Negotiating futility, managing emotions : nursing the transition to palliative care

Nurses play a pivotal role in caring for patients during the transition from life-prolonging care to palliative care. This is an area of nursing prone to emotional difficulty, interpersonal complexity, and interprofessional conflict. It is situated within complex social dynamics, including those related to establishing and accepting futility and reconciling the desire to maintain hope. Here, drawing on interviews with 20 Australian nurses, we unpack their accounts of nursing the transition to palliative care, focusing on the purpose of nursing at the point of transition; accounts of communication and strategies for representing palliative care; emotional engagement and burden; and key interprofessional challenges. We argue that in caring for patients approaching the end of life, nurses occupy precarious interpersonal and interprofessional spaces that involve a negotiated order around sentimental work, providing them with both capital (privileged access) and burden (emotional suffering) within their day-to-day work.

Fine-mapping the HOXB region detects common variants tagging a rare coding allele : evidence for synthetic association in prostate cancer

The HOXB13 gene has been implicated in prostate cancer (PrCa) susceptibility. We performed a high resolution fine-mapping analysis to comprehensively evaluate the association between common genetic variation across the HOXB genetic locus at 17q21 and PrCa risk. This involved genotyping 700 SNPs using a custom Illumina iSelect array (iCOGS) followed by imputation of 3195 SNPs in 20,440 PrCa cases and 21,469 controls in The PRACTICAL consortium. We identified a cluster of highly correlated common variants situated within or closely upstream of HOXB13 that were significantly associated with PrCa risk, described by rs117576373 (OR 1.30, P = 2.62×10(-14)). Additional genotyping, conditional regression and haplotype analyses indicated that the newly identified common variants tag a rare, partially correlated coding variant in the HOXB13 gene (G84E, rs138213197), which has been identified recently as a moderate penetrance PrCa susceptibility allele. The potential for GWAS associations detected through common SNPs to be driven by rare causal variants with higher relative risks has long been proposed; however, to our knowledge this is the first experimental evidence for this phenomenon of synthetic association contributing to cancer susceptibility.

Writing embodied practice from the inside : outside the exegesis

The textual turn is a good friend of expert spectating, where it assumes the role of writing-productive apparatus, but no friend at all of expert practices or practitioners (Melrose, 2003). Introduction The challenge of time-based embodied performance when the artefact is unstable As a former full-time professional practitioner with an embodied dance practice as performer, choreographer and artistic director for three decades, I somewhat unexpectedly entered the world of academia in 2000 after completing a practice-based PhD, which was described by its examiners as ‘pioneering’. Like many artists my intention was to deepen and extend my practice through formal research into my work and its context (which was intercultural) and to privilege the artist’s voice in a research world where it was too often silent. Practice as research, practice-based research, and practice-led research were not yet fully named. It was in its infancy and my biggest challenge was to find a serviceable methodology which did not betray my intentions to keep practice at the centre of the research. Over the last 15 years, practice led doctoral research, where examinable creative work is placed alongside an accompanying (exegetical) written component, has come a long way. It has been extensively debated with a range of theories and models proposed (Barrett & Bolt, 2007, Pakes, 2003 & 2004, Piccini, 2005, Philips, Stock & Vincs 2009, Stock, 2009 & 2010, Riley & Hunter 2009, Haseman, 2006, Hecq, 2012). Much of this writing is based around epistemological concerns where the research methodologies proposed normally incorporate a contextualisation of the creative work in its field of practice, and more importantly validation and interrogation of the processes of the practice as the central ‘data gathering’ method. It is now widely accepted, at least in the Australian creative arts context, that knowledge claims in creative practice research arise from the material activities of the practice itself (Carter, 2004). The creative work explicated as the tangible outcome of that practice is sometimes referred to as the ‘artefact’. Although the making of the artefact, according to Colbert (2009, p. 7) is influenced by “personal, experiential and iterative processes”, mapping them through a research pathway is “difficult to predict [for] “the adjustments made to the artefact in the light of emerging knowledge and insights cannot be foreshadowed”. Linking the process and the practice outcome most often occurs through the textual intervention of an exegesis which builds, and/or builds on, theoretical concerns arising in and from the work. This linking produces what Barrett (2007) refers to as “situated knowledge… that operates in relation to established knowledge” (p. 145). But what if those material forms or ‘artefacts’ are not objects or code or digitised forms, but live within the bodies of artist/researchers where the nature of the practice itself is live, ephemeral and constantly transforming, as in dance and physical performance? Even more unsettling is when the ‘artefact’ is literally embedded and embodied in the work and in the maker/researcher; when subject and object are merged. To complicate matters, the performing arts are necessarily collaborative, relying not only on technical mastery and creative/interpretive processes, but on social and artistic relationships which collectively make up the ‘artefact’. This chapter explores issues surrounding live dance and physical performance when placed in a research setting, specifically the complexities of being required to translate embodied dance findings into textual form. Exploring how embodied knowledge can be shared in a research context for those with no experiential knowledge of communicating through and in dance, I draw on theories of “dance enaction” (Warburton, 2011) together with notions of “affective intensities” and “performance mastery” (Melrose, 2003), “intentional activity” (Pakes, 2004) and the place of memory. In seeking ways to capture in another form the knowledge residing in live dance practice, thus making implicit knowledge explicit, I further propose there is a process of triple translation as the performance (the living ‘artefact’) is documented in multi-facetted ways to produce something durable which can be re-visited. This translation becomes more complex if the embodied knowledge resides in culturally specific practices, formed by world views and processes quite different from accepted norms and conventions (even radical ones) of international doctoral research inquiry. But whatever the combination of cultural, virtual and genre-related dance practices being researched, embodiment is central to the process, outcome and findings, and the question remains of how we will use text and what forms that text might take.

