ICU nurses' experiences and perspectives of caring for obstetric patients in intensive care: A qualitative study

Aims and objectives.  The aim of this study was to gain an understanding of the experiences and perspectives of intensive care nurses caring for critically ill obstetric patients. Background.  Current literature suggests critically ill obstetric patients need specialised, technically appropriate care to meet their specific needs with which many intensive care nurses are unfamiliar. Furthermore, there is little research and evidence to guide the care of this distinct patient group. Design.  This study used a descriptive qualitative design. Methods.  Two focus groups were used to collect data from 10 Australian intensive care units nurses in May 2007. Open-ended questions were used to guide the discussion. Latent content analysis was used to analyse the data set. Each interview lasted no longer than 60 minutes and was recorded using audio tape. The full interviews were transcribed prior to in-depth analysis to identify major themes. Results.  The themes identified from the focus group interviews were competence with knowledge and skills for managing obstetric patients in the intensive care unit, confidence in caring for obstetric patients admitted to the intensive care unit and acceptance of an expanded scope of practice perceived to include fundamental midwifery knowledge and skills. Conclusion.  The expressed lack of confidence and competence in meeting the obstetric and support needs of critically ill obstetric women indicates a clear need for greater assistance and education of intensive care nurses. This in turn may encourage critical care nurses to accept an expanded role of clinical practice in caring for critically ill obstetric patients. Relevance to clinical practice.  Recognition of the issues for nurses in successfully caring for obstetric patients admitted to an adult intensive care setting provides direction for designing education packages, ensuring specific carepaths and guidelines are in place and that support from a multidisciplinary team is available including midwifery staff.

Actioning university-community engagement : leadership, mentoring and professional communities

This presentation focuses on actioning university-community engagement through a Department of Employment, Education and Work Relations (DEEWR) grant. The project associated with this grant is titled Teacher Education Done Differently (TEDD) and it is currently in its third and final year of operation. TEDD aims to facilitate benefits for all partners (i.e., teachers, school executives, students, preservice teachers, university staff, and education departments). This project aims to facilitate understandings and skills on advancing mentoring and teaching practices for preservice teachers.

Breastfeeding self-efficacy and alternative techniques to overcome maternal or infant breastfeeding challenges : a retrospective descriptive study

Background: Breastfeeding is the internationally accepted ideal in infant feeding. Ensuring mothers and babies receive optimal benefits, in both the short and long term, is dependent upon the successful establishment of breastfeeding in the first week. Many maternal and infant challenges can occur during the establishment of breastfeeding (Lactogenesis II). There are also many methods and devices (alternative techniques) which can be used to help, but the majority do not have an evidence-base. The mother.s self-confidence (self-efficacy) can be challenged by these unexpected circumstances, but understanding of the relationship is unclear. Method: This descriptive study used mail survey (including the Breastfeeding Self-Efficacy Scale . Short Form) to obtain the mother.s reports of their self-efficacy and their breastfeeding experience during the first week following birth, as well as actual use of alternative techniques. This study included all mothers of full term healthy singleton infants from one private hospital in Brisbane who began any breastfeeding. The data collection took place from November 2008 to February 2009. Ethical approval was granted from the research site and QUT Human Research Ethics Committee. Results: A total of 128 questionnaires were returned, a response rate of 56.9%. The sample was dissimilar to the Queensland population with regard to age, income, and education level, all of which were higher in this study. The sample was similar to the Queensland population in terms of parity and marital status. The rate of use of alternative techniques was 48.3%. The mean breastfeeding self-efficacy score of those who used any alternative technique was 43.43 (SD=12.19), and for those who did not, it was 58.32 (SD=7.40). Kruskal-Wallis analysis identified that the median self efficacy score for those who used alternative techniques was significantly lower than median self efficacy scores for those who did not use alternative techniques. The reasons women used alternative techniques varied widely, and their knowledge of alternative techniques was good. Conclusion: This study is the first to document breastfeeding self-efficacy of women who used alternative techniques to support their breastfeeding goals in the first week postpartum. An individualised clinical intervention to develop women.s self-efficacy with breastfeeding is important to assist mother/infant dyads encountering challenges to breastfeeding in the first week postpartum.

Young People and Work

This edited book brings together empirical studies of young people in paid employment from a variety of disciplinary perspectives and in different national settings. In the context of increasing youth labour market participation rates and debates about the value of early employment, it draws on multi-level analyses to reflect the complexity of the field. Each of the three sections of the book explores a key aspect of young people's employment: their experience of work, intersections between work and education, and the impact of other actors and institutions. The book contributes to broadening and strengthening knowledge about the opportunities and constraints that young people face during their formative experiences in the labour market.

Social and emotional determinants of health

- describe what is meant by socioeconomic differences in health, and the social and emotional determinants of health - understand how health inequalities are affected by the social and economic circumstances that people experience throughout their lives - discuss how factors such as living and working conditions, income, place and education can impact on health - identify actions for public health policy-makers that have the potential to make a difference in improving health outcomes within populations - appreciate the concept of social cohesion and social capital, and their role as potential protective factors in health - understand conceptual models that can assist in analysing these issues.

