Theory-based self-management programs for promoting recovery in community-dwelling stroke survivors : a systematic review

Background Post-stroke recovery is demanding. Increasing studies have examined the effectiveness of self-management programs for stroke survivors. However no systematic review has been conducted to summarize the effectiveness of theory-based stroke self-management programs. Objectives The aim is to present the best available research evidence about effectiveness of theory-based self-management programs on community-dwelling stroke survivors’ recovery. Inclusion criteria Types of participants All community-residing adults aged 18 years or above, and had a clinical diagnosis of stroke. Types of interventions Studies which examined effectiveness of a self-management program underpinned by a theoretical or conceptual framework for community-dwelling stroke survivors. Types of studies Randomized controlled trials. Types of outcomes Primary outcomes included health-related quality of life and self-management behaviors. Secondary outcomes included physical (activities of daily living), psychological (self-efficacy, depressive symptoms), and social outcomes (community reintegration, perceived social support). Search Strategy A three-step approach was adopted to identify all relevant published and unpublished studies in English or Chinese. Methodological quality The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist for experimental studies. Data Collection A standardized JBI data extraction form was used. There was no disagreement between the two reviewers on the data extraction results. Data Synthesis There were incomplete details about the number of participants and the results in two studies, which makes it impossible to perform meta-analysis. A narrative summary of the effectiveness of stroke self-management programs is presented. Results Three studies were included. The key issues of concern in methodological quality included insufficient information about random assignment, allocation concealment, reliability and validity of the measuring instruments, absence of intention-to-treat analysis, and small sample sizes. The three programs were designed based on the Stanford Chronic Disease Self-management program and were underpinned by the principles of self-efficacy. One study showed improvement in the intervention group in family and social roles three months after program completion, and work productivity at six months as measured by the Stroke Specific Quality of Life Scale (SSQOL). The intervention group also had an increased mean self-efficacy score in communicating with physicians six months after program completion. The mean changes from baseline in these variables were significantly different from the control group. No significant difference was found in time spent in aerobic exercise between the intervention and control groups at three and six months after program completion. Another study, using SSQOL, showed a significant interaction effect by treatment and time on family roles, fine motor tasks, self-care, and work productivity. However there was no significant interaction by treatment and time on self-efficacy. The third study showed improvement in quality of life, community participation, and depressive symptoms among the participants receiving the stroke self-management program, Stanford Chronic Disease Self-management program, or usual care six months after program completion. However, there was no significant difference between the groups. Conclusions There is inconclusive evidence about the effectiveness of theory-based stroke self-management programs on community-dwelling stroke survivors’ recovery. However the preliminary evidence suggests potential benefits in improving stroke survivors’ quality of life and self-efficacy.

Greener workplace : understanding senior management's adoption decisions through the Theory of Planned Behaviour

Human Resources (HR) policies and practices have changed due to global environmental instability. These policies and practices are key factors for successful environmental management. Using the Theory of Planned Behaviour, this article aims to understand the critical factors which influence senior management’s decision to adopt ‘green’ HR practices. Data were collected from 210 organisations in Australia using two separate surveys. Survey one, which was addressed directly to HR managers and directors, contained questions relating to HR policies (the dependent variables), while survey two, which was addressed directly to CEOs and senior managers, contained questions about environmental-related attitudes, subjective norms and perceived control (the independent variables). Results indicated that senior management’s environmental-related attitudes, subjective norms from stakeholders and perceived green resource readiness influenced their decision to adopt green HR initiatives. However, attitudes and green resource readiness in particular had greater impacts than subjective norms. Limitations, implications and future research are also outlined.

