Health professionals’ perspectives on information provision for patients with brain tumours and their families

A significant number of patients diagnosed with primary brain tumours report unmet information needs. Using concept mapping methodology, this study aimed to identify strategies for improving information provision, and to describe factors that health professionals understood to influence their provision of information to patients with brain tumours and their families. Concept mapping is a mixed methods approach that uses statistical methods to represent participants’ perceived relationships between elements as conceptual maps. These maps, and results of associated data collection and analyses, are used to extract concepts involved in information provision to these patients. Thirty health professionals working across a range of neuro-oncology roles and settings participated in the concept mapping process. Participants rated a care coordinator as the most important strategy for improving brain tumour care, with psychological support as a whole rated as the most important element of care. Five major themes were identified as facilitating information provision: health professionals’ communication skills, style and attitudes; patients’ needs and preferences; perceptions of patients’ need for protection and initiative; rapport and continuity between patients and health professionals; and the nature of the health care system. Overall, health professionals conceptualised information provision as ‘individualised’, dependent on these interconnected personal and environmental factors.

Stakeholder service delivery expectations of military facilities management

Purpose – The purpose of this paper is to examine the quality of service of a South East Asian country's military facilities management organisation. Design/methodology/approach – An interview survey and questionnaire survey were used to obtain a description and summary of stakeholders’ expectations and the extent to which they were being satisfied by the services provided. Findings – The method provides a useful means of identifying and prioritising varying expectations between stakeholder groups and of indicating any mismatch in expectations in the management of military facilities. Social implications – The development and use of a method to test and improve the effectiveness and efficiency of the management of military facilities helps in providing better value for money. Originality/value – In addition to re-affirming Parasuraman's overall dimensions of service expectation, the empirical summary of the stakeholders’ expectations obtained in this way is of practical value for the service provider in developing a strategy for expectation management. For the case studied, it is also apparent that although the current processes in service delivery are well understood by all involved stakeholders, there is a need for further improvement with regards to their expectation levels. It is also one of the very few reported studies on the management of military facilities.

Workable solutions : the intersubjective careers of women with families

This chapter considers to what degree the careers of women with young families, both in and out of paid employment, are lived as contingent, intersubjective projects pursued across time and space, in the social condition of growing biographical possibilities and uneven social/ideological change. Their resolutions of competing priorities by engaging in various permutations of home-work and paid work are termed ‘workable solutions’, with an intentional play on the double sense of ‘work’ – firstly as labour, thus being able to perform work, whether paid or not; secondly as in being able to make things work or function in the family unit’s best interests, however defined.

Thai family support (TFS) : working with families of young substance users in primary health care

Living with substance users negatively impacts upon family members in many ways, and distress is common. Despite these deep and wide-ranging impacts, supportive interventions for family members in their own right are rarely available. Thailand has substantial and growing problems with substance use, and there is very little support or family members of drug users, especially in community setting. The Thai Family Support (TFS) program was designed for implementation in primary health care units (PCUs) in Thailand. TFS was based on two approaches with existing empirical support in Western contexts—the 5-step method and CRAFT—with adaptations to a Thai setting that included integration with Buddhist practices. Its aims were to increase well-being of family members, reduce mental distress, improve family relationships between family members, and engage substance users in behaviour change. A small-scale randomised controlled trial on TFS with a Delayed Treatment control was conducted, with assessments at 8 weeks (Post 1) and 20-24 weeks (Post 2). Structured interviews with participants and PCU staff and an examination of five case studies augmented the quantitative results. Mixed Model Analyses were applied to quantitative outcomes, and thematic analysis was used for qualitative data. Thirty-six participants (18 in each of Immediate and Delayed Conditions) were recruited. A significant difference at Baseline between the two conditions was observed on the Thai GHQ-28 and Gender, but it was not possible to statistically control for these effects. There was a significant Time by Condition interaction on the Thai GHQ-28, WHOQOL-BREF-THAI and FAS, reflecting greater improvements in the Immediate condition by Post 1, but with the Delayed condition meeting or exceeding that effect by Post 2. On FES Cohesion and Conflict, there were falls across conditions at Post 2, but only Cohesion also showed a Time by Condition interaction, and that effect was consistent with a delayed impact of treatment. Overall, TFS by PCU staff in the Delayed Condition gave similar results to TFS conducted by the researcher, supporting the viability of its dissemination to standard health services. Qualitative data also confirmed the quantitative results. Most participants reported physiological and psychological improvements even though their substance-using relative did not change their drug use behaviour. After completing TFS, participants reported increased knowledge, group support and sharing feeling, having positive patient-professional relationship, having greater knowledge of substance abuse and social support. In particular, they changed their behaviour towards the substance user, resulting in improvements to family relationships. PCU staff gave similar responses on the efficacy of TFS, and saw it as feasible for routine use, although some implementation challenges were identified. The cultural adaptation and in particular the religious activities, were recognised by participants and PCU staff as an important component of TFS to support psychological health and well-being. Findings from this study showed the impact of substance use on family members and difficulties that they experienced when living with the substance users, resulting distresses and burden that may develop severe mental health disease. Drug use policies should be modified to support family members and response to their needs effectively for early prevention. This study also gave preliminary support for application of the TFS program in rural primary care settings and identified some policies that will be required for it to be disseminated more broadly.

