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Goal Setting and Attainment in a Randomised Controlled Trial of Digital Health-Assisted Lifestyle Interventions in People with Kidney and Liver Disease
Get PDFIntroduction: Goal setting is an effective strategy in altering fitness and dietary behaviours. The goal attainment scale (GAS) is a patient-reported outcome measure that can be used to quantify goal achievement. The GAS has not been extensively assessed in lifestyle intervention trials. This study aimed to describe the goal setting process and assess the impact of a digital exercise and diet service and self-efficacy on goal attainment in people with chronic disease and at increased cardiometabolic risk. Methods: This study presents a single-centre, 26-week, randomised controlled trial (RCT) comparing standard care to digital health technologies (text messages, nutrition/exercise app, video consultations with dietitian and/or exercise physiologist). The comparator group was offered dietitian review (per standard care), and both groups received a wearable activity monitor. Individualised goal setting was facilitated prior to randomisation. Goal importance, performance measures, and self-efficacy were determined by participants. Goal outcome and ‘Change in GAS’ scores, reflecting the difference between baseline and follow-up performance, were calculated using validated formulae. Results: Goal setting was completed and reviewed by 66 participants, with a median age of 51 years and 56% being male. The most common goals related to weight loss (46%), fitness (29%), and diet (15%). Most participants (62%) reported improvements in their goals, with most improvements in dietary (71%), fitness (52%), and weight loss (39%) goals. There was no significant difference in goal outcomes between intervention and comparator groups (p = 0.99). There was, however, a significant correlation between nutrition self-efficacy and dietary goal achievement (p = 0.04). Conclusions:The novelty and feasibility of goal setting and attainment were demonstrated in this RCT of lifestyle interventions in people with chronic disease. Though the intervention did not significantly improve goal attainment, most participants reported improvements in their lifestyle goals. There were greater improvements in dietary goals than in fitness or weight loss goals. Participant-led goal setting with GAS and participant self-efficacy has potentially important applications in future lifestyle modification research and clinical implementation endeavours
From words to action: time for Australia to take shared decision making implementation seriously
No full textWhy is embedding shared decision making within the Australian health care system essential and urgent? Shared decision making is a process of engagement and partnership between a patient and their clinician that enables a collaborative decision to be made based on the best evidence, individual circumstances, and what matters most to the patient.1 Patient involvement in making informed health decisions is a fundamental right2 and is central to safe and quality health care. Shared decision making represents the highest standard of informed consent3 and is a cornerstone of value-based health care. As well as benefitting individual patients and clinicians, shared decision making also has an important role in addressing unwarranted variations in health care and has the potential to contribute to health system sustainability by reducing the overuse of low-value care (where the benefits do not, or hardly, outweigh the harms) and increasing the uptake of care that is known to be effective but is underutilised
Portraits of an Artist on Fire: Pusher II, Pusher III, and Refn’s Divine Comedy
No full textLimited Edition Contents:- Rigid slipcase with new artwork by Thomas Walker- 120-page book with new essays by Jamie Graham, Justin LaLiberty, Janine Pipe, Ariel Power-Schaub, Alison Taylor and Nadine Whitney plus an excerpt from Scandinavian Blue by Jack Stevenson on the films of Poul Nyrup- 5 collectors' art cards “Some people ask me if I was gonna do Pusher part II; I was like no way. Never doing that.” – Nicolas Winding Refn In the audio commentary on his first feature, Pusher (1996), recorded in 2000, Refn is upbeat, carrying the confidence of a young artist who has dared to defy the Danish establishment and won. In conversation with Bill Lustig, he recalls the scandal of having forsaken a coveted position at the exclusive Danish Film School to begin his directorial career entirely untrained. Now four years behind him, Pusher has been a breakout success, and his follow up feature Bleeder (1999) had been selected for the Venice International Film Festival. Refn has proven himself in Denmark and has plans to further expand his reach into international markets, noting his next film will be shot in English for this very reason. By the end of the commentary, the director’s glee is palpable. Of course, any recording is a time capsule of sorts, but in retrospect, Pusher’s audio commentary has the feeling of a moment precariously suspended. Three years later, Fear X, his then most ambitious and accomplished work, would fail to recoup investments, bankrupting his production company. With this hindsight, the director’s concluding remarks about the prospect of more Pusher films being out of the question conjure an image of Refn like the Tarot’s fool—head aloft, blissfully unaware he is marching towards a precipice.<br/
'Ask someone, what is their Dreaming?' Exploring occupational performance coaching with service providers supporting Aboriginal and Torres Strait Islander families
