Job satisfaction, stress and burnout in haemodialysis nurses

Haemodialysis nurses provide health care for people with end stage kidney disease leading to a unique, intense and complex interaction between nurses and patients. This study involved the development of a model which explains the relationships between the work environment, job satisfaction, stress and burnout of haemodialysis nurses in Australia and New Zealand. Results from this study identified that haemodialysis nurses, while being satisfied by their jobs, were also experiencing high levels of burnout. This study's novel contribution could lead to improving the retention of the nursing workforce which is crucial due to the growing global burden of chronic disease.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

A longitudinal investigation of coping processes during a merger: Implications for job satisfaction and organizational identification

This study tested the utility of a stress and coping model of employee adjustment to a merger. Two hundred and twenty employees completed both questionnaires (Time 1: 3 months after merger implementation; Time 2: 2 years later). Structural equation modeling analyses revealed that positive event characteristics predicted greater appraisals of self-efficacy and less stress at Time 1. Self-efficacy, in turn, predicted greater use of problem-focused coping at Time 2, whereas stress predicted a greater use of problem-focused and avoidance coping. Finally, problem-focused coping predicted higher levels of job satisfaction and identification with the merged organization (Time 2), whereas avoidance coping predicted lower identification.

Socioeconomic inequalities in diet and bodyweight: Evidence, causes, and intervention options

Diets low in fruits, vegetables, and whole grains, and high in saturated fat, salt, and sugar are the major contributors to the burden of chronic diseases globally. Previous research, and studies in this issue of Public Health Nutrition (PHN), show that unhealthy diets are more commonly observed among socioeconomically disadvantaged groups, and are key contributors to their higher rates of chronic disease. Most research examining socioeconomic inequalities in diet and bodyweight has been descriptive, and has focused on identifying the nature, extent, and direction of the inequalities. These types of studies are clearly necessary and important. We need however to move beyond description of the problem and focus much more on the question of why inequalities in diet and bodyweight exist. Furthering our understanding of this question will provide the necessary evidence-base to develop effective interventions to reduce the inequalities. The challenge of tackling dietary inequalities however doesn’t finish here: a maximally effective approach will also require equity-based policies that address the unequal population-distribution of social and economic resources, which is the fundamental root-cause of dietary and bodyweight inequalities.

Shaping development through mechanical strain: The transcriptional basis of diet-induced phenotypic plasticity in a cichlid fish

Adaptive phenotypic plasticity, the ability of an organism to change its phenotype to match local environments, is increasingly recognized for its contribution to evolution. However, few empirical studies have explored the molecular basis of plastic traits. The East African cichlid fish Astatoreochromis alluaudi displays adaptive phenotypic plasticity in its pharyngeal jaw apparatus, a structure that is widely seen as an evolutionary key innovation that has contributed to the remarkable diversity of cichlid fishes. It has previously been shown that in response to different diets, the pharyngeal jaws change their size, shape and dentition: hard diets induce an adaptive robust molariform tooth phenotype with short jaws and strong internal bone structures, while soft diets induce a gracile papilliform tooth phenotype with elongated jaws and slender internal bone structures. To gain insight into the molecular underpinnings of these adaptations and enable future investigations of the role that phenotypic plasticity plays during the formation of adaptive radiations, the transcriptomes of the two divergent jaw phenotypes were examined. Our study identified a total of 187 genes whose expression differs in response to hard and soft diets, including immediate early genes, extracellular matrix genes and inflammatory factors. Transcriptome results are interpreted in light of expression of candidate genesmarkers for tooth size and shape, bone cells and mechanically sensitive pathways. This study opens up new avenues of research at new levels of biological organization into the roles of phenotypic plasticity during speciation and radiation of cichlid fishes.

Factors influencing radiation therapy student clinical placement satisfaction

Introduction Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning.