Parent and adolescent perceptions of family functioning : a comparison of clinic and non-clinic families

In this paper two studies are reported which compare (a) the perceptions of family functioning held by clinic and non-clinic adolescents, and (b) the perceptions of family functioning held by adolescents and their mothers in clinic and non-clinic families. In Study 1, matched group of clinic and non-clinic adolescents were compared on their responses to a 30-item scale (ICPS) designed to measure three factors of family functioning: Intimacy (high vs. low), Parenting Style (democratic vs. controlled) and Conflict (high vs. low). Clinic and non-clinic adolescents were also compared on their responses to a multi-dimensional measure of adolescent self-concept. Although there was little difference between the two groups of adolescents in terms of their perceptions of family functioning, there were strong relationships between the self-concept variables and the family functioning variables. In Study 2, comparisons were made between the perceptions of family functioning held by mothers and adolescents for both clinical and non-clinic families. There were no differences between the two groups of adolescents in terms of their perceptions of family functioning, although there were clear differences between the two groups of mothers. In addition, clinic adolescents and their mothers did not differ in their perceptions of the family, whereas adolescents in the non-clinic group saw their families significantly as less intimate and more conflicted than did their mothers.

Mobius markets : professional families in rural educational markets

Australia has many isolated communities that require human services provided by qualified professionals. Maintaining a viable and equitable spread of such educational capital across space as a public good is a challenge. Reports investigating this problem repeatedly point to ‘family issues’ such as limited options for children’s education, and limited access to ongoing professional development, as deterrents for rural/remote employment despite lucrative incentive schemes. This paper draws on semi-structured interviews with 30 parents of school-aged children, who work as doctors, nurses, teachers and police in six rural/remote towns in Queensland. We asked them how their family units reconcile career opportunities with educational strategy for family members over time and space. This paper considers these issues as a sociology of education problem in a context of educational marketisation and spiralling credentialism. This paper offers the concept of ‘mobius markets’ to capture the cyclical and intergenerational process underway in middle class professional families of investing in educational capitals, maintaining or maximising their value and profiting from them. A mobius strip is the topological anomaly of a single loop with one twist in it, whereby the loop becomes one continuous surface, not the double-sided shape it appears to be. This project is interested in how the middle class professional family is similarly on a constant circuit, investing in educational capitals, upgrading their currency/value, and profiting from them. This elaborated sense of educational markets extends the more usual sociological focus on school choice.

Integrating crowd-behavior modeling into military simulation using game technology

Crowds of noncombatants play a large and increasingly recognized role in modern military operations and often create substantial difficulties for the combatant forces involved. However, realistic models of crowds are essentially absent from current military simulations. To address this problem, the authors are developing a crowd simulation capable of generating crowds of noncombatant civilians that exhibit a variety of realistic individual and group behaviors at differing levels of fidelity. The crowd simulation is interoperable with existing military simulations using a standard, distributed simulation architecture. Commercial game technology is used in the crowd simulation to model both urban terrain and the physical behaviors of the human characters that make up the crowd. The objective of this article is to present the design and development process of a simulation that integrates commercially available game technology with current military simulations to generate realistic and believable crowd behavior.