Early childhood education

Young children are the most vulnerable and most at risk of environmental challenges, current and future. Yet, early learning around environment and sustainability issues and topics has been neglected and underrated in early childhood education even though there is an expanding body of research literature – from economics, neuroscience, sociology and health – that shows that early investments in human capital offer substantial returns for individuals and for communities and have a long reach into the future. Early childhood education for sustainability (ECEfS) - a synthesis of early childhood education (ECE) and education for sustainability (EfS) - builds on groundings in play, outdoor learning and nature education, but takes a stronger focus on learning about, and engagement with, environmental and sustainability issues. Child participation and agency is central to ECEfS and can relate, for example, to local environmental problem-solving such as water and energy conservation or waste reduction in a childcare centre, kindergarten or preschool, or young children’s social learning for Indigenous Reconciliation and cultural inclusivity. While the ECE field has been much slower than other educational sectors in taking up the challenges of sustainability, this situation is rapidly changing as early childhood practitioners begin to engage – it is fast moving from the margins of early childhood curriculum and pedagogic decision-making into the mainstream. This presents challenges, however, as ECEfS is somewhat misunderstood and misrepresented and, as a new field, is under-researched and under-theorised.

Designing a capstone experience for Australian legal education

Literature suggests that universities, and law schools in particular, are not engaging final year students in a genuine capstone experience which supports the development of their professional identity and their transition out of university. Students in their final year also face significant transition issues which are just as challenging as those facing first year students entering the tertiary environment (Jervis & Hartley, 2005, 314)...

Enhancing Chinese TEFL academics' research performance : necessity and urgency

China’s increasing participation in world affairs and the growing popularity of English as a lingua franca have made significant impact on Chinese society, culture and education. As such, considerable research topics in relation to English require TEFL researchers’ attentions. Additionally, higher education reform in China has created higher demand on academics by stressing research as an important element in academics’ assessment. Recurrent rhetoric in the field of TEFL also calls on practitioners to theorise their practice. All these practical needs and theoretical arguments point to the necessity and significance of TEFL academics’ engagement in research. To find out whether Chinese TEFL academics’ research meet the new demand on them, a survey of TEFL academics at three Chinese higher institutions was conducted. One hundred eighty two of them provided valid responses which were analysed using SPSS. It was found that TEFL academics’ research productivity in each category of research products was quite low. Large percentages of them did not produce any item in the investigated categories of research. They were least productive in conference papers and research products at the national level. However for these least productive categories, there were highly-productive TEFL academics. The categories of research where the TEFL academics were found relatively productive were non-core journal articles and provincial projects. The findings suggest that it is necessary and urgent for Chinese TEFL academics to enhance their research productivity to be able to meet the demand that new era has rendered.

Parenting behaviours and maternal infant-feeding practices in first-time Australian mothers

Introduction: There is emerging evidence that parenting style and early feeding practices are associated with child intake, eating behaviours and weight status. The aim of this cross sectional study was to examine the relationships between general maternal parenting behaviour and feeding practices and beliefs. Methods: Participants were 421 first-time mothers of 9-22 week old healthy term infants (49% male, mean±sd age 19±4 weeks) enrolled in the NOURISH trial. At baseline mothers self-reported their parenting behaviours (self-efficacy, warmth, irritability) and infant-feeding beliefs using questions from the Longitudinal Study of Australian Children and the Infant Feeding Questionnaire (Baughcum, 2001), respectively. Multivariable regression analyses were used with feeding practices (four factors) as the dependent variables, Independent variables were maternal BMI, weight concern, age, education level perception of infant weight status, feeding mode (breast vs formula) and infant gender, age and weight gain z-score. Results: Parenting behaviours partly were associated with feeding beliefs (adjusted R2 =0.21-0.30). Higher maternal parenting self-efficacy was inversely associated with concerns that the baby would become underweight (p=0.006); become overweight (p<0.001); and lack of awareness of infant hunger/satiety cues (p<0.001). Higher maternal irritability was positively associated with lack of awareness of cues (p<0.05). Maternal warmth was not associated with any feeding beliefs. Infant weight- gain (from birth) z-score and age, maternal BMI and education level and mothers’ perception of infant weight status and feeding mode were covariates. Conclusions: These findings suggest strategies to improve early feeding practices need to be address broader parenting approaches, particularly self-efficacy and irritability.

