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.

'Getting a job' : Aborignal Women's issues and experiences in the health sector

Indigenous participation in employment has long been seen as an indicator of Indigenous economic participation in Australia. Researchers have linked participation in employment to improved health outcomes, increased education levels and greater self-esteem. There has been a dramatic increase in the number of Indigenous workforce policies and employment strategies as employers and industries attempt to employ more Aboriginal and Torres Strait Islander people. Coupled with this has been a push to employ more Indigenous people in specific sectors to address the multiple layers of disadvantage experienced by Indigenous people, for example, the health sector. This paper draws on interview discussions with Aboriginal women in Rockhampton, Central Queensland, along with findings from the research of others to offer a greater understanding of the mixed benefits of increased Indigenous employment. What is demonstrated is that the nature of Indigenous employment is complex and not as simple as ‘just getting a job’.

Driving and licensing experiences of learner drivers in two Australian states prior to major changes in the licensing laws

The learner licence is an important component of the graduated driver licensing system. This research describes the driving and licensing experiences of learner drivers in Queensland and New South Wales licensed prior to the changes made to the system in mid-2007. The sample consisted of 392 participants who completed a telephone interview just after they obtained their provisional licence. The results suggest that learner drivers in the two states had many similar experiences when they were obtaining a learner licence. However, once a learner licence was obtained, there were differences in the amount of practice, the supervisor learners practised with, the type of vehicle they used and the amount of unlicensed driving. This paper provides important baseline descriptive data that can be used to measure the impact of the changes that were introduced to the learner licence phase in mid-2007 in both of these states.

Teaching business process modelling : experiences and recommendations

A curriculum for a university-level course called Business Process Modeling is presented in order to provide guidance for the increasing number of institutions who are currently developing such contents. The course caters to undergraduate and post graduate students. Its content is drawn from recent research, industry practice, and established teaching material, and teaches ways of specifying business processes for the analysis and design of process-aware information systems. The teaching approach is a blend of lectures and classroom exercises with innovative case studies, as well as reviews of research material. Students are asked to conceptualize, analyze, and articulate real life process scenarios. Tutorials and cheat sheets assist with the learning experience. Course evaluations from 40 students suggest the adequacy of the teaching approach. Specifically, evaluations show a high degree of satisfaction with course relevance, content presentation, and teaching approach.

Reading Squadron: Crossing borders in literacy experiences for preservice teachers.

Teaching literacy requires accurate and current knowledge in the field (Commonwealth of Australia, 2005). There have been persistent inquiries into what constitutes specialist knowledge and skills for teaching students to be literate. Preservice teacher education is fundamental to literacy development, which includes the approaches universities employ to prepare graduates for teaching literacy. Indeed, preservice teacher programs and literacy education also elicit insatiable media coverage. There is a continued push to improve literacy outcomes for school students across the nation and prepare the literacy knowledge and skills of Australian teachers. This study mainly focuses on 10 final-year preservice teachers attending a regional university campus who volunteered for further experiences to teach students to read traditional texts. These preservice teachers completed three university literacy units before commencing with practical applications. A literacy program, titled Reading Squadron, was developed in partnership between a local primary school and the university. Primary students were identified by the school as requiring literacy support. Preservice teachers attended a whole day training session run by school staff at the university and then visited the school for two one-hour sessions each week over a six-week period. Each preservice teacher was assigned two students and worked with each student for half an hour twice a week. The aim of this small-scale qualitative study was to investigate the perceptions of the preservice teachers and school staff as a result of their involvement in the Reading Squadron program. The preservice teachers completed a questionnaire to determine their views of the program and ascertain how it assisted their development. Further data were gathered from the preservice teachers through individual face-to-face interviews. Three school staff involved in the program also completed a questionnaire to determine the value of the program. Results indicated that the preservice teachers made links between theory and practice, and felt they gained knowledge about teaching reading. Three preservice teachers noted it was difficult to work around timetable commitments but gained from the experience and suggested embedding such experiences into university literacy units. Data gathered from school staff indicated that six-weeks was not sufficient time to measure improvements in the school students, however, they were supportive of such a program, particularly for its continuation. Collaborations between schools and universities can provide opportunities for preservice teachers to use theoretical knowledge gained from core university subjects with application to assist primary students’ literacy development in schools. Teachers in this study were supportive of the Reading Squadron program, however, more data needed to be collected to understand the literacy improvement of students. Longitudinal studies are required to ascertain specific knowledge and skills gained by preservice teachers to teach reading and how these programs enhance students’ literacy levels.

