Patients' decision-making strategies for managing postoperative pain

Despite technological advances, many postoperative patients continue to suffer unrelieved pain. The aim of this study was to identify the strategies used by postoperative patients to bring about pain management decisions. A single-group noncomparative study design was chosen using observations as the means of examining pain activities in 2 surgical units of a metropolitan teaching hospital in Melbourne, Australia. A total of 52 nurses and 312 patients participated in the study, and 316 pain activities were observed. The most common strategy used was patients acting as a passive recipient for pain relief (60%), whereas problem solving (23%) and active negotiation (17%) were less commonly used. Patients in this study were admitted for surgical treatment of a particular condition, and their subsequent pain was specifically related to this acute event. Therefore, the lack of familiarity of the situation and the severity of pain experienced may have encouraged passivity. Patients may have also felt uncertain about how to approach the pain decision, preferring to defer to nurses. Because increased pain levels can be associated with fear, patients could have been unwilling to speak with nurses to discuss their need for pain relief.

The application of soft systems methodology to supply chain management

This chapter reflects upon techniques that might facilitate improved strategic decision making in a supply chain management (SCM) environment. In particular, it presents the integration of a selection of techniques adapted from an approach to systems-based problem solving that has emerged primarily in the UK over the last 20-30 years—the soft systems methodology (SSM). The results reported indicate that SSM techniques can complement existing SCM decision-making tools. In particular, this chapter outlines a framework for integrating some SSM techniques with approaches based upon the supply-chain operations reference-model (SCOR) .

Teaching for life : generic capabilities that link university learning with workplace learning

Business schools are under increasing pressure to enhance the learning capability and employability of graduates. Business professional institutes and employer organizations are demanding more than the technical knowledge and skills required to perform discipline/professional specific tasks. They want graduates who can demonstrate capabilities in communication, teamwork, risk taking, decision making, problem solving, critical thinking, analytical reasoning, visioning and innovation, leadership, ethical practices, appreciation of diversity, and a commitment to social justice. Evidence in literature and reports (Karpin, 1995; Kirby, 2000; Commonwealth of Australia, 2002; Nelson, 2002) and in test data (McCowan & Richardson, 1998; Employer Survey, 1998; DETYA, 2000) shows that the employability gap7 is closed when graduates possess these generic capabilities. What is important, however, is the increasing research showing that the strategies used to develop generic capabilities lead to improved learning, both in university courses and in the workplace.

Simulation to practice: developing nursing skills in mental health: an Australian perspective

A variety of developments in nursing education in Australia including some innovative and exciting models, educational enterprises between education and industry, and evidence of developing strengths in research and professional alliances on a national level have been discussed recently. This paper presents Simulation to Practice as an example of an educational program that can maximise skill mastery for nurses in mental health fields as practised by Deakin University in Victoria, Australia. The program is multimodal and is under-pinned by a problem-solving approach and has an online presentation. The extension of nursing skills through this approach encourages nurses to take theoretical skills to practice during these scenarios which help student nurses to gain experience through simulated real life characters. These sessions, while challenging at the time, were highly valued by students and seen as a beneficial part of their learning as a beginning nurse and often instrumental in moving comprehensively trained students into mental health careers.

The usefulness of a science degree : the "lost voices" of science trained professionals

This paper reports a study of science graduates who are employed in positions outside their discipline specialisation. The research was designed to uncover the reasons for them choosing to study science at university, the competencies they utilise in their work and their lives, and how these relate to their undergraduate education in science. The study is seen as important in that already about one-half of science graduates are in such positions and it is argued that there is a need in scientific and technologically based societies to have a greater representation of such people in decision-making positions in government and industry. The directions for the science degree that can be drawn from the data gathered are congruent with those arising from other relevant studies. That is, attention should be paid to widely used skills, such as communication and problem-solving, and to developing an understanding of science within its social and ethical context. An argument is mounted for considering the way the science degree is presented to potential students and to the general public.

The impact of the financial costs of multiple sclerosis on quality of life

This study examined the financial costs of multiple sclerosis (MS) and the impact of financial strain on the subjective quality of life of people with MS and their families. Due to the lack of research in this area, a qualitative research design was employed. Interviews were conducted with 16 health professionals, 26 people with MS, and 11 family members of people who had MS. Adjusting to actual or threatened loss of income caused financial stress. These financial struggles led to a lower quality of life among respondents. Problem solving, coping, and positive reappraisal helped people to adjust to financial changes. Professionals focused on increased funding for services, whereas people with MS focused on improved income support. These findings highlight the need for professionals to consider the financial strain associated with this disease and the impact of this strain on the quality of life of individuals with MS and their families.

