Nursing and competencies - a natural fit : the politics of skill/competency formation in nursing

The last two decades have seen a significant restructuring of work across Australia and other industrialised economies, a critical part of which has been the appearance of competency based education and assessment. The competency movement is about creating a more flexible and mobile labour force to increase productivity and it does so by redefining work as a set of transferable or ‘soft’ generic skills that are transportable and are the possession of the individual. This article sought to develop an analysis of competency based clinical assessment of nursing students across a bachelor of nursing degree course. This involved an examination of a total of 406 clinical assessment tools that covered the years 1992-2009 and the three years of a bachelor degree. Data analysis generated three analytical findings: the existence of a hierarchy of competencies that prioritises soft skills over intellectual and technical skills; the appearance of skills as personal qualities or individual attributes; and the absence of context in assessment. The article argues that the convergence in nursing of soft skills and the professionalisation project reform has seen the former give legitimacy to the enduring invisibility and devaluation of nursing work.

The politics of technology adoption : Water metering in Progressive Era Chicago

This paper examines the interactions between knowledge and power in the adoption of technologies central to municipal water supply plans, specifically investigating decisions in Progressive Era Chicago regarding water meters. The invention and introduction into use of the reliable water meter early in the Progressive Era allowed planners and engineers to gauge water use, and enabled communities willing to invest in the new infrastructure to allocate costs for provision of supply to consumers relative to use. In an era where efficiency was so prized and the role of technocratic expertise was increasing, Chicago’s continued failure to adopt metering (despite levels of per capita consumption nearly twice that of comparable cities and acknowledged levels of waste nearing half of system production) may indicate that the underlying characteristics of the city’s political system and its elite stymied the implementation of metering technologies as in Smith’s (1977) comparative study of nineteenth century armories. Perhaps, as with Flyvbjerg’s (1998) study of the city of Aalborg, the powerful know what they want and data will not interfere with their conclusions: if the data point to a solution other than what is desired, then it must be that the data are wrong. Alternatively, perhaps the technocrats failed adequately to communicate their findings in a language which the political elite could understand, with the failure lying in assumptions of scientific or technical literacy rather than with dissatisfaction in outcomes (Benveniste 1972). When examined through a historical institutionalist perspective, the case study of metering adoption lends itself to exploration of larger issues of knowledge and power in the planning process: what governs decisions regarding knowledge acquisition, how knowledge and power interact, whether the potential to improve knowledge leads to changes in action, and, whether the decision to overlook available knowledge has an impact on future decisions.

Narrative therapy for adults with major depressive disorder: Improved symptom and interpersonal outcomes

