The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls

The current study was designed to evaluate the role of sociocultural influences over a 16 month period on strategies to lose weight, extreme weight loss strategies, and strategies to increase muscles among adolescent boys (n=344) and girls (n=246). All participants completed measures of body dissatisfaction, body image importance, strategies to lose weight, extreme weight loss strategies, and strategies to increase muscles. Measures of perceived pressure to lose weight or increase muscles from mother, father, best male friend, best female friend and the media were also evaluated. Data were gathered on three occasions, 8 months apart. The results demonstrated that boys showed a decrease in strategies to lose weight and increase muscles over time, whereas girls showed an increase. Both boys and girls showed an increase in extreme weight loss strategies with girls demonstrating a greater increase than boys. The sociocultural influences generally were perceived by girls to relate to messages to lose weight, whereas for boys they were perceived to relate to increasing muscles. Messages from parents, particularly fathers, were strong predictors of both strategies to lose weight and increase muscles among boys, with the media and best male friend playing a limited role. For girls, the strongest influences were mothers and best female friends, with few influences from fathers or the media. The results of this study are discussed in terms of the importance of the various sociocultural influences in shaping body change strategies among young adolescent boys and girls, and the implications of these findings for intervention programs for adolescents.

A longitudinal study of quality of life among people living with a progressive neurological illness

This study investigated predictors of quality of life (QOL) of people with progressive neurological illnesses. Participants were 257 people with motor neurone disease (MND), Huntington’s disease (HD), multiple sclerosis (MS), or Parkinson’s. Participants completed questionnaires on two occasions, 12 months apart. There was an increase in severity of symptoms for people withMND, negative mood for people with HD and Parkinson’s, and social support satisfaction for people with MS. Regression analyses were conducted to determine predictors of QOL for each group. Predictor variables were length of illness, symptoms (physical symptoms, control over body, cognitive symptoms and psychological symptoms), mood, relationship satisfaction and social support. Predictors of QOL were severity of symptoms for people withMND, HD and MS; negative mood for people withMNDand Parkinson’s; and social support satisfaction for people with MS. These results demonstrate the importance of illness severity and mood in predicting QOL, but also indicate differences between illness groups. The limited role played by social support and relationship is a surprising finding from the current study.

Effect of epinephrine on glucose disposal during exercise in humans: role of muscle glycogen

This study examined the effect of epinephrine on glucose disposal during moderate exercise when glycogenolytic flux was limited by low preexercise skeletal muscle glycogen availability. Six male subjects cycled for 40 min at 59 ± 1% peak pulmonary O₂ uptake on two occasions, either without (CON) or with (EPI) epinephrine infusion starting after 20 min of exercise. On the day before each experimental trial, subjects completed fatiguing exercise and then maintained a low carbohydrate diet to lower muscle glycogen. Muscle samples were obtained after 20 and 40 min of exercise, and glucose kinetics were measured using [6,6-²H]glucose. Exercise increased plasma epinephrine above resting concentrations in both trials, and plasma epinephrine was higher (P < 0.05) during the final 20 min in EPI compared with CON. Muscle glycogen levels were low after 20 min of exercise (CON, 117 ± 25; EPI, 122 ± 20 mmol/kg dry matter), and net muscle glycogen breakdown and muscle glucose 6-phosphate levels during the subsequent 20 min of exercise were unaffected by epinephrine infusion. Plasma glucose increased with epinephrine infusion (i.e., 20-40 min), and this was due to a decrease in glucose disposal (R_d) (40 min: CON, 33.8 ± 3; EPI, 20.9 ± 4.9 µmol · kg^-1 · min^-1, P < 0.05), because the exercise-induced rise in glucose rate of appearance was similar in the trials. These results show that glucose R_d during exercise is reduced by elevated plasma epinephrine, even when muscle glycogen availability and utilization are low. This suggests that the effect of epinephrine does not appear to be mediated by increased glucose 6-phosphate, secondary to enhanced muscle glycogenolysis, but may be linked to a direct effect of epinephrine on sarcolemmal glucose transport.

The role of human resource management (HRM) in Australian-Malaysian joint ventures

This article examines human resource management (HRM) for successful Australian-Malaysian joint ventures (JVs), on the basis of survey data and case studies. The findings suggest that each phase of JV development had its own pattern of HR practices. Three phases of development were distinguished - initiation, transitional, and maturational. The first phase involved selecting, recruiting and training a skilled workforce and formulating rudimentary human resource policies. Cultural differences were most marked in this phase. The second phase, after three years of operation, involved evolution of human resource policies better suited to local conditions, and more polycentric management staffing. The final phase, after six years of operation, saw the development of a distinctive human resources system, and the minimisation of cultural differences as an operational issue. In this phase there was also a move to more geocentric management staffing.

