The nature and impact of incontinence in men who have undergone prostate surgery and implications for nursing practice

Aim: The aim of this study was to increase knowledge and understanding of the nature and experiences of incontinence in men one or more years post prostate surgery.

Methods: This descriptive study used a sample of convenience. Two hundred and twelve male participants who had undergone prostate surgery more than a year ago were asked about their experiences of incontinence. Participants were asked to fill in two questionnaires: The Expanded Prostate Cancer Index Composite and the Incontinence Impact Questionnaire. Participants were also asked about their prostate surgery, their health seeking behaviour in relation to incontinence, the type of discharge information they were given, and demographic information.

Results: Sixty-six percent of participants indicated that, in the last four weeks, their overall urinary function had been a problem and 36.3% reported their bowel habits were problematic, which affected the quality of their lives. In addition, 41% of participants reported that they were not given discharge information regarding the possibility of developing urinary incontinence and sexual problems post prostate surgery.

Conclusions: Health care professionals should pay more attention to routinely providing information to all men regarding the possibility of developing incontinence or sexual problems post prostate surgery. This may assist them to better manage these problems.

The physiological and behavioural development of diving in Australian fur seal (Arctocephalus pusillus doriferus) pups

The physiological and behavioural development of diving was examined in Australian fur seal (Arctocephalus pusillus doriferus) pups to assess whether animals at weaning are capable of exploiting the same resources as adult females. Haematocrit, haemoglobin and myoglobin contents all increased throughout pup development though total body oxygen stores reached only 71% of adult female levels just prior to weaning. Oxygen storage components, however, did not develop at the same pace. Whereas blood oxygen stores had reached adult female levels by 9 months of age, muscle oxygen stores were slower to develop, reaching only 23% of adult levels by this age. Increases in diving behaviour corresponded to the physiological changes observed. Pups spent little time (<8%) in the water prior to moulting (age 1–2 months) whereas following the moult, they spent >27% of time in the water and made mid-water dives (maximum depth 35.7 ± 2.9 m) with durations of 0.35 ± 0.03 min. By 9 months (just prior to weaning), 30.5 ± 9.3% of all dives performed were U-shaped benthic dives (maximum depth 65.0 ± 6.0 m) with mean durations of 0.87 ± 0.25 min, significantly shorter than those of adult females. These results suggest that while Australian fur seal pups approaching the age of weaning are able to reach similar depths as adult females, they do not have the physiological capacity to remain at these depths for sufficient durations to exploit them to the same efficiency.

Motivational processes associated with unhealthy body change attitudes and behaviours

Objective
The relationship between approach–avoidance motivational processes and unhealthy body change attitudes and behaviours was investigated.
Method
Self-reported sensitivity to rewards (SR) and sensitivity to punishments (SP) were measured for a convenience sample of 130 women, aged 18 to 40 years, along with measures of disordered eating symptomatology and exercise dependence.
Results
Together, SR and SP significantly predicted variance in drive for thinness (21%), bulimia (17%), and obligatory exercise (7%). These relationships were partly mediated by internalization of the thin ideal, body comparison, and subjective importance of achieving one's ‘ideal’ body and of avoiding one's ‘worst possible’ body. Interestingly, body dissatisfaction partly mediated the relationships involving SP but not SR.
Discussion
The results suggest that an underlying sensitivity to punishments, but not rewards, can manifest as a ‘fear of fatness’. Both of these motivational traits can increase the salience of self evaluations, and thus indirectly contribute to unhealthy body change attitudes and behaviours.

The diversity of emergency code telephone numbers in Australian hospitals: the feasibility of an Australian standard emergency code

This study explored the diversity of emergency code telephone numbers currently in use in Australian hospitals and examined the feasibility of a standard emergency code telephone number for all Australian hospitals, based on the United Kingdom experience. An email and telephone convenience survey of Australian hospitals from six states and two territories was conducted. Of the 108 hospitals surveyed, seven did not use a telephone number system and used a button/ pager system to call an emergency. Of the 101 hospitals surveyed that used a telephone number system, 40 different emergency telephone numbers were in place, and in nine hospitals the telephone number used for Code Blue (medical emergency) was different to the telephone number used for other emergency codes. With increasing mobility of staff across hospitals, uniformity of emergency code telephone numbers is required to reduce confusion, potential danger and improve staff response in emergency situations. A single Australian standard emergency telephone number for all Australian hospitals is advocated.

The problem of obesity : is there a role for antagonists of the renin-angiotensin system?