"Over The Hill" is not so far away : crossing teaching contexts to create benefits for all through rural teaching experiences.

Attracting and retaining quality teachers to rural and remote areas has been a challenge over the last decade. Many preservice teachers are reluctant to experience a rural and remote practicum and may not consider applying to teach in such areas when they graduate. Education departments and universities need to explore innovative ways that will encourage graduates to consider undertaking a teaching position in the bush. As a way forward, preservice teachers from a regional campus of a Queensland University were invited to participate in a six-day rural experience entitled ‘Over the Hill’ that included being billeted with local families, participating in community activities and observing and teaching in classrooms. Fifteen preservice teachers were accompanied by two university academics who returned to work in a classroom as teacher for their own rural and remote professional experience. The aim of this qualitative study was to explore and describe the perceptions of a rural and remote teaching experience from the perspectives of the preservice teachers, the accompanying academics and the school staff hosting the program. Data were collected from the preservice teachers and accompanying academics in the form of written reflections while fourteen school staff completed a related questionnaire. The results indicated that a six-day rural and remote teaching program can provide professional benefits for all involved, preservice teachers, accompanying academics and the school staff hosting the program. Indeed, this study indicates that short experiences such as “Over the Hill” not only assist preservice teachers to make informed decisions about teaching in rural and remote areas but can provide professional benefits for accompanying academics and the schools.

Integrating Engineering Experiences within the Elementary Mathematics Curriculum

Engineering education for elementary school students is a new and increasingly important domain of research by mathematics, science, technology, and engineering educators. Recent research has raised questions about the context of engineering problems that are meaningful, engaging, and inspiring for young students. In the present study an environmental engineering activity was implemented in two classes of 11-year-old students in Cyprus. The problem required students to use the data to develop a procedure for selecting among alternative countries from which to buy water. Students created a range of models that adequately solved the problem although not all models took into account all of the data provided. The models varied in the number of problem factors taken into consideration and also in the different approaches adopted in dealing with the problem factors. At least two groups of students integrated into their models the environmental aspect of the problem (energy consumption, water pollution) and further refined their models. Results provide evidence that engineering model-eliciting activities can be successfully integrated in the elementary mathematics curriculum. These activities provide rich opportunities for students to deal with engineering contexts and to apply their learning in mathematics and science to solving real-world engineering problems.

Recent Italian cinema : spaces, contexts, experiences

The book is an in-depth view of recent Italian cinema - bringing an interdisciplinary knowledge to the study of a complex cinema industry. The book aims to address a number of questions about Italian cinema of the last twenty years, bringing interdisciplinary knowledge to a cinema that eschews traditional definitions and categories, and challenges critical assumption about a film industry that is struggling to find a new direction. In doing so, Recent Italian Cinema offers a transverse analysis of the Italian cinema industry in its dealings with national and international production, and of the themes and issues that have emerged in films produced during the period 1980-2006.