PREPARE Study: Patient satisfaction survey with care provided in the low clearance clinic

Background Formalised predialysis care has been shown to extend the wellness of individuals with advanced chronic kidney disease, slow disease progression and increase the uptake of home dialysis. Predialysis care, incorporating multidisciplinary input is also vital in delaying the onset of end-stage kidney disease and reducing hospital admissions; thereby decreasing financial demands on health budgets. Predialysis care should include comprehensive information provision and predialysis education. This empowers patients to choose self-care strategies and therapies.

Food literacy: Definitions, components, learning and links to diet and health outcomes

Recently, the term ‘food literacy’ has emerged in policy, research and practice to describe the collection of knowledge, skills and behaviours required to practically meet food needs. This presentation will described research undertaken to empirically define the term and propose its impact on nutrition

Haemodialysis work environment contributors to job satisfaction and stress: A sequential mixed methods study

Background: Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Methods: Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction(IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. Results: From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Conclusions: Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

The role of engagement on stakeholder's satisfaction with the destination marketing organisation's performance

In the tourism literature there has been a lack of research related to stakeholders' satisfaction with destination marketing organisations (DMO). This study addresses this research gap, in the context of the national tourism office of Oman, by investigating the relationship between stakeholder's perceptions of DMO performance and their overall satisfaction with the DMO. Conceptually the study found DMO engagement with stakeholders to partially mediate satisfaction, a finding of relevance to destination marketers in other parts of the world. From a practical perspective the research was supported by the Oman national tourism office, which has only been in operation for 10 years.

Low-density koala (Phascolarctos cinereus) populations in the mulgalands of south-west Queensland. II. Distribution and diet

This study used faecal pellets to investigate the broadscale distribution and diet of koalas in the mulgalands biogeographic region of south-west Queensland. Koala distribution was determined by conducting faecal pellet searches within a 30-cm radius of the base of eucalypts on 149 belt transects, located using a multi-scaled stratified sampling design. Cuticular analysis of pellets collected ffom 22 of these sites was conducted to identify the dietary composition of koalas within the region. Our data suggest that koala distribution is concentrated in the northern and more easterly regions of the study area, and appears to be strongly linked with annual rainfall. Over 50% of our koala records were obtained from non-riverine communities, indicating that koalas in the study area are not primarily restricted to riverine communities, as bas frequently been suggested. Cuticular analysis indicates that more than 90% of koala diet within the region consists of five eucalypt species. Our data highlights the importance of residual Tertiary landforms to koala conservation in the region.

Aspects of reproduction and diet of the Australian endemic skate Dipturus polyommata (Ogilby) (Elasmobranchii: Rajidae), by-catch of a commercial prawn trawl fishery

The Australian endemic skate Dipturus polyommata collected from by-catch of a benthic prawn fishery off southern Queensland was examined to provide information on reproduction and diet. Morphological relationships of total length (LT) to disc width and LT to mass were estimated. Size at birth was estimated at c. 100-110 mm and size at first feeding at c. 105-110 mm LT. Size at 50% maturity (LT50 and 95% CI) was 321 (305-332) and 300 (285-306) mm LT for females and males, respectively. Size at first maturity corresponded to 87.7% of observed maximum size in females (366 mm LT) and 87.5% in males (343 mm L T). Two females, representing 18.2% of mature females sampled in the austral winter were each carrying two egg cases. Descriptions of egg cases are given. Diet described by the index of relative importance as a percentage (%IRI) was predominantly crustacean based with carid shrimps (53.64%) and penaeoid prawns (23.30%) the most significant prey groups. Teleosts (11.72%), gammarid amphipods (5.31%) and mysids (4.72%) were also important to the diet of the species, while a further six prey groups made only a minor contribution to diet (1.31%). An ontogenetic change was evident between the diets of immature and mature skates. Immature animals fed more extensively on carids and amphipods and mature animals on penaeoids, teleosts and mysids.