Can Business Continuity Management Create Reliability in Airports? (Issues from Theory into Practice)

The advances made within the aviation industry over the past several decades have significantly improved the availability, affordability and convenience of air travel and have been greatly beneficial in both social and economic terms. Air transport has developed into an irreplaceable service being relied on by millions of people each day and as such airports have become critical elements of national infrastructure to facilitate the movement of people and goods. As components of critical infrastructure (CI), airports are integral parts of a national economy supporting regional as well as national trade, commercial activity and employment. Therefore, any disruption or crisis which impacts the continuity of operations at airports can have significant negative consequences for the airport as a business, for the local economy and other nodes of transport infrastructure as well as for society. Due to the highly dynamic and volatile environment in which airports operate in, the aviation industry has faced many different challenges over the years ranging from terrorist attacks such as September 11, to health crises such as the SARS epidemic to system breakdowns such as the recent computer system outage at Virgin Blue Airlines in Australia. All these events have highlighted the vulnerability of airport systems to a range of disturbances as well as the gravity and widespread impact of any kind of discontinuity in airport functions. Such incidents thus emphasise the need for increasing resilience and reliability of airports and ensuring business continuity in the event of a crisis...

The implementation of a guideline of care for patients with a Sengstaken-Blakemore tube in situ in a general intensive care unit using transitional change theory

The use of the Sengstaken–Blakemore tube as a life-saving treatment for bleeding oesophageal varices is slowly becoming the least preferred method possibly due to the potential complications associated with its placement. Nursing practice pertaining to the care of this patient group appears ad hoc and reliant on local knowledge and experience as opposed to recognised evidence of best practice. Therefore, this paper focuses on the application of Lewin's transitional change theory used to introduce a change in nursing practice with the application of a guideline to enhance the care of patients with a Sengstaken–Blakemore tube in situ within a general intensive care unit. This method identified some of the complexities surrounding the change process including the driving and restraining forces that must be harnessed and minimised in order for the adoption of change to be successful.

Advancing practice in critical care : a model of knowledge integration

Aim The aim of this paper was to discuss the potential development of a conceptual model of knowledge integration pertinent to critical care nursing practice. A review of the literature identified that reflective practice appeared to be at the forefront of professional development. Background It could be argued that advancing practice in critical care has been superseded by the advanced practice agenda. Some would suggest that advancing practice is focused on the core attributes of an individual’s practice, which then leads onto advanced practice status. However, advancing practice is more of a process than identifiable skills and as such is often negated when viewing the development of practitioners to the advanced practice level. For example, practice development initiatives can be seen as advancing practice for the masses, which ensures that practitioners are following the same level and practice of care. The question here is, are they developing individually? Relevance to clinical practice What this paper presents is that reflection may not be best suited to advancing practice if the individual practitioner does not have a sound knowledge base both theoretically and experientially. The knowledge integration model presented in this study uses multiple learning strategies that are focused in practice to develop practice, e.g. the use of work-based learning and clinical supervision. To demonstrate the models application, an exemplar of an issue from practice shows its relevance from a practical perspective. Conclusions In conclusion, further knowledge acquisition and its relationship with previously held theory and experience will enable individual practitioners to advance their own practice as well as being a resource for others.

Cartographic Strategies of Postmodernity : the Figure of the Map in Contemporary Theory and Fiction

The last fifty years have witnessed the growing pervasiveness of the figure of the map in critical, theoretical, and fictional discourse. References to mapping and cartography are endemic in poststructuralist theory, and, similarly, geographically and culturally diverse authors of twentieth-century fiction seem fixated upon mapping. While the map metaphor has been employed for centuries to highlight issues of textual representation and epistemology, the map metaphor itself has undergone a transformation in the postmodern era. This metamorphosis draws together poststructuralist conceptualizations of epistemology, textuality, cartography, and metaphor, and signals a shift away from modernist preoccupations with temporality and objectivity to a postmodern pragmatics of spatiality and subjectivity. Cartographic Strategies of Postmodernity charts this metamorphosis of cartographic metaphor, and argues that the ongoing reworking of the map metaphor renders it a formative and performative metaphor of postmodernity.

