Implications of comorbidity for clinical practice

In the past, people with comorbidity have often received inadequate care. The ethical principle of equal access to quality services has important implications for agencies, when combined with knowledge about comorbidity and its management, and about diffusion of innovations across organizations. Comorbidity is common, and often has profound impacts on individuals and families. Tobacco smoking in particular is endemic and affects morbidity, mortality, and functioning. This implies that screening for co-occurring problems should be routine, and that a boutique comorbidity service is impractical. Large numbers mean that universal screening and intervention must be capable of large-scale implementation. Since multiple, closely linked problems are often present, treatments should address these multiple issues, and closely interrelated problems will require well-integrated treatment. Involvement of a single health agency is typically needed. Numbers and severity of problems can blind practitioners and patients to strengths and unaffected areas; these should be assessed and fostered. Better policies and practices for co-occurring disorders will require organizational change. Co-occurring disorders must become core business for organizations and practitioners, so that effective comorbidity practice is rewarded, required skills are present or taught, cues to use the practices are provided, and a culture supporting their application is established.

Ruptured relations : guerrilla theatre, time & Pranksterish disability performance practice

Guerrilla theatre tends, by its very definition, to pop up unpredictably – it interrupts what people might see as the proper or typical flow of time, place and space. The subversive tenor of such work means that questions about ‘what has happened’ tend to the decidedly less polite form of ‘WTF’ as passersby struggle to make sense of, and move on from, moments in which accustomed narratives of action and interaction no longer apply. In this paper I examine examples of guerrilla theatre by performers with disabilities in terms of these ruptures in time, and the way they prompt reflection, reconfigure relations, or recede into traditional relations again - focusing particularly on comedian Laurence Clark. Many performers with disabilities – Bill Shannon, Katherine Araniello, Aaron Williamson, Ju Gosling, and others – find guerrilla-style interventions in public places apposite to their aesthetic and political agendas. They prompt passersby to reflect on their relationship to people with disabilities. They can be recorded for later dissection and display, teaching people something about the way social performers, social spectators and society as a whole deal with disability. In this paper, as I unpack Clark's work, I note that the embarrassment that characterises these encounters can be a flag of an ethical process taking place for passersby. Caught between two moments in which time, roles and relationships suddenly fail to flow along the smooth routes of socially determined habits, passersbys’ frowns, gasps and giggles flag difficulties dealing with questions about their attitude to disabled people they do not now know how to answer. I consider the productivity, politics and performerly ethics of drawing passersby into such a process – a chaotic, challenging interstitial time in which a passersbys choices become fodder for public consumption – in such a wholly public way.

A profile of Australian travel journalists' professional views and ethical standards

Despite significant changes in mainstream journalism in recent decades, journalistic fields beyond the news have been little explored. In an attempt to contribute to a deeper understanding of such fields, this article examines the role perceptions of 85 Australian travel journalists. By viewing travel journalism as a distinct field of practice that is affected by a unique mix of influences, this study identifies five dimensions of practitioners’ role perceptions. These relate to travel journalists’ views of themselves as Cultural Mediators, Critics, Entertainers, Information Providers and Travellers. In addition, the study examines in some depth the ethical standards of travel journalists. Determinants of these views and standards are explored. The study argues that, in light of travel journalists’ increasingly important role in reporting about foreign places, more remains to be done to promote travel stories that show a deeper understanding of other cultures and which contain a more critical appraisal of destinations.

Reconnecting theory and practice in a pluralistic organizing context : issues and Aristotelian considerations

The overall purpose of this paper is to contribute to the theory - practice gap debate in organization studies, especially in pluralistic contexts such as project organizing. We briefly outline some of the current debates, i.e. modernist and postmodernist proposals, and the prevalent dichotomous thinking stance assumptions to better move beyond it, anchoring our contribution in the Aristotelian ethical and practical philosophy. We introduce the current state of the debate, part of the broad question of “science that matters”, and the various discourses between practice and academia within social sciences and more specifically organizational studies. We briefly critically summarize some main features of the two main philosophical stances (modernism, postmodernism), before presenting some key aspects, for the purpose of this paper, of the Aristotelian pre-modern practical and ethical philosophy. Then, we build on the foundations above established, discussing propositions to reconnect theory and practice according the Aristotelian ethical and practical philosophy, and some key implications for research notably in the following areas: roles played by practitioners and scholars, emancipatory praxeological style of reasoning, for closing the “phronetic gap” and reconnecting means and ends, facts and values, relation between collective praxis, development of “good practice” (standards), ethics and politics. We conclude highlighting the role of the suggested shift to an Aristotelian emancipatory style of reasoning for reconciling theory and practice.

