Nutritional intake of opioid replacement therapy patients in community pharmacies: A pilot study

Aim: Opioid replacement therapy (ORT) is an established therapy for a patient group that has been associated with nutrition-related comorbidities. This paper aims to assess the nutritional intake and supplementation in ORT patients, determine the extent of nutritional/dietary advice supplied to ORT patients and to briefly examine patients' perception of pharmacists' provision of nutritional advice. Methods: The nutritional intake of ORT patients receiving treatment in community pharmacies within the Australian Capital Territory was assessed via a 24-hour recall survey. Food intake data were analysed via nutrient analysis software and compared with Australian Nutrition Reference Values and the nutrient intakes of the Australian population. Patients were surveyed to determine supplement use and perceptions of nutritional advice gained by pharmacists. Results: Potential insufficient intake of various macronutrients and micronutrients was observed in both sexes. Less than 25 of patients recorded supplement use. Fifteen percent of males and 21 of females stated that they had approached a pharmacist with a nutrition-related query. All patients who received nutritional advice followed the advice. Conclusions: ORT patients dosing at community pharmacies appear to have poor nutritional intake. ORT patients appear to be receptive to pharmacist's advice. Community pharmacists can potentially increase the beneficial health outcomes in this population through the proactive supply of accurate nutritional advice.

Orienting to emotion in computer-mediated Cognitive Behavioural Therapy

Exploring emotions is a defining feature of psychotherapy. This study explores how therapists explore emotions when they cannot see or hear their clients. In analysing 1,279 sessions of online text-based Cognitive Behavioural Therapy (CBT) we focused on therapists’ commiserations (e.g., “I’m sorry to hear that”) and their affective inferences (e.g., “that sounds very scary for you”). Both practices routinely prefaced moves to pursue a range of therapeutic activities, many of which did not prioritise sustained focus on the emotion that had just been oriented to. By separating message composition from message transmission, the modality used for these therapy sessions enabled therapists to combine orientations to emotion with attempts to shift the focus of discussion. Our analysis finds that although physically co-present and computer-mediated psychotherapy share a common focus on emotional experience, the modality used for therapy can be relevant in the design and use of these orientations. Data are in British English.

Employability and job status as moderators of the effects of job insecurity on work outcomes

Despite greater use of temporary employment contracts, little is known about how employees react to job length uncertainty. Individual careers within the safety of one or two primary organisations are no longer the norm. This study investigates the effects of job insecurity and employment status (temporary/permanent) on work outcomes. Three hundred and ninety-one employees (122 temporary and 269 permanent) in low to medium level non-academic positions from two Australian universities completed a survey. The results show that a belief that comparable employment is easily available did not alleviate the negative effects of job insecurity. Work attitudes for temporaries and permanents though were differentially influenced by employee perceptions of their own employability.

The implications of creative industries for regional outcomes

As the 21st century progresses, the most successful economies and societies will be creative ones. Worldwide, governments are producing strategies to encourage the development of creative industries and to strengthen the role of knowledge cities nationally and internationally. There is a significant policy discussion regarding the role of creative clusters in strengthening local economies and significant energy has been expended discussing the many positive outcomes of such developments. This article takes these issues as a starting point and considers the role of creative industries within broader concerns regarding uneven metropolitan development. By developing a typology of jobs across Australia’s metropolitan regions, the article will consider the broad social and economic impacts of uneven development of creative industry jobs between metropolitan regions and also the implications for individual metropolitan regions and policy outcomes.

A three species model to simulate application of hyperbaric oxygen therapy to chronic wounds

Chronic wounds are a significant socioeconomic problem for governments worldwide. Approximately 15% of people who suffer from diabetes will experience a lower-limb ulcer at some stage of their lives, and 24% of these wounds will ultimately result in amputation of the lower limb. Hyperbaric Oxygen Therapy (HBOT) has been shown to aid the healing of chronic wounds; however, the causal reasons for the improved healing remain unclear and hence current HBOT protocols remain empirical. Here we develop a three-species mathematical model of wound healing that is used to simulate the application of hyperbaric oxygen therapy in the treatment of wounds. Based on our modelling, we predict that intermittent HBOT will assist chronic wound healing while normobaric oxygen is ineffective in treating such wounds. Furthermore, treatment should continue until healing is complete, and HBOT will not stimulate healing under all circumstances, leading us to conclude that finding the right protocol for an individual patient is crucial if HBOT is to be effective. We provide constraints that depend on the model parameters for the range of HBOT protocols that will stimulate healing. More specifically, we predict that patients with a poor arterial supply of oxygen, high consumption of oxygen by the wound tissue, chronically hypoxic wounds, and/or a dysfunctional endothelial cell response to oxygen are at risk of nonresponsiveness to HBOT. The work of this paper can, in some way, highlight which patients are most likely to respond well to HBOT (for example, those with a good arterial supply), and thus has the potential to assist in improving both the success rate and hence the costeffectiveness of this therapy.