Critical reflections on the use of participatory methodologies to build evaluation capacities in international development organisations

"In this chapter the authors present a critique of Participatory Evaluation as worked in development projects, in this case, in Nepal. The article works between established claims that Participatory Evaluation builds capacity at programmatic and organisational levels, and the specific experiences of these claims in the authors’ current work. They highlight the need to address key difficulties such as high turn-over of staff and resulting loss of capacity to engage in Participatory Evaluation, and the difficulty of communication between academic as compared with local practical wisdoms. A key issue is the challenge of addressing the inevitable issues of power inequities that such approaches encounter. While Participatory Evaluation has been around for some time, it has only enjoyed more widespread recognition of its value in comparatively recent times, with its uptake in international development environments. To this extent, the practice is still in its early stages of development, and Jo, June and Michael’s work contributes to strengthening and more comprehensively understanding it. With regard to the meta-theme of this publication, this chapter is an example of how context not only influences the methodology to be used and the praxis of how it is to be used, but contributes to early explication of the core nature of an emerging methodology."

Predicting emotional exhaustion among haemodialysis nurses : a structural equation model using Kanter’s structural empowerment theory

Aim To test an explanatory model of the relationships between the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter's theory of organizational empowerment. Background Understanding the organizational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses, yet the relationships between nurses' work environment, job satisfaction, stress and emotional exhaustion in this population are poorly understood. Design A cross-sectional online survey. Methods 417 nurses working in haemodialysis units completed an online survey between October 2011–April 2012 using validated measures of the work environment, job satisfaction, job stress and emotional exhaustion. Results Overall, the structural equation model demonstrated adequate fit and we found partial support for the hypothesized relationships. Nurses' work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. Conclusion The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses' job satisfaction also predicts their level of job stress and emotional exhaustion. Our findings suggest staff retention can be improved by creating empowering work environments that promote job satisfaction among haemodialysis nurses.

Challenges to ES Success : A Critical Need for Knowledge Integration

Recent literature on Enterprise System (ES) implementation projects highlights the importance of Knowledge Integration (KI) for implementation success. The fundamental characteristics of ES - integration of modules, business process view, and aspects of information transparency - necessitate that all frequent end-users share a reasonable amount of common knowledge and integrate their knowledge to yield new knowledge. Unfortunately, the importance of KI is often overlooked and little about the role of KI in ES success is known. In this chapter, the authors study the KI impact on ES success that is relevant to the ES post-implementation in support of organizations' returns on their ES investments. They adopt the ES post-implementation segment of ES utilization to explore whether the KI approach is causally linked to ES success. The research model was tested in a multi-industry sample in Malaysia from which data was gathered from managerial and operational employees spread across six large organizations. Consistent with the explanation by knowledge-based theory, the results show that KI was valid and significantly related to the outcome of ES that relates to an organization's performance, which the authors refer to as ES success. The KI positive impact on the success of ES drives one to highlight the importance of ontological KI in the complexity of the ES environment. The authors believe that focusing on an ontology through the KI perspective can make significant contributions to current ES problems.

Unpacking the Australian Curriculum HPE - proposition 5 : include a critical inquiry approach

Overview • AC HPE and critical thinking • Interrelated propositions: Examples • Inquiry approach and questions • Summary and our challenge

Human resource management and entrepreneurship : building theory at the intersection

