Everyone's problem but nobody's job : staff perceptions and explanations for poor nutritional intake in older medical patients

Aim: Up to 60% of older medical patients are malnourished with further decline during hospital stay. There is limited evidence for effective nutrition intervention. Staff focus groups were conducted to improve understanding of potential contextual and cultural barriers to feeding older adults in hospital. Methods: Three focus groups involved 22 staff working on the acute medical wards of a large tertiary teaching hospital. Staff disciplines were nursing, dietetics, speech pathology, occupational therapy, physiotherapy, pharmacy. A semistructured topic guide was used by the same facilitator to prompt discussions on hospital nutrition care including barriers. Focus groups were tape-recorded, transcribed and analysed thematically. Results: All staff recognised malnutrition to be an important problem in older patients during hospital stay and identified patient-level barriers to nutrition care such as non-compliance to feeding plans and hospital-level barriers including nursing staff shortages. Differences between disciplines revealed a lack of a coordinated approach, including poor knowledge of nutrition care processes, poor interdisciplinary communication, and a lack of a sense of shared responsibility/coordinated approach to nutrition care. All staff talked about competing activities at meal times and felt disempowered to prioritise nutrition in the acute medical setting. Staff agreed education and ‘extra hands’ would address most barriers but did not consider organisational change. Conclusions: Redesigning the model of care to reprioritise meal-time activities and redefine multidisciplinary roles and responsibilities would support coordinated nutrition care. However, effectiveness may also depend on hospitalwide leadership and support to empower staff and increase accountability within a team-led approach.

Front page schools, back page schools : a case study of factors perceived to affect academic performance in five Papua New Guinea secondary schools

Papua New Guinea has reformed its colonial established education system and made huge investments with the help of donors to achieve equal access and quality education for all its citizens. Despite this national aspiration and these policy reforms and investments, secondary schools that enrol grade 9 students who are relatively equal in education ability show huge disparities in their grade 10 academic performances. This study examined perceptions of students, teachers and principals regarding factors affecting the disparity in academic performance in the context of a developing country. The central question for the study is: What are the perceptions of students and teachers of the factors that affect disparities in secondary schools' academic performance? This qualitative case study involved two high and three low academic performing secondary schools in Western Highlands Province of Papua New Guinea. Primary data were collected through focus groups and semi-structured interviews involving 112 participants. Students and teachers are key participants in this study, as it intends to find out the realities of schools, yet they are an under-researched group. A postcolonial and sense of community conceptual framework was developed for the analysis of the participants. perceptions. In addition, scholarship on school effectiveness and equity in education informed the interpretation of the findings. Three themes were evident in participants. views. First, participants expressed their view that differences in academic performance were related to the adequacy and equitability of resources. The inequities in resource inputs led some of them to coin the metaphor of .back page and front page. schools. Second, many expressed the view that deficiencies in implementing bilingual education, given the difficulty of catering for 800 vernacular languages, contribute to poor English proficiency and subsequent poor academic performance. Finally, participants believed that, in order to have a positive school culture, it is necessary for educators to recognise and respect contemporary students. identities, communal/tribal membership and needs. This study has implications for national education policy on resource allocation to address equality and equity, bilingual education and teacher education. Moreover, as the study found that high academic performance in this context is also influenced by intra-school social relationships, these relationships need to be nurtured. When appropriately nurtured, they become an important factor in sustaining quality education for all secondary school students. This thesis has laid the foundations for further research and invites further investigations into policy and implementation of school reforms aimed at improving academic achievement.