The association between maternal infant feeding practices and child weight at 11-17 months in first-time Australian mothers

Introduction: Emerging evidence reveals that early feeding practices are associated with child food intake, eating behaviour and weight status. This cross-sectional analysis examined the association between maternal infant feeding practices/beliefs and child weight in Australian infants aged 11-17 months. Methods: Participants were 293 first-time mothers of healthy term infants (144 boys, mean age 14±1 months) enrolled in the NOURISH RCT. Mothers self-reported infant feeding practices and beliefs using the Infant Feeding Questionnaire (Baughcum, 2001). Anthropometric data were also measured at baseline (infants aged 4 months). Multiple regression analysis was used, adjusting for infant age, gender, birth weight, infant feeding mode (breast vs. formula), maternal perceptions of infant weight status, pre-pregnancy weight, weight concern, age and education. Results: The average child weight-for-age z-score (WAZ) was 0.62±0.83 (range:-1.56 to 2.94) and the mean change in WAZ (WAZ change) from 4 to 14 months was 0.62±0.69 (range:-1.50 to 2.76). Feeding practices/beliefs partly explained child WAZ (R2=0.28) and WAZ change (R2=0.13) in the adjusted models. While child weight status at 14 months was inversely associated with responsive feeding (e.g. baby feeds whenever she wants, feeding to stop baby being unsettled) (β=-0.104, p=0.06) and maternal concern about the child becoming underweight (β=-0.224, p<0.001), it was positively associated with mother’s concern about child overweight (β=0.197, p<0.05). Birth weight, infant’s age, maternal weight concern and perceiving her child as overweight were significant covariates. WAZ change was only significantly associated with responsive feeding (β=-0.147, p<0.05). Conclusion: Responsive feeding may be an important strategy to promote healthy child weight.

Young, inexperienced and on the road : do novice drivers comply with road rules?

The graduated driver licensing (GDL) program in Queensland, Australia, was considerably enhanced in July 2007. This paper explores the compliance of young Learner and Provisional (intermediate) drivers with current GDL requirements and general road rules. Unsupervised driving, Learner logbook accuracy, and experiences of punishment avoidance were explored, along with speeding as a Provisional driver. Participants (609 females; M = 17.43 years) self-reported sociodemographic characteristics, driving behaviours and licensing experiences as Learners. A subset of participants (238 females, 105 males) completed another survey six months later exploring their Provisional behaviours and experiences. While the majority of the participants reported compliance with both the GDL requirements and general road rules such as stopping at red lights on their Learner licence; a considerable proportion reported speeding. Furthermore, they reported becoming less compliant during the Provisional phase, particularly with speed limits. Self-reported speeding was predicted by younger age at licensure, being in a relationship, driving unsupervised, submitting inaccurate Learner logbooks, and speeding as a Learner. Enforcement and education countermeasures should focus upon curtailing noncompliance, targeting speeding in particular. Novice drivers should be encouraged to comply with all road rules, including speed limits, and safe driving behaviours should be developed and reinforced during the Learner and early Provisional periods. Novice drivers have been found to model their parents’ driving, and parents are pivotal in regulating novice driving. It is vital young novice drivers and parents alike are encouraged to comply with all road rules, including GDL requirements.

‘Show Me Your Wiki and I’ll Show you Mine’: Using Online Interactive Media to Improve Academic Writing and Research in a Public Health Under-Graduate Cohort

The number of Internet users in Australia has been steadily increasing, with over 10.9 million people currently subscribed to an internet provider (ABS, 2011). Over the past year, the most avid users of the Internet were 15 – 24 year olds, with approximately 95% accessing the internet on a regular basis (ABS, Social Trends, 2011). While the internet has been described as fundamental to higher education students, social and leisure internet tools are also increasingly being used by these students to generate and maintain their social and professional networks and interactions (Duffy & Bruns 2006). Rapid technological advancements have enabled greater and faster access to information for learning and education (Hemmi et al, 2009; Glassman and Kang, 2011). As such, we sought to integrate interactive, online social media into the assessment profile of a Public Health undergraduate cohort at the Queensland University of Technology (QUT). The aim of this exercise was to engage students to both develop and showcase their research on a range of complex, contemporary health issues within the online forum of Wikispaces (http://www.wikispaces.com/) for review and critique by their peers. We applied Bandura’s Social Learning Theory (SLT) to analyse the interactive processes from which students developed deeper and more sustained learning, and via which their overall academic writing standards were raised. This paper outlines the assessment task, and the students’ feedback on their learning outcomes in relation to the Attentional, Retentional, Motor Reproduction, and Motivational Processes outlined by Bandura in SLT. We conceptualise the findings in a theoretical model, and discuss the implications for this approach within the broader tertiary environment.

On secrets, lies, and fiction : girls learning the art of survival

This chapter’s interest in fiction’s relationship to truth, lies, and secrecy is not so much a matter of how closely fiction resembles or mirrors the world (its mimetic quality), or what we can learn from fiction (its epistemological value). Rather, the concern is both literary and philosophical: a literary concern that takes into account how texts that thematise secrecy work to withhold and to disclose their secrets as part of the process of narrating and sequencing; and a philosophical concern that considers how survival is contingent on secrets and other forms of concealment such as lies, deception, and half-truths. The texts selected for examination are: Secrets (2002), Skim (2008), and Persepolis: The Story of a Childhood (2003). These texts draw attention to the ways in which the lies and secrets of the female protagonists are part of the intricate mechanism of survival, and demonstrate the ways in which fiction relies upon concealment and revelation as forms of truth-telling.