Abstract This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder. RÉSUMÉ Cette étude a investigué les symptômes dépressifs et les relations interpersonnels d'une thérapie narrative en huit séances chez 47 adultes souffrant d'un trouble dépressif majeur. Après la thérapie, l'amélioration des symptômes dépressifs (d=1.36) et la proportion de clients atteignant un changement significatif (74%), le mouvement vers la population fonctionnelle (61%), enfin l'amélioration clinique significative (53%) étaient comparables aux performances des études de résultats. L'amélioration des relations interpersonnelles (d=0.62) était inférieure à l'amélioration symptomatique. Le suivi à trois mois montrait un maintien des gains symptomatiques mais pas pour les relations interpersonnelles. L’évaluation des performances et les analyses de significativité clinique modèrent les limitations du plan de recherche à mesures répétées et apportent une preuve empirique qui étaie l'efficacité des thérapies narratives pour des adultes avec un trouble dépressif majeur. Este estudo investigou sintomas depressivos e resultados interpessoais relacionados em oito sessões de terapia narrativa manualizada para 47 adultos com perturbação depressiva major. No pós terapia, melhoria de sintomas depressivos (d=1,36) e proporção de clientes que alcançam melhoria válida (74%), movimento para a população funcional (61%) e melhoria clinicamente significativa (53%) foram comparáveis com os resultados da investigação reportados. As melhorias pós terapia nos resultados interpessoais relacionados (d=.62) foi menos substancial do que para os sintomas. Aos três meses de seguimento houve a manutenção dos sintomas mas não dos ganhos interpessoais. As análises de benchemarking e de melhoria clinicamente significativas atenuam as limitações de um design de medidas repetidas, fornecendo evidência empírica para a terapia narrativa para adultos com perturbação depressiva major. Questo lavoro ha valutato i sintomi depressivi e gli outcome nella capacità di relazionarsi a livello interpersonale in 8 sedute di psicoterapia narrativa manualizzata in un gruppo di 47 adulti con depressione maggiore. I risultati ottenuti relativamente a: post terapy, miglioramento dei sintomi depressivi (d_1.36), proporzione di pazienti che hanno raggiunto un miglioramento affidabile e consistente (74%), movimento verso il funzionamento atteso nella popolazione (61%) e miglioramento clinicamente significativo (53%) sono paragonabili ai valori di riferimento della ricerca sull'outcome. I miglioramento della capacità di relazionarsi valutata alla fine del trattamento (d_.62) si è rivelata meno sostanziale rispetto ai sintomi. Un follow-up dopo 3 mesi ha dimostrato che il miglioramento sintomatologico è stato mantenuto, ma non quello degli obiettivi interpersonali. Valori di riferimento e analisi della significatività clinica hanno fatto fronte ai limiti del disegno a misure ripetute, offrendo prove empiriche sulla rilevanza della terapia narrativa in pazienti adulti con depressione maggiore

The Scottish media and politics

This chapter will explore the performance of the Scottish media in post-devolution political life, before turning its attention to the specific coverage of the 2007 election.

Adventure as the metaphoric basis for constructing a narrative to defuse a collective critical incident

This article describes an exercise in collective narrative practice, built around the metaphor of adventure. This metaphor helped to scaffold the development of stories of personal agency for a group of Australian primary school children whose teachers were afraid they might be traumatised by events which occurred during a school excursion. During the excursion, the group of 110 Year 5 and 6 school children had their accommodation broken into on two separate occasions and various belongings stolen. The very brief period made available for ‘debriefing’ was used to introduce the metaphor of adventure, and open up space for the children to begin constructing a story in which they were ‘powerful’, as an alternative to the story of powerlessness and victimhood in which they were initially caught up.

Politics and school education in Australia : a case of shifting purposes

Purpose – The paper aims to argue that there has been a privileging of the private (social mobility) and economic (social efficiency) purposes of schooling at the expense of the public (democratic equality) purposes of schooling. Design/methodology/approach – The paper employs a literature review, policy and document analysis. Findings – Since the late 1980s, the schooling agenda in Australia has been narrowed to one that gives primacy to purposes of schooling that highlight economic orientations (social efficiency) and private purposes (social mobility). Practical implications – The findings have wider relevance beyond Australia, as similar policy agendas are evident in many other countries raising the question as to how the shift in purposes of education in those countries might mirror those in Australia. Originality/value – While earlier writers have examined schooling policies in Australia and noted the implications of managerialism in relation to these policies, no study has analysed these policies from the perspective of the purposes of schooling. Conceptualising schooling, and its purposes in particular, in this way refocuses attention on how societies use their educational systems to promote (or otherwise) the public good.

Dietary modification for women after breast cancer treatment : a narrative review

Diet is thought to account for about 25% of cancers in developed countries. It is well documented that the risks associated with both the breast cancer itself and its treatments are important for women previously treated for breast cancer. Women are at risk of recurrence of the primary disease and prone to develop treatment-induced co-morbidities, some of which are thought to be modified by diet. With a view to making dietary recommendations for the breast cancer patients we encounter in our clinical nursing research, we mined the literature to scope the most current robust evidence concerning the role of the diet in protecting women against the recurrence of breast cancer and its potential to ameliorate some of the longer-term morbidities associated with the disease. We found that the evidence about the role of the diet in breast cancer recurrence is largely inconclusive. However, drawing on international guidelines enabled us to make three definitive recommendations. Women at risk of breast cancer recurrence, or who experience co-morbidities as a result of treatment, should limit their exposure to alcohol, moderate their nutritional intake so it does not contribute to postmenopausal weight gain, and should adhere to a balanced diet. Nursing education planned for breast cancer patients about dietary issues should ideally be individually tailored, based on a good understanding of the international recommendations and the evidence underpinning them