Negative change and job outcomes : the impact of subjective fit in public sector health care organization

There is an ongoing level of organizational-wide change (such as empowerment and downsizing) occurring within the Australian health care sector. However, there is a paucity of empirical evidence on how public and nonprofit sector nurses cope with these organizational-wide change initiatives and their consequences on individual and work outcomes. This will be the primary aim of the current paper. To this end, a path model is developed base on an integration of existing theoretical perspectives on occupational stress, change management, and person-organizational fit. Data were collected from 252 public and not-for-profit sector nurses. The path analysis suggests that public and nonprofit nurses experience positive and negative change initiatives. Negative change initiatives resulted in an increase in the level of administrative-related stressors. Nurses with more congruent values report less experience with administrative stressors. As nurses experienced more administrative stressors, they tend to report more job dissatisfaction. Nurses whose values were more congruent during organizational change reported higher level of psychological wellbeing. Nurses who were had higher level of psychological wellbeing were found to have higher job satisfaction, which subsequently led to a higher level of organizational commitment.

Four years on – are the Gazelles still running? A longitudinal study of firm performance after a period of rapid growth

Gazelles, or very rapidly growing firms, are important because they contribute disproportionately to economic growth. There is a concern that some of these firms pursue growth too aggressively resulting in lower subsequent performance. We investigate the relationship between growth and subsequent profitability for gazelle firms, and how this is moderated by firm strategy. Previous empirical research regarding the growth-profitability relationship for firms in general is rather inconclusive, with only one study specifically investigating gazelle firms. Likewise, there are theoretical arguments both for and against growth leading to profitability that equally apply to gazelle firms. Further, while contingency theory might suggest the relationship depends on the firm’s strategy, earlier studies have not investigated this relationship. We address these questions using longitudinal data (seven years) for a sample of 964 Danish Gazelle firms. Our study finds a clear positive relationship between growth and subsequent profitability among gazelle firms. Moreover, this relationship is stronger for firms pursuing a broad market strategy rather than a focus or niche strategy. An important managerial implication is that the growth strategy should be clearly integrated with the general strategic orientation of the firm.

A common neighbour based two-way collaborative recommendation method

Traditional recommendation methods offer items, that are inanimate and one way recommendation, to users. Emerging new applications such as online dating or job recruitments require reciprocal people-to-people recommendations that are animate and two-way recommendations. In this paper, we propose a reciprocal collaborative method based on the concepts of users' similarities and common neighbors. The dataset employed for the experiment is gathered from a real life online dating network. The proposed method is compared with baseline methods that use traditional collaborative algorithms. Results show the proposed method can achieve noticeably better performance than the baseline methods.

Thermal performance of non-load bearing LSF walls using numerical studies

Fire safety of light gauge cold-formed steel frame (LSF) wall systems is significant to the build-ing design. Gypsum plasterboard is widely used as a fire safety material in the building industry. It contains gypsum (CaSO4.2H2O), Calcium Carbonate (CaCO3) and most importantly free and chemically bound water in its crystal structure. The dehydration of the gypsum and the decomposition of Calcium Carbonate absorb heat, which gives the gypsum plasterboard fire resistant qualities. Recently a new composite panel system was developed, where a thin insulation layer was used externally between two plasterboards to improve the fire performance of LSF walls. In this research, finite element thermal models of both the traditional LSF wall panels with cavity insulation and the new LSF composite wall panels were developed to simulate their thermal behaviour under standard and realistic design fire conditions. Suitable thermal properties of gypsum plaster-board, insulation materials and steel were used. The developed models were then validated by comparing their results with fire test results. This paper presents the details of the developed finite element models of non-load bearing LSF wall panels and the thermal analysis results. It has shown that finite element models can be used to simulate the thermal behaviour of LSF walls with varying configurations of insulations and plasterboards. The results show that the use of cavity insulation was detrimental to the fire rating of LSF walls while the use of external insulation offered superior thermal protection. Effects of real fire conditions are also presented.

