Clients’ understanding of the role of nurse practitioners

Introduction: Nurse Practitioners (NPs) have an emerging role in the Australian healthcare system. However, there remains a dearth of available data about public understanding of the NP role. ---------- Aim: To evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. ---------- Method: All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales (NSW) were invited to recruit five consecutive clients to complete the self-administered survey. ---------- Results: Thirty two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (p=0.005), and where applicable would to prefer to see a NP rather than a doctor (p=0.022). ---------- Discussion: Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction more awareness of the scope of the NP role is required.

Safety in occupational driving : development of a driver behaviour scale for the workplace context

International statistics indicate that occupational, or work-related driving, crashes are the most common cause of workplace injury, death, and absence from work. The majority of research examining unsafe driver behavior in the workplace has relied on general road safety questionnaires. However, past research has failed to consider the organizational context in the use of these questionnaires, and as such, there is ambiguity in the dimensions constituting occupational driving. Using a theoretical model developed by Hockey (1993, 1997), this article proposes and validates a new scale of occupational driver behavior. This scale incorporates four dimensions of driver behavior that are influenced by demanding workplace conditions; speeding, rule violation, inattention, and driving while tired. Following a content validation process, three samples of occupational drivers in Australia were used to assess the scale. Data from the first sample (n=145) were used to reduce the number of scale items and provide an assessment of the factorial validity of the scale. Data from the second sample (n=645) were then used to confirm the factor structure and psychometric properties of the scale including reliability and construct validity. Finally, data from the third sample (n=248) were used to establish criterion validity. The results indicated that the scale is a reliable and valid measure of occupational driver behavior.

Manifolds, patterns and transitions in a creative life

Using sculpture and drawing as my primary methods of investigation, this research explores ways of shifting the emphasis of my creative visual arts practice from object to process whilst still maintaining a primacy of material outcomes. My motivation was to locate ways of developing a sustained practice shaped as much by new works, as by a creative flow between works. I imagined a practice where a logic of structure within discrete forms and a logic of the broader practice might be developed as mutually informed processes. Using basic structural components of multiple wooden curves and linear modes of deployment – in both sculptures and drawings – I have identified both emergence theory and the image of rhizomic growth (Deleuze and Guattari, 1987) as theoretically integral to this imagining of a creative practice, both in terms of critiquing and developing works. Whilst I adopt a formalist approach for this exegesis, the emergence and rhizome models allow it to work as a critique of movement, of becoming and changing, rather than merely a formalism of static structure. In these models, therefore, I have identified a formal approach that can be applied not only to objects, but to practice over time. The thorough reading and application of these ontological models (emergence and rhizome) to visual arts practice, in terms of processes, objects and changes, is the primary contribution of this thesis. The works that form the major component of the research develop, reflect and embody these notions of movement and change.

Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use : current evidence and directions for future research

Issues and Approach: The high rates of co-occurring depression and substance use, and the negative impact of this on illness course and outcomes have been well established. Despite this, few clinical trials have examined the efficacy of cognitive behaviour therapy (CBT). This paper systematically reviews these clinical trials, with an aim of providing recommendations for how future research can develop a more robust evidence base for the treatment of these common comorbidities. Leading electronic databases, including PubMed (ISI) and PsychINFO (CSA), were searched for peer-reviewed journal articles using CBT for the treatment of co-occurring depression and substance use. Of the 55 articles identified, 12 met inclusion criteria and were included in the review. ---------- Key Findings: There is only a limited evidence for the effectiveness of CBT either alone or in combination with antidepressant medication for the treatment of co-occurring depression and substance use. While there is support for the efficacy of CBT over no treatment control conditions, there is little evidence that CBT is more efficacious than other psychotherapies. There is, however, consistent evidence of improvements in both depression and substance use outcomes, regardless of the type of treatment provided and there is growing evidence that that the effects of CBT are durable and increase over time during follow up. ---------- Conclusions. Rather than declaring the ‘dodo bird verdict’ that CBT and all other psychotherapies are equally efficacious, it would be more beneficial to develop more potent forms of CBT by identifying variables that mediate treatment outcomes.

Reading nineteenth century schoolbooks online : user behavior in a digitized special collection

Special collections, because of the issues associated with conservation and use, a feature they share with archives, tend to be the most digitized areas in libraries. The Nineteenth Century Schoolbooks collection is a collection of 9000 rarely held nineteenth-century schoolbooks that were painstakingly collected over a lifetime of work by Prof. John A. Nietz, and donated to the Hillman Library at the University of Pittsburgh in 1958, which has since grown to 15,000. About 140 of these texts are completely digitized and showcased in a publicly accessible website through the University of Pittsburgh’s Library, along with a searchable bibliography of the entire collection, which expanded the awareness of this collection and its user base to beyond the academic community. The URL for the website is http://digital.library.pitt.edu/nietz/. The collection is a rich resource for researchers studying the intellectual, educational, and textbook publishing history of the United States. In this study, we examined several existing records collected by the Digital Research Library at the University of Pittsburgh in order to determine the identity and searching behaviors of the users of this collection. Some of the records examined include: 1) The results of a 3-month long user survey, 2) User access statistics including search queries for a period of one year, a year after the digitized collection became publicly available in 2001, and 3) E-mail input received by the website over 4 years from 2000-2004. The results of the study demonstrate the differences in online retrieval strategies used by academic researchers and historians, archivists, avocationists, and the general public, and the importance of facilitating the discovery of digitized special collections through the use of electronic finding aids and an interactive interface with detailed metadata.

