Patient recall of receiving lifestyle advice for overweight and hypertension from their general practitioner

Background
Overweight, obesity and hypertension can be prevented through improvements in lifestyle including nutrition and physical activity. General practitioners (GPs) in Australia have access to over 90% of the population in the course of a year and therefore, the general practice setting may be ideal to assist patients with lifestyle change for weight management and hypertension. The present study aimed to determine the proportion of overweight/obese patients that recalled receiving advice by their GP to make lifestyle changes for weight loss. Recall of advice received by hypertensive patients to reduce salt intake was also measured.

Methods
A face to face survey was conducted on a representative sample (urban, suburban and rural) of South Australian residents. Respondents provided information on height and weight (self-report), whether they had received lifestyle advice from their GP for weight loss, and for those with self reported hypertension if they had received advice to reduce dietary salt.

Results
The sample included 2947 South Australian adult residents (58% female; BMI (mean (SD)), 26.6 (5.3) kg/m2; age, 50.7 (18.0) years). Ninety-six percent had visited their GP in the past 12 months. Forty-one percent of males and 25% of females were overweight and 19% of males and 20% of females were obese. Twenty-seven percent of overweight/obese respondents reported receiving lifestyle advice for weight loss purposes. Of the 33% who reported they had hypertension, 34% reported receiving advice to reduce salt intake.

Conclusions
Less than 1/3 of overweight/obese patients reported that they had received lifestyle advice that could assist with weight loss from their GP. About a third of respondents with hypertension reported that they received advice to reduce salt intake. There are potentially missed opportunities in which GPs could provide re-enforcement of benefits of lifestyle changes with respect to weight and blood pressure control.

Sustainable workforce reform : case study of Victorian nurse practitioner roles

Nurse practitioner (NP) roles have been identified as a key strategy in the development of a sustainable and responsive health workforce. To date, the focus of research related to NP roles has been on implementation and short-term evaluation of aspects of NP care; however, little is known about the sustainability of NP roles. A major challenge for the
healthcare sector is to demonstrate long-term outcomes of NP care and shift the research focus from individual NPs to the effectiveness of healthcare teams that incorporate NPs. This paper draws on a framework of the following domains of sustainability in primary care: political, institutional, financial–economic, workforce and client (or patient) and applies these domains to NP planning in the Victorian context.

Practitioner prognostications on the future of online marketing

In arguably the most dynamic period in the history of marketing, and in particular the management of marketing communication, the challenges and opportunities presented by online marketing are both immense and unprecedented. In an effort to understand how these challenges are perceived at the ‘coal face’, this paper solicits and longitudinally compares senior marketing practitioners’ perceptions and perspectives, both recently (late 2008) and five years prior (2003). Due to the rapid evolution of online marketing and its impact on both consumer behaviour and marketing strategy, a longitudinal qualitative research design was employed to track changes in senior marketers’ perceptions. Findings are presented and discussed within the context of six recurring themes: interactivity, personalisation, integration, evaluation, agency structures, and capabilities. The paper concludes by examining the utility of integrated marketing communication as a marketing management framework for online marketing strategy.

Self-reflective practice in sustainable design

A range of personal self-transformation strategies that rest on empathy and certainty were identified as critical to sustainable design practice. The dynamic influences design as both praxis and a decision making process, yet praxis, as the intuitive dimension of design is overlooked for its strategic importance to this dynamic.

Value-change and self-reflective practice in ecologically sustainable design

Ecologically sustainable design is a transformative design paradigm based on the theory of interdependence. This theory requires that the transformative agenda of design is holistic in practice. In effect, the requirement is for value-change on the part of the designer along with transformation of the built environment. This paper, based on recently completed research into design practice, argues that value-change rests on certainties that are drawn on intuitively while designing, and that this intuitive process is characteristic of design as praxis. It is further argued that design, as praxis, requires a phenomenological approach for inculcating value-change. A phenomenological approach relies on self-reflective practices exemplified by meditation and yoga that can focus on the designer’s ethical know-how. A model for this approach to value-change, the biopsychosocial approach, already exists within clinical medicine. This paper presents findings from interviews with key architects practising self-reflection and/or ecologically sustainable design. These highlight the premium placed by these architects on both certainty and empathy, and how these values influence design as praxis. Formalising techniques for closer scrutiny of these values will highlight design as praxis. Doing so will critically strengthen ecologically sustainable design as holistic, transformative practice.

A partnership in induction and mentoring : noticing how we improve our practice

This article focuses on the induction and mentoring of early career teachers. The context is a suburban primary school in Victoria, Australia, as the school develops mentoring networks for graduate and beginning teachers. Instigated from a school–university partnership, the research draws from the traditions of practitioner research. In the research design and likewise in successful mentoring the importance of a genuine commitment to the discipline of reflective practice or what we have come to describe as “ noticing ” (Mason, 2002; Moss et al., 2004) is illustrated. The approach offers a new method for small scale–close up research in teacher education.

Exploring the development and assessment of work-readiness using reflective practice in construction education.

It is well known that the construction industry is characterized by the need for practical knowledge and skill. However, this creates special challenges for universities in the development of work readiness in graduates. This research investigates the attitudes of students towards a course which was designed to develop work-readiness skills in construction management. The paper focuses on the distinctive issues associated with Work-Integrated Learning (WIL) using a formally assessed industry-mentored course of study. Past research shows that university degrees should promote reflective thinking since, in construction, it is necessary to make reflective judgements which deal with ill-defined problems. This is a generic capability that is needed by all graduates in knowledge-based occupations. The study utilized reflective practice to examine the perceptions of construction management students towards the development of attributes which were known to improve work skills. The students were asked to capture their reflections on their experiences in the form of reflective diaries, which were prepared weekly throughout the course. The results showed that the students expressed very positive views about their learning experiences. This occurred in spite of the challenges caused by the formal assessment processes that were undertaken as part of the course. This paper compares the student perceptions with the teachers’ reflections on the ability of traditional assessment methods to measure graduate attributes and work-readiness. The research explores the issues associated with assessing work-readiness skills in higher education. The findings suggest that student reflection is a necessary precondition to the development of effective work-readiness. In addition, the research concludes that more nontraditional assessment approaches are needed in construction programmes in order to develop the type of graduate required by the industry.

Implementation of the nurse practitioner role within a Victorian healthcare network : an organisational perspective

Objective
This paper presents a discussion of the development of a framework to implement and sustain the nurse practitioner (NP) role within one health service designed to strengthen the capacity of the health system and which could be readily transferable to other health services.
Setting
Eastern Health (EH) is a multi‑campus tertiary health care organisation servicing a population of approximately 800,000 people in the east and outer eastern suburbs of Melbourne, Australia. EH is committed to advancing the nursing profession and exploring innovative, research based models of practice that are responsive to the needs of the community it serves.
Primary argument
The Framework documents the processes of providing a new career pathway for advanced practice nurses that incorporates education and training, and utilises current evidenced‑based practice guidelines to define and promote the scope of practice.
Conclusion
Strong organisational support to facilitate interdisciplinary and multidisciplinary learning opportunities assists integration of the NP role into the healthcare team. Role clarity will assist interprofessional teams to understand and value the role NPs provide.