Informatics to support patient choice between diverse medical systems

Culturally, philosophically and religiously diverse medical systems including Western medicine, Traditional Chinese Medicine, Ayurvedic Medicine and Homeopathic Medicine, once situated in places and times relatively unconnected from each other, currently co-exist to a point where patients must choose which system to consult. These decisions require comparative analyses, yet the divergence in key underpinning assumptions is so great that comparisons cannot easily be made. However, diverse medical systems can be meaningfully juxtaposed for the purpose of making practical decisions if relevant information is presented appropriately. Information regarding privacy provisions inherent in the typical practice of each medical system is an important element in this juxtaposition. In this paper the information needs of patients making decisions regarding the selection of a medical system are examined.

Foreword

"The 1996 edition of ‘Harvard Educational Review’ hosted the now seminal article from the New London Group, ‘The Pedagogy of Multiliteracies’. Coining the term ‘multiliteracies’ to describe the advent of new technologies as well as the rapidly changing social and cultural literacies of the emerging new world order, the New London Group proffered an ambitiously new educational agenda constituted by four non-hierarchical and non-linear components of pedagogy: situated practice, overt instruction, critical framing and transformed practice..."

Women’s perceptions of their lifestyle and quality of life several years after a diagnosis of endometrial cancer

Background Few studies have examined the long-term changes experienced by women treated for endometrial cancer. Objective The objectives of this study were to describe what women perceived important to their lifestyle and quality of life in the years following their diagnosis and to provide new insights that might inform healthcare practice. Methods This was a thematic analysis of 237 open-ended comments from Australian women diagnosed with endometrial cancer 3 to 5 years previously. Results We identified 3 main themes: (1) personal change, in which women spoke about cancer as permanently altering their lives in mostly negative but sometimes positive ways; (2) continuity of former life, which described both the minimal impact of cancer on women's lives and identities and the difficulties negotiating this within the dominant "cancer survivorship" culture; (3) social support, where women wrote about how the quality of their relationships shaped their cancer trajectory. Conclusions While typical "survivorship" issues exist for many women with endometrial cancer (eg, physical, emotional, sexual health changes), a proportion of women will not be focused on their cancer and can be encouraged to form lives and identities that are not situated within the "cancer survivorship" culture. Implications for Practice A network of support, sensitive to women's responses to having cancer, may benefit women's long-term adjustment. Regular standardized assessment of women's needs may facilitate appropriate support for those with concerns, whereas those without concerns could be reassured by health professionals that their experience is normal and shared by other people with cancer. This may encourage women to form lives that are personally meaningful.

