Enhancing the dietary management of general practice patients through collaborative care: perspectives of general practitioners and dietitians

Aim:  To describe how general practitioners and dietitians view their role in the dietary management of cardiac patients and to provide insights on how to facilitate collaborative care.
Methods:  Two studies were conducted in Victoria (Australia) 2005–2006. Study One: semi-structured interviews with general practitioners. Study Two: cross-sectional quantitative surveys of general practitioners and dietitians. Study One: texts were analysed using the grounded theory approach. Study Two: frequency analysis was conducted and chi-squared test for independence was used to explore the impact of age, sex and consultation time on the role and reporting scales.
Results:  Study One: Themes arising from the interviews with 30 general practitioners showed their involvement in dietary management fell into three broad roles: ‘Influencing’, ‘Coordinator’ of referrals and dietary ‘Educator’. They described dietetic education as a process that included dietary assessment, education, application of behavioural change techniques and reporting back to general practitioners. Study Two: Respondents were 248 general practitioners (30% response) and 180 dietitians (60% response). General practitioners' counselling consisted mostly of advocating for dietary change, coordinating dietetic referrals and reinforcing dietitians' recommendations. General practitioners considered dietary education as the role of dietitians. Dietitians reported a much broader role in the management of patients with some overlap with general practitioners' roles.
Conclusions:   The findings indicate the need: (i) for more structured reporting to ensure general practitioners receive appropriate information to enable them to reinforce dietetic counselling and recommendations; and (ii) to streamline the communication process in order to expedite dietitians' reports to general practitioners.

Scope of practice of occupational therapists working in Victorian community health settings

Background/aim: Current health policy places emphasis on community-based health care and it is expected that there will be an increase in the number of people receiving care in community settings. This study aimed to examine the profile and scope of practice of occupational therapists working in Victorian community health settings and the amount and type of health promotion activity incorporated into their role.
Method:  An anonymous postal questionnaire was sent to 205 community-based Victorian occupational therapists. One hundred and one (49.3% response rate) questionnaires were returned, with 72 respondents (35.1%) meeting study inclusion criteria. A descriptive research design was used to address study aims.
Results:  Results indicate that the majority of community health occupational therapists are experienced practitioners, have a varied scope of practice and report a high level of job satisfaction. Compared with previous studies, there is an increase in new graduate occupational therapists starting their career in community health settings, a greater number of part-time workers and a diversification of clinical and non-clinical roles. Barriers to practice that exist include high demand for service, limited funding and time spent on administrative tasks. Although health promotion was regarded as an important role of community health workers, a large number of therapists were not involved in this activity because of limited knowledge and clinical work taking priority.
Conclusion: Study findings have implications for occupational therapy training, and there is a clear need for input at policy level to address the significant resource allocation issues raised.

The use of heuristics in valuation practice : implications in a changing market

Despite the existence of prescribed frameworks, valuation remains a cause of much controversy and variety of opinion. It does not matter whether procedures are undertaken in exactly the same way, the conclusion of ‘value’ will vary from valuer to valuer – sometimes considerably. This uncertainty within valuation is founded on property’s heterogeneous nature and the imperfect market that is the property market; in addition to the unpredictability of human behaviour in making judgements (French and Gabrielli 2004). Uncertainty, in valuation is found in the amalgam of locational, physical and legal characteristics and innumerable other forces which control and energise the property market (Whipple 1995). Particular irregular occurrences, or drastic changes in property markets, from either within market evolution or external forces, for example the creation of global financial markets, cause further uncertainty for valuers and provides challenges in identifying ‘market value’ in valuation practice. The praxis of valuation in a commercial sense navigates this complexity using a combination of algorithms and heuristics to identify the value of a property. The application of theoretical mathematical algorithms based on economic theory (Brown 1995), is augmented by valuers’ ability to apply appropriate adjustment based on their knowledge of the market, their ability to analyse, assess and compare the attributes of a property in comparison to its market, and their practical experience (Sliogeriene 2008). Despite the necessity of algorithms, the application of appropriate adjustments and assumptions are important in arriving at a value. This paper is a critical reflection on the basis of valuation practice as guided by standards, methods, and ethics (algorithms), and the use of heuristics in practice. This is important because changes within property markets challenge the inter-relationship between these two aspects of valuation practice. Through the authors’ industry experience and a review of previous research and statements of practice norms this paper provides an analysis of the ability of valuers to address market change in their valuation practices.

