Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians.

Objective: To evaluate the Arthritis Self-Management Course (ASMC) when applied in a nationwide context.

Methods: Four hundred fifty-two people who participated in the ASMC across Australian states took part in a longitudinal followup study. ASMC is a 6 week, 2 h group educational program designed to assist people with chronic illness to better manage their condition. Measures of program effectiveness included health status and service utilization. Data were collected on 3 occasions: before intervention (baseline) and 6 months and 2 years after the program.

Results: Several indicators of health status showed improvement at 6 months following the ASMC. These included reduction in pain (4%; p < 0.001), fatigue (3%; p < 0.01), and health distress (12%; p < 0.001) as well as increase in self-efficacy (6%; p < 0.001). Increased self-efficacy was a significant predictor of positive change in health status. Health-related behaviors such as aerobic exercise also increased, with the proportion of people who did little or no exercise decreasing by up to 8%. These changes were sustained at 2 years. There was an increase in use of analgesics at 6 months and an increase in use of nonsteroidal antiinflammatory drugs at 2 years. No changes in healthcare utilization (physician visits, allied health visits, and hospitalizations) were observed.

Conclusion: The ASMC is a widely applied program in which participants benefit through a reduction in pain, fatigue, and health distress. Although the absolute changes in health status are small, the low cost and wide application of the intervention suggests the program may have a substantial public health effect.

Project management practice in transition of old residential region

With the rapid urbanisation worldwide, the transitions of old residential regions inside or close to the urban districts have been challenging both governments and professionals. The sustainable maintenance, innovation and construction of these regions incorporate the history, culture, environment and policy factors into the economic objectives. Over the long and complex process of a transition project, the dedicated project management crew are frequently confronted with diversified novel issues and obliged to contribute appropriate solutions urgently. In this paper, the authors first analyse the state of the art of transition projects of old residential regions based on their practices in real projects. Furthermore, the authors explore the sustainable alternatives of transition projects from the reservation and development perspectives of culture, environment, society and infrastructure. Finally, the authors develop a multi-dimensional implementary framework for guiding the practices of management of transition projects.

Transition to a low carbon footprint : a conceptual model of impacts and management for Australian businesses

Australian businesses will face profound and wide-ranging structural impacts during their transition to a low carbon footprint economy. This paper synthesizes the impacts for the firm during the transition and identifies the crucial impact variables. In doing so, it explores the link between the opportunities and benefits, costs, risks and structural changes and evaluates the challenges in managing the multiple impacts. The paper provides a conceptual model that will assist decision-makers deal with risk management or bottom-line protection issues as well as exploiting the business opportunity the new regulatory environment will produce. The model argues for a holistic corporate governance mechanism, with responsibility and accountability of climate change risk management placed with the board of directors and senior management. The literature review is presented first, followed by the discussion and the model. Future empirical research direction is also presented with the development of a series of propositions for testing.

Communicating about the management of medications as patients move across transition points of care: an observation and interview study

RATIONALE, AIMS AND OBJECTIVES: As patients move across transition points, effective medication management is critical for patient safety. The aims of this study were to examine how health professionals, patients and family members communicate about managing medications as patients moved across transition points of care and to identify possible sources of communication failure.

METHOD: A descriptive approach was used involving observations and interviews. The emergency departments and medical wards of two hospitals were involved. Observations focused on how health professionals managed medications during interactions with other health professionals, patients and family members, as patients moved across clinical settings. Follow-up interviews with participants were also undertaken. Thematic analysis was completed of transcribed data, and descriptive statistics were used to analyse characteristics of communication failure.

RESULTS: Three key themes were identified: environmental challenges, interprofessional relationships, and patient and family beliefs and responsibilities. As patients moved between environments, insufficient tracking occurred about medication changes. Before hospital admission, patients participated in self-care medication activities, which did not always involve exemplary behaviours or match the medications that doctors prescribed. During observations, 432 instances of communication failure (42.8%) were detected, which related to purpose, content, audience and occasion of the communication.