In 2008 we brought together much work at the intersection of entrepreneurship and human resource management (HRM) (Barrett & Mayson, 2008), after calls for more research (Baron, 2003; Katz, Aldrich, Welbourne & Williams, 2000; Tansky & Heneman, 2003). More has been collated since (Soriano, Dobon & Tansky, 2010; Tansky, Soriano & Dobon, 2010). We think it is now time again to regroup, pull conversational threads together and have a critical look at recent research at the intersection of HRM and Entrepreneurship. As editors of International Handbook of Entrepreneurship and HRM (Barrett & Mayson, 2008) we were privileged to collect 23 wonderfully diverse chapters from scholars around the globe addressing a range of issues at the intersection of the two pertinent disciplines or fields: HRM and entrepreneurship. This edition represented a coalescing of ideas that had been swirling about for some time. In three sections, the first dealt with theory and research methods, the second with the nature of HRM in small and entrepreneurial firms and the third with the functional aspects of HRM. At the time we were aware that the handbook did not cover the entire field and many topics were left unexplored. For example, the topic of regulation was generally absent while issues such as career advancement, performance management, organisational change and gender, diversity and ethnicity were also missing. In essence, the majority of those contributions sought to develop an understanding of the context in which particular aspects of HRM can be played out.

Examining the critical interplay of knowledge acquisition and integration capabilities in service innovation-based competitive advantage in project oriented service firms

While past knowledge-based approaches to service innovation have emphasized the role of knowledge integration in the delivery of customer-focused solutions, these approaches do not adequately address the complexities inherent in knowledge acquisition and integration in project-oriented firms. Adopting a dynamic capability framework and building on knowledge-based approaches to innovation, the current study examines how the interplay of learning capabilities and knowledge integration capability impacts service innovation and sustained competitive advantage. This two-stage multi-sample study finds that entrepreneurial project-oriented service firms in their quest for competitive advantage through greater innovation invest in knowledge acquisition and integration capabilities. Implications for theory and practice are discussed and directions for future research provided.

Graph theory based representation of building information models for access control applications

Building information models are increasingly being utilised for facility management of large facilities such as critical infrastructures. In such environments, it is valuable to utilise the vast amount of data contained within the building information models to improve access control administration. The use of building information models in access control scenarios can provide 3D visualisation of buildings as well as many other advantages such as automation of essential tasks including path finding, consistency detection, and accessibility verification. However, there is no mathematical model for building information models that can be used to describe and compute these functions. In this paper, we show how graph theory can be utilised as a representation language of building information models and the proposed security related functions. This graph-theoretic representation allows for mathematically representing building information models and performing computations using these functions.

Critical linguistics in the early years : exploring functions of language through sophisticated picture books and process drama strategies

In this chapter we describe a critical fairytales unit taught to 4.5 to 5.5 year olds in a context of intensifying pressure to raise literacy achievement. The unit was infused with lessons on reinterpreted fairytales followed by process drama activities built around a sophisticated picture book, Beware of the Bears (MacDonald, 2004). The latter entailed a text analytic approach to critical literacy derived from systemic functional linguistics (Halliday, 1978; Halliday & Matthiessen, 2004). This approach provides a way of analysing how words and discourse are used to represent the world in a particular way and shape reader relations with the author in a particular field (Janks, 2010).

A critical realist perspective of Enterprise Architecture evolution : conditioning and outcomes

This paper investigates how Enterprise Architecture (EA) evolves due to emerging trends. It specifically explores how EA integrates the Service-oriented Architecture (SOA). Archer’s Morphogenetic theory is used as an analytical approach to distinguish the architectural conditions under which SOA is introduced, to study the relationships between these conditions and SOA introduction, and to reflect on EA evolution (elaborations) that then take place. The paper focuses on reasons for why EA evolution could take place, or not and what architectural changes could happen due to SOA integration. The research builds on sound theoretical foundations to discuss EA evolution in a field that often lacks a solid theoretical groundwork. Specifically, it proposes that critical realism, using the morphogenetic theory, can provide a useful theoretical foundation to study enterprise architecture (EA) evolution. The initial results of a literature review (a-priori model) were extended using explorative interviews. The findings of this study are threefold. First, there are five different levels of EA-SOA integration outcomes. Second, a mature EA, flexible and well-defined EA framework and comprehensive objectives of EA improve the integration outcomes. Third, the analytical separation using Archer’s theory is helpful in order to understand how these different integration outcomes are generated.