumed that the skiagrams were measured before the changes in refraction were monitored, Hoogerheide et al. did not state that this was the case. Second, if the skiagrams were obtained at an initial examination and given the likely rates of recruitment and successful completion of training, the study must have taken place during a period of 10 to 15 years; it is much more likely that Hoogerheide et al. measured the skiagrams in a shorter period. Third, despite there being many more emmetropes and hyperopes in the Rempt et al. article than there are in the Hoogerheide et al. article, the number of people in two types of “at risk” skiagrams is greater in the latter; this is consistent with the central refraction status being reported from an earlier time by Hoogerheide et al. than by Rempt et al. In summary, we believe that the skiagrams reported by Hoogerheide et al. were taken at a later examination, after myopia did or did not occur, and that the refraction data from the initial examination were retrieved from the medical archives. Thus, this work does not provide evidence that peripheral refraction pattern is indicative of the likely development of myopia.

Cancer-related psychosocial research : what are the perspectives of cancer care centre users on participation?

Purpose To explore the perspectives of cancer care centre users on participation in psychosocial research to inform research design and ethics. Methods The study is based on a qualitative research design. Fourteen semistructured interviews were carried in people diagnosed with cancer and carers. The interview included four main questions about practical barriers to participation, types of research design, motivating factors and the conduct of research in a cancer care support setting. The data were analysed using qualitative content analysis. Results Interviewees demonstrated a willingness to participate in psychosocial research within certain circumstances. There were no practical barriers identified, although they considered payment for research-related travel important. The most acceptable research design was the face-to-face interview and the least preferred was the randomised control trial. The factors that motivated participation were altruism, valuing research, and making a contribution to the centre. Interviewees supported the conduct of research in cancer care support centres conditional upon delaying recruitment during the initial months of users’ visits and its need to be discreet to avoid deterring visitors from accessing the centre. Conclusions The study concludes that the personal interaction between participants and researchers is the most important feature of decision-making by patients/carers to join studies. Taking into account the perspectives of people affected by cancer during the early stages of research design may enhance recruitment and retention and can contribute to the development of research protocols and ethics.

Turnover in entrepreneurial teams : are spousal teams different?

Entrepreneurial teams are increasingly prevalent. An important stage in new venture formation involves the recruitment and retention of team members, characterised by changes in the membership of the ET. ET turnover involves members joining or leaving the team, which could have positive or negative effects on the team and the firm. Spousal Entrepreneurial Teams (SET) are a frequently occurring, yet unique type of ET, with very distinct characteristics and dynamics. In an SET turnover is likely to be have different meanings and effects than in Other Entrepreneurial Teams. This research asks: What influences members joining and leaving entrepreneurial teams? And are SET different? Using data from 561 young firms over X years, we find significant differences between SET and NSET. Specifically, we find X.

Impact of cognitive behaviour therapy via mail for cessation of benzodiazepine use : a series of case reports

Benzodiazepines are widely prescribed to manage sleep disorders, anxiety and muscular tension. While providing short-term relief, continued use induces tolerance and withdrawal, and in older users, increases the risk of falls. However, long-term prescription remains common, and effective interventions are not widely available. This study developed a self-managed cognitive behaviour therapy package for cessation of benzodiazepine use delivered to participants via mail (M-CBT) and trialled its effectiveness as an adjunct to a general practitioner (GP)-managed dose reduction schedule. In the pilot trial, participants were randomly assigned to GP management with immediate or delayed M-CBT. Significant recruitment and engagement problems were experienced, and only three participants were allocated to each condition. After immediate M-CBT, two participants ceased use, while none receiving delayed treatment reduced daily intake by more than 50%. Across the sample, doses at 12 months remained significantly lower than baseline, and qualitative feedback from participants was positive. While M-CBT may have promise, improved engagement of GPs and participants is needed for this approach to substantially impact on community-wide benzodiazepine use.