Supervisory safety practices in the work-related driving context

Work-related driving crashes are the most common cause of work-related injury, death, and absence from work in Australia and overseas. Surprisingly however, limited attention has been given to initiatives designed to improve safety outcomes in the work-related driving setting. This research paper will present preliminary findings from a research project designed to examine the effects of increasing work-related driving safety discussions on the relationship between drivers and their supervisors and motivations to drive safely. The research project was conducted within a community nursing population, where 112 drivers were matched with 23 supervisors. To establish discussions between supervisors and drivers, safety sessions were conducted on a monthly basis with supervisors of the drivers. At these sessions, the researcher presented context specific, audio-based anti-speeding messages. Throughout the course of the intervention and following each of these safety sessions, supervisors were instructed to ensure that all drivers within their workgroup listened to each particular anti-speeding message at least once a fortnight. In addition to the message, supervisors were also encouraged to frequently promote the anti-speeding message through any contact they had with their drivers (i.e., face to face, email, SMS text, and/or paper based contact). Fortnightly discussions were subsequently held with drivers, whereby the researchers ascertained the number and type of discussions supervisors engaged in with their drivers. These discussions also assessed drivers’ perceptions of the group safety climate. In addition to the fortnightly discussion, drivers completed a daily speed reporting form which assessed the proportion of their driving day spent knowingly over the speed limit. As predicted, the results found that if supervisors reported a good safety climate prior to the intervention, increasing the number of safety discussions resulted in drivers reporting a high quality relationship (i.e., leader-member exchange) with their supervisor post intervention. In addition, if drivers reported a good safety climate, increasing the number of discussions resulted in increased motivation to drive safely post intervention. Motivations to drive safely prior to the intervention also predicted self-reported speeding over the subsequent three months of reporting. These results suggest safety discussions play an important role in improving the exchange between supervisors and their drivers and drivers’ subsequent motivation to drive safely and, in turn, self reported speeding.

Queer cops in Queensland : exploring LGBT narrative histories in the Queensland Police Service

This chapter reports on a narrative project recording the experiences of LGBT former and current police officers in the Queensland Police Service (QPS), Australia. It begins by examining the historical and research contexts of LGBT police officers, followed by a discussion of the methodology employed for the project. The chapter then examines and analyzes key themes emerging from the data about coming out, macho police culture, and the double life syndrome often experienced by LGBT police officers. Finally, it suggests that further research might uncover a more widespread application of these findings.

Regulating for Sustainability : Property Issues

All Australian governments recognize the need to ensure that land and natural resources are used sustainably. In this context, ‘resources’ includes natural resources found on land such as trees and other vegetation, fauna, soil and minerals, and cultural resources found on land such as archaeological sites and artefacts. Regulators use a wide range of techniques to promote sustainability. To achieve their objectives, they may, for example, create economic incentives through bounties, grants and subsidies, encourage the development of self-regulatory codes, or enter into agreements with landowners specifying how the land is to be managed. A common way of regulating is by making administrative orders, determinations or decisions under powers given to regulators by Acts of Parliament (statutes) or by regulations (delegated legislation). Generally the legislation provides for specified rights or duties, and authorises a regulator to make an order or decision to apply the legislative provisions to particular land or cases. For example, legislation might empower a regulator to make an order that requires the owner of a contaminated site to remediate it. When the regulator exercises the power by making an order in relation to particular land, the owner is placed under a statutory duty to remediate. When regulators exercise their statutory powers to manage the use of private land or natural or cultural resources on private land, property law issues can arise. The owner of land has a private property right that the law will enforce against anybody else who interferes with the enjoyment of the right, without legal authority to do so. The law dealing with the enforcement of private property rights forms part of private law. This report focuses on the relationship between the law of private property and the regulation of land and resources by legislation and by administrative decisions made under powers given by legislation (statutory powers).

The development of an intervention to improve the safety of community care nurses while driving and a qualitative investigation of its preliminary effects

This paper details the development of, and perceived role and effectiveness of an innovative intervention designed to ultimately improve the safety of a group of community care (CC) nurses while driving. Recruiting participants from an Australian CC nursing car fleet, qualitative responses from a series of open-ended questions were obtained from drivers (n = 36), supervisors (n = 22), and managers (n = 6). The findings supported the effectiveness of the intervention in reducing self-reported speeding and promoting greater insight into one’s behaviour on the road. This research has important practical implications in that it highlights the value of developing an intervention based on a sound theoretical framework and which is aligned with the needs and beliefs of personnel within a particular organisation.