Obesity is a major health problem worldwide; it is associated with more than 30 medical conditions and is a leading cause of unnecessary deaths. Adipose tissue not only acts as an energy store, but also behaves like an endocrine organ, synthesising and secreting numerous hormones and cytokines. Angiotensin II (ANG II) is the biologically active component of the renin-angiotensin system (RAS). The RAS is present in adipose tissue and evidence suggests that ANG II is intimately linked to obesity. Indeed, ANG II increases fat cell growth and differentiation, increases synthesis, uptake and storage of fatty acids and triglycerides and possibly inhibits lipolysis. Evidence obtained using genetically modified animals has shown that the amount of body fat is directly related to the amount of ANG II, i.e., animals with low levels of ANG II have reduced fat stores while animals with excessive ANG II have increased fat stores. In humans, epidemiological evidence has shown that body fat is correlated with angiotensinogen, a precursor of ANG II, or other components of the RAS. Furthermore, blocking the production and/or actions of ANG II with drugs or natural substances decreases body fat. The decrease in body fat caused by such treatments predominantly occurs in abdominal fat depots and appears to be independent of energy intake and digestibility. Clearly, ANG II has an important role in the accumulation of body fat and the possibility exists that treatment of obesity will be enhanced by the use of natural or synthetic substances that interfere with ANG II.

An exploratory analysis of the factors that influence food choice among young women

Food sales represent a significant proportion of hospitality industry income; however, little research has been conducted into the factors that influence food purchasing behaviour. This study employed a sequential mixed method research design to identify the factors that influence food choice among 18-30-year-old females. The study is important because this age group has considerable spending power and has been found to have different consumption priorities to their male counterparts. While confirming the importance of previous studies, this study found that physical health, time, marketing, price, and the quality of food are major factors of influence in the purchasing and consumption decision.

Temporal dynamics of oocyte development, plasma sex steroids and somatic energy reserves during seasonal ovarian maturation in captive Murray cod Maccullochella peelii peellii

The temporal dynamics of oocyte growth, plasma sex steroids and somatic energy stores were examined during a 12 month ovarian maturation cycle in captive Murray cod Maccullochella peelii peelii under simulated natural photothermal conditions. Ovarian function was found to be relatively uninhibited in captivity, with the exception that post-vitellogenic follicles failed to undergo final maturation, resulting in widespread pre-ovulatory atresia. Seasonal patterns of oocyte growth were characterised by cortical alveoli accumulation in March, deposition of lipids in April, and vitellogenesis between May and September. Two distinct batches of vitellogenic oocytes were found in Murray cod ovaries, indicating a capacity for multiple spawns. Plasma profiles of 17β-oestradiol and testosterone were both highly variable during the maturation period suggesting that multiple roles exist for these steroids during different stages of oocyte growth. Condition factor, liver size and visceral fat stores were all found to increase prior to, or during the peak phase of vitellogenic growth. Murray cod appear to strategically utilise episodes of high feeding activity to accrue energy reserves early in the reproductive cycle prior to its deployment during periods of rapid ovarian growth.

What makes continuing education effective : perspectives of community pharmacists

Objective To explore how different aspects of the professional environment for Australian community pharmacists are perceived to be influencing the effectiveness of continuing education models in improving practice.

Setting Australian community pharmacy.

Methods A convenience sample of practising community pharmacists (n = 15) was recruited using the 'snowballing' technique to participate in one of four focus group teleconferences. Each focus group examined continuing education experiences from different professional perspectives and training needs (recent graduates, experienced practitioners, specialist practitioners and rural/remote practitioners).

Key findings Facilitation of professional development by accreditation bodies, and new challenges resulting from the introduction of cognitive services were seen to promote a favourable environment for continuing education engagement. Complex continuing education delivery models combined with high costs and excessive workloads made it more difficult to engage with continuing education systems or try to apply knowledge to the workplace.

Conclusion Results support findings from previous research that practice development requires a multifaceted approach with continuing education as just one component. Affordable and integrated models of continuing education are required in order to optimise efficacy for participants.