Fasting increases serum bilirubin levels in clinically normal, healthy males but not females : a retrospective study from phase I clinical trial participants

Aim: To examine if fasting affects serum bilirubin levels in clinical healthy males and females. Methods: We utilised retrospective data from phase 1 clinical trials where blood was collected in either a fed or fasting state at screening and pre-dosing time points and analysed for total bilirubin levels as per standard clinical procedures. Participants were clinically healthy males (n = 105) or females (n = 30) aged 18 to 48 inclusive who participated in a phase 1 clinical trial in 2012 or 2013. Results: We found a statistically significant increase in total serum bilirubin levels in fasting males as compared to non-fasting males. The fasting time correlated positively with increased bilirubin levels. The age of the healthy males did not correlate with their fasting bilirubin level. We found no correlation between fasting and bilirubin levels in clinically normal females. Conclusions: The recruitment and screening of volunteers for a clinical trial is a time-consuming and expensive process. This study clearly demonstrates that testing for serum bilirubin should be conducted on non-fasting male subjects. If fasting is required, then participants should not be excluded from a trial based on an elevated serum bilirubin that is deemed non-clinically significant.

Applying quantile regression for modeling equivalent property damage only crashes to identify accident blackspots

Hot spot identification (HSID) aims to identify potential sites—roadway segments, intersections, crosswalks, interchanges, ramps, etc.—with disproportionately high crash risk relative to similar sites. An inefficient HSID methodology might result in either identifying a safe site as high risk (false positive) or a high risk site as safe (false negative), and consequently lead to the misuse the available public funds, to poor investment decisions, and to inefficient risk management practice. Current HSID methods suffer from issues like underreporting of minor injury and property damage only (PDO) crashes, challenges of accounting for crash severity into the methodology, and selection of a proper safety performance function to model crash data that is often heavily skewed by a preponderance of zeros. Addressing these challenges, this paper proposes a combination of a PDO equivalency calculation and quantile regression technique to identify hot spots in a transportation network. In particular, issues related to underreporting and crash severity are tackled by incorporating equivalent PDO crashes, whilst the concerns related to the non-count nature of equivalent PDO crashes and the skewness of crash data are addressed by the non-parametric quantile regression technique. The proposed method identifies covariate effects on various quantiles of a population, rather than the population mean like most methods in practice, which more closely corresponds with how black spots are identified in practice. The proposed methodology is illustrated using rural road segment data from Korea and compared against the traditional EB method with negative binomial regression. Application of a quantile regression model on equivalent PDO crashes enables identification of a set of high-risk sites that reflect the true safety costs to the society, simultaneously reduces the influence of under-reported PDO and minor injury crashes, and overcomes the limitation of traditional NB model in dealing with preponderance of zeros problem or right skewed dataset.

Management [5th Asia-Pacific Edition]

The fifth edition of this text has been thoroughly updated, continuing its strong emphasis on the importance of the Asian region to contemporary Australian and New Zealand organisations. Many Asian case examples are featured to illustrate key management concepts, and these provide a useful basis for comparison with management practices in Australia and New Zealand. Numerous practical examples throughout the text highlight contemporary management issues, such as: •workplace diversity •sustainability •ethics/corporate social responsibility •the impact of technology •innovation in the workplace •globalisation •employee engagement •flexible working arrangements •work-life balance •generational issues in the workplace •skills shortages in various industries •the importance of effective employee recruitment and training •organisational culture •workforce flexibility and casualisation •the ‘24/7’ nature of contemporary communication technology, including social media •outsourcing Management, 5th Asia Pacific edition, has also retained the features that have made previous editions so popular with students and lecturers, including the Career Readiness Workbook activities at the end of the book, and the accompanying Interactive Study Guide with its vast array of multimedia resources.

A multidimensional model of client success when engaging external consultants

Too often the relationship between client and external consultants is perceived as one of protagonist versus antogonist. Stories on dramatic, failed consultancies abound, as do related anecdotal quips. A contributing factor to many "apparently" failed consultancies is a poor appreciation by both the client and consultant of the client's true goals for the project and how to assess progress toward these goals. This paper presents and analyses a measurement model for assessing client success when engaging an external consultant. Three main areas of assessment are identified: (1) the consultant;s recommendations, (2) client learning, and (3) consultant performance. Engagement success is emperically measured along these dimensions through a series of case studies and a subsequent survey of clients and consultants involved in 85 computer-based information system selection projects. Validation fo the model constructs suggests the existence of six distinct and individually important dimensions of engagement success. both clients and consultants are encouraged to attend to these dimensions in pre-engagement proposal and selection processes, and post-engagement evaluation of outcomes.