The role of trading partner relationships in determining innovation performance: an empirical examination

This paper examines the respective roles of trading partner relationships and innovation management practices in predicting product and process related innovation performance. The empirical data were drawn from 194 Australian managers. Data analysis using structural equation modelling indicates that supplier relationships and customer relationships have less impact on product and process innovation performance than do knowledge and creativity management. However, the results also indicate that trading partner relationships have a strong and positive association with innovation management practices, meaning that organisations commonly implement both in a synchronous manner.

A conceptual model of the role of marketing employees in marketing performance

In general, there is a gap in research in marketing in relation to understanding the role of marketing employees in organisational marketing performance. An exception to this is the performance of salespeople as a subset of all marketing employees. Broader human resource management research into the people-performance link is also severely limited The proposed model argues that marketing employees are one of an organisation's strategic assets and are essential to the superior performance of the firm. Based on the People and Performance model (Purcell et al. 2003), the current model conceptualises marketing employee competencies as a precursor to performance outcomes and is, specifically, concerned with identifying and understanding the nature of the marketing employee performance relationship. Of note, where current performance research, in the main, adopts intermediate measures of labour turnover and labour productivity, this model proposes a three-tiered approach to performance measurement.

A role for workforce competencies in evidence-based health promotion education

Education programs should be based on research about the knowledge and skills required for practice, rather than on intuition or tradition, but there is limited published curriculum research on health promotion education. This paper describes a case study of how workforce competencies have been used to assist evidence-based health promotion education in the areas of curriculum design, selection of assessment tasks and continuous quality assurance processes in an undergraduate program at an Australian university. A curriculum-competency mapping process successfully identified gaps and areas of overlap in an existing program. Previously published health promotion workforce competencies were effectively used in the process of selecting assessment items, providing clear guidelines for curriculum revision and a useful method to objectively assess competency content in an evidence informed framework. These health promotion workforce competencies constituted an additional tool to assess course quality. We recommend other tertiary institutions consider curriculum-competency mapping and curriculum based assessment selection as quality and evidence based curriculum review strategies.

Developmental language disorders and adolescent risk: a public-health advocacy role for speech pathologists?

Within the multi-disciplinary team concerned with child and adolescent development, speech pathologists are uniquely positioned to understand the nature and overall developmental significance of language acquisition in childhood and adolescence. Other disciplines contribute valuable insights about psychosocial development during the childhood and adolescent years. The field of developmental psychology, for example provides a large and convincing body of evidence about the role of academic success as a protective factor against a range of psychosocial harms, in particular substance misuse, truancy, early school leaving, and juvenile offending. In this paper, we argue that juvenile offending embodies the notion of "adolescent risk", but in Australia in particular, has been under-investigated with respect to possible associations with developmental language disorders and subsequent academic failure. We present findings pertaining to a sample of 30 male juvenile offenders completing community based orders. Performance on a range of oral language processing and production skills was poorer than that of a demographically similar comparison group. Our results confirm the need to conceptualize language within a broader risk and protective framework. We therefore emphasize the public health importance of early language competence, by virtue of the psychosocial protection it confers on young people with respect to the development of prosocial skills, transition to literacy and overall academic achievement. We argue that speech pathologists are best positioned to advocate at a policy level about the broader public health importance of oral language competence.

Masculine gender role stress and the pursuit of muscularity.

The relationship between masculine gender role stress and body change was examined in 129 men, aged between 18 and 40 years (M = 24.38; SD = 6.04), who completed the Masculine Gender Role Stress scale (MGRS), the Drive for Muscularity Scale, the Eating Disorder Inventory, and the Eating Disorder Examination-Questionnaire. Significant relationships were observed between MGRS and drive for muscularity and, to a lesser extent, drive for thinness and disordered eating symptomatology. These relationships were mediated by body dissatisfaction, and several of the relationships were positively moderated by self-reported affective problems and personal ineffectiveness. Although interpretation of the results is limited by the cross-sectional design employed, the results are consistent with the proposition that a fear of deviating from the masculine gender role, particularly in men who feel ineffective and who have difficulty controlling and accessing their emotions, is related to concern with, and pursuit of, muscularity and leanness.