Be careful what you ask for : how inquiry strategy influences readiness mode

Much has been written about affecting change in the workplace, including how to help employees prepare for the process. However, little is known about how participation influences employees' emotions and attitudes at the start of an intervention. By qualitatively analyzing conversations that were triggered by an organizational change effort, we explored how different inquiry strategies influence readiness for change. We examined four inquiry strategies by combining strength or deficit frames with individual or organizational focus. Distinctive conversational patterns emerged within each strategy, which we believe influence peoples' change readiness. In this article we present four readiness modes to describe these patterns and conclude with implications for managers who seek to shape their change efforts more effectively.

Leveraging training outcomes on public construction projects

The paper explores the efficacy of public agencies using their contracting relationships with private firms to affect training outcomes in the construction industry. It develops a theoretical perspective on this issue by extending a framework that was originally developed by Hart, Schleifer and Vishny (1997) to study privatisation. This paper shows how their framework can also be applied to situations where the provision of public works is already privatised and the government is attempting to regulate training outcomes via a contracting arrangement. An empirical study of two training policies of the Western Australian government complements this theoretical discussion. We report the results of an analysis of data drawn from the government’s Tender Registration System between 1997 & 2006. As such we use a unique and comprehensive resource to examine the possible effects of new training policies on an important segment of the construction ‘market’.

Project Diagnostics : Providing Successful Project Outcomes

Project Diagnostics is a tool for construction industry stakeholders wishing to improve project delivery and outcomes. This software identifies areas of poor project health, then establishes probable root causes and provides suggested remedial measures. Its focus is to act as an advanced warning system for construction projects that are failing to meet predetermined objectives based on the critical success factors (CSFs) of cost, time, quality, safety, relationships, environment and stakeholder value.

Can governments use their construction contracts to improve training outcomes?

This paper explores the likely efficacy of government agencies using their contracting relationships with private firms to affect training outcomes in the construction industry. Specifically, it reports on the results of a study of two training policies of theWestern Australian government. Empirical data is drawn from the government’s Tender Registration System between 1997 and 2006. The main finding of the quantitative analysis is that in the absence of strong industry commitment to policy objectives, the contracting approach is likely to result in high levels of avoidance activity and generate very few benefits. The results of a qualitative investigation also support these findings.

PEPA workshops for allied health professionals : outcomes and directions for the future

The Program of Experience in the Palliative Approach (PEPA) started in 2003 as an initiative of the Australian Government, Department of Health and Ageing. The overall aim of PEPA is to improve the quality, availability and access to palliative care for people who are dying, and their families, by providing high quality learning experiences for primary care providers, including allied health professionals. As part of the program, an allied health workshop program has been developed following an extensive review of the literature and in consultation with experts in the field. The PEPA allied health workshops are offered across all states/territories.

Compliance in peritoneal dialysis : a qualitative study of renal nurses

End-stage renal failure is a life-threatening condition, often treated with home-based peritoneal dialysis (PD). PD is a demanding regimen, and the patients who practise it must make numerous lifestyle changes and learn complicated biomedical techniques. In our experience, the renal nurses who provide mostPDeducation frequently express concerns that patient compliance with their teaching is poor. These concerns are mirrored in the renal literature. It has been argued that the perceived failure of health professionals to improve compliance rates with PD regimens is because ‘compliance’ itself has never been adequately conceptualized or defined; thus, it is difficult to operationalize and quantify. This paper examines how a group of Australian renal nurses construct patient compliance with PD therapy. These empirical data illuminate how PD compliance operates in one practice setting; how it is characterized by multiple and often competing energies; and how ultimately it might be pointless to try to tame ‘compliance’ through rigid definitions and measurement, or to rigidly enforce it in PD patients. The energies involved are too fractious and might be better spent, as many of the more experienced nurses in this study argue, in augmenting the energies that do work well together to improve patient outcomes.