Book review : Ethics and organizational practice : questioning the moral foundations of management

The arena of ethics and business is a colossus: thousands of books, multiple dedicated journals, de rigueur organizational ethics policies and CSR initiatives - most of which we can be fairly confident would receive poor reviews by the editors and authors of Ethics and organizational practice: Questioning the moral foundations of management. This edited collection is a self-identified ‘critical’ take on business ethics, one that according to the editors’ introduction wishes to ‘expose business ethics to its crises’ and ‘critically investigate(s) what ethics means’. The ‘critical’ which Muhr, Sørensen and Vallentin invoke is one that would be familiar to authors and readers of Critical Management Studies – that is, to use Fournier and Grey’s (2000) oft-referenced depiction, the study of management and organization that is non-performative with regards to managerialist concerns of efficiency and profitability, that seeks to denaturalize taken-for-granted legitimations, and the normalization of current organizational practices and ideologies, and one which demonstrates significant reflexivity with regard to the philosophies and methodologies it deploys. To the above, we may also add pluralism, and indeed some playfulness, with a wide diversity of conceptual, theoretical, historical and popular sources mined for their potential to help us reconsider the organizational present.

Observing different faiths, learning about ourselves : practice with inter-married Muslims and Christians

The present article offers practitioners initial ideas for work with clients in mixed-faith relationships. Based on local, empirical research that investigated Muslim-Christian marriages, six patterns of adaptation to a mixed-faith marriage are outlined. In addition, from a practice-oriented review of the data, four questions are identified that can be used by practitioners to clarify their thinking and practice focus. Increasingly technical, these reference questions are: (i) how is the public-private divide being understood and managed; (ii) how is identity and selfhood being practiced; (iii) how may practitioners position themselves with respect to asymmetries related to gender; and (iv) should religious differences be reframed? Rather than practitioners seeking to be experts on the other, the belief animating the current contribution is that work with diverse clients offers workers a mirror upon which we practitioners can better observe our own outlines. In contrast with the pursuit of imperial generalisations, the authors of the present study commend the benefits of reflectively denaturalising our own positions.

Glimpses of generative practice : constructing pre-service teachers' learning in partnership

In this paper, the authors describe a program to enhance pre-service teachers' mathematical and pedagogical knowledge through a partnership with middle years teachers and learners in a primary school. The authors wanted to investigate how pre-service teachers' experience of teaching mathematics could enhance both their knowledge of mathematics and the development of generative practices. The findings have inspired the development of similar partnerships with other primary schools.

Twenty years of the Journal of Marketing Theory and Practice

This paper reviews the work published in JMTP during its first 20 years. It finds extensive global coverage in terms of authors and material, despite a U.S. emphasis. In addition, a diversity of topics is covered and is making a significant contribution, as defined by citations, to broader academic discourse. The works published have a strong applied focus, although this might be expected to have been higher given the journal's applied foundations. The paper also identifies the most prolific individuals and institutions, based on the number of articles published and citations to those articles. The paper concludes that JMTP has made a valuable contribution to marketing academia and its global recognition continues to grow.

Power and discourse in information systems practice : a narrative research method

Relationships of authority and control and their effect on information systems actors has interested IS researchers since at least the 1980’s. The study of power itself has also troubled organisational and sociological theorists, from which information systems researchers have drawn various lines of attack. Our approach to power rests on an historical synchronic theory that seeks to uncover the places and operation of power through an examination of narrative ‘testaments’ which are analysed not from the perspective of the giving individual but from the structural elements of discourse that they may represent. This paper compliments previous research methods on the topic of power especially in expert reports and systems development methodologies; provides specific guidance on how to apply the notion of discourse synchronically; and reconstructs the commercial practice of information systems, not as a broad church, but as one of competing and epistemologically incommensurate discourse, where the fates of the powerful are balanced against the fearful and silent disciplined.