Managing Ethical Dilemmas

This chapter reviews almost a decade of research and writing undertaken by the authors into ethical dilemmas faced by leaders in a number of different operational contexts, including schools, universities and the public sector. The importance of this body of work is emphasised by one of our research participants who argued that ethical dilemmas were the 'bread and butter' of what leaders do. The chapter comprises four main sections. The first section overviews key theoretical aspects as background to the chapter, including relevant discussions about ethics and ethical decision-making. The second section synthesises the research findings from our work in the three contexts noted above, drawing out a set of learnings that contribute to better understandings of the nature, complexities and challenges of ethical dilemmas. This section is followed by a discussion of an explanatory conceptual model of ethical dilemmas that was developed initially from the literature and confirmed by our research. The model reminds us of some of the critical issues at play in ethical dilemmas, and some of the consequences and implications for organisational culture building they can generate. By way of a short scenario, the final section provides a theory-to-practice illustration of an ethical dilemma in action. A set of recommendations, drawn from the ideas of school leaders who have worked with this and similar dilemmas, is offered as a way forward to better understanding and resolution of such dilemmas so prevalent in our schools today.

Studying refugee settlement through longitudinal research : methodological and ethical insights from the Good Starts study

Research involving resettled refugees raises methodological and ethical complexities. These complexities typically emerge within cross-sectional research that focuses on refugee experiences at a specific point in time. Given the long term and dynamic nature of refugee settlement, longitudinal research is valuable, yet it raises distinct complexities within the research process. This article focuses on the methodological and ethical insights that emerged in a longitudinal study of settlement and wellbeing with a cohort of young people from refugee backgrounds in Australia. It considers: engagement and retention of a cohort over time; the need to adapt research tools to changing settlement contexts and life stages; participants’ experiences of long-term involvement in the study; and the challenge of timely translation of findings into evidence for policy and practice. The article contributes to a growing understanding of the practical, ethical and epistemological challenges and opportunities presented by longitudinal research, in this case, with resettled refugee background youth.

Female genital cutting : An overview of Australian legal principles, ethical controversies, and medical, legal and social challenges

Female genital cutting (also often called female genital mutilation, or female circumcision) is a cultural practice that originated thousands of years ago. Female genital cutting has various forms, some of which are more invasive than others, but all of which produce health, legal and social consequences for those involved. Due to patterns of immigration in Australia, especially since the 1990s, there are women in Australia who have experienced female genital cutting. There may be some families, or some parents, who still hold a cultural commitment to female genital cutting. As a result, female genital cutting presents complex legal, ethical, medical and social challenges in contemporary Australian society. Medical practitioners and other health and welfare workers may encounter women who have experienced genital cutting and who require treatment for its sequelae. Currently, legislative frameworks for female genital cutting vary across states and territories, including the penalties for conducting it, and for removing a child for the purpose of conducting it outside Australia. This presentation provides an overview of the history, nature and consequences of the various forms of female genital cutting, and of the major Australian legal principles, ethical controversies, and medical, legal and social challenges in this field.

The ethical intricacies of injury rehabilitation within a dance training context

Exploring the ethical issues present in professional practice within the field of sport, exercise and performance psychology, this case study outlines challenges that may be encountered, ways to address issues should they arise, and the overall ethical considerations of supporting injury rehabilitation within a dance training context.

Playing Pranks: Traditions, communities & co-creative cultural performance practice

Pranks, hoaxes and practical jokes are co-creative cultural performance practices that appear across times, contexts and cultures. These practices include everyday play amongst families, friends and coworkers, entertainment programs such as Prank Patrol, Punked or Scare Tactics, and aesthetic and activist pranks perpetrated by situationist artists, guerrilla artists, and, most recently, culture ‘jammers’ or ‘hackers’ intent on turning capitalist systems back on themselves. Although it can, in common usage, describe almost any show off behaviour, a prank in the strictest definition of the term is a performance that deploys a very specific set of strategies. It is an act of trickery, mischief, or deceit, that must be taken as real, and momentarily cause real fear, anger or worry for an unwitting spectator-become-performer, who is meant to play along until the trick is revealed and their response can be represented back to the prankster, other spectators, or society as a whole, either for the sake of entertainment or for the sake of commentary on a cultural phenomenon. A prank, in this sense, deliberately blurs the boundaries between daily and dramatic performance. It creates a moment of uncertainty, in which both the prankster’s ability to be creative, clever, or culturally astute, and the prankee’s ability to play along, discern the trick, discern the point of the trick, and, in the end, be duped, be a good sport, or even play/pay the prankster back, are both put to the test. In this paper, I consider a number of pranking traditions popular where I am in Australia, from the community-building pranks of footballers, bucks parties and ‘drop bear’ tales told to tourists, to the more controversial pranks of radio shock jocks, activists and artists. I use performance, spectatorship and ethical theory to examine the engagement between prankster, pranked spectator, and other spectators, in this most distinctive sort of community-driven performance practice, and the way it builds and breaks status, social and other sorts of relationships within and between specific communities.