Mediating cultural politics : a dialogue with Georgina Born

The following dialogue is based on an interview conducted as part of Professor Born’s visit to Brisbane in 2006, which included three public seminars at the University of Queensland (UQ) and Queensland University of Technology (QUT). The following dialogue provides a counterpoint to these events and to Born’s work as a whole, drawing together and extending key themes in the cultural politics of both public service broadcasting and new media technologies. It begins by discussing the possibilities of public sphere theory to provide useful models of institutional design. The discussion moves from there to SBS Television – an example of Public Service Broadcasting that provides an interesting contrast to the BBC, especially by virtue of SBS’s relationship with the politics of multiculturalism in Australia. The second half of the interview draws out the issues around cultural value, cultural power and the politics of technology in relation to new media, and concludes by focusing especially on the problems and potentialities of ‘user-generated content’.

Sacred cows and crashing boars : ethno-religious minorities and the politics of online representation in Malaysia

Starting with the incident now known as the Cow’s Head Protest, this article traces and unpacks the events, techniques, and conditions surrounding the representation of ethno-religious minorities in Malaysia. The author suggests that the Malaysian Indians’ struggle to correct the dominant reading of their community as an impoverished and humbled underclass is a disruption of the dominant cultural order in Malaysia. It is also among the key events to have has set in motion a set of dynamics—the visual turn—introduced by new media into the politics of ethno-communal representation in Malaysia. Believing that this situation requires urgent examination the author attempts to outline the problematics of the task.

Enlightenment out of chaos : power, politics and The Chaser’s War on Everything

This paper focuses on the satirical Australian television show The Chaser’s War on Everything, and uses it to critically explore the potential ramifications of what McNair (2006) has called ‘cultural chaos’. Through an analysis of several examples from this particular program, alongside interviews with its production team and qualitative audience research, this paper argues that this TV show’s engagement with political issues in a creative, entertaining way that departs from the conventions of traditional journalism, allows it to present a perhaps more authentic image of political agents than is often cultivated in the mainstream news media. This paper therefore provides clear evidence that the shift from homogeneity to heterogeneity in the news media presents a significant challenge to those who wish to heavily control public opinion. It also provides further support for an optimistic re-appraisal of entertainment which emphasises its central (not merely periphery) role in political discourse.

Deviant knowledge : criminology, politics and policy

The “political” dynamics and the details of conducting criminological research on a day-to-day basis are examined. The role of government and commercial contracts in contemporary criminological scholarship are explored, as well as the various obstacles that criminologists must negotiate during the completion of a research project. The criminological implications of the ways in which academic environments are changing under new managerialist philosophies are examined. The ways in which notions of “critique” have become subordinate to the politics of existing governing rationalities are also examined. Chapter 1 details the questions, contours, and methods of “deviant knowledge.” Chapter 2 discusses the contours of criminological knowledge, including early criminological developments, international reconstruction and developments in criminological research following World War II, the United Nations, and the rise of critical genres. Chapter 3 explores criminology, government, and public policy, including the policies of the Home Office of England and Wales; the National Institute of Justice in Washington, DC; and the Australian Institute of Criminology in Canberra. The politics and control of criminological knowledge are discussed in chapter 4, along with ethical and legal issues, gathering and accessing data, and publishing results of research. Chapter 5 describes the “War on Terror” and government intolerance and suppression of free speech. Chapter 6 examines the new modes of governance and the commercialization of criminological knowledge. Chapter 7 discusses intellectual independence and collective concern, and the value of critique. 3 appendices, 546 references, index