The resource-based view of strategy: application to the agricultural industry

IP a The paper examines the application of the Resource-Based View of strategy (RBV) to the Australian floral industry. Despite the RBV's successful application to research in a number of discipline areas and the formalisation of its relationship with Competitive Advantage (CA) 15 years ago, the empirical support for the benefit of the RBV and development of research constructs has been inadequate. This has been partly due to the difficulty of identifying and separating the contribution of resources. The RBV literature is now consistent in the criteria required of a resource for CA and identifies a range of empirical research objectives (e.g. the need for contextual constructs), data evaluation focuses (e.g. measuring the impact of management, process, regional and scale affects) and results objectives (such as identifying the causal structure of resources). Research was conducted in the Australian floral industry to produce supporting generalisable data and constructs for the RBV. This industry is well bounded with several strongly differentiating resources and operates in a global market environment, which is necessary for these research objectives. Six hypotheses were examined; (1) the use of resources as the input of the CA, (2) the impact of the development process on resources, (3) the impact of management control on the development of resources (4) the impact on capability of management, process, region and scale, (5) the impact of resource development maturity on the approach to resource development and (6) the possibility of evaluating individual resources according to various criteria. The data was collected using selected participant interviews, with validation of conclusions by industry experts. It was analysed using content analysis, comparative analysis and cognitive mapping. The research determined that organisations in the Australian floral industry possessed important resources including geography, skills, technology, R&D, supply chains and production costs. These contributed to four CA creating production outputs; quality, capacity, reliability and customer convenience. The research findings supported hypotheses 1, 3, 4, 5 and 6. The lack of support for the two remaining hypotheses, relating to the process of resource development, may be explained by the low resource development maturity of the industry which masks the impact of the resource development process. The results also determined that one resource could contribute to a number of CAs and that resources not meeting all of the normal RBV CA criteria could still provide a CA in an industry where few resources met all criteria. It was postulated that these resources’ contribution to competitive was not durable.

The composition of brand knowledge across product categories

This research reported in this paper tested the composition of the brand knowledge construct across three product categories. The brand knowledge construct was tested for a fast-moving consumer good (fmcg), a service, and a durable good. A quasi-experimental method was utilised, with the order of recall manipulated. Respondents undertook a free recall exercise using category cues, and then completed multi-item measures of brand knowledge. This exercise was repeated for each product category. A usable sample of 270 responses was gained. Analysis of the data found that respondents utilised different components of the knowledge construct depending on the product category being recalled. In addition, the order of recall (fmcg or durable first) affected the recall performance for later categories. Recall performance was highest for the durable category, which indicated that respondents may have been delving into different memory stores, and accessing long-term memory for durable good recall. This paper makes a contribution to the field of branding by providing a test of the knowledge structure across three product categories, and indicating the components that contribute to knowledge for each category. These findings have implications for advertising design, and the formation of links to brands in memory by advertisers, for use in later recall episodes.

What women want in a relationship (with retail salespeople)

The purpose of our study was to examine what women shoppers seek in establishing relationships with sales associates and stores. Based on 70+ personal interviews in 4 countries, we found that women seek a variety of relationship types. It is incumbent upon the retailer and sales associates to assess each customer and determine the level and type of interaction each customer is seeking. "One size does not fit all" when it comes to forging relationships with customers.

Low carbohydrate diets: what are the potential short and long term health implications?

Low-carbohydrate diets for weight loss are receiving a lot of attention of late. Reasons for this interest include a plethora of low-carbohydrate diet books, the over-sensationalism of these diets in the media and by celebrities, and the promotion of these diets in fitness centres and health clubs. The re-emergence of low-carbohydrate diets into the spotlight has lead many people in the general public to question whether carbohydrates are inherently 'bad' and should be limited in the diet. Although low-carbohydrate diets were popular in the 1970s they have resurged again yet little scientific fact into the true nature of how these diets work or, more importantly, any potential for serious long-term health risks in adopting this dieting practice appear to have reached the mainstream literature. Evidence abounds that low-carbohydrate diets present no significant advantage over more traditional energy-restricted, nutritionally balanced diets both in terms of weight loss and weight maintenance. Studies examining the efficacy of using low-carbohydrate diets for long-term weight loss are few in number, however few positive benefits exist to promote the adoption of carbohydrate restriction as a realistic, and more importantly, safe means of dieting. While short-term carbohydrate restriction over a period of a week can result in a significant loss of weight (albeit mostly from water and glycogen stores), of serious concern is what potential exists for the following of this type of eating plan for longer periods of months to years. Complications such as heart arrhythmias, cardiac contractile function impairment, sudden death, osteoporosis, kidney damage, increased cancer risk, impairment of physical activity and lipid abnormalities can all be linked to long-term restriction of carbohydrates in the diet. The need to further explore and communicate the untoward side-effects of low-carbohydrate diets should be an important public health message from nutrition professionals.

