Palliative care challenges : implications for nurses' practice in renal settings

The very act of withdrawing dialysis places renal nurses in a unique practice setting requiring a sudden shift in care delivery from one of providing Ife-sustaining, active treatment to that of palliation. The impact of this act on the renal nurse remains largely invisible. Minimal research has been conducted that explores the significant issues and challenges that exist for renal nurses in the delivery of palliation following withdrawal of dialysis treatment. This paper attempts to highlight the issues and challenges that do exist for renal nurses in providing palliation and the subsequent lack of available research knowledge to inform practice in the renal setting. It recommends further research be conducted into the renal setting so as to inform the development of appropriate education to support renal nurses practice in the future.

Empirical research in business process management : introduction to the special issue

In this editorial letter, we provide the readers of Information Systems and e-Business Management with an introduction to Business Process Management and the challenges of empirical research in this field. We then briefly describe selected examples of current research efforts in this fields and how the papers accepted for this special issue contribute to extending our body of knowledge.

“A special kind of city knowledge” : innovative clusters, tacit knowledge and the ‘Creative City’

That the cultural industries are highly networked and operate in clusters is now well established. The notion of cluster is linked to the idea of place-based advantage with cultural industries gaining competitive advantage from mobilising the resources of places to compete in global markets. ‘Place’ in the cultural industries is frequently taken to be the city where city is seen as the key resource for cultural industry clusters and a primary point of intervention for cultural industry policy in creative city policy making. In this article I want to look at some of the implications of these moves for both academic research and policy discussion. The reasons for this emphasis on policy relates to some large questions of urban governance and cultural politics surrounding the proactive government of clusters which are raised by recent work on the cultural industries, notably by Alan Scott.

On the consistency of multiclass classification methods

Binary classification is a well studied special case of the classification problem. Statistical properties of binary classifiers, such as consistency, have been investigated in a variety of settings. Binary classification methods can be generalized in many ways to handle multiple classes. It turns out that one can lose consistency in generalizing a binary classification method to deal with multiple classes. We study a rich family of multiclass methods and provide a necessary and sufficient condition for their consistency. We illustrate our approach by applying it to some multiclass methods proposed in the literature.

Ensuring student success : the role of support services in improving the quality of the student learning experience

This paper is based on the premise that universities have an obligation to provide adequate student support services, such as learning assistance (that is, assistance with academic writing and other study skills) and that in order to be effective such services must be responsive to the wider policy and social implications of student attrition and retention. The paper outlines briefly some of the factors that have influenced the development of learning assistance practices in Australia and America. This is followed by an account of experiences at one Australian metropolitan university where learning assistance service provision shifted from a decentralised, faculty-based model to a centralised model of service delivery. This shift was in response to concerns about lack of quality and consistency in a support model dependent upon faculty resources yet a follow up study identified other problems in the centralised delivery of learning assistance services. These problems, clustered under the heading contextualised versus decontextualised learning assistance, include the relevance of generic learning assistance services to students struggling with specific course related demands; the apparent tensions between challenging students and assisting students at risk of failure; and variations in the level of collaboration between learning advisers and academic staff in supporting students in the learning environment. These problems are analysed using the theoretical modelling derived from the tools made available through cultural historical activity theory and expansive visibilisation (Engeström & Miettinen, 1999).

Aspiration levels and educational choices: An experimental study

The explanation of social inequalities in education is still a debated issue in economics. Recent empirical studies tend to downplay the potential role of credit constraint. This article tests a different potential explanation of social inequalities in education, specifically that social differences in aspiration level result in different educational choices. Having existed for a long time in the sociology of education, this explanation can be justified if aspiration levels are seen as reference points in a prospect theory framework. In order to test this explanation, this article applies the method of experimental economics to the issue of education choice and behaviour. One hundred and twenty-nine individuals participated in an experiment in which they had to perform a task over 15 stages grouped in three blocks or levels. In order to continue through the experiment, a minimum level of success was required at the end of each level. Rewards were dependent on the final level successfully reached. At the end of each level, participants could either choose to stop and take their reward or to pay a cost to continue further in order to possibly receive higher rewards. To test the impact of aspiration levels, outcomes were either presented as gains or losses relative to an initial sum. In accordance with the theoretical predictions, participants in the loss framing group choose to go further in the experiment. There was also a significant and interesting gender effect in the loss framing treatment, such that males performed better and reached higher levels.

Factors contributing to nurse job satisfaction in the acute hospital setting : a review of recent literature

Aim  To explore and discuss from recent literature the common factors contributing to nurse job satisfaction in the acute hospital setting. Background  Nursing dissatisfaction is linked to high rates of nurses leaving the profession, poor morale, poor patient outcomes and increased financial expenditure. Understanding factors that contribute to job satisfaction could increase nurse retention. Evaluation  A literature search from January 2004 to March 2009 was conducted using the keywords nursing, (dis)satisfaction, job (dis)satisfaction to identify factors contributing to satisfaction for nurses working in acute hospital settings. Key issues  This review identified 44 factors in three clusters (intra-, inter- and extra-personal). Job satisfaction for nurses in acute hospitals can be influenced by a combination of any or all of these factors. Important factors included coping strategies, autonomy, co-worker interaction, direct patient care, organizational policies, resource adequacy and educational opportunities. Conclusions  Research suggests that job satisfaction is a complex and multifactorial phenomenon. Collaboration between individual nurses, their managers and others is crucial to increase nursing satisfaction with their job. Implications for nursing management  Recognition and regular reviewing by nurse managers of factors that contribute to job satisfaction for nurses working in acute care areas is pivotal to the retention of valued staff.

