Clinical research and leadership training program as a knowledge translation initiative across an Australian health care service

&nbsp;Health professionals need to be integrated more effectively in clinical research initiatives to ensure that research addresses key clinical needs and provides practical, implementable solutions at the coal face of care. Here we describe the informative phase of a broader program to enable and support health professionals at Monash Health who do not have a research background, to engage in and lead research to improve healthcare outcomes. The findings will be used to develop a dedicated clinical research and leadership training program. The training program will support Monash Health staff to up-skill or enhance skills to conduct rigorous research; engage and lead multidisciplinary, collaborative teams; and to use research to guide practice, as well as identify and address gaps in clinical research. &nbsp;<div><section></section></div>

Community center-based resistance training for the maintenance of glycemic control in adults with type 2 diabetes

OBJECTIVE--The purpose of this study Was to determine whether beneficial effects on glycemic control of an initial laboratory-supervised resistance training program could be sustained through a community center-based maintenance program.<br /><br />RESEARCH DESIGN AND METHODS--We studied 57 overweight (BMI [greater than or equal to] 27 kg/[m.sup.2]) sedentary men and women aged 40-80 years with established (&gt;6 months) type 2 diabetes. Initially, all participants attended a twice-weekly 2-month supervised resistance training program conducted in the exercise laboratory. Thereafter, participants undertook a resistance training maintenance program (2 times/week) for 12 months and were randomly assigned to carry this out either in a community fitness and recreation center (center) or in their domestic environment (home). Glycemic control ([HbA.sub.1c] [A1C]) was assessed at 0, 2, and 14 months.<br /><br />RESULTS--Pooling data from the two groups for the 2-month supervised resistance training program showed that compared with baseline, mean A1C fell by -0.4% [95% CI -0.6 to -0.2]. Within-group comparisons showed that A1C remained lower than baseline values at 14 months in the center group (-0.4% [-0.7 to -0.03]) but not in the home group (-0.1% [-0.4 to 0.3]). However, no between-group differences were observed at each time point. Changes in A1C during the maintenance period were positively associated with exercise adherence in the center group only.<br /><br />CONCLUSIONS--Center-based but not home-based resistance training was associated with the maintenance of modestly improved glycemic control from baseline, which was proportional to program adherence. Our findings emphasize the need to develop and test behavioral methods to promote healthy lifestyles including increased physical activity in adults with type 2 diabetes. <br />

Linking secondary school physical education with community sport and recreation for girls: a process evaluation

The purpose of this study was to undertake a process evaluation to examine the reach, adoption and implementation of a school-community linked physical activity (PA) program for girls aged 12 - 15 years (School Years 7 - 9) using the RE-AIM framework.

Applying GIS in physical activity research: community walkability and walking behaviours.

Physical activity provides many health benefits, including reduced risk of cardiovascular disease, Type II diabetes and some cancers. Environmental exposure factors (e.g., the built environment) are now receiving ever-increasing attention. Large-scale interdisciplinary studies on the association between attributes of local community environments and residents&rsquo; physical activity are being conducted. We will focus on findings from Australia - the Physical Activity in Localities and Community Environments (PLACE) study. PLACE is examining factors that may influence the prevalence and the social and spatial distribution of walking for transport and walking for recreation. A stratified two-stage cluster sampling strategy was used to select 32 urban communities (154 census collection districts), classified as high and low &lsquo;walkable&rsquo; using a GISbased walkability index (dwelling density, intersection density, net retail area and land use mix) and matched for socio-economic status. We report data on a sub-sample of 1,216 residents who provided information on the perceived attributes of their community environments (e.g., dwelling density, access to services, street connectivity) and weekly minutes of walking for transport and for recreation. Moderate to strong associations were found between GIS indicators of walkability and the corresponding self-report measures. The walkability index explained the same amount of neighborhood-level variance in walking for transport as did the complete set of self-report measures. No significant associations were found with walking for recreation. Relevant GIS-based indices of walkability, for purposes other than transport need to be&nbsp;&nbsp; developed.<br />

MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers

<b>Background : </b>Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.<br /><br /><b>Methods/Design :</b> MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.<br /><br /><b>Discussion :</b> Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.<br />

Performing masculinity and leadership : male academics' work practices and identities

In this thesis, a folio comprising a major dissertation and three elective tasks, issues including masculinity(ies), identities, leadership and academics’ work practices are considered against a backdrop of change in the higher education sector. Narrative research methods are applied throughout the folio. The first elective, a discussion and commentary arising from an interview with an experienced practitioner in gender education, amounts to a feasibility study for the dissertation, whereas the second elective experiments with the use of computer mediated communication as a means of interviewing a small number of male academics about their inclusive teaching practices. Primarily curiosity-driven research, the conclusion is drawn that computer mediated communication, if used at all, ought provide a complementary, not primary means of data collection. The third elective conveys the life story of an Asian-Australian academic who expresses different masculinities according to the social settings in which he finds himself. The conclusion is made that there is neither a single colored masculinity nor a single working class masculinity. The milieux of race and class need to be considered together. The research described in the major dissertation was undertaken with a group of eleven male academics from a number of rural and metropolitan universities – men who were thought by their colleagues and peers to practice collaborative approaches to leadership. Whereas the majority of the men practised what could be described as transformational approaches to leadership, a small number exploited the process of collaboration mainly for their own protection. Very few of the men engaged in discourses of gender. One of the principal conclusions reached in the paper is that there are ramifications for future leadership training that universities offer so that it becomes more relevant and socially inclusive. Another main conclusion relates to the intimidation reported by some of the men in the study, and that there are implications for universities in the way they protect their employees from such incidents. A third significant conclusion is that there is some way to go before gender is integrated into the discourse of male academics. Until this can occur, limited opportunities exist for alliances to be formed between most male academics and feminist academics for the advancement of socially just workplaces.

Social capital, educational institutions and leadership

Social capital refers to the norms and networks that enable people to act collectively. It is a set of resources that reside in the relationships among people that allow them to share their knowledge and skills. Social capital is built and accessed through interactions between people and groups. Educational institutions and their community benefit from building social capital. Educational leaders who are committed to lifelong learning and view the community as a resource for the institution have a key role in unlocking and building social capital. Social capital is developed through a partnership process with common purpose or vision where leadership is gradually shared between institution and community.<br />

The new heritage studies and education, training, and capacity-building

Over the last three decades, community and professional views of what constitutes significant cultural heritage have broadened in many countries around the world. Heritage practice has moved from a narrowly technical or fabric focus to a values-based approach engaging all stakeholders, including indigenous communities. While much Western heritage knowledge and practice remains indispensable, gaps can be filled in by drawing on other knowledge areas and ethical considerations, including links between heritage practice and human rights. These new directions require new approaches in the preparation of practitioners as well as others engaged in heritage processes. In addition to education and training, a third concept &ndash; capacity-building &ndash; is overarching and potentially powerful in reaching new heritage actors. The aim of giving heritage a valued role in the life of the community, which applies at global, national, and local levels, represents the greatest challenge for educators, trainers, and capacity-builders in the contemporary world.

Acceptance and leadership-hegemonies of e-commerce policy perspectives

This paper presents an analysis of the e-Commerce policies developed and implemented in the USA, Canada, Australia, Victoria, Finland, Norway, the UK, Ireland, the EU (by the OECD), Singapore, Japan, Malaysia, Thailand and Hong Kong (Special Administrative Region). The paper shows that e-Commerce policy adopted is generally trying to achieve two fundamental aims:<br /><br />1. to minimize regulatory environments for e-Commerce; and<br />2. to ease logistical problems in doing e-Commerce&mdash;i.e. in paying electronically, in deliver y of goods and in customs, tariffs and duties.<br /><br />These strategies are designed to create an environment where e-Commerce is adopted by business and government in these countries to achieve &lsquo;best practice&rsquo;, to become &lsquo;modern&rsquo;, to gain &lsquo;efficiencies&rsquo;, because &lsquo;it is the way to go&rsquo;, because &lsquo;we must have it, because everybody has it&rsquo;, and because they &lsquo;perceive the benefits of it&rsquo;. In essence it is being used to gain hegemony in the economic competitiveness of the geopolitical environment created by the Internet. This paper argues that differentiating types of policy is related to ideology and hegemony in the various countries.<br />