Get PDFIntroduction:Culturally responsive health services have been highlighted as a national priority in Australia. Yet, Aboriginal and/or Torres Strait Islander families still experience notable challenges accessing and engaging in culturally responsive health and community services across states and territories in Australia.Methods:Aboriginal and/or Torres Strait Islander health service providers partnered with researchers to consider the alignment of occupational performance coaching (OPC) with current practice and its potential applicability when working with Aboriginal and/or Torres Strait Islander families. Yarning Circle methodologies were adopted to support data collection, with main themes analysed using a blend of evidence-based approaches from Indigenous and Western cultures, including Thought Ritual and reflexive thematic analysis.Consumer and Community Involvement:Description and depiction of themes were co-developed by members of the research team, including researchers and service providers from Aboriginal and/or Torres Strait Islander and white cultural backgrounds from Australia and New Zealand.Findings:Four key themes emerged from the Yarning Circles and were described and depicted iteratively until agreement was reached. The themes, which intersect around concepts of Dreaming, relationship-building, system disruption, and moving forward, describe how Aboriginal and/or Torres Strait Islander health service providers consider their ways of working in response to prompts around the three domains of OPC. The imagery of a river depicts the links between, and flow of, themes that emerged from the data, with synergy with OPC domains described.Conclusion:OPC holds promise as an approach for family support, from the perspective of Aboriginal and/or Torres Strait Islander health service providers. Further work is needed to explore its feasibility and applicability from multiple perspectives, including family and community members across all regions of Australia
WHAT INNOVATION MANAGER CAN LEARN FROM THE VOLUNTEERING INDUSTRY
No full text1. Introduction and research problemInnovation managers operate at the forefront of organizational transformation but face a unique set of challenges that often hinder the success of their initiatives. Five major problems commonly encountered include: resistance to change in general, lack of sustained stakeholder engagement, misalignment between innovation and corporate culture, difficulty securing resources, and unclear ownership of innovation outcomes. A critical and often underestimated aspect is that every innovation project is inherently a change initiative. Whether introducing a new product, process, or business model, these projects disrupt routines, roles, and structures, triggering uncertainty, fear, and defensive behaviours.Within such change projects, managers must address several challenges. Three core issues include: (1) overcoming resistance from affected staff, (2) maintaining alignment between innovation goals and operations, and (3) sustaining motivation among employees impacted by the change. The latter is particularly complex, as these individuals are often not directly involved in the innovation work, yet their support is essential for success.To address this motivational challenge, it may be useful to look beyond traditional approaches and explore how other sectors manage motivation under difficult conditions. The volunteering sector presents an intriguing parallel: in these organizations, motivation is not driven by financial reward, but by intrinsic factors such as purpose, recognition, and belonging. Maintaining volunteer engagement is a core competency, making these organizations a valuable source of insight.This study therefore asks: How can understanding the motivational principles of volunteers help innovation managers engage and motivate company personnel impacted by innovation activities? Based on 20 qualitative interviews with volunteers from various organizations, the research identifies different motivational profiles and how they evolve over time, offering practical guidance for managing human dynamics within innovation projects.2. MethodsThe methodology of the research was grounded in an inductive approach, selected to explore complex human motivations that are difficult to quantify. This approach was appropriate because the study aimed to generate new insights rather than test existing theories. Specifically, the research sought to understand why and how volunteers remain engaged or disengage over time, with the goal of transferring these insights to improve engagement in innovation projects.To gather rich and nuanced data, the study relied primarily on qualitative semi-structured interviews, which allowed for flexibility and depth in exploring individual experiences. This method was chosen because it enables participants to share detailed, personal accounts that reveal underlying motivational patterns and context-specific challenges. A total of 20 interviews were conducted with volunteers of various backgrounds and commitment levels, both active and disengaged, ensuring a diverse range of perspectives. Interviews were held in person or via Microsoft Teams in the second half of 2024 in southeast Queensland, Australia.The data were analysed using thematic analysis following Braun and Clarke’s six-phase process, enhanced by the MECE (Mutually Exclusive, Collectively Exhaustive) framework to ensure clarity and structure in theme development. This methodology allowed for the identification of distinct motivational profiles and evolving engagement patterns, which are highly relevant for innovation managers seeking to motivate employees affected by continuous change.3. Results and findingsThis study