Enhancing transition : an enhanced model of clinical placement for final year nursing students

Specialised support for student nurses making the transition to graduate nurse can be crucial to successful and smooth adjustment, and can create a path to positive and stable career experiences. This paper describes an enhanced model of final year nursing student placements which was trialled in 2006 at the Queensland University of Technology. The model involved collaboration with two major urban health services and resources were developed to support effective transition experiences. Ninety-two students, including 29 trial participants and 63 non-trial participants were assessed on preparedness for professional practice, before and after the trial semester. Results indicated an increase in preparedness across the entire sample, but students participating in the trial did not differ significantly in overall preparedness change from those who did not participate. Higher baseline preparedness in the trial group highlighted the possibility that proactive students who choose enrichment experiences tend to be likelier to gain benefit from such options than those who do not. Qualitative findings from focus groups conducted with 12 transition group students highlighted that one of the main beneficial aspects of the experience for students was the sense of belonging to a team that understood their learning needs and could work constructively with them.

Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care

Aims and objectives: The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. ---------- Background: Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. ---------- Design: Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. ---------- Methods: Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. ---------- Results: The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. ---------- Conclusions: This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. ---------- Relevance to clinical practice: It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

Accommodating the diverse cultural needs of cancer patients and their families in palliative care

Cultural issues have become an increasingly important consideration in healthcare. Such cultural issues, however, are underresearched in Australia, especially in palliative care. This study has sought to address this gap, exploring the social construction of cultural issues in palliative care by oncology nurses. A grounded theory approach was used. Semistructured interviews with 7 Australian oncology nurses provided the data for the study. The core category emerging from the study was that of accommodating cultural needs whereby to meet patients' specific cultural requirements, nurses actively found ways to accommodate the needs of patients and their families. This process often included compromise and negotiation whereby limits were set. In addition, the use of cross-cultural communication strategies emerged from the data as an important feature of cultural care. A series of subcategories were also identified as factors that could influence the process by which nurses would accommodate cultural needs.

The consequences of substance use among gay and bisexual men : a consensual qualitative research analysis

- Background Substance use is common among gay/bisexual men and is associated with significant health risks (e.g. HIV transmission). The consequences of substance use, across the range of substances commonly used, have received little attention. The purpose of this study is to map participant’s beliefs about the effects of substance use to inform prevention, health promotion and clinical interventions. - Methods Participants were interviewed about experiences regarding their substance use and recruited through medical and sexual health clinics. Data were collected though a consumer panel and individual interviews. Responses regarding perceived consequences of substance use were coded using Consensual Qualitative Research (CQR) methodology. - Results Most participants reported lifetime use of alcohol, cannabis, stimulants and amyl nitrite, and recent alcohol and cannabis use. A wide range of themes were identified regarding participant’s thoughts, emotions and behaviours (including sexual behaviours) secondary to substance use, including: cognitive functioning, mood, social interaction, physical effects, sexual activity, sexual risk-taking, perception of sexual experience, arousal, sensation, relaxation, disinhibition, energy/activity level and numbing. Analyses indicated several consequences were consistent across substance types (e.g. cognitive impairment, enhanced mood), whereas others were highly specific to a given substance (e.g. heightened arousal post amyl nitrite use). - Conclusions Prevention and interventions need to consider the variety of effects of substance use in tailoring effective education programs to reduce harms. A diversity of consequences appear to have direct and indirect impacts on decision-making, sexual activity and risk-taking. Findings lend support for the role of specific beliefs (e.g. expectancies) related to substance use on risk-related cognitions, emotions and behaviours.

Emergency department nurses' understanding and experiences of implementing discharge planning

Aim: This paper is a report of a study conducted to describe emergency department nurses' understanding and experiences of implementing discharge planning. ---------- Background: Discharge planning in the emergency department is an important issue because of increased healthcare costs and greater emphasis on continuity of care. When executed as a collaborative process involving a multi-disciplinary team with the patient and family, discharge planning provides continuity of care for patients, less demand on hospitals, improvement in community services and in the services of other healthcare organizations. ---------- Method: The qualitative approach of phenomenography was used in this study. Thirty-two emergency department nurses were recruited between July and September 2005. Semi-structured interviews were conducted. ---------- Findings: From interviewees' descriptions of implementing discharge planning, six categories were established: implementing discharge planning as 'getting rid of my patients', completing routines, being involved in patient education, professionally accountable practice, autonomous practice and demonstrating professional emergency department nursing care. The referential meaning of implementing discharge planning 'in the outcome space' was the professional commitment to emergency department provision of effective discharge services. ---------- Conclusion: The results of this research contribute to knowledge of emergency department nurses' experience in the implementation of the discharge planning process. Key requirements for the provision of manageable discharge services both in Taiwan and worldwide highlighted by this study include adequate workloads, sufficient time, clear policies and standards of discharge planning and enhancement of professional commitment.