Fresh Freud: no longer lost in translation

The new translations of Freud into English highlight the question as to the nature of Freud's quest and achievement. They show a livelier Freud than the Strachey translations (Freud, 1953-1974), who used everyday language in his work instead of trying to establish a new technical vocabulary for an esoteric new discipline. However, with the new Penguin editions thus far, fresh Freud is no longer lost in translation. The Standard Edition was created importantly to create an authoritative international trademark and was made more natural "scientific" in appearance. The fresh translations show a Freud in tune with Karl Popper's (1976) approach in his later work that viewed science as essentially problem solving. The example of "Mourning and Melancholia" (Freud, 1917/ 1964, 1917/1981, 1917/2005) is discussed as an exercise in exploration, conjectures, criticism, construct formation, and problem solving. Translation issues are discussed. Instead of being a particular trade mark, the very fact of there being new and different translations opens Freud's works to further questioning about their meanings and intents in the marketplace of ideas and practices

CHC students online : responses to course organisation

Previous research by the authors has shown that Confucian Heritage Students participating in online problem solving discussions show a high degree of message postings that are related to the organization of the course of study, rather than to its contents and intellectual challenges. The authors argue that this is consistent with the more broadly based research outcomes relating to the achieving strategy that is quite typically exhibited among CHC students. This interview based study explores the perceptions of CHC students as they engage with collaborative learning online, and shows that the concerns relate to matters to do with assessment, with the reliability and timeliness of group member inputs, and the possibilities of plagiarism.

Thinking teaching: seeing mathematics teachers as active decision makers

Many teachers are now incorporating a broader range of strategies into their teaching, including problem solving, investigations and open-ended questions. Among other things, such teaching requires teachers to talk less but to make more decisions. The acknowledgment of this complexity and the centrality of active decision making have implications for teacher education and teacher development, and for the strategies and resources used.

Cognitive behavioural strategies for general practice

Cognitive behavioural strategies (CBS) are circumscribed psychologial skills that can be incorporated into general practice, and need to be distinguished from cognitive behavioural therapy (CBT), a comprehensive therapeutic approach which require more intensive training.  The CBS outlined in this article can be integrated with other behavioural and structured problem solving approaches.

Children's mathematical thinking in different classroom cultures

The relationship between normative patterns of social interaction and children's mathematical thinking was investigated in 5 classes (4 reform and 1 conventional) of 7- to 8-year-olds. In earlier studies, lessons from these classes had been analyzed for the nature of interaction broadly defined; the results indicated the existence of 4 types of classroom cultures (conventional textbook, conventional problem solving, strategy reporting, and inquiry/argument). In the current study, 42 lessons from this data resource were analyzed for children's mathematical thinking as verbalized in class discussions and for interaction patterns. These analyses were then combined to explore the relationship between interaction types and  expressed mathematical thinking. The results suggest that increased complexity in children's expressed mathematical thinking was closely related to the types of interaction patterns that differentiated class discussions among the 4 classroom cultures.

Extending studies of collaborative cognition by way of care giving situations

Care giving situations contain several features that offer opportunities for expanding the way that collaborative cognition is conceptualised and explored. These features are the presence of several possible contributors, more than one kind of change in participation, distinctions drawn among parts of a task, and differences in understanding based on interests. All represent departures from the traditional focus on dyads, tasks that emphasise one kind of change only, single problems, and differences in competence or expertise. All are also features likely to be found in everyday problem solving. Study 1 focuses on family contributions, based on reports by care givers about their current situation and their preferences for the involvement of other family members. Study 2 presents a standard family scenario and focuses on the views held by care givers, older adults, and community nurses about the reasonableness of various changes in participation. Results are discussed in terms of the ways situations such as care giving can help build a richer picture of collaborative cognition, one that is applicable to a variety of tasks and to all parts of the life span.