Mind games : applying White’s principles of narrative therapy to the creation of a cabaret about depression and bipolar disorder

This PhD represents my attempt to make sense of my personal experiences of depression through the form of cabaret. I first experienced depression in 2006. Previously, I had considered myself to be a happy and optimistic person. I found the experience of depression to be a shock: both in the experience itself, and also in the way it effected my own self image. These personal experiences, together with my professional history as a songwriter and cabaret performer, have been the motivating force behind the research project. This study has explored the question: What are the implications of applying principles of Michael White’s narrative therapy to the creation of a cabaret performance about depression and bipolar disorder? There is a 50 percent weighting on the creative work, the cabaret performance Mind Games, and a 50 percent weighting on the written exegesis. This research has focussed on the illustration of therapeutic principles in order to play games of truth within a cabaret performance. The research project investigates ways of telling my own story in relation to others’ stories through three re-authoring principles articulated in Michael White’s narrative therapy: externalisation, an autonomous ethic of living and rich descriptions. The personal stories presented in the cabaret were drawn from my own experiences and from interviews with individuals with depression or bipolar disorder. The cabaret focussed on the illustration of therapeutic principles, and was not focussed on therapeutic ends for myself or the interviewees. The research question has been approached through a methodology combining autoethnographic, practice-led and action research. Auto ethnographic research is characterised by close investigation of assumptions, attitudes, and beliefs. The combination of autoethnographic, practice-led, action research has allowed me to bring together personal experiences of mental illness, research into therapeutic techniques, social attitudes and public discourses about mental illness and forms of contemporary cabaret to facilitate the creation of a one-woman cabaret performance. The exegesis begins with a discussion of games of truth as informed by Michel Foucault and Michael White and self-stigma as informed by Michael White and Erving Goffman. These concepts form the basis for a discussion of my own personal experiences. White’s narrative therapy is focused on individuals re-authoring their stories, or telling their stories in different ways. White’s principles are influenced by Foucault’s notions of truth and power. Foucault’s term games of truth has been used to describe the effect of a ‘truth in flux’ that occurs through White’s re-authoring process. This study argues that cabaret is an appropriate form to represent this therapeutic process because it favours heightened performativity over realism, and showcases its ‘constructedness’ and artificiality. Thus cabaret is well suited to playing games of truth. A contextual review compares two major cabaret trends, personal cabaret and provocative cabaret, in reference to the performer’s relationship with the audience in terms of distance and intimacy. The study draws a parallel between principles of distance and intimacy in Michael White’s narrative therapy and relates these to performative terms of distance and intimacy. The creative component of this study, the cabaret Mind Games, used principles of narrative therapy to present the character ‘Jo’ playing games of truth through: externalising an aspect of her personality (externalisation); exploring different life values (an autonomous ethic of living); and enacting multiple versions of her identity (rich descriptions). This constant shifting between distance and intimacy within the cabaret created the effect of a truth in ‘constant flux’, to use one of White’s terms. There are three inter-related findings in the study. The first finding is that the application of principles of White’s narrative therapy was able to successfully combine provocative and empathetic elements within the cabaret. The second finding is that the personal agenda of addressing my own self-stigma within the project limited the effective portrayal of a ‘truth in flux’ within the cabaret. The third finding presents the view that the cabaret expressed ‘Jo’ playing games of truth in order to journey towards her own "preferred identity claim" (White 2004b) through an act of "self care" (Foucault 2005). The contribution to knowledge of this research project is the application of therapeutic principles to the creation of a cabaret performance. This process has focussed on creating a self-revelatory cabaret that questions notions of a ‘fixed truth’ through combining elements of existing cabaret forms in new ways. Two major forms in contemporary cabaret, the personal cabaret and the provocative cabaret use the performer-audience relationship in distinctive ways. Through combining elements of these two cabaret forms, I have explored ways to create a provocative cabaret focussed on the act of self-revelation.