Future landscapes in South-eastern Australia : the role of protected areas and biolinks in adaptation to climate change

The extent and rapidity of global climate change is the major novel threatening process to biodiversity in the 21 st century. Globally, numerous studies suggest movement of biota to higher latitudes and altitudes with increasing empirical -evidence emerging. As biota responds to the direct and consequent effects of climate change the potential to profoundly affect natural systems (including the reserve system) of south-eastern Australia is becoming evident. Climate change is projected to accelerate major environmental drivers such as drought, fire and flood regimes. Is the reserve system sufficient for biodiversity conservation under a changing climate? Australia is topographically flat, biologically mega-diverse with high species endemism, and has the driest and most variable climate of any inhabited continent. Whilst the north-south orientation and aftitude gradient of eastern Australia's forests and woodlands provides some resilience to projected climatic change, this has been eroded since European settlement, particularly in the cool-moist Bassian zone of the south-east. Following settlement, massive land-use change for agriculture and forestry caused widespread loss and fragmentation of habitats; becoming geriatric in agricultural landscapes and artificially young in forests. The reserve system persists as an archipelago of ecological islands surrounded by land uses of varying compatibility with conservation and vulnerable to global warming. The capacity for biota to adapt is limited by habitat availability. The extinction risk is exacerbated. Re-examination of earlier analysis of ecological connectivity through biolink zones confirms biolinks as an appropriate risk management response within a broader suite of measures. Areas not currently in the reserve system may be critical to the value and ecological function of biological assets of the reserve system as these assets change. Ecological need and the rise of ecosystem services, combined with changing socio-economic drivers of land-use and social values that supported the expansion of the reserve system, all suggest biolink zones represent a new, necessary and viable multi-functional landscape. This paper explores some of the key ecological elements for restoration within biolink zones (and landscapes at large) particularly through currently agricultural landscapes.

The role of leadership theory in raising the profile of women in management

Purpose: To consider how leadership theories have helped or hindered raising the profile of women in management and leadership roles.

Design/methodology/approach: This paper traces the earlier leadership theories through to the contemporary research on transactional and transformational leadership styles and offers a viewpoint on how each theory has contributed, or otherwise, to an awareness and acceptance of women in management and leadership roles.

Findings:  In 1990, research began to report gender differences in leadership styles with female managers being seen in positive terms as participative, democratic leaders. More recent work reports that women are believed to exhibit more transformational leadership style than their male colleagues, and this is equated with effective leadership.

Research limitations/implications:  All of the earlier theories on leadership excluded women and this exacerbated the problem of women not being seen as an appropriate fit in a management or leadership role. Recent findings clearly describe that the transformational qualities of leadership that women exhibit are required by the flatter organisational structures of today. Therefore, a more positive outcome for women advancing to senior roles of management or leadership may be observed in the future.

Originality/value:  The paper reviews the major leadership theories, and links these to a timeframe to illustrate how women were not visible in a management context until relatively recently. Such an omission may have contributed to the continuing low numbers of women who advance to senior management and leadership roles.

Police stress : the role of psychological contract and perceptions of fairness

Purpose – The overall purpose of this paper is to examine the extent to which breaches in psychological contracts and perceptions of organizational fairness account for variations in job stress experienced by operational police officers (as measured by psychological distress and employee performance), after controlling for the variance associated with more established job stressors (i.e. job demands, job control and social support).

Design/methodology/approach – This study is based on data collected through a self-report survey involving operational members of a large Australian police force (n=582).

Findings – Results of hierarchical multiple regression analyses indicate that vast majority of explained variance in psychological distress and extra-role performance is attributed to the additive effects of demand, control, and support. Furthermore, only one of the social exchange dimensions (interpersonal fairness) is predictive of either target variable.

Research limitations/implications – The limitations that need to be taken into account are the cross-sectional nature of the study design and the focus on a single police service.

Practical implications – Despite the generally weak support for the social exchange variables, there are signs that dimensions of justice (particularly interpersonal justice) should be included in future police-stress investigations. The results also suggest that job characteristics such as job demand, job control and social support should be taken into account when developing strategies to prevent and/or reduce chronic job stress in policing services.

Originality/value – This is one of the first studies to examine the relationships between psychological contract breach, perceptions of fairness and police stress.

New residents—new city. The role of urban activists in the transformation of inner city Melbourne

This study of inner suburban residents' associations in Melbourne in the 1960s and 1970s examines the role of social activism in shaping Australia's urban dynamics. It argues that the focus on gentrification as an all-embracing explanatory concept in urban studies in Australia and elsewhere has detracted attention from the importance of structural change especially the de-industrialisation of the inner suburbs and the influence of urban activists and residents' associations in this period. The article concludes that insufficient analysis of social and economic change and the limited recognition of the importance of diverse communities continue to limit inclusive policy responses to urban reconstruction in Australia.