Contextual factors which influence creativity in requirements engineering

In many disciplines, creativity has been recognised as an important part of problem solving. In business, creativity enables the generation of better solutions and provides an opportunity to gain a competitive advantage. In Information Systems (IS) creativity assists developers in finding solutions to difficult problems by helping to efficiently utilise available resources and allows the more effective planning and running of complex projects. One of the most important aspects of IS development is Requirements Engineering (RE), the development activity aimed at understanding the needs and wants of IS customers. While previous RE researchers suggested that creativity is crucial in building high quality information systems, fostering creative outcomes in RE is difficult as it is affected by the multifaceted socioorganisational context within which IS development commonly takes place. This paper reports findings from an empirical study into creativity in RE. Specifically, it reports various contextual factors which were found to influence the creativity of individuals and their teams

Family law

This series comprises a range of student texts, each adopting a problem-solving approach within a discrete area of the law. This text is designed as an easily accessible account of the legislative and judicial principles contained in Australian family law.

Working and learning in vocational education and training in the knowledge era : final report of the professional development for the future project

This Report summarises the outcomes of the phases of the Professional
Development for the Future Project and presents the implications of this research for professional development of staff in Vocational Education and Training (VET), as they become knowledge workers.

These shifts are occurring within the knowledge era. Distinguishing features of this era are summarised into four broad areas:
- the importance and value placed on knowledge in organisations
- the time span of discretion
- the complexity of relationships, and
- the ubiquitous nature of information and communication technology.

It is within this context that work is currently performed, and understanding this context provides the foundation for considering new capabilities required in the knowledge era.
Key capabilities required of knowledge workers to work effectively in the
knowledge era were drawn together from an analysis of the theoretical literature and the results of interviews with knowledge workers. The core capabilities identified include:
- adaptive problem solving – becoming designers as well as problem -
solvers
- rapid knowledge gathering and sharing with others
- discriminating between relevant and irrelevant information, and
- understanding and working effectively with the organisation’s culture.

Knowledge era characteristics and knowledge worker capabilities have been mapped to each other illustrating conceptual linkages between these two areas.

Professional development themes drawn from interviews with knowledge
workers are presented. While global trends in knowledge work have been well documented, the impact of these trends on the capabilities of workers, and the ways in which knowledge workers develop these capabilities is less well understood. Their learning methods challenge our current thinking in relation to the ways in which workers acquire skills and knowledge. Some of the professional development methods include seeking exposure to new ideas from a wide variety of sources, embracing intense learning opportunities, and using relationships to increase knowledge.

‘Thought pieces’ (see p17 ff) commissioned for this Project, as well as
subsequent interviews with the authors, provided further insights into the
professional development of knowledge workers. The implications of these insights are an extension of earlier themes and emphasise:
- the emergent nature of knowledge work
- the importance of relationships that facilitate knowledge sharing
- coherent conversations and dialogue
- collaborative work and generosity.

A key insight is the shift from thinking about knowledge work in terms of
borrowed knowledge to an emphasis on generated knowledge within a context.

Data from focus groups of the Project provide further insights for knowledge worker professional development. These augment the perspectives of the earlier data analysis but also add greater emphasis to:
- the clear and direct relationship between professional development and
work and career aspirations of knowledge workers,
- the relationship of professional development to the organisational
mission, and
- the issues of managing and leading knowledge workers and their
development.

As part of this analysis the defining features of organisational life in VET were reviewed in relation to effective professional development of knowledge workers.

The final section of the Report revisits the core dimensions of the Project.
Concise commentaries on working and learning in the knowledge era,
professional development in the knowledge era, and leadership and
management in the knowledge era are presented.

The Report concludes with a discussion of the enablers of professional
development for knowledge workers in VET. This discussion is introduced by a re-statement of the VET sector’s positioning in the knowledge era and the consequences of this for VET managers an d staff in terms of complexity, uncertainty and diminished prospects for accurate predictiveness. The enablers comprised:
- integration of information technology into socio -technical systems
- greater understanding of the organisation from within
- connecting staff to the organisation’s fundamental identity
- connecting to the work and career trajectories of workers
- establishing work structures which integrate the use of professional
development resources with knowledge work
- providing workers with the autonomy to design their own professional
development activities
- building professional development into the iterative nature of knowledge
work, and
- creating organisational contexts that value intuitive thinking and working.

Professional development needs to be thou ght of in a much broader context in the knowledge era. What each VET staff member knows and shares will become increasingly central to their work, and in that sense all VET workers require capabilities for knowledge work. This report accurately describes t he VET context, the capabilities required, and the organisational enablers that will promote ‘knowing’ and thus embed a new style of professional development within VET.