identified key challenges faced by personnel affected by innovation projects, including uncertainty, resistance to change, loss of control, and declining motivation. These challenges often stem from the disruptive nature of innovation, which alters established routines and roles. To better understand these dynamics, we clustered affected individuals into five overarching functional groups, each defined by their role within the company and how they are affected by the innovation project. Within each group, we identified three subtypes, depending on their general attitude to change, resulting in a total of 15 distinct personas representing different reactions to change.In parallel, five core motivational patterns were identified from interviews with volunteers: (1) purpose-driven, (2) community-oriented, (3) growth-seeking, (4) value-aligned, and (5) recognition-focused. Each pattern was linked to a set of proven strategies used by volunteering organisations to sustain engagement over time.By mapping these motivational patterns onto the 15 identified personas, we developed a practical cross-sector framework. This enabled us to apply volunteer-based motivation strategies to specific types of personnel affected by innovation.For example, value-aligned individuals benefit from clearly communicated purpose, while recognition-focused types respond to visible appreciation. This approach offers innovation managers targeted engagement tactics to support motivation, reduce resistance, and enhance the success of innovation initiatives through tailored, human-centered interventions.4. Conclusions, implications and significanceThis study highlights the untapped potential of cross-sector learning between the volunteering and innovation management domains. By identifying parallels in motivational dynamics, we developed a practical framework that allows innovation managers to apply proven volunteer engagement strategies to support personnel affected by change. The classification of 15 employee personas, each aligned with one of five motivational patterns derived from volunteer behaviour, offers a nuanced understanding of how different individuals respond to innovation projects. These insights provide a foundation for designing tailored motivation strategies that go beyond traditional management techniques and directly address the emotional and psychological needs of staff during change.The implications are significant: innovation managers are better equipped to anticipate resistance, increase buy-in, and foster sustained engagement across diverse stakeholder groups. Rather than relying on a one-size-fits-all approach, this research advocates for personality- and motivation-driven interventions, improving the likelihood of innovation success. Additionally, the findings underscore the importance of purpose, recognition, community, and personal development, often overlooked in corporate settings but central to volunteer retention. As organisations continue to pursue transformation, these insights offer a human-centred approach to innovation management that aligns strategy with engagement, ultimately enhancing project outcomes and organisational resilience in times of change.<br/
Comparison of inguinal fist compression versus commercial windlass tourniquet for reduction in femoral artery blood flow by untrained providers: a protocol for a superiority, assessor-blinded, cross-over, randomised controlled trial
Get PDFIntroductionEffective haemorrhage control is crucial in cases of limb trauma involving arterial injury, such as shark attacks, to prevent potentially fatal outcomes. International first aid consensus recommends the use of arterial tourniquets (proprietary or makeshift) as a primary treatment for life-threatening external bleeding. Manual pressure applied directly over a major artery proximal to the injury, such as inguinal fist compression (IFC), is more accessible in a first-aid situation, but is currently not recommended due to limited evidence. The purpose of this study is to determine whether the application of IFC is superior to commercial windlass tourniquets (CWTs) in reducing blood flow in the femoral artery when performed by untrained bystanders.Methods and analysis Stopping Haemorrhage by Application of Randomised Compression or Tourniquet (SHARC-2) is a superiority, assessor-blinded, cross-over, randomised controlled trial conducted with healthy untrained adult volunteers in non-clinical settings. Participants will be rotated as providers and recipients of both IFC and CWT, with providers randomised to the order that they perform the techniques. Providers will be exposed to an educational infographic before applying that technique to a recipient behind a drop sheet. A sonographer, blinded to the technique, will measure the peak systolic velocity of blood flow in the superficial femoral artery using Doppler ultrasound at baseline and then during application of each technique for 5 min. The mean percentage reduction in peak systolic velocity will be compared between IFC and CWT groups.Ethics and dissemination Ethics approval for this study was granted by the Bond University Human Research Ethics Committee (BUHREC JF01036) on 23 January 2023. All participants will be provided with written informed consent prior to enrolment and the trial will involve healthy adult volunteers. To minimise risk, preintervention screening, sonographic assessment and postintervention follow-up will be implemented with adverse events monitored and reported in accordance with HREC guidelines. Results will be disseminated through peer-reviewed journals, academic conferences, local resuscitation forums and public health education initiatives. A lay summary will also be shared with relevant community groups and via social media platforms to enhance public accessibility