Breastfeeding experiences of Japanese women living in Perth, Australia

The aim of this study was to document the breastfeeding practices of Japanese-Australian mothers living in Perth. A cross-sectional survey of mothers who had delivered babies in Japan or Australia or both was carried out on a sample of 163 mothers recruited through Japanese social and cultural groups in Perth and by a 'snowball' technique. Factors involved in the decision to breastfeed were analysed using multivariate regression analysis. The main outcome measures were the initiation and duration of breastfeeding and cultural beliefs about breastfeeding. Breastfeeding initiation rates of the Japanese- Australian mothers in Japan and in Australia were higher than for other Australians and are consistent with breastfeeding rates in Japan. In Australia, 65% of Japanese-Australian mothers were still breastfeeding at six months. The most common reason for the decision to cease breastfeeding was 'insufficient breastmilk'. The significant factors in breastfeeding duration were 'the time the infant was introduced to infant formula', 'the time when the feeding decision was made', 'doctors support breastfeeding' and 'the mother received enough help from hospital staff'; these were positively associated with the duration of breastfeeding. Japanese mothers take a lot of notice of advice given by health professionals about infant feeding practices.

Postpartum fatigue and driving : relating experiences, thoughts and opinions 12 weeks post-birth

Fatigue in the postnatal period is such a common experience for most mothers that the term ‘postpartum fatigue’ (PPF) has been coined to describe it. When new mothers experience extreme fatigue, it follows that their physical health, mental health, and social-wellbeing is negatively affected. It is interesting to note that there is a distinct lack of empirical investigations focusing on the link between PPF and increased risk of injury; particularly when the links between fatigue and increased risk of road crashes are well documented. The purpose of this investigation was to undertake pilot research to develop an understanding of the duration of PPF and the performance impairments experienced by new mothers when involved in safety-sensitive activities, such as driving a motor vehicle. Semi-structured interviews were undertaken with women (N = 24) at 12 weeks postpartum living in South-east Queensland, Australia. Key themes were identified; with a particular emphasis towards understanding the link between the participant’s experience of postpartum fatigue and the impact this has on their overall cognitive and physiological functioning, as well as their experience of the driving task. Further, sleep/wake data was collected and using the Karolinska Sleepiness Scale (KSS) the potential crash risk for this group of mothers is discussed. It is proposed that the findings of this investigation could be used to improve current knowledge among new mothers and practitioners regarding the mechanisms and consequences of fatigue and to inform interventions that lead to a decreased risk of injury associated with postpartum fatigue.

Contrasting views and experiences of health professionals on the management of comorbid substance misuse and mental disorders

Objectives: To determine opinions and experiences of health professionals concerning the management of people with comorbid substance misuse and mental health disorders. Method: We conducted a survey of staff from mental health services and alcohol and drug services across Queensland. Survey items on problems and potential solutions had been generated by focus groups. Results: We analysed responses from 112 staff of alcohol and drug services and 380 mental health staff, representing a return of 79% and 42% respectively of the distributed surveys. One or more issues presented a substantial clinical management problem for 98% of respondents. Needs for increased facilities or services for dual disorder clients figured prominently. These included accommodation or respite care, work and rehabilitation programs, and support groups and resource materials for families. Needs for adolescent dual diagnosis services and after-hours alcohol and drug consultations were also reported. Each of these issues raised substantial problems for over 70% of staff. Another set of problems involved coordination of client care across mental health and alcohol and drug services, including disputes over duty of care. Difficulties with intersectoral liaison were more pronounced for alcohol and drug staff than for mental health. A majority of survey respondents identified 13 solutions as practical. These included routine screening for dual diagnosis at intake, and a range of proposals for closer intersectoral communication such as exchanging client information, developing shared treatment plans, conducting joint case conferences and offering consultation facilities. Conclusions: A wide range of problems for the management of comorbid disorders were identified. While solution of some problems will require resource allocation, many may be addressed by closer liaison between existing services.

