General practitioners’ experiences of the psychological aspects in the care of a dying patient

Objective: General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients. Method: Fifteen general practitioners whose patient had been recently referred to the Mt. Olivet Palliative Home Care Services in Brisbane participated in an individual case review discussions guided by key questions within a semistructured format. These interviews focused on the psychosocial aspects of care and management of the referred patient, including aspects of the doctor/patient relationship, experience of delivering diagnosis and prognosis, addressing the psychological concerns of the patients' family, and the doctors' personal experiences, reactions, and responses. Qualitative analysis was conducted on the transcripts of these interviews. Results: The significant themes that emerged related to perceived barriers to exploration of emotional concerns, including spiritual issues, and the discussion of prognosis and dying, the perception of patients' responses/coping styles, and the GP's personal experience of the care (usually expressed in terms of identification with patient). Significance of results: The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.

Five case studies applying soft systems methodology to knowledge management

Construction projects are faced with a challenge that must not be underestimated. These projects are increasingly becoming highly competitive, more complex, and difficult to manage. They become problems that are difficult to solve using traditional approaches. Soft Systems Methodology (SSM) is a systems approach that is used for analysis and problem solving in such complex and messy situations. SSM uses “systems thinking” in a cycle of action research, learning and reflection to help understand the various perceptions that exist in the minds of the different people involved in the situation. This paper examines the benefits of applying SSM to problems of knowledge management in construction project management, especially those situations that are challenging to understand and difficult to act upon. It includes five case studies of its use in dealing with the confusing situations that incorporate human, organizational and technical aspects.

A model for engaging and evaluating innovative cross-sectoral education reform : case studies from Queensland, Australia

This paper will explore how a general education can contribute successfully to vocational outcomes using both Participatory Action Research (PAR) and Program Theory methodology. The paper will focus on the development aspects of ‘marrying’ vocational and general education including engagement processes, student, teacher, institute and employer preparation and the pathway possibilities that emerge. Successful cases presented include the: Healthy Futures program (pathways into the Health and Allied industries); Accounting Pathways program (simultaneously studying a general Accounting subject and a Certificate III vocational qualification); and Sustainable Sciences initiative (development of a vocational qualification that focuses on the emerging renewable energy industry and is linked to school science programs). The case studies have been selected because they are unique in character and application and can be used as a basis for future program development in other settings or curriculum areas.

Communication and control : case studies in Australian telecommuting

This paper discusses the results of in-depth semi-structured interviews with 39 telecommuters from 12 Australian organisations. The paper serves two broad aims: firstly, it identifies current trends in telecommuting and offers a perspective on Australian developments. Secondly, it provides a focus on significant communication aspects of the Australian telecommuting experience. Findings are that the majority of interviewees reported overall satisfaction with telecommuting as an important contributor to their improved work and lifestyle outcomes. Overall, telecommuters appear to cope with communication aspects of their work environments. They also were not overreliant on advanced communications media when telecommuting. Difficulties as reported by telecommuter interviewees included: perceived discomfort over lack of management support for their telecommuting; reduced levels of interpersonal communication suggesting the likely need to adopt a ‘media mix’ approach to servicing their communication needs; problems of information access; and telecommuters’ reported levels of difficulty with their uses of some computer and communication technologies. Problems relating to telecommuters’ perceived professional and social isolation, were also identified. Finally, the paper underscores where organisational communication theorists and practitioners need to more energetically embrace the concepts of virtual work and telecommuting

The impact of software-as-a-service on business models of leading software vendors : experiences from three exploratory case studies

The number of software vendors offering ‘Software-as-a-Service’ has been increasing in recent years. In the Software-as-a-Service model software is operated by the software vendor and delivered to the customer as a service. Existing business models and industry structures are challenged by the changes to the deployment and pricing model compared to traditional software. However, the full implications on the way companies create, deliver and capture value are not yet sufficiently analyzed. Current research is scattered on specific aspects, only a few studies provide a more holistic view of the impact from a business model perspective. For vendors it is, however, crucial to be aware of the potentially far reaching consequences of Software-as-a-Service. Therefore, a literature review and three exploratory case studies of leading software vendors are used to evaluate possible implications of Software-as-a-Service on business models. The results show an impact on all business model building blocks and highlight in particular the often less articulated impact on key activities, customer relationship and key partnerships for leading software vendors and show related challenges, for example, with regard to the integration of development and operations processes. The observed implications demonstrate the disruptive character of the concept and identify future research requirements.

Case studies on vibration based damage identification : multi-criteria approach

Vibration based damage identification methods examine the changes in primary modal parameters or quantities derived from modal parameters. As one method may have advantages over the other under some circumstances, a multi-criteria approach is proposed. Case studies are conducted separately on beam, plate and plate-on-beam structures. Using the numerically simulated modal data obtained through finite element analysis software, algorithms based on flexibility and strain energy changes before and after damage are obtained and used as the indices for the assessment of the state of structural health. Results show that the proposed multi-criteria method is effective in damage identification in these structures.