Discharge planning in the emergency department : a comprehensive approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

Rephrasing voice : art, practice-led research and the limits and sites of articulacy

While my PhD is practice-led research, it is my contention that such an inquiry cannot develop as long as it tries to emulate other models of research. I assert that practice-led research needs to account for an epistemological unknown or uncertainty central to the practice of art. By focusing on what I call the artist's 'voice,' I will show how this 'voice' is comprised of a dual motivation—'articulate' representation and 'inarticulate' affect—which do not even necessarily derive from the artist. Through an analysis of art-historical precedents, critical literature (the work of Jean-François Lyotard and Andrew Benjamin, the critical methods of philosophy, phenomenology and psychoanalysis) as well as of my own painting and digital arts practice, I aim to demonstrate how this unknown or uncertain aspect of artistic inquiry can be mapped. It is my contention that practice-led research needs to address and account for this dualistic 'voice' in order to more comprehensively articulate its unique contribution to research culture.

Difference and dispersion : educational research in a postmodern context

Difference and Dispersion is the fourth in a series of annual research papers produced by doctoral students from The Graduate School of Education, The University of Queensland, following their presentation at the School’s annual Postgraduate Research Conference in Education. The work featured herein celebrates the diversity of cultural and disciplinary backgrounds of education researchers who come from as far afield as Germany, Hong Kong, China, Nigeria, Russia, Singapore, Thailand and of course different parts of Australia. In keeping with a postmodern epistemology, ‘difference’ and ‘dispersion’ are key themes in apprehending the multiplicity of their research topics, methodologies, methods and speaking/writing positions. From widely differing contexts and situations, these writers address the consequences, implications and possibilities for education at the beginning of the third millennium. Their interest ranges from location-specific issues in schools and classrooms, change in learning contexts and processes, educational discourses and relations of power in diverse geographical settings, and the differing articulations of the local and the global in situated policy contexts. Conceived and developed in a spirit of ongoing dialogue with and insight to alternative views and visions of education and society, this edited collection exemplifies the quality in diversity and the high levels of scholarship and supervision at one of Australia’s finest Graduate Schools of Education.

Research training and national innovation systems in Australia, Finland and the United States : a policy and systems study supported by 30 case studies of research students in the fields of geospatial science, wireless communication, biosciences, and materials science and engineering

Reforms to the national research and research training system by the Commonwealth Government of Australia sought to effectively connect research conducted in universities to Australia's national innovation system. Research training has a key role in ensuring an adequate supply of highly skilled people for the national innovation system. During their studies, research students produce and disseminate a massive amount of new knowledge. Prior to this study, there was no research that examined the contribution of research training to Australia's national innovation system despite the existence of policy initiatives aiming to enhance this contribution. Given Australia's below average (but improving) innovation performance compared to other OECD countries, the inclusion of Finland and the United States provided further insights into the key research question. This study examined three obvious ways that research training contributes to the national innovation systems in the three countries: the international mobility and migration of research students and graduates, knowledge production and distribution by research students, and the impact of research training as advanced human capital formation on economic growth. Findings have informed the concept of a research training culture of innovation that aims to enhance the contribution of research training to Australia's national innovation system. Key features include internationally competitive research and research training environments; research training programs that equip students with economically-relevant knowledge and the capabilities required by employers operating in knowledge-based economies; attractive research careers in different sectors; a national commitment to R&D as indicated by high levels of gross and business R&D expenditure; high private and social rates of return from research training; and the horizontal coordination of key organisations that create policy for, and/or invest in research training.

The conceptualisation, sensitivity and measurement of holding costs and other selected elements impacting housing affordability (Literature review and research methodology for confirmation of PhD candidature)