Reconnecting theory and practice in pluralistic contexts: Issues and Aristotelian considerations

The purpose of this article is to contribute, from a research practitioner perspective, to the theory–practice gap debate in organization studies, focusing on pluralistic contexts such as project organizing. The current debate is introduced; then the features of the two main philosophical traditions (i.e., modernism and postmodernism) are critically summarized. Then, propositions to reconnect theory and practice according to the Aristotelian premodern ethical and practical philosophy are discussed. Some key implications in the following areas are outlined: roles played by practitioners and scholars; emancipatory praxeological style of reasoning; closing the “phronetic gap”; and the development of “good practice,” ethics, and politics.

Ethical leadership in a time of increasing accountability

Australia, like many other countries, has embraced national testing as part of wider reforms and increased accountability in schooling. Results for standardised testing programs, such as NAPLAN, are widely published yet form only one part of accountability for educators. We argue that accountability also has moral, ethical and professional dimensions. In this paper we offer a discussion of background to our study of ethical leadership in a time of data driven or contractual accountability. Based on Starratt’s (1996) model, we define ethical leadership as a social, relational practice concerned with the moral purpose of education (Angus, 2006). Our central thesis is that given increasing accountabilities, school leaders need to consider approaches to ethical leadership to improve quality and equity in education and achieve equitable outcomes for all students. The paper concludes with key implications for school leaders.

Surface materials and aspects of care: A study in modes of being in a visual art practice

Through creative practice and written research, this thesis explores the peculiar qualities of surface materials, revealing a broader ethos of practice which I identify as care. I propose that care arises as a mode of being between artist and work, work and beholder, and between the parts of the work. The thesis situates the art practice within an ethical framework, premised on, but extending, Heidegger's ontological equation of care with being. The original contribution is in the claim that the particular qualities of worldly matter generate the terms for care as a particular mode of engagement that is reciprocal and intransitive.

Dance teacher education in the 21st century : Linking cultural and aesthetic practice

This paper describes the implementation of the recommendations of a series of research projects, within an undergraduate dance teacher-training course, into the training of collaborative, empathetic, ethical and creative dance teachers. Banks’s Dimensions for Multicultural Education (Banks, 1993) was used as a lens to analyze the design and delivery of cultural dance activities within a university dance-teaching unit, implemented in Australia and Timor Leste, and to reflect on the adaptability of the Performance in Context Model (Stevens & Huddy, in press) across different cultural contexts. Content and contextual knowledge, transformational learning pedagogy, teaching for equity and empathy development were explored through a culturally responsive teaching and learning unit, supported by critical analysis and reflection. This analysis identified a number of key understandings in relation to the design and delivery of cultural dance activities.

Diffusing research into routine midwifery practice

This research applied Greenhalgh et al's (2005) organisational change theoretical framework and a case study method approach to explore the process of implementing a smoking cessation intervention for pregnant women. The study was carried out according to the principles laid down in the National statement on ethical conduct in human research, produced by the National Health and Medical Research Council, Australia. Ethical approval for the research was sought and received from Queensland University of Technology human research ethics committee, prior to the start of the study. The sample constituted four participants who had been involved in the process of disseminating a training programme for midwives to implement a smoking cessation intervention. Eight semi-structured interviews were undertaken with these participants and the interviews and background programme data were subjected to theoretical analysis. The data were analysed through the lens of the Greenhalgh et al (2005) framework. The result was a disaggregation and (re)aggregation of data in the formation of an analytical outcome (Charmaz, 2006).

How can evaluative thinking and practice inform performance models for organizations and personnel

In the world today there are many ways in which we measure, count and determine whether something is worth the effort or not. In Australia and many other countries, new government legislation is requiring government-funded entities to become more transparent in their practice and to develop a more cohesive narrative about the worth, or impact, for the betterment of society. This places the executives of such entities in a position of needing evaluative thinking and practice to guide how they may build the narrative that documents and demonstrates this type of impact. In thinking about where to start, executives, project and program managers may consider this workshop as a professional development opportunity to explore both the intended and unintended consequences of performance models as tools of evaluation. This workshop will offer participants an opportunity to unpack the place of performance models as an evaluative tool through the following: · What shape does an ethical, sound and valid performance measure for an organization or personnel take? · What role does cultural specificity play in the design and development of a performance model for an organization or for personnel? · How are stakeholders able to identify risk during the design and development of such models? · When and where will dissemination strategies be required? · And so what? How can you determine that your performance model implementation has made a difference now or in the future?