Out of time: The moral temporality of sex, crime and taboo

This paper discusses the relationship between law and morality. Morality does not necessarily coincide with the law, but it contributes to it. An act may be legal but nevertheless considered to be immoral in a particular society. For example, the use of pornography may be considered by many to be immoral. Nevertheless, the sale and distribution of non-violent, non-child related, sexually explicit material is legal (or regulated) in many jurisdictions. Many laws are informed by, and even created by, morality. This paper examines the historical influence of morality on the law and on society in general. It aims to develop a theoretical framework for examining legal moralism and the social construction of morality and crime as well as the relationship between sex, desire and taboo. Here, we refer to the moral temporality of sex and taboo, which examines the way in which moral judgments about sex and what is considered taboo change over time, and the kinds of justifications that are employed in support of changing moralities. It unpacks the way in which abstract and highly tenuous concepts such as ‘‘desire’’, ‘‘art’’ and ‘‘entertainment’’ may be ‘‘out of time’’ with morality, and how morality shapes laws over time, fabricating justifications from within socially constructed communities of practice. This theoretical framework maps the way in which these concepts have become temporally dominated by heteronormative structures such as the family, marriage, reproduction, and longevity. It is argued that the logic of these structures is inexorably tied to the heterosexual life-path, charting individual lives and relationships through explicit phases of childhood, adolescence and adulthood that, in the twenty-first century, delimit the boundaries of taboo surrounding sex more than any other time in history.

Sex, crime and morality

Over the last few decades, there has been a marked increase in media and debate surrounding a specific group of offences in modern Democratic nations which bear the brunt of the label ‘crimes against morality’. Included within this group are offences related to prostitution and pornography, homosexuality and incest and child sexual abuse. This book examines the nexus between sex, crime and morality from a theoretical perspective. This is the first academic text to offer an examination and analysis of the philosophical underpinnings of sex-related crimes and social attitudes towards them and the historical, anthropological and moral reasons for differentiating these crimes in contemporary western culture. The book is divided into three sections corresponding to three theoretical frameworks: Part 1 examines the moral temporality of sex and taboo as a foundation for legislation governing sex crimes Part 2 focuses on the geography of sex and deviance, specifically notions of public morality and the public private divide Part 3 examines the moral economy of sex and harm, including the social construction of harm. Sex, Crime and Morality will be key reading for students of criminology, criminal justice, gender studies and ethics, and will also be of interest to justice professionals.

Absence of malice: Constructing the female sex offender

It could be argued that all crimes have a general moral basis, condemned as ‘wrong’ or ‘bad’ in the society in which they are proscribed, however, there are a specific group of offences in modern democratic nations which bear the brunt of the label, crimes against morality. Included within this group are offences related to prostitution and pornography, homosexuality and incest, as well as child sexual abuse. While the places where sex and morality meet have shifted over time, these two concepts continue to form the basis of much criminal legislation and associated criminal justice responses. Offenders of sexual mores are positioned as the reviled corruptors of innocent children, the purveyors of disease, an indictment on the breakdown of the family and/or the secularisation of society, and a corruptive force (Davidson 2008, Kincaid 1998). Other types of offending may divide public and political opinion, but the consensus on sex crimes appears constant.

Integrated Acquisition Engineering Model for acquiring heavy engineering assets

In asset intensive industries such as mining, oil & gas, utilities etc. most of the capital expenditure happens on acquiring engineering assets. Process of acquiring assets is called as “Procurement” or “Acquisition”. An asset procurement decision should be taken in consideration with the installation, commissioning, operational, maintenance and disposal needs of an asset or spare. However, such cross-functional collaboration and communication does not appear to happen between engineering, maintenance, warehousing and procurement functions in many asset intensive industries. Acquisition planning and execution are two distinct parts of asset acquisition process. Acquisition planning or procurement planning is responsible for determining exactly what is required to be purchased. It is important that an asset acquisition decision is the result of cross-functional decision making process. An acquisition decision leads to a formal purchase order. Most costly asset decisions occur even before they are acquired. Therefore, acquisition decision should be an outcome of an integrated planning & decision making process. Asset intensive organizations both, Government and non Government in Australia spent AUD 102.5 Billion on asset acquisition in year 2008-09. There is widespread evidence of many assets and spare not being used or utilized and in the end are written off. This clearly shows that many organizations end up buying assets or spares which were not required or non-conforming to the needs of user functions. It is due the fact that strategic and software driven procurement process do not consider all the requirements from various functions within the organization which contribute to the operation and maintenance of the asset over its life cycle. There is a lot of research done on how to implement an effective procurement process. There are numerous software solutions available for executing a procurement process. However, not much research is done on how to arrive at a cross functional procurement planning process. It is also important to link procurement planning process to procurement execution process. This research will discuss ““Acquisition Engineering Model” (AEM) framework, which aims at assisting acquisition decision making based on various criteria to satisfy cross-functional organizational requirements. Acquisition Engineering Model (AEM) will consider inputs from corporate asset management strategy, production management, maintenance management, warehousing, finance and HSE. Therefore, it is essential that the multi-criteria driven acquisition planning process is carried out and its output is fed to the asset acquisition (procurement execution) process. An effective procurement decision making framework to perform acquisition planning which considers various functional criteria will be discussed in this paper.