Challenges of recruiting hospice patients with advanced cancer to research : reflections on a delirium screening study

Introduction Delirium research in palliative care, particularly in the dying phase, is possible but is frequently met with ethical and methodological challenges. This paper describes the challenges faced in a previous delirium screening study. Methods Within 72 hours of admission to an acute inpatient specialist palliative care unit one hundred consecutive patients over 18 years of age with advanced cancer were invited to be screened for delirium using validated screening tools. Results Of the 100 consecutive admissions 49 patients were unable to participate including seven who did not meet the inclusion criteria and nine (six families and three patients) who withheld consent. The remaining 33 patients were more unwell and closer to death than those who were recruited. Reasons for non- participation included being too unwell (ten), unresponsive (nine), died (two) or discharged (three) before recruitment and exceeding the 72hour time limit (nine). Conclusion Gate keeping and physical condition of patients were the main obstacles to recruitment and is consistent with barriers faced in previous studies involving palliative care and dying patients. While it is possible and necessary to conduct studies in palliative care, including the terminal phase, as reflective practitioners we must maintain the balance between the demands for evidence-based practice and our compassion and respect for our most vulnerable of patients.

Osteogenic differentiation of murine embryonic stem cells is mediated by fibroblast growth factor receptors

The mechanisms involved in the control of embryonic stem (ES) cell differentiation are yet to be fully elucidated. However, it has become clear that the family of fibroblast growth factors (FGFs) are centrally involved. In this study we examined the role of the FGF receptors (FGFRs 1-4) during osteogenesis in murine ES cells. Single cells were obtained after the formation of embryoid bodies, cultured on gelatin-coated plates, and coaxed to differentiate along the osteogenic lineage. Upregulation of genes was analyzed at both the transcript and protein levels using gene array, relative-quantitative PCR (RQ-PCR), and Western blotting. Deposition of a mineralized matrix was evaluated with Alizarin Red staining. An FGFR1-specific antibody was generated and used to block FGFR1 activity in mES cells during osteogenic differentiation. Upon induction of osteogenic differentiation in mES cells, all four FGFRs were clearly upregulated at both the transcript and protein levels with a number of genes known to be involved in osteogenic differentiation including bone morphogenetic proteins (BMPs), collagen I, and Runx2. Cells were also capable of depositing a mineralized matrix, confirming the commitment of these cells to the osteogenic lineage. When FGFR1 activity was blocked, a reduction in cell proliferation and a coincident upregulation of Runx2 with enhanced mineralization of cultures was observed. These results indicate that FGFRs play critical roles in cell recruitment and differentiation during the process of osteogenesis in mES cells. In particular, the data indicate that FGFR1 plays a pivotal role in osteoblast lineage determination.

Analysis of temporary traffic control cost items in transportation construction bidding process

Temporary Traffic Control Plans (TCP’s), which provide construction phasing to maintain traffic during construction operations, are integral component of highway construction project design. Using the initial design, designers develop estimated quantities for the required TCP devices that become the basis for bids submitted by highway contractors. However, actual as-built quantities are often significantly different from the engineer’s original estimate. The total cost of TCP phasing on highway construction projects amounts to 6–10% of the total construction cost. Variations between engineer estimated quantities and final quantities contribute to reduced cost control, increased chances of cost related litigations, and bid rankings and selection. Statistical analyses of over 2000 highway construction projects were performed to determine the sources of variation, which later were used as the basis of development for an automated-hybrid prediction model that uses multiple regressions and heuristic rules to provide accurate TCP quantities and costs. The predictive accuracy of the model developed was demonstrated through several case studies.