It is widely held that strong relationships exist between housing, economic status, and well being. This is exemplified by widespread housing stock surpluses in many countries which threaten to destabilise numerous aspects related to individuals and community. However, the position of housing demand and supply is not consistent. The Australian position provides a distinct contrast whereby seemingly inexorable housing demand generally remains a critical issue affecting the socio-economic landscape. Underpinned by high levels of immigration, and further buoyed by sustained historically low interest rates, increasing income levels, and increased government assistance for first home buyers, this strong housing demand ensures elements related to housing affordability continue to gain prominence. A significant, but less visible factor impacting housing affordability – particularly new housing development – relates to holding costs. These costs are in many ways “hidden” and cannot always be easily identified. Although it is only one contributor, the nature and extent of its impact requires elucidation. In its simplest form, it commences with a calculation of the interest or opportunity cost of land holding. However, there is significantly more complexity for major new developments - particularly greenfield property development. Preliminary analysis conducted by the author suggests that even small shifts in primary factors impacting holding costs can appreciably affect housing affordability – and notably, to a greater extent than commonly held. Even so, their importance and perceived high level impact can be gauged from the unprecedented level of attention policy makers have given them over recent years. This may be evidenced by the embedding of specific strategies to address burgeoning holding costs (and particularly those cost savings associated with streamlining regulatory assessment) within statutory instruments such as the Queensland Housing Affordability Strategy, and the South East Queensland Regional Plan. However, several key issues require investigation. Firstly, the computation and methodology behind the calculation of holding costs varies widely. In fact, it is not only variable, but in some instances completely ignored. Secondly, some ambiguity exists in terms of the inclusion of various elements of holding costs, thereby affecting the assessment of their relative contribution. Perhaps this may in part be explained by their nature: such costs are not always immediately apparent. Some forms of holding costs are not as visible as the more tangible cost items associated with greenfield development such as regulatory fees, government taxes, acquisition costs, selling fees, commissions and others. Holding costs are also more difficult to evaluate since for the most part they must be ultimately assessed over time in an ever-changing environment, based on their strong relationship with opportunity cost which is in turn dependant, inter alia, upon prevailing inflation and / or interest rates. By extending research in the general area of housing affordability, this thesis seeks to provide a more detailed investigation of those elements related to holding costs, and in so doing determine the size of their impact specifically on the end user. This will involve the development of soundly based economic and econometric models which seek to clarify the componentry impacts of holding costs. Ultimately, there are significant policy implications in relation to the framework used in Australian jurisdictions that promote, retain, or otherwise maximise, the opportunities for affordable housing.

Using virtual reality modelling in cultural management, archiving and research

This paper outlines how the Ortelia project’s 3D virtual reality models have the capacity to assist our understanding of sites of cultural heritage. The VR investigation of such spaces can be a valuable tool in 'real world' empirical research in theatre and spatiality. Through a demonstration of two of Ortelia's VR models (an art gallery and a theatre), we suggest how we might consider interpreting cultural space and sites as contributing significantly to cultural capital. We also introduce the potential for human interaction in such venues through motion-capture to discuss the potential for assessing how humans interact in such contexts.

Creating deep and broad change through research and systems approaches in early childhood education for sustainability

The co-authors raise two matters they consider essential for the future development of ECEfS. The first is the need to create deep foundations based in research. At a time of increasing practitioner interest, research in ECEfS is meagre. A robust research community is crucial to support quality in curriculum and pedagogy, and to promote learning and innovation in thinking and practice. The second 'essential' for the expansion and uptake of ECEfS is broad systemic change. All level within the early childhood education system - individual teachers and classrooms, whole centres and schools, professional associations and networks, accreditation and employing authorities, and teacher educators - must work together to create and reinforce the cultural and educational changes required for sustainability. This chapter provides explanations of processes to engender systemic change. It illustrates a systems approach, with reference to a recent study focused on embedding EfS into teacher education. This study emphasises the apparent contradiction that the answer to large-scale reform lies with small-scale reforms that build capacity and make connections.

Early childhood education for sustainability : why it matters, what it is, and how whole centre action research and systems thinking can help

The global financial crisis, global pandemics, global warming and peak oil are indicative of a world facing major environmental, social and economic problems. At the same time, world population continues to rise and global inequalities deepen. Children are the most vulnerable to the impacts of unsustainable living with specific harms arising because of their physical and cognitive vulnerabilities. Nevertheless, children do not have to be victims in the face of these challenges. Education, including early childhood education, has an important role to in building resilience and capabilities in children that equip them as active and informed citizens now and in the future and who are capable of contributing to healthy and sustainable ways of living. Drawing on educational change literature, action research, education for sustainability, health promotion and systems theory, this paper outlines three strategies that can help reorient early childhood education towards sustainability. One strategy is the adoption of whole centre approaches to sustainability and education for sustainability. This means working across the whole of a centre’s operations – curriculum and pedagogy, physical and social environments, its partnerships and community connections. The second strategy – applied in conjunction with the first – is the use of action research to investigate the early childhood setting and to create the desired changes. The third strategy is the adoption of systems thinking as a way of leveraging support and momentum for change so that education for sustainability goes beyond the initiatives of individual teachers and centres, and becomes a systems-wide imperative.

Choosing "interesting" research methods and facing the challenges for publication

This paper discusses the choice to use two less conventional or “interesting” research methods, Q Methodology and Experience Sampling Method, rather than “status quo” research methods so common in the marketing discipline. It is argued that such methods have value for marketing academics because they widen the potential for discovery. The paper outlines these two research methods, providing examples of how they have been used in an experiential consumption perspective. Additionally the paper identifies some of the challenges to be faced when trying to publish research that use such less conventional methods, as well as offering suggestions to address them.