Problem-based learning (PBL) in Virtual Space : Developing experiences for professional development

This book reports the outcomes of an investigation into discovering the qualitatively different ways that students experience Problem-based learning (PBL)in virtual space. PBL is increasingly being used in many fields including engineering education. At the same time, many engineering education providers are turning to online distance education. Unfortunately there is a dearth of research into what constitutes an effective learning experience for adult learners who undertake PBL instruction through online distance education. Data were collected from a course which adopted the PBL strategy and was delivered entirely in virtual space. Students were asked to respond to open-ended questions designed to elicit their learning experiences. Data were analysed using the phenomenographic approach. Five qualitatively different ways of experiencing PBL in virtual space were discovered. Results indicate that the design of students' online learning experience was responsible for making students aware of deeper ways of experienceing PBL in virtual space. The outcomes imply that pedagogical strategies can be devised for shifting students' focus as they engage in virtual PBL.

Parent and child experiences of childhood cancer : an interpretative phenomenological analysis approach

A diagnosis of cancer represents a significant crisis for the child and their family. As the treatment for childhood cancer has improved dramatically over the past three decades, most children diagnosed with cancer today survive this illness. However, it is still an illness which severely disrupts the lifestyle and typical functioning of the family unit. Most treatments for cancer involve lengthy hospital stays, the endurance of painful procedures and harsh side effects. Research has confirmed that to manage and adapt to such a crisis, families must undertake measures which assist their adjustment. Variables such as level of family support, quality of parents’ marital relationship, coping of other family members, lack of other concurrent stresses and open communication within the family have been identified as influences on how well families adjust to a diagnosis of childhood cancer. Theoretical frameworks such as the Resiliency Model of Family Adjustment and Adaptation (McCubbin and McCubbin, 1993, 1996) and the Stress and Coping Model by Lazarus and Folkman (1984) have been used to explain how families and individuals adapt to crises or adverse circumstances. Developmental theories have also been posed to account for how children come to understand and learn about the concept of illness. However more descriptive information about how families and children in particular, experience and manage a diagnosis of cancer is still needed. There are still many unanswered questions surrounding how a child adapts to, understands and makes meaning from having a life-threatening illness. As a result, developing an understanding of the impact that such a serious illness has on the child and their family is crucial. A new approach to examining childhood illness such as cancer is currently underway which allows for a greater understanding of the experience of childhood cancer to be achieved. This new approach invites a phenomenological method to investigate the perspectives of those affected by childhood cancer. In the current study 9 families in which there was a diagnosis of childhood cancer were interviewed twice over a 12 month period. Using the qualitative methodology of Interpretative Phenomenological Analysis (IPA) a semi-structured interview was used to explicate the experience of childhood cancer from both the parent and child’s perspectives. A number of quantitative measures were also administered to gather specific information on the demographics of the sample population. The results of this study revealed a number of pertinent areas which need to be considered when treating such families. More importantly experiences were explicated which revealed vital phenomena that needs to be added to extend current theoretical frameworks. Parents identified the time of the diagnosis as the hardest part of their entire experience. Parents experienced an internal struggle when they were forced to come to the realization that they were not able to help their child get well. Families demonstrated an enormous ability to develop a new lifestyle which accommodated the needs of the sick child, as the sick child became the focus of their lives. Regarding the children, many of them accepted their diagnosis without complaint or question, and they were able to recognise and appreciate the support they received. Physical pain was definitely a component of the children’s experience however the emotional strain of loss of peer contact seemed just as severe. Changes over time were also noted as both parental and child experiences were often pertinent to the stage of treatment the child had reached. The approach used in this study allowed for rich and intimate detail about a sensitive issue to be revealed. Such an approach also allowed for the experience of childhood cancer on parents and the children to be more fully realised. Only now can a comprehensive and sensitive medical and psychosocial approach to the child and family be developed. For example, families may benefit from extra support at the time of diagnosis as this was identified as one of the most difficult periods. Parents may also require counselling support in coming to terms with their lack of ability to help their child heal. Given the ease at which children accepted their diagnosis, we need to question whether children are more receptive to adversity. Yet the emotional struggle children battled as a result of their illness also needs to be addressed.