Diet-induced hypercholesterolemia promotes androgen-independent prostate cancer metastasis via IQGAP1 and caveolin-1

Obesity and metabolic syndrome are associated with several cancers, however, the molecular mechanisms remain to be fully elucidated. Recent studies suggest that hypercholesterolemia increases intratumoral androgen signaling in prostate cancer, but it is unclear whether androgenindependent mechanisms also exist. Since hypercholesterolemia is associated with advanced, castrate-resistant prostate cancer, in this study, we aimed to determine whether and how hypercholesterolemia affects prostate cancer progression in the absence of androgen signaling. We demonstrate that diet-induced hypercholesterolemia promotes orthotopic xenograft PC-3 cell metastasis, concomitant with elevated expression of caveolin-1 and IQGAP1 in xenograft tumor tissues. In vitro cholesterol treatment of PC-3 cells stimulated migration and increased IQGAP1 and caveolin-1 protein level and localization to a detergent-resistant fraction. Down-regulation of caveolin-1 or IQGAP1 in PC-3 cells reduced migration and invasion in vitro, and hypercholesterolemia-induced metastasis in vivo. Double knock-down of caveolin-1 and IQGAP1 showed no additive effect, suggesting that caveolin-1 and IQGAP1 act via the same pathway. Taken together, our data show that hypercholesterolemia promotes prostate cancer metastasis independent of the androgen pathway, in part by increasing IQGAP1 and caveolin-1. These results have broader implications for managing metastasis of cancers in general as IQGAP1 and hypercholesterolemia are implicated in the progression of several cancers.

Diet quality and liveweight gain of steers grazing Leucaena-grass pasture estimated with faecal near infrared reflectance spectroscopy (F.NIRS)

Three drafts of Bos indicus cross steers (initially 178-216 kg) grazed Leucaena-grass pasture [Leucaena leucocephala subspecies glabrata cv. Cunningham with green panic (Panicum maximum cv. trichoglume)] from late winter through to autumn during three consecutive years in the Burnett region of south-east Queensland. Measured daily weight gain (DWGActual) of the steers was generally 0.7-1.1 kg/day during the summer months. Estimated intakes of metabolisable energy and dry matter (DM) were calculated from feeding standards as the intakes required by the steers to grow at the DWGActual. Diet attributes were predicted from near infrared reflectance spectroscopy spectra of faeces (F.NIRS) using established calibration equations appropriate for northern Australian forages. Inclusion of some additional reference samples from cattle consuming Leucaena diets into F.NIRS calibrations based on grass and herbaceous legume-grass pastures improved prediction of the proportion of Leucaena in the diet. Mahalanobis distance values supported the hypothesis that the F.NIRS predictions of diet crude protein concentration and DM digestibility (DMD) were acceptable. F.NIRS indicated that the percentage of Leucaena in the diet varied widely (10-99%). Diet crude protein concentration and DMD were usually high, averaging 12.4 and 62%, respectively, and were related asymptotically to the percentage of Leucaena in the diet (R2 = 0.48 and 0.33, respectively). F.NIRS calibrations for DWG were not satisfactory to predict this variable from an individual faecal sample since the s.e. of prediction were 0.33-0.40 kg/day. Cumulative steer liveweight (LW) predicted from F.NIRS DWG calibrations, which had been previously developed with tropical grass and grass-herbaceous legume pastures, greatly overestimated the measured steer LW; therefore, these calibrations were not useful. Cumulative steer LW predicted from a modified F.NIRS DWG calibration, which included data from the present study, was strongly correlated (R2 = 0.95) with steer LW but overestimated LW by 19-31 kg after 8 months. Additional reference data are needed to develop robust F.NIRS calibrations to encompass the diversity of Leucaena pastures of northern Australia. In conclusion, the experiment demonstrated that F.NIRS could improve understanding of diet quality and nutrient intake of cattle grazing Leucaena-grass pasture, and the relationships between nutrient supply and cattle growth.