The impact of shift-work and organizational climate on health outcomes in nurses

Shift workers have a higher rate of negative health outcomes than day shift workers. Few studies however, have examined the role of difference in workplace environment between shifts itself on such health measures. This study investigated variation in organizational climate across different types of shift work and health outcomes in nurses. Participants (n = 142) were nursing staff from a metropolitan Melbourne hospital. Demographic items elicited the type of shift worked, while the Work Environment Scale and the General Health Questionnaire measured organizational climate and health respectively. Analysis supported the hypotheses that different organizational climates occurred across different shifts, and that different organizational climate factors predicted poor health outcomes. Shift work alone was not found to predict health outcomes. Specifically, permanent night shift workers had significantly lower coworker cohesion scores compared with rotating day and evening shift workers and significantly higher managerial control scores compared with day shift workers. Further, coworker cohesion and involvement were found to be significant predictors of somatic problems. These findings suggest that differences in organizational climate between shifts accounts for the variation in health outcomes associated with shift work. Therefore, increased workplace cohesion and involvement, and decreased work pressure, may mitigate the negative health outcomes of shift workers.

Adapting musicology for commercial outcomes

Recent claims that orchestras around the world are facing new financial pressures threatening their survival, suggest that it is critical to investigate the potential for musicology to adapt to commercial outcomes. This paper takes the Australian music industry as a case study to prototype a new and sustainable orchestral model appropriate for twenty first century audiences. The paper includes a review of musical and social innovations from previous and current orchestral models, a review of arts marketing strategies developed for the new consumer, the identification of successful new performance modes including distribution methods and developments in acoustic and digital instrument design, and the documentation of the implementation and testing of such a model to live audiences.

Social structures of science and approaches to outcomes-based medical research

Recently, two seemingly divergent approaches have emerged in outcomes-based medical research. Proponents of evidence-based medicine (EBM) argue that the most effective treatments will be found by adopting a hierarchical approach that gives pre-eminence to randomized controlled clinical trials, where these are available. Proponents of participatory medical research argue that research undertaken with consumers and other partners in the community will produce the best outcomes. While one approach marginalizes consumer experience the other approach draws consumers into it. EBM assumes a high level of consensus in a scientific community, while participatory medical research relies on co-opting consumer experience. This paper indicates that each approach involves a particular view of social structure in science. The paper uses theories of social relations among scientists for the purpose of critically assessing EBM and the participatory model.

Regional and urban Victorian diabetic youth: clinical and quality-of-life outcomes

Objectives: To compare groups of urban and regional Victorian diabetic children and assess their quality of life, diabetes knowledge, access to services and metabolic control.

Methods: Forty-seven children from three regional Victorian communities (Horsham, Warrnambool and Sale; n = 16, 18 and 13, respectively) were compared with 120 age-, sex- and duration of diabetes-matched children attending the Royal Children's Hospital (RCH) diabetes clinic in Melbourne. Quality of life, diabetes knowledge, use of services, and metabolic control were assessed using the child health questionnaire (CHQ PF-50/CF-80); a diabetes-knowledge questionnaire; access to a diabetes nurse educator (DNE), dietitian and complication screening; and indices of mean HbA1C (values are taken every 3 months in the 'yearly HbA1C'), respectively.

Results: Comparisons of CHQ data showed that regional diabetic youth scored significantly lower on most subscales. The greatest deficits were seen in areas of mental health, self-esteem, parent impact (emotional) and family cohesion. Diabetes knowledge and median yearly HbA1C for patients were not significantly different between the regional and urban centres (8.1%, 8.9%, 8.4% and 8.6% at RCH, Horsham, Warrnambool and Sale, respectively). Patients in regional centres had reportedly less access to team-based diabetes care.

Conclusions: Regional youth in Victoria, with similar levels of metabolic control and diabetes knowledge as their urban counterparts, have a markedly lower quality of life, implying a negative synergy between diabetes and the demands of regional lifestyles.

Metabolic and cardiac outcomes after acute myocardial infarction

The original DIGAMI protocol recommended using intravenous insulin to manage myocardial infarction from first presentation followed by subcutaneous insulin for 3 months in patients with diabetes. This paper describes the metabolic and cardiac outcomes and barriers to implementing a protocol designed to match the DIGAMI principles across our emergency and cardiology departments. Patients managed using the revised DIGAMI protocol achieved better blood glucose control and had fewer reinfarcts than those managed without insulin. The major barrier to using the protocol appeared to be staff fear of causing hypoglycaemia.

Gender differences and learning outcomes: does gender matter?

Student placement outcomes were examined using archival data from a field education program on the gender of both students and supervisors to test the hypothesis that gender is a predictor of placement outcome. The results of these analyses suggest that whilst the supervisor gender is not critical, the student gender is a significant predictor of placement outcome. As male students are more likely to encounter placement difficulties than female students, inquiry into the student’s concept of masculinity is proposed as a way to assist male students in field education.

Expanding the buyer-supplier relationship definition: its antecedents and relationship with performance outcomes

This paper aims to contribute to current buyer-supplier relationship literature through conceptually examining associations between the buyer-supplier relationship itself, organisational antecedents and the external environment. Whilst the presence of relational components within the transaction has been acknowledged, there is, has been, and remains, great difficulty in defining and understanding the dynamics of the buyer-supplier relationship itself. This study aims to address current research limitations and further develop understanding of the dynamics between buyers and suppliers, through a grounded theory research approach. The core focus is to understand the basic motivations and considerations for organisations when potentially considering relationship development with a trade partner. Thus, the organisational attributes that must be apparent and those preferred by potential trade partners are studied. Development of a conceptual model leads to the recognition of three key research questions that are to be addressed in future empirical investigation of the model.

Pursuing HPE outcomes through health education

This chapter provides an analysis of how the contemporary curriculum operates in relation to pursuing Health and Physical Education (HPE) outcomes within health education and some of the intended and unintended consequences of such an approach