Using Conversations, Listening and Leadership to Support Staff Wellness: The CALM Framework
Get PDFHealthcare workers' (HCWs) wellness is a critical concern, particularly following the COVID-19 pandemic. Staff Wellness Rounding (SWR) has emerged as a leadership-driven strategy to support HCWs but research on its effectiveness remains limited. This study examines the impact of SWR within a large healthcare organisation in Australia and introduces the CALM (Conversation, Active Listening, Leadership Engagement, Mechanism for Feedback) Framework to enhance leadership-driven wellness initiatives. SWR was implemented across six acute hospitals and 14 community health centres in New South Wales, Australia (July to October 2021). A sequential mixed-methods design was used to evaluate SWR effectiveness, leadership engagement, and key components for a structured wellness approach. Phase One included a survey of 169 HCWs to capture their experiences, and Phase Two and Three comprised semi-structured interviews with SWR leaders, participants of SWR and analysis of 342 SWR records. Findings showed that informal conversations foster trust, active listening supports emotional well-being, and leadership engagement facilitates issue escalation. However, feedback mechanisms require improvement: 77.5% of HCWs felt able to escalate concerns but only 32.5% believed feedback was effectively addressed. These insights directly informed the development of the CALM Framework with implications for leadership training and digital wellness integration in healthcare settings.</p
Exploring the influence of social media ‘Mumfluencers’ on postpartum body image
No full textSocial media is an external influence thought to notably impact body image. There is limited research to date exploring whether the rise of social media ‘Mumfluencers’ – women who gain large social media followings by sharing their experiences of motherhood – positively or negatively influence postpartum body image and wellbeing. The current study explored the lived experience of 208 women up to 4 years postpartum through open-ended survey responses. Through reflexive thematic analysis, we identified three main themes: (i) Protecting Body Image and Mental Health through Authentic Discourse, (ii) Conflicts of Interest and Appearance Ideals Shape Body Image Outcomes, and (iii) Postpartum Agency in Social Media Consumption. Our findings indicate that postpartum women are adaptable in navigating the complexities of Mumfluencer content for their body image. By implementing protective strategies and limiting harmful exposure, participants controlled their online experiences, curating environments that best supported positive body image
Micro-expressions of care in higher education: Creating an environment of care
No full textIn this roundtable, we will explore how, as educators, we show care to our students within the context of higher education institutions that use formal policies, processes, and procedures to manage their duty of care to students. The purpose of the roundtable is to engage other academics in how they care for their students in small ways that can create an environment of empathy, compassion, and well-being when students are experiencing high levels of stress, anxiety, and depression in their student and personal lives
Building Megaprojects in SE Queensland: An Analysis from the Planning, Property and Project Management Perspectives
Get PDFMegaprojects are becoming part of global urban transformation, creating landmarks, jobs, and essential infrastructure, but they face challenges like stakeholder engagement, cost overruns, delays, and delivery risks. These projects need diverse professionals to ensure value creation, stakeholder satisfaction, and risk management. Southeast Queensland is experiencing significant growth with mega projects such as Queen’s Wharf Brisbane, Waterfront Brisbane, Cross River Rail, and Brisbane Metro. The 2032 Brisbane Olympics will further drive significant sports infrastructure and property developments. Collaboration among city planners, property developers, project managers, and corporate property asset advisors is essential for optimal performance, sustainability, and value creation. The main aim of the paper is to analyse megaprojects from multidisciplinary planning, property, and construction project management perspectives. The research methods include a literature review and a case study of a large megaproject - Queen’s Wharf Brisbane. The study examined planning mechanisms, property development, and project management approaches, highlighting key issues and lessons for Southeast Queensland. From a planning perspective, some important considerations for megaprojects include an understanding of planning legislation and the important role of state government in implementing megaprojects. Megaprojects should be aligned with strategic plans for the region and cities. Likewise, from a property development perspective, the feasibility and cost-benefit of megaprojects should include the analysis of the project's economic impact, providing value creation to the project. From a project management perspective, controlling cost overruns, managing time delays, dealing with conflicts and mitigating risks is crucial. Post-construction, property management and asset management of megaprojects need to consider the sustainability of these developments in the long run. A multidisciplinary lifecycle perspective can indeed provide valuable lessons for planning and developing megaprojects such as the Brisbane Olympics 2032 in Southeast Queensland