Subtropical futures : Victoria Park re-imagined

Brisbane, the capital of Queensland, in South-East Queensland is situated on the Brisbane River, one of the largest rivers (and floodplains) on the east coast of Australia. The river defines the city and gives it its name. The river has been a natural place to accommodate some population growth for the city with high-density development that capitalises on the natural amenity, cycleways and a string of parks and the flatter land. The major floods of 2011 and the scare of 2013, has seen a more malevolent quality of the river and shift of thinking on its role within the city. The floods have made council, for the first time, acquire prime development sites near the river, with proposals for high density development and made them parks, at great cost. The pressure for population growth in Brisbane remains. 140,000 new dwellings are required by 2031. Brownfield sites are less plentiful and there is interest to rethink of some of the other strategic locations in the city away from the river on higher ground and steeper slopes. Some of these places are currently open spaces. Victoria Park Golf Course sits on a high ridge line and a very strategic part of the city just north of the city centre is one of the few remaining golf courses close to the centre of an Australian capital city. While it is a public course and a valuable community asset, it has been compromised by the recently completed northern busway with two bus stations constructed on its edges. It is bounded on the west and north-east by two major community facilities, the Queensland University of Technology (QUT) to the west and RBW Hospital at its northern end. In a city in need of urban consolidation, perhaps it is time to review the future of the golf course. This question has been investigated as a conjecture in the Master of Architecture program at the QUT. The project has been to re-imagine Victoria Park as a new city parkland and a place that makes an urban connection from the QUT to the hospital. This new urban precinct is be a medium to high-density transit oriented development that capitalises on the bus way stations and the proximity of the university and hospital. The precinct will frame/define/interact with the new major urban park for the city. A key question being addressed is how the design can embody and define principles of a subtropical urbanism. Students are identifying the appropriate street and block structure, density and built form to be accommodated on blocks that define and activate a rich sequence of streets and public spaces. The paper will present a critical overview of the project work that provides a lens to how future professionals may respond to these issue that will be the focus of their professional lives.

Nursing casualisation and communication : a critical ethnography

Aim The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Background Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Design Critical ethnography. Methods Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008–2009. Results The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Conclusion Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management.

Trashtopia by Maison Briz Vegas

Description of the Work Trashtopia was a fashion exhibition at Craft Queensland’s Artisan gallery showcasing outfits made entirely from rubbish materials. The exhibition was part of an on-going series by the Queensland Fashion Archives, called Remember or Revive. Maison Briz Vegas designers, Carla Binotto and Carla van Lunn created a dystopian beach holiday tableau referencing mid-century Californian and Gold Coast beach culture and style, and today’s plastic pollution of the world’s oceans. The display engaged a popular audience with ideas about environmental destruction and climate change while bringing twentieth and twenty-first century consumer and leisure culture into question. The medium of fashion was used as a means of amusement and provocation. The fashion objects and installation questioned current mores about the material value of rubbish and the installation was also a work of environmental activism. Statement of the Research Component The work was framed by critical reflections of contemporary consumer culture and research fields questioning value in waste materials and fashion objects. The work is situated in the context of conceptual and experimental fashion design practice and fashion presentation. The exhibited work transgressed the conventional production methods and material choice of designer fashion garments, for example, discarded plastic shopping bags were painstakingly shredded to mimic ostrich feathers. The viewer was prompted to reflect on the materiality of rubbish and its potential for transformation. The exhibition also sits in the context of culture jamming and contemporary activist practice. The work references and subverts twentieth century beach holiday culture, contrasting resort wear with a contemporary picture of plastic pollution of the oceans and climate change. Hawaiian style prints contained a playful and dark narrative of dying marine-life and the viewer was invited to take a “Greetings from Trashtopia” postcard depicting fashion models floating in oceans of plastic rubbish. This reflective creative practice sought to address the question of whether fashion made from recycled rubbish materials can critically and emotionally engage viewers with questions about contemporary consumer culture and material value. This work presents an innovative model of fashion design practice in which rubbish materials are transformed into designer garments and rubbish is placed centre stage in the public presentation of the designs. In overturning the traditional model of fashion presentation, the viewer is also given a deeper connection to the recycling process and complex ideas of waste and value. In 2015 two outfits from the exhibition were selected, along with works from three leading Australian fashion labels, and four leading New Zealand labels, for a commemorative ANZAC fashion collection shown at iD Dunedin Fashion Week. The show titled, “Together Alone, revisited” reprised an Australian and New Zealand fashion exhibition first held at the National Gallery of Victoria in 2009.

