Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE] : rationale and design for a cluster randomised controlled trial

Background: Despite evidence that physical activity improves the health and well-being of prostate cancer survivors, many men do not engage in sufficient levels of activity. The primary aim of this study (ENGAGE) is to determine the efficacy of a referral and physical activity program among survivors of prostate cancer, in terms of increasing participation in physical activity. Secondary aims are to determine the effects of the physical activity program on psychological well-being, quality of life and objective physical functioning. The influence of individual and environmental mediators on participation in physical activity will also be determined.
Methods/Design: This study is a cluster randomised controlled trial. Clinicians of prostate cancer survivors will be randomised into either the intervention or control condition. Clinicians in the intervention condition will refer eligible patients (n = 110) to participate in an exercise program, comprising 12 weeks of supervised exercise sessions and unsupervised physical activity. Clinicians allocated to the control condition will provide usual care to eligible patients (n = 110), which does not involve the recommendation of the physical activity program. Participants will be assessed at baseline, 12 weeks, 6 months, and 12 months on physical activity, quality of life, anxiety, depression, self-efficacy, outcome expectations, goals, and socio-structural factors.
Discussion: The findings of this study have implications for clinicians and patients with different cancer types or other chronic health conditions. It will contribute to our understanding on the potential impact of clinicians promoting physical activity to patients and the long term health benefits of participating in physical activity programs.

Corporate ethics in TQM: management versus employee expectations and perceptions

Purpose – The objective of this research is to develop and describe a conceptual framework of corporate ethics in total quality management (TQM).

Design/methodology/approach – The research is based on a summarised in-depth and longitudinal case illustration. The summarised case describes corporate ethics in an intra-corporate relationship.

Findings – TQM requires human resources and failing to care for them will affect accordingly the success of TQM. The case description illustrates the evolution of management versus employee expectations and perceptions of corporate ethics. It has an emphasis on the human resources of a company that strives towards TQM. As the quality of corporate ethics decreases the outcome of TQM is also affected (i.e. directly or indirectly). The case is initialised in an atmosphere of management and employee optimism and positivism of corporate ethics, which is a requisite from both parties in order to ensure prosperous TQM. The successive change towards pessimism and negativism of corporate ethics in the intra-corporate relationship concludes the in-depth case description.

Research limitations/implications – Four parameters of corporate ethics are used to incorporate corporate ethics into TQM, namely management versus employee expectations and perceptions. Internal corporate quality management should always be regarded as dependent upon the achieved equilibrium between management and employee perceptions. It is also dependent upon the derived equilibrium between management and employee previous expectations.

Practical implications – An important insight of this research is that TQM requires the continuous attention to the management versus employee expectations and perceptions inherent in corporate ethics of internal business operations. Furthermore, corporate ethics is complementary to business ethics.

Originality/value – The case description has shown that TQM may be running well and accomplishing the hard goals. However, TQM is not only about figures, profits and costs. It is also a business approach that should penetrate all activities inside and outside that are related to the company, including the soft issues.

Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R); a measure of the quality of postoperative pain management employed internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from two point-prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients. Parallel analysis indicated four and three factor solutions for Danish and Australian patients respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α=.54) and Australian (Cronbach α=.63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience", but not "pain management". This reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings to past research conducted in the U.S. and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience", but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. PERSPECTIVE: This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R.

Accountability, completeness, credibility and the audit expectations gap

This article deals with two concerns in achieving greater accountability in social reports: the lack of completeness of reporting, and the lack of credibility of reports. The article focuses, in particular, on the role of social audits in improving the completeness and credibility of reporting, thereby reducing the audit expectations gap. We suggest that this gap arises due to an over-emphasis on the validity of performance data at the expense of addressing completeness and credibility, both of which, we argue, require stakeholder involvement. The article reviews recent guidelines aimed at ensuring that companies produce reports that are complete in all material respects including those produced by the Global Reporting Initiative and the Federation des Experts Comptables Europeens, focusing particularly on AccountAbility's AA1000 Standard and AA1000S Assurance Standard. Finally, the article considers the development of a practical approach to social audit following principles increasingly being incorporated into developing assurance guidelines aimed at reducing the audit expectations gap.

University and employer expectations of new dietetic graduates

Objectives:  The first objective of this study was to identify the knowledge, skills and attributes (KSAs) that employers seek in newly graduated dietitians. The second objective was to compare the KSAs that employers seek in newly graduated dietitians to the Deakin University Graduate Attributes and to the Dieticians Association of Australia (DAA) Competencies in order to determine if there is a mismatch.

Methods:   Views were gathered from a combination of group and individual in-depth, semistructured interviews with 19 employers from a range of employment settings and sorted into an existing framework using the DAA Competencies and the Deakin University Graduate Attributes. Data from taped interviews were transcribed and sorted into a table of generic skills and a KSAs matrix.

Results: Employers sought graduates who had practical knowledge of dietetics and the workplace, Key skills sought included communication, interpersonal, work management and information technology skills. Key attributes sought were the ability to be a team player, to demonstrate some insight into one's own limitations, to demonstrate an appropriate level of initiative, and to be flexible and adaptable. There was a large overlap between the KSAs identified by employers as being important and those that have been identified by the DAA and Deakin University. However, there were some areas of mismatch. The University and employers valued information technological skills, whereas the DAA did not state these as a competency. The University and the industry employers were concerned about the global perspective, but the DAA and the clinical employers were not.