Cultural support workers and long day care services

In Australia, eligible long day care services may apply for support at the state level to assist with the transition of children from culturally or linguistically diverse backgrounds into childcare settings. For staff in childcare services, this support comes in the form of a cultural support worker (CSW). The primary role of a CSW is to build capacity in childcare staff to support children and families as they enter the childcare program. This paper draws on interview data and documentation from multiple sources to report the perspectives of key stakeholders affiliated with a cultural support program in an Australian childcare setting. It concludes that a more flexible approach to policy that directs the work of CSWs is needed, as well as further research into ways to build capacity for cultural competence for both CSWs and childcare staff who work collaboratively to support young children as they transition to childcare.

Evaluating educational software : a historical overview and the challenges ahead

Teachers are under increasing pressure from government and school management to incorporate technology into lessons. They need to consider which technologies can most effectively enhance subject learning, encourage higher order thinking skills and support the performance of authentic tasks. This chapter reviews the practical and theoretical tools that have been developed to aid teachers in selecting software and reviews the software assessment methodologies from the 1980s to the present day. It concludes that teachers need guidance to structure the evaluation of technology, to consider its educational affordances, its usability, its suitability for the students and the classroom environment and its fit to the teachers’ preferred pedagogies.

The transition to school of children with developmental disabilities : views of parents and teachers

The transition from early intervention programs to inclusive school settings presents children with developmental disabilities with a range of social challenges. In Queensland, in the year of transition to school, many children with developmental disabilities attend an Early Childhood Development Program for 2 to 3 days each week and also begin attendance in a mainstream program with the latter increasing to full-time attendance during the year. Quantitative and qualitative data were collected by parent interviews and teacher questionnaires for 62 children participating in the Transition to School Project regarding their perceptions of the success of the transition process and the benefits and challenges of inclusion. Both parents and teachers saw a range of benefits to children from their inclusion in ‘regular’ classrooms, with parents noting the helpfulness of teachers and their support for inclusion. Challenges noted by parents included the school’s lack of preparation for their child’s particular developmental needs especially in terms of the physical environment while teachers reported challenges meeting the needs of these children within the context and resources of the classroom. Parents were more likely than teachers to view the transition as easy. Correlational analyses indicated that teachers were more likely to view the transition as easy when they felt that the child was appropriately placed in a ‘regular’ classroom. Findings from this project can inform the development of effective transition-to-school programs in the early school years for children with developmental disabilities.

Entrepreneurial becoming : an educational pathway out of poverty

This paper reports a longitudinal analysis of 20 necessity driven micro-entrepreneurs operating in Beira, Central Mozambique, who received funding and training from the same NGO to establish or grow their business activities and reports the development of these entrepreneurs in terms of their acquired entrepreneurial potential for long-term success. The results indicate there is a process of entrepreneurial becoming that is not just about access to finance but especially learning and, when successful, this process supports the transformation of survival micro-enterprises into entrepreneurial micro-businesses. The concept of ‘becoming’ contains an implicit temporal dimension. Becoming suggests a transformation over time: a change from what one is already. In this study, we witness a significant change in understanding how a business needs to operate, in recognizing opportunities, thinking more creatively, and building self-confidence.

Integrating treatment for mental and physical disorders and substance misuse in Indigenous primary care settings

Objective: Australian Indigenous peoples in remote and rural settings continue to have limited access to treatment for mental illness. Comorbid disorders complicate presentations in primary care where Indigenous youths and perinatal women are at particular risk. Despite this high comorbidity there are few examples of successful models of integrated treatment. This paper outlines these challenges and provides recommendations for practice that derive from recent developments in the Northern Territory. Conclusions: There is a strong need to develop evidence for the effectiveness of integrated and culturally informed individual and service level interventions. We describe the Best practice in Early intervention Assessment and Treatment of depression and substance misuse study which seeks to address this need.

The challenge of working in mental health settings: perceptions of newly graduated occupational therapists

Working in mental health settings is a growing area of practice for occupational therapists. The work nowadays is mostly within the community, where occupational therapists may be found in a wide variety of teams. This study investigated the specific challenges that new graduate occupational therapists are faced with when commencing work in a mental health setting. One-to-one semi-structured interviews were carried out with 15 newly graduated occupational therapists, working in mental health settings in south-east Queensland. The interview transcripts were analysed using a consensual qualitative research approach. Three domains were identified from the transcripts. The first related to the ideas of the participants about the skills and knowledge needed by new graduates commencing mental health practice; the second related to the extent to which undergraduate studies had prepared them for practice; and the third related to the means by which they acquired capacity to practise and overcame deficits in skills and knowledge. The core ideas and themes associated with these domains are examined and the implications of the findings for education and training and for orientation to practice are discussed.