Implementing novel models of posttreatment care for cancer survivors: Enablers, challenges and recommendations

AIM: The American Society of Clinical Oncology and US Institute of Medicine emphasize the need to trial novel models of posttreatment care, and disseminate findings. In 2011, the Victorian State Government (Australia) established the Victorian Cancer Survivorship Program (VCSP), funding six 2-year demonstration projects, targeting end of initial cancer treatment. Projects considered various models, enrolling people of differing cancer types, age and residential areas. We sought to determine common enablers of success, as well as challenges/barriers. METHODS: Throughout the duration of the projects, a formal "community of practice" met regularly to share experiences. Projects provided regular formal progress reports. An analysis framework was developed to synthesize key themes and identify critical enablers and challenges. Two external reviewers examined final project reports. Discussion with project teams clarified content. RESULTS: Survivors reported interventions to be acceptable, appropriate and effective. Strong clinical leadership was identified as a critical success factor. Workforce education was recognized as important. Partnerships with consumers, primary care and community organizations; risk stratified pathways with rapid re-access to specialist care; and early preparation for survivorship, self-management and shared care models supported positive project outcomes. Tailoring care to individual needs and predicted risks was supported. Challenges included: lack of valid assessment and prediction tools; limited evidence to support novel care models; workforce redesign; and effective engagement with community-based care and issues around survivorship terminology. CONCLUSION: The VCSP project outcomes have added to growing evidence around posttreatment care. Future projects should consider the identified enablers and challenges when designing and implementing survivorship care.

Energy productivity and total-factor productivity in the Australian construction industry

There is urgent need to consider energy consumption when measuring total-factor productivity in the construction industry. This paper adopts the Malmquist index method to investigate the factors affecting the energy productivity of the Australian construction industry and compares them with those decomposed from the total-factor productivity. An input-oriented distance function and a contemporaneous benchmark technology are employed to develop the data envelopment analysis models. The Malmquist productivity index is decomposed into the technological change, pure technical efficiency change and activity effect to gain comprehensive insights into changes of construction productivity in the Australian states and territories over the past two decades. Research results show that both energy productivity and total-factor productivity improved in Australia, particularly related to technological development. The pure technical efficiency and activity indices changed slightly over time or across regions. This study demonstrates that there exists a linkage between energy productivity and total-factor productivity through their technological and technical efficiency changes. The Australian construction industry could enhance these two productivities by introducing advanced technologies and implementing them efficiently.

Factor structure and measurement invariance of the Health Education Impact Questionnaire: does the subjectivity of the response perspective threaten the contextual validity of inferences?

Objective:
On-going evidence is required to support the validity of inferences about change and group differences in the
evaluation of health programs, particularly when self-report scales requiring substantial subjectivity in response generation are used as outcome measures. Following this reasoning, the aim of this study was to replicate the factor structure and investigate the measurement invariance of the latest version of the Health Education Impact Questionnaire, a widely used health program evaluation measure.
Methods:
An archived dataset of responses to the most recent version of the English-language Health Education Impact
Questionnaire that uses four rather than six response options (N=3221) was analysed using exploratory structural equation
modelling and confirmatory factor analysis appropriate for ordered categorical data. Metric and scalar invariance were
studied following recent recommendations in the literature to apply fully invariant unconditional models with minimum
constraints necessary for model identification.
Results:
The original eight-factor structure was replicated and all but one of the scales (Self Monitoring and Insight) was
found to consist of unifactorial items with reliability of ⩾0.8 and satisfactory discriminant validity. Configural, metric and scalar
invariance were established across pre-test to post-test and population sub-groups (sex, age, education, ethnic background).
Conclusion:
The results support the high level of interest in the Health Education Impact Questionnaire, particularly for use as a pre-test/post-test measure in experimental studies, other pre–post evaluation designs and system-level monitoring and evaluation.

Meaning in life in earlier and later older-adulthood : confirmatory factor analysis and correlates of the meaning in life questionnaire

OBJECTIVE: To validate the Meaning in Life Questionnaire (MLQ) in earlier and later older-adulthood, and examine its correlates. METHOD: Participants in earlier (n = 341, M age = 68.5) and later older-adulthood (n = 341, M age = 78.6) completed the MLQ and other measures. Confirmatory multigroup analysis, correlations, and regression models were conducted. RESULTS: A two-factor (presence and search), eight-item model of the MLQ had a good fit and was age-invariant. Presence and search for meaning were largely unrelated. Meaning was associated with life satisfaction, well-being across a range of domains, and psychological resources. Searching for meaning correlated negatively with these variables, but to a lesser degree in later older-adulthood. DISCUSSION: The MLQ is valid in older-adulthood. Meaning in life is psychologically adaptive in older-adulthood. Searching for meaning appears less important, especially in later older-adulthood. Findings are discussed in the context of aging and psychosocial development.

The role of intragroup dynamics in nonprofit governance models: a systematic quantitative literature review

Nonprofit governance models rarely incorporate board intragroup dynamics as a significant board factor that influences performance. However, intragroup dynamics such 81 cohesion and conflicthave demonstrated a relationship with board performance suggesting that board Intragroup dynamics play a larger role than previously thought. ID order to better understand the relationship between lntragroup dynamics and performance, a systematic quantitative literature review was conducted.Through an extensive search process and the application of a series of inclusion criteria, 43 papers were identified and reviewed. Three types of lntragroup dynamics (cohesion, the board-CEO relationship, and boardroom climate) were shown to have a positive relationship with performance whereas the relationship between performance and two other lntragroup dynamics (conflict and power patterns) was mixed. It was concluded that lntragroup dynamics should be a central factor in board governance models. Using the findings of this review, directions for future research were identified.