Impact of shifts in health policy on the role and practice of generalist community health nurses

Provides a critical analysis of trends in health policy which are impacting on the role and practice of generalist community nurses in Victoria. The thesis draws on critical social theory to research and analyse trends in health policy in relation to the Community Health Program.

Practice nurses' role and knowledge about diabetes management within rural and remote Australian general practices

Background: The increasing prevalence of diabetes and obesity represents a significant disease burden in Australia. Practice nurses (PNs) play an important role in diabetes education and management.

Aim: To explore PNs' roles, knowledge and beliefs about diabetes education and management in rural and remote general practice in Australia.

Method: Exploratory study undertaken in three phases: 1) Pilot study to test the performance of the questionnaire; 2) One-shot cross-sectional survey using self-complete questionnaires; 3) Individual interviews.

Results: Ten PNs completed the pilot test; the draft questionnaire was deemed appropriate to the study purpose. Then, 65 questionnaires were distributed to PNs and 21 responded. Fourteen respondents had worked in the role <5 years, and most PNs attended diabetes education programmes in their workplace. A minority (40%) used diabetes management guidelines regularly. Most knew obesity to be the most common risk factor for diabetes but only 50% knew that glycosylated haemoglobin indicates blood glucose levels over the preceding three months. Self-reported competency to assess patients' self-care practices and medication management practices varied.

Conclusion: PNs' diabetes management was self-reported; their knowledge varied and their perceived benefits of diabetes education differed from those of patients.

The role and regulation of MAFbx/atrogin-1 and MuRF1 in skeletal muscle atrophy

Skeletal muscle atrophy occurs in many chronic diseases and disuse conditions. Its severity reduces patient recovery, independence and quality of life. The discovery of two muscle-specific E3 ubiquitin ligases, MAFbx/ atrogin-1 and Muscle RING Finger-1 (MuRF1), promoted an expectation of these molecules as targets for therapeutic development. While numerous studies have determined the conditions in which MAFbx/atrogin-1 and MuRF1 mRNA levels are regulated, few studies have investigated their functional role in skeletal muscle. Recently, studies identifying new target substrates for MAFbx/atrogin-1 and
MuRF1, outside of their response to the initiation of muscle atrophy, suggest that there is more to these proteins than
previously appreciated. This review will highlight our present knowledge of MAFbx/atrogin-1 and MuRF1 in skeletal muscle atrophy, the impact of potential therapeutics and their known regulators and substrates. Finally, we will comment on new approaches that may expand our knowledge of these two molecules in their control of skeletal muscle function.

Nutrient profiling interventions targeting obesity prevention : role and potential impact

This thesis outlined the role and potential impact of a range of policy options for obesity prevention. It provided evidence that population-wide interventions, such as changes to food labelling and taxes on unhealthy foods, are likely to offer excellent 'value for money' for governments from an obesity prevention perspective.

Non-face to face consultations and communications in primary care : the role and perspective of general practice managers in Scotland

Background Practice managers play an important role in the organisation and delivery of primary care, including uptake and implementation of technologies. Little is currently known about practice managers’ attitudes to the use of information and communication technologies, such as email or text messaging, to communicate or consult with patients.

Objectives To investigate practice managers’ attitudes to non-face-to-face consultation/communication technologies in the routine delivery of primary care and their role in the introduction and normalisation of these technologies.

Methods We carried out a mixed-methods study in Scotland, UK. We invited all practice managers in Scotland to take part in a postal questionnaire survey. A maximum variation sample of 20 survey respondents participated subsequently in in-depth qualitative interviews.

Results Practice managers supported the use of new technologies for routine tasks to manage workload and maximise convenience for patients, but a range of contextual factors such as practice list size, practice deprivation area and geographical location affected whether managers would pursue the introduction of these technologies in the immediate future. The most common objections were medico-legal concerns and lack of perceived patient demand.

Conclusion Practice managers are likely to play a central role in the introduction of new consultation/communication technologies within general practice. They hold varying views on the appropriateness of these technologies, influenced by a complex mix of contextual characteristics.Managers from areas in which the ethos of the practice prioritises personalised care in service delivery are less enthusiastic about the adoption of remote consultation/ communication technologies.

Natah and telajakan : the role and identity in indigenous villages

There are many Indigenous villages scattered across Bali Island. Most of these villages are located surrounding a mountain so that an Indigenous village in Bali is called 'Bali Aga' or 'Bali Kuna', which means "Mountain Balinese·. Bali has unique Indigenous villages still possessing traditional village patterns in harmony with their natural environment. Natah and telajakan are an integral part of traditional housing patterns in these villages. Both are often forgotten about in contemporary housing developments in Bali, because most people in the Denpasar want to construct their building with a modern style but these do not have an eco-friendly atmosphere.Natah is the open space in the centre of a compound of Balinese traditional buildings. Natah functions as a place for traditional ceremonies; as a centre of building orientation; and, as well as ecological function. Research into natah has demonstrated that the more extensive the natah and the more luxuriant its plants the greater the reductions of wind speed and humidity modification in traditional housing (Primayatna, 2010). This means that the natah direcUy influences a better quality of living in the traditional housing. Telajakan is an outdoor open space pattern of traditional housing which is located between traditional fencing (penyengker) and drainage lines (jelinjingan), which is planted for spiritual and economic functions. Natah and telajakan are largely integral components of Balinese Indigenous villages. Most well-known Indigenous villages in Bali still retain their natural linear sequences of natah and telajakan such as Penglipuran Village, Tenganan Village, etc.The paper examines the role of natah and telajakan as part of Indigenous Balinese housing traditional patterns which serves not only aesthetic functions, but economic functions, health and ecological aspects, and informs the identity of Indigenous villages in Bali. This paper focuses on how both natah and telajakan values and patterns can be adopted for future lifestyles and development in Bali.

Corporate entrepreneurship and innovation part 2 : a role- and process-based approach

Purpose – To extend the discussion held in part 1, and develop a two-tier fifth-generation model of corporate entrepreneurship and innovation. Design/methodology/approach – The components that have been synthesized from a review of the literature in Part 1 are extended using evidence from the literature. These components are used to construct a two-tier model of corporate entrepreneurship and innovation; a macro model which presents the high-level environmental drivers of innovation and a micro model that discusses the contextual factors that underpin the corporate entrepreneurship and innovation process. Findings – From the analysis conducted in part 1 it is evident that there is a strong relationship between the role of the corporate entrepreneur and the innovation process. It is suggested that by separating the corporate entrepreneur from the innovation process previous models have been overly reductionist in their construction, and their utility has, as a consequence, been severely constrained. The study therefore combines the role and activities of the entrepreneur with the innovation process into a unified framework. In doing so the paper develops a two-tier fifth-generation model of corporate entrepreneurship and innovation. The final sections of the paper present the model's implications for management and suggestions for further research. Originality/value – This paper fulfils an identified gap in the literature, namely the development of a new holistic model of corporate entrepreneurship and innovation, which illustrates the environmental and contextual relationships between the corporate entrepreneur and the innovation process.

The role and regulation of stars in skeletal muscle

STARS is a muscle specific protein that is upregulated in response to endurance exercise and may potentially increase skeletal muscle cell sensitivity to muscle contraction. STARS enhances the activation of intracellular signalling pathways involved in skeletal muscle growth, regeneration and oxidative metabolism.