Partnerships for capacity building: community, governments and universities working together

This paper summarises initiatives in the area of capacity building between communities, governments and universities since Rio 1992.<br /><br />First the global advances through the UN and associated agencies are described with lessons learned and challenges remaining being highlighted. This is followed by a similar approach for first regionally based initiatives and finally some of the better examples of nationally based approaches.<br /><br />Among the key findings from the review were: trying to keep the initial message simple, asking the &ldquo;user&rdquo; what they want and what they need from capacity building, the use of local experts in capacity building where ever possible, universities extending themselves to engage in genuine partnerships as well as offering new courses, subjects, etc., attempting to match the strengths and weaknesses of partners in capacity building, concentrating on improving regional partnerships across national boundaries, deriving methods to sustain capacity building programs over the long term, questioning the absence of the private sector from capacity building partnerships, questioning whether capacity building is receiving the attention, funding and centrality to ICM promotion that it warrants, a proposal to build a global ICM capacity building network, the need for greater critical analysis of capacity building programs, integrating capacity building into ICM practices and recognising that effective capacity building practice may require some time and effort to build up, i.e. there are no universal &ldquo;quick-fixes&rdquo;.<br />

Conspiring to run: women, their bodies and athletics training

Women's athletics commenced about 60 years after the start of the men's sport. Women's involvement in athletics was held back by the medical and general views that this was a strenuous sport requiring a level of exertion beyond the biological capabilities of female bodies. Their difficult initiation into athletics occurred under male gaze; they encountered opposition from the public, the medical profession and from the male-controlled athletics organizations. A serious participation in athletics requires significant exertion and dedicated training. While the prevailing view was that moderate physical exercise without strain enhanced women's health, the exertion required for athletics was deemed to be potentially dangerous. Within essentialist views of gender, women's involvement in athletics was thought to have implications for their nurturing and domestic roles. When the pioneer women athletes tried to excel, they were said to be straining themselves and their participation in the sport was brought into question. By using theoretical insights drawn mostly from Foucault, training manuals from the early decades of women's athletics and material from interviews with some of the first English female athletes are examined to investigate the attitudes of both genders to women in athletics and to analyse how they circumvented the potential veto of their sport by men.<br />

Community organisations and the dance of good and bad risk

This paper is concerned with an element of contemporary society that forms. the backdrop for some of the contradictory expectations and practices that currently bedevil community organisations in Australia. This element is the idea of risk, or more pertinently, the construction of the idea of risk society. The argument presented is that there are two different interpretations of risk, risk as threat and risk as opportunity. Each interpretation is examined to reveal the ways in which it affects community organisations in Australia. The paper concludes with the view that both ways in which risk is constructed are being used as part of the rationale for new forms of control.<br />

Entrepreneurship, marketing and leadership in non-profit performing arts organisations

This paper argues that the entrepreneurial leader in non-profit PAOs has received too little attention in literature pertaining to these organisations. This criticism also applies to museums. The paper explores how leaders in non-profit performing arts organisations balance the interests of the various funding sources and market opportunities to service their revenue requirements. It reviews a tension in non-profit performing arts organisations: the relationship between limited funding and the subsequent need to act entrepreneurially and innovatively among the various funding sources. Using longitudinal analysis of annual reports, the paper uncovers interplay essential to entrepreneurship. Hence, strategies and tensions are highlighted that non-profit leaders have used. Comparisons are made with non-profit art museums which previous research has shown have the same funding tensions.<br />