The relationship between academic library usage and perceived personal performance in Kuwait

Academic libraries around the world often have to justify high maintenance costs. High maintenance costs of university libraries are often justified by the belief that regular use of an academic library improves the grades of students. However, this is a difficult statement to support, therefore demonstrating the link between library use and student outcomes is critical to ensuring that library investment continues. Questionnaires and interviews were conducted and the findings were analysed to derive users’ perceptions. The findings revealed interesting results regarding how users make use of the library and how users feel the library improves their personal performance. Overall, the perception of all three groups of the academic libraries within Kuwait is positive, however many users are dissatisfied with some academic library services. Students answered positively regarding their grades and use of the academic library. Academics and administrators were generally positive and offered an experienced insight into the quality of the library. This study offers the first perception based results in Kuwait. The inclusion of administrators’ perceptions is also novel in terms of the Gulf States. A refined model was designed based on the overall findings within the study. This model can be applied to any academic library, regardless of size or collection type. Based on findings, the researcher recommends taking the following points into consideration in order to improve library services and facilities for all users. Improvements could be made in the structure of library training courses and academic libraries should be providing flexible spaces for individuals and group study as well as social activities.

Examination of relationships and mediating effects of self-efficacy, locus of control, coping and the practice environment on caring efficacy and job satisfaction in Australian registered nurses

Background to the Problem: Improving nurses' self-efficacy and job satisfaction may improve the quality of nursing care to patients. Moreover, to work effectively and consistently with professional nursing standards, nurses have to believe they are able to make decisions about their practice. In order to identify what strategies and professional development programmes should be developed and implemented for registered nurses in the Australian context, a comprehensive profile of registered nurses and factors that affect nursing care in Australia needs to be available. However, at present, there is limited information available on a) the perceived caring efficacy and job satisfaction of registered nurses in Australia, and b) the relationships between the demographic variables general self-efficacy, work locus of control, coping styles, the professional nursing practice environment and caring efficacy and job satisfaction of registered nurses in Australia. This is the first study to 1) investigate relationships between caring efficacy and job satisfaction with factors such as general self-efficacy, locus of control and coping, 2) the nursing practice environment in the Australian context and 3) conceptualise a model of caring efficacy and job satisfaction in the Australian context. Research Design and Methods: This study used a two-phase cross-sectional survey design. A pilot study was conducted in order to determine the validity and reliability of the survey instruments and to assess the effectiveness of the participant recruitment process. The second study of the research involved investigating the relationships between the socio-demographic, dependent and independent variables. Socio-demographic variables included age, gender, level of education, years of experience, years in current job, employment status, geographical location, specialty area, health sector, state and marital status. Other independent variables in this study included general self-efficacy, work locus of control, coping styles and the professional nursing practice environment. The dependent variables were job satisfaction and caring efficacy. Results: A confirmatory factor analysis of the Brisbane Practice Environment Measure (B-PEM) was conducted. A five-factor structure of the B-PEM was confirmed. Relationships between socio-demographic variables, caring efficacy and job satisfaction, were identified at the bivariate and multivariable levels. Further, examination using structural equation modelling revealed general self-efficacy, work locus of control, coping style and the professional nursing practice environment contributed to caring efficacy and job satisfaction of registered nurses in Australia. Conclusion: This research contributes to the literature on how socio-demographic, personal and environmental variables (work locus of control, general self-efficacy and the nursing practice environment) influence caring efficacy and job satisfaction in registered nurses in Australia. Caring efficacy and job satisfaction may be improved if general self-efficacy is high in those that have an internal work locus of control. The study has also shown that practice environments that provide the necessary resources improve job satisfaction in nurses. The results have identified that the development and implementation of strategies for professional development and orientation programmes that enhance self-efficacy and work locus of control may contribute to better quality nursing practice and job satisfaction. This may further assist registered nurses towards focusing on improving their practice abilities. These strategies along with practice environments that provide the necessary resources for nurses to practice effectively may lead to better job satisfaction. This information is important for nursing leaders, healthcare organisations and policymakers, as the development and implementation of these strategies may lead to better recruitment and retention of nurses. The study results will contribute to the national and international literature on self-efficacy, job satisfaction and nursing practice.