Crowd modelling for military simulations using game technology

Crowds of non-combatants play a large and increasingly recognized role in modern military operations, and often create substantial difficulties for the combatant forces involved. However, realistic models of crowds are essentially absent from current military simulations. To address this problem we are developing a crowd simulation capable of generating crowds of non-combatant civilians that exhibit a variety of realistic individual and group behaviours at differing levels of fidelity. The crowd simulation is interoperable with existing military simulations using a standard distributed simulation architecture. Commercial game technology is utilized in the crowd simulation to model both urban terrain and the physical behaviours of the human characters that make up the crowd. The objective of this paper is to present the process involved with the design and development of a simulation that integrates commercially available game technology with current military simulations in order to generate realistic and believable crowd behaviour.

Empower me : social innovation design for homeless families : collective design creativity

Design Creativity has largely been explored as an individual expression of design cognition rather than as the collective manifestation of interaction in context. Recent approaches to design with an emphasis on co-design suggest that the problem-solution space co-evolves through social interaction. Socially Responsive Design for Social Innovation constitutes the most recent and perhaps the most promising domain of application for design thinking practices that emphasize collaborative innovation. In this paper, we describe the ideation of a service design solution for homeless families (Em.power.me), developed through consultation with a range of stakeholders over a three month period. This service design innovation aimed to visualise how such a service would operate and identify the potential benefits for all stakeholders. We focus here on the phases leading to the ideation of the service design.

Social influences and the physical activity intentions of parents of young-children families: An extended Theory of Planned Behavior Approach

Evidence within Australia and internationally suggests parenthood as a risk factor for inactivity; however, research into understanding parental physical activity is scarce. Given that active parents can create active families and social factors are important for parents’ decision making, the authors investigated a range of social influences on parents’ intentions to be physically active. Parents (N = 580; 288 mothers and 292 fathers) of children younger than 5 years completed an extended Theory of Planned Behavior questionnaire either online or paper based. For both genders, attitude, control factors, group norms, friend general support, and an active parent identity predicted intentions, with social pressure and family support further predicting mothers’ intentions and active others further predicting fathers’ intentions. Attention to these factors and those specific to the genders may improve parents’ intentions to be physically active, thus maximizing the benefits to their own health and the healthy lifestyle practices for other family members.

It's just an old apron : aprons, artefacts and art - representations of personal and private 'her-stories', as public histories

This paper examines art and artefact in the representation and recollection of deeply personal WWII women’s experiences as POW’s under the Japanese. This kind of treatment of internees in the Tjideng Women and Children’s internment camp (and others) in Batavia under the Japanese in WWII, stands in stark and brutal contrast to the idyllic life lived by many families up to that time in what was then known as the Dutch East Indies (Indonesia). The deprivation and brutality of the Japanese incarceration of these women and children evoked responses - not military, but certainly militant, if muted. Representations of those responses – as both art and artefact - may be found in the most unlikely places and unexpected forms - and are still being unearthed to this day. However close we might personally be to these artists and artisans, can we, as observers from a distance, ever truly comprehend through spoken or written words alone, the day-today realities of those extraordinary times?

Agentive motility meets structural viscosity: Australian families relocating in educational markets

This paper will develop and illustrate a concept of institutional viscosity to balance the more agentive concept of motility with a theoretical account of structural conditions. The argument articulates with two bodies of work: Archer’s (2007, 2012) broad social theory of reflexivity as negotiating agency and social structures; and Urry’s (2007) sociology of mobility and mobility systems. It then illustrates the concept of viscosity as a variable (low to high viscosity) through two empirical studies conducted in the sociology of education that help demonstrate how degrees of viscosity interact with degrees of motility, and how this interaction can impact on motility over time. The first study explored how Australian Defence Force families cope with their children’s disrupted education given frequent forced relocations. The other study explored how middle class professionals relate to career and educational opportunities in rural and remote Queensland. These two life conditions have produced very different institutional practices to make relocations thinkable and doable, by variously constraining or enabling mobility. In turn, the degrees of viscosity mobile individuals meet with over time can erode or elevate their motility.