CONCLUSIONS: Extensive challenges exist involving the management of medications at transition points of care. Bedside handovers and ward rounds can be utilized as patient counselling opportunities about changes in the medication regimen. Greater attention is needed on how patients in the community make medication-related decisions.

Mortgages and bonds: the asset management practices of Australian life insurers to 1960

Recent studies of the experience of the British life insurance industry indicate that a period of transition, and the development of more diversified investment strategies, began in the interwar period. Australian life insurers lagged behind their British counterparts in the introduction of such strategies. This paper investigates why this was the case. It argues that in the Australian market there was both a lack of opportunity and incentive to broaden asset portfolios. However, this did not mean that asset management practices did not advance. Australian life offices became progressively more sophisticated in their approach to portfolio management during this period. Developments in the interwar period provided a grounding for post-war expansion into the equity market.

Understanding transition towards information security culture change

Transitioning towards an information security culture for organisations has not been adequately explored in the current security and management literature. Many authors have proposed how information security culture can be created, fostered and managed within organisations, but have failed to adequately address the transition process towards information security culture change, particularly for small medium enterprises (SMEs). This paper aims to (1) recapitulate key developments and trends within information security culture literature; (2) explore in detail the transition process towards organisational change; (3) adapt the transition process with respects to the key players involved in transition and propose a transition model for information security culture change; and (4) consider how this model could be used by managers and employees of Australian SMEs. A major intention of this paper is to provide academic researchers and practicing managers with an understanding of the transition process towards achieving information security culture change within SMEs.

Sir George Simpson : 19th century fur trade governor and precursor of systematic management

Purpose – Sir George Simpson, the Governor of the Hudson's Bay Company (HBC) from 1821 to his death in 1860, was the subject of numerous biographical works that described various facets of the man including his managerial abilities, literary prowess, physical stamina, abundant energy, extensive art collection and ethnological specimens. Two related aspects of his outstanding management style have been overlooked: the genesis of his management style and where it can be placed in the evolution of management practices during the 19th century.

Design/methodology/approach – Primary data from the Hudson's Bay Company archives plus secondary sources.

Findings – Simpson's management abilities came from his grammar school education and his apprenticeship to a counting house. More importantly, it can be attributed to his association with his mentor Andrew Wedderburn, his dedication to the HBC, and his high level of physical and intellectual energy. His information intensive management style was also a significant precursor to systematic management, which occurred later in the 19th century.

Research limitations/implications – Future research should examine other examples of the evolution of management during the 19th century, particularly the transition from sub-unit accountability to systematic management.

Originality/value – The paper emphasizes the importance of managers in making management systems work.

A possible journey to an Australian knowledge management framework

World wide there is a transition towards knowledge-based economies In order to foster them, many economies have built frameworks in conjunction with world forums that promote international cooperation. Our research focuses on Australia, an economy that has been named by the OECD as knowledge-based. Specifically, the paper appraises the transition towards knowledge economies in general. We then examine the Australian context through the implemented eEurope framework with the intent of providing suggestions to Australia in its transition towards building its knowledge management
framework.

The attraction, retention/transition and nurturing process of sport development : some Australian evidence

The purpose of this study was to explore and map the sport development processes in Australia. A grounded theory approach identified sport development processes by examining 74 annual reports from 35 national sporting organizations (NSOs) over a period of 4 years, before and after the Sydney Olympic Games. The 3 frameworks presented in this article representing the attraction, retention/ transition, and nurturing process illustrate the generic processes and strategies described by NSOs. The results show that each sport development process requires human and financial input from various stakeholders. These stakeholders initiate or implement sport development strategies for each process and each process has different sport development outputs. These results contribute to the extant literature of sport development by demonstrating that sport development is more complex and encompassing than previously described. It is proposed that the generic frameworks derived from this study be subject to more specific testing using other sport systems, as context and case studies could lead to tailoring the frameworks to represent specific sport development processes and systems.