Regulation of metabolic genes in human skeletal muscle by short-term exercise and diet manipulation

Changes in dietary macronutrient intake alter muscle and blood substrate availability and are important for regulating gene expression. However, few studies have examined the effects of diet manipulation on gene expression in human skeletal muscle. The aim of this study was to quantify the extent to which altering substrate availability impacts on subsequent mRNA abundance of a subset of carbohydrate (CHO)- and fat-related genes. Seven subjects consumed either a low- (LOW; 0.7 g/kg body mass CHO) or high- (HIGH; 10 g/kg body mass CHO) CHO diet for 48 h after performing an exhaustive exercise bout to deplete muscle glycogen stores. After intervention, resting muscle and blood samples were taken. Muscle was analyzed for the gene abundances of GLUT4, glycogenin, pyruvate dehydrogenase kinase-4 (PDK-4), fatty acid translocase (FAT/CD36), carnitine palmitoyltransferase I (CPT I), hormone-sensitive lipase (HSL), β-hydroxyacyl-CoA dehydrogenase (΄β-HAD), and uncoupling binding protein-3 (UCP3), and blood samples for glucose, insulin, and free fatty acid (FFA) concentrations. Glycogen-depleting exercise and HIGH-CHO resulted in a 300% increase in muscle glycogen content (P < 0.001) relative to the LOW-CHO condition. FFA concentrations were twofold higher after LOW- vs. HIGH-CHO (P < 0.05). The exercise-diet manipulation exerted a significant effect on transcription of all carbohydrate-related genes, with an increase in GLUT4 and glycogenin mRNA abundance and a reduction in PDK-4 transcription after HIGH-CHO (all P < 0.05). FAT/CD36 (P < 0.05) and UCP3 (P < 0.01) gene transcriptions were increased following LOW-CHO. We conclude that 1) there was a rapid capacity for a short-term exercise and diet intervention to exert coordinated changes in the mRNA transcription of metabolic related genes, and 2) genes involved in glucose regulation are increased following a high-carbohydrate diet.

What`s the story? An exploration of narrative language abilities in male juvenile offenders

This paper is concerned with the narrative language (story telling) abilities of a group of juvenile offenders completing community-based court orders in Melbourne, Australia. A convenience sample of 30 male young offenders was compared with 50 male non-offenders attending government high schools in the same region of Melbourne. Participants provided an audiotaped description of a six-frame cartoon (the “Flowerpot Incident”). Samples were transcribed and subjected to story grammar analysis, to examine differences between groups regarding both structural and qualitative adequacy. Young offenders produced narratives which were significantly poorer than those of controls with respect to the presence and adequacy of the seven story grammar elements described by Stein and Glenn (In R. O. Freedle (Ed.), New Directions in Discourse Processing (pp. 53-120) 1979). Findings are discussed in relation to implications for investigative and evidentiary interviewing.

Can Australain general practitioners tackle chidhood overweight/obesity? Methods and processes from the LEAP (live, eat, and play) randomized controlled trial

Background: General practitioners (GPs) could make an important contribution to management of childhood overweight. However, there are no efficacy data to support this, and the feasibility of this approach is unknown.

Objectives: To determine if GPs and families can be recruited to a randomized controlled trial (RCT), and if GPs can successfully deliver an intervention to families with overweight/obese 5- to 9-year-old children.

Methods: A convenience sample of 34 GPs from 29 family medical practices attended training sessions on management of childhood overweight. Practice staff trained in child anthropometry conducted a cross-sectional body mass index (BMI) survey of 5- to 9-year-old children attending these practices. The intervention focused on achievable goals in nutrition, physical activity and sedentary behaviour, and was delivered in four solution-focused behaviour change consultations over 12 weeks.

Results: General practitioners were recruited from across the sociodemographic spectrum. All attended at least two of the three education sessions and were retained throughout the trial. Practice staff weighed and measured 2112 children in the BMI survey, of whom 28% were overweight/obese (17.5% overweight, 10.5% obese), with children drawn from all sociodemographic quintiles. Of the eligible overweight/obese children, 163 (40%) were recruited and retained in the LEAP RCT; 96% of intervention families attended at least their first consultation.

Conclusions: Many families are willing to tackle childhood overweight with their GP. In addition, GPs and families can participate successfully in the careful trials that are needed to determine whether an individualized, family-based primary care approach is beneficial, harmful or ineffective.