Two QUT Research Projects : Lightsite Perminant and Koonga Maya

Bushfire Responsive Architecture proposals (2) detailed in a 144 page document containing orginal architectural designs and site surveys by Dr Ian Weir. Presented in support of Dr Weir's sucessful planning application for the perminant artwork/land art project "Lightsite Perminant" situated on Point Henry, Western Australia.

Situating learning : (re)examining the notion of apprenticeship in coach education

The last two decades has seen a proliferation in the provision of, and importance attached to, coach education in many Western countries [1]. Pivotal to many coach education programmes is the notion of apprenticeship [2,3,4]. Increasingly, mentoring is being positioned as a possible tool for enhancing coach education and consequently professional expertise [5]. However, there is a paucity of empirical data on interventions in, and evaluations of, coach education programmes. In their recent evaluation of a coach education programme Cassidy, Potrac & McKenzie [6] conclude that the situated learning literature could provide coach educators with a generative platform for the (re)examinationof apprenticeships and mentoring in a coach education context. This paper consequently discusses the merits of using situated learning theory [7] and the associated concept of Communities of Practice (CoP) [8] to stimulate discussion on developing new understandings of the practices of apprenticeship and mentoring in coach education.

Composing an email : social interaction in a preschool classroom

The chapter contributes understandings of digitally mediated interactions in early childhood classrooms. Ethnomethodological and conversation analysis approaches are used to analyse a video-recorded episode of children and teacher composing an email in a preschool classroom. In their talk we find how the teacher directs the children to what counts procedurally, such as the components of an email, and the teacher’s moral work in producing a culturally correct way form of personal communication. Such considerations of situated examples can encourage investigations of digital practices that extend beyond operational skills to broader understandings of digital practices as cultural and situated activities.

Mobile interaction design approaches for reducing domestic food waste

This thesis is a trans-disciplinary study of domestic food waste in Australia. Firstly, it examines why consumers are prone to waste food. Secondly, it explores several situated design interventions to reduce domestic food waste by informing consumer food supply and location awareness, and improving the level of food literacy among consumers. The thesis outcomes have implications for academic and industry domains within the fields of Human-Computer Interaction, urban informatics, environmental sustainability, food security and public health.

Mandatory Reporting Laws for Child Sexual Abuse in Australia : A Legislative History

This work conducts a comprehensive historical review and analysis of the legislative principles for mandatory reporting of child sexual abuse in each State and Territory of Australia. The research traces and explains all the significant changes in the development of the laws in each jurisdiction since their inception in 1969 to the year 2013. The research also identifies why the legislation changed in each jurisdiction, covering research into publicly available records, focusing on significant government inquiries and law reform reports, and parliamentary debates. The research is situated within a treatment of the modern discovery of child sexual abuse as a widespread phenomenon of significant public health concern.

Critical literacy

In this chapter, we provide an overview of the concept of critical literacy and outline how it can inform classroom practice. This is no simple task, because there is no singular, normative version of critical literacy. Rather, it is a concept that has been shaped by various theoretical paradigms over the years and formulated in practice in ways that are deeply contextualized and specifically situated. This means that providing a historical overview of its development is well nigh impossible. Nevertheless, we will, in this introductory session, trace critical literacy's origins in critical theory and pedagogy, and offer a brief review of other theoretical influences on its development