Considerations for performing arts organisations in a climate of transition to the open market context in Vietnam

The emergence of a global economy and culture has created a worldwide climate of change since the 1980s. These changes impact on the growth of a national economy and change the significance of sectors in society, for example the service sector, which increasingly accounts for an important part of the economy (Burbules & Torres, 2000). The arts have also been profoundly influenced by social changes, and technological development. While these changes pose new challenges for the arts, most of which struggle for financial viability in an era of globalisation, privatisation and reduced public funding, the developments also open new opportunities for arts companies/artists but require them to possess the capability to identify and adapt to change. This process underlines the necessary new capacities of arts management, arts marketing, arts leaders and artists.

Doi moi - Vietnamese economic reforms in 1986 - provided impetus for change in every sector, resulting in growth of the service sector in Vietnam (UNDP, 2002). Arts organisations in Vietnam found themselves operating in a more competitive environment, forcing them to adjust to this new economic structure. Improved Vietnamese living standards helped to create more demands for a diverse entertainment industry and allowed both the government and individuals to spend more on the arts. A new cultural policy - socialisation (somewhat equivalent to privatisation in Western countries) was implemented in the arts and cultural sector, producing for performing arts organisations (PAOs) as well as a broader cultural milieu in Vietnam, challenges of being self-sustaining but also more autonomy and greater funding diversity. Simultaneously, this led to upgraded artistic standards, improved infrastructure and higher musicians’ salaries; the latter having only experienced slow improvement during the subsidised era.

This paper investigates how social changes affected organisational operations of selected PAOs in Vietnam and Australia. The analysis of how PAOs in each country adjusted to rapid changes will provide experience for learning from each other, particularly for the Vietnamese case. These analyses provide points of discussion, comparison and implications for development of arts management training in Vietnam. Case studies, personal interviews with key participants and policy actors have been used to discern which direction performing arts management should take in order to correspond with Vietnam’s present and future economic situation and its political position in the world.

Processes influencing the development of graduate nurse capabilities in clinical risk management : an Australian study

Objectives: To explore and describe key processes influencing the development of graduate nurse capabilities in clinical risk management (CRM).

Methods: This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably: 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administratiors employed by the participating health service; patient outcome data; and pertinent literature.

Results: Data strongly suggested that graduate nurse capabilities in CRM were most influenced not by their supposed lack of clinical knowledge and skills but by their lack of corporate knowledge. The failure to provide new graduate nurses with pertinent information on CRM at the beginning of their employment and thereafter at pertinent intervals during the graduate nurse year program aslo hindered the development of their capabilities to manage clinical risk.

Conclusions: Management and educational processes pertinent to informing and involving new graduate nurses in a hospital's local CRM program (including information about the organization's local policies and procedures) need to be implemented systematically at the very beginning of a new graduate's employment and thereafter throughout the remainder of the graduate nurse year.

Comparison of the pre-post and transition question assessments in a health education setting

Objective : This study examined the classical pre-intervention/post-intervention assessment (pre–post) and the single post-intervention transition question assessment (transition question) to determine how well these methods reflected qualitative interview–based participant-reported outcomes from chronic disease self-management education programs (CDSMEPs).

Study Design and Setting : A mixed-method qualitative and quantitative approach was applied in 25 interviews with participants recruited from CDSMEPs within Australia. Qualitative interviews with participants were used as a relative “gold standard” and compared with questionnaire-based pre–post and transition question assessments.

Results : Comparison of the two questionnaire-based assessments showed that most of the individual paired responses were discordant (61%). Using participant's qualitative narratives as a “true” indicator, the pre–post assessment was found on more occasions to be discordant with participant-reported outcomes than the transition question. The origin of the inconsistency was largely because of a change in respondents' perspective that had occurred after pretest, which was mediated by CDSMEPs' experiences and insights.

Conclusion : This study suggests that the pre–post assessment has poor validity for the assessment of health education program outcomes. Alternative assessments, such as the transition question, may result in a more accurate reflection of the impact of such programs on participants.

From learning to earning : the school-to-work transition of Australian graduates

Aims to investigate the transition of graduates from school-to-work through the triagulation of three data sets. A 3-stage model based on what graduates "want", "do" and "get" in their first job was designed. Findings revealed causality between the three stages.