Conclusions: The results of this study show a large overlap between the KSAs valued by the profession, the University and the employers.

HRQOL and subjective well-being: noncomplementary forms of outcome measurement

This review considers some of the broad principles that concern quality of life assessment. These are discussed in relation to health-related quality of life (HRQOL) and the measurement of subjective well-being. It is argued that there are serious logical and methodological issues concerning HRQOL measurement, to the extent that the instruments may not be regarded as valid measures of life quality as this term is generally understood. It is recommended that HRQOL measurement be abandoned in favor of three separate forms of measurement as medical symptoms, subjective well-being and specific dimensions of psychological ill-being.

Managing student expectations online

In contrast to other studies of students in online environments, which examine the skills and attitudes that students bring to an online university learning environment, we are interested in the expectations with which students come to online university study. Four expectational barriers, which arise from students’ background and cultural history, are identified as being: who is responsible for learning, who is responsible for student interaction with content, who is responsible for the use of appropriate learning strategies and who is responsible for required ancillary skills. There is a discussion of how these barriers arise and how one might attempt to manage the students’ expectations and ameliorate their effects.

Understanding student expectations in developing environmental science courses

Developing relevant and innovative University courses is a complex and often difficult task. This is particularly true when developing environmental science courses as the banner of environmental science has the potential to include an extremely vast array of subject material and course content. Added to this is the diversity of students entering these courses, and their associated course expectations and aspirations. A third component that cannot be ignored when developing courses includes employer demands and expectations of graduates at course completion. As tertiary educators we therefore have the challenge of developing innovative environmental science courses that are academically challenging, but meet the expectations of students, staff and potential future employers. To ensure that we meet this challenge it is vital that we determine the expectations of all relevant parties (students, staff, and potential employers) and develop our courses accordingly.  Here we report on the 'student expectations' component of this. To determine student expectations we conducted a survey of all commencing first year environmental science students. The survey asked students to provide information on drivers for course selection, preferred learning styles, the importance of different approaches to teaching, subject interest areas and employment aspirations. Our results found that environmental science students have a preference for fieldwork and hands-on experience and are very supportive of teaching that combines different teaching methods. On-line teaching was not supported by commencing environmental science students. Commencing students showed a very strong interest in key subject areas of environmental science such as Wildlife, animal conservation, national and marine parks, conservation and marine Wildlife; however, some of the critical areas of environmental science such as population statistics, social sciences and chemistry did not attract the same level of interest. Most commencing students had some idea on where they would like to gain employment on course completion. Knowledge relating to student expectations is Vital, particularly when designing courses, developing specific unit content and undertaking marketing and course information sessions. With this knowledge we can be confident that students enrolling in environmental science will, to a large extent, have their expectations met.

Gatekeeping or redressing social exclusion : expectations on social work educators in relation to incarcerated students

Until recently, the author was in Scotland, where professional registration in social work extends to students and involves criminal record checks prior to acceptance into a course of study. She is now teaching at Deakin University in Australia, which places a high priority on making higher education available to persons and groups who have traditionally been excluded, both through the provision of courses through off campus (distance education) study mode and an innovative and culturally sensitive mode of provision for indigenous Australians. One result of our attempts to redress social exclusion is that, on occasion, we discover that some of our students are incarcerated. There are important logistical issues which may emerge as a consequence of accepting prisoners into a program of social work education. However, it would seem that the inclusion of prisoners is symbolic of a fundamental difference in philosophy with programmes of social work education in countries where there is a strong expectation that social work educators act as gatekeepers to the profession, especially in respect of students with criminal convictions. This in tum reflects an expectation among social work educators in Australia that it may be more appropriate for professional associations or registration bodies to determine whether or not a graduate with a criminal record is suitable for employment as a professional social worker. In some settings, a prior criminal record is not a barrier to being an effective service provider, as well as international differences in understandings of the social work role and employment
destinations of social work graduates.

The impact of service intangibility on consumer service quality expectations

Research consistently demonstrates the strategic benefits of providing quality in service delivery (Tse and Wilton 1988; Anderson and Zeithaml 1984). However, to deliver a quality service, it is first necessary to determine the level of quality expectations that consumers have for a particular service industry. This paper examines whether quality expectations vary across services based on their degree of total intangibility. A controlled, repeated measures design is utilised, whereby subjects are each asked to evaluate three services that vary in their degree of intangibility. Contrary to past findings, results indicate that consumer expectations for service quality do not vary with the level of intangibility of the service.

The emergence of the public sector expectations gap

This paper focuses on the continuing worldwide phenomenon of homogenisation of audit rules, regulation and procedures between the government and private sectors. The observations are informed by Pusey’s (1991) criticisms of ‘economic rationalism’ as the driving mechanism behind public sector reforms in Australia. The presumed superiority of commercial audit is questioned in association with the work of Hopwood (1983, 1998), Otley and Pierce (1996) and, Power (1992, 1994, 1995, 1996, 1997) that contextualise the role of audit. In the private sector audit there continues to be an ‘expectations gap’ arising from commercial pressures and a rhetorical support for the public interest. It is contended that audit quality in the public sector is driven by a different perception of public interest that has been eroded with the advent of economic rationalism. The consequent emergence of a public sector audit ‘expectations gap’ is an amalgam of new components particular to the government audit environment and, aspects of the private ‘expectations gap’ which have been transplanted into the public domain.