Compliance in peritoneal dialysis : a qualitative study of renal nurses

End-stage renal failure is a life-threatening condition, often treated with home-based peritoneal dialysis (PD). PD is a demanding regimen, and the patients who practise it must make numerous lifestyle changes and learn complicated biomedical techniques. In our experience, the renal nurses who provide mostPDeducation frequently express concerns that patient compliance with their teaching is poor. These concerns are mirrored in the renal literature. It has been argued that the perceived failure of health professionals to improve compliance rates with PD regimens is because ‘compliance’ itself has never been adequately conceptualized or defined; thus, it is difficult to operationalize and quantify. This paper examines how a group of Australian renal nurses construct patient compliance with PD therapy. These empirical data illuminate how PD compliance operates in one practice setting; how it is characterized by multiple and often competing energies; and how ultimately it might be pointless to try to tame ‘compliance’ through rigid definitions and measurement, or to rigidly enforce it in PD patients. The energies involved are too fractious and might be better spent, as many of the more experienced nurses in this study argue, in augmenting the energies that do work well together to improve patient outcomes.

Confirmatory factor analysis of the Way of Coping Checklist-Revised (WCCL-R) in the Asian context

Industrial employment growth has been one of the most dynamic areas of expansion in Asia; however, current trends in industrialised working environments have resulted in greater employee stress. Despite research showing that cultural values affect the way people cope with stress, there is a dearth of psychometrically established tools for use in non-Western countries to measure these constructs. Studies of the "Way of Coping Checklist-Revised" (WCCL-R) in the West suggest that the WCCL-R has good psychometric properties, but its applicability in the East is still understudied. A confirmatory factor analysis (CFA) is used to validate the WCCL-R constructs in an Asian population. This study used 1,314 participants from Indonesia, Sri Lanka, Singapore, and Thailand. An initial exploratory factor analysis revealed that original structures were not confirmed; however, a subsequent EFA and CFA showed that a 38-item, five-factor structure model was confirmed. The revised WCCL-R in the Asian sample was also found to have good reliability and sound construct and concurrent validity. The 38-item structure of the WCCL-R has considerable potential in future occupational stress-related research in Asian countries.

The impact of pain on the quality of life of people with multiple sclerosis: A community survey

The purpose of this study was to examine the impact of pain on functioning across multiple quality of life (QOL) domains among individuals with multiple sclerosis (MS). A total of 219 people were recruited from a regional MS society membership database to serve as the community-based study sample. All participants completed a questionnaire containing items about their demographic and clinical characteristics, validated measures of QOL and MS-related disability, and a question on whether or not they had experienced clinically significant pain in the preceding 2 weeks. Respondents who reported pain then completed an in-person structured pain interview assessing pain characteristics (intensity, quality, location, extent, and duration). Comparisons between participants with and without MS-related pain demonstrated that pain prevalence and intensity were strongly correlated with QOL: physical health, psychological health, level of independence, and global QOL were more likely to be impaired among people with MS when pain was present, and the extent of impairment was associated with the intensity of pain. Moreover, these relationships remained significant even after statistically controlling for multiple demographic and clinical covariates associated with self-reported QOL. These findings suggest that for people with MS, pain is an important source of distress and disability beyond that caused by neurologic impairments.

Benefits of e-learning benchmarks : Australian case studies

In 2004, the Australian Flexible Learning Framework developed a suite of quantitative and qualitative indicators on the uptake, use and impact of e-learning in the Vocational Education and Training (VET) sector. These indicators were used to design items for a survey to gather quantitative data for benchmarking. A series of four surveys gathered data from VET providers, teachers, students and their employers. The data formed baseline indicators that were used to establish organisational goals and benchmarks for e-learning. These indicators were the first know set for benchmarking e-learning in Australia. The case studies in this paper illustrate ways in which VET providers have approached e-learning benchmarking, the benefits achieved and the lessons that they learned. The cases exemplify how VET providers have adapted the baseline indicators, how the indicators informed organisational plans and e-learning outcomes. The benefits of benchmarking are categorised under three purposes: reporting, performance management, and service improvement. A set of practical strategies is derived from the cases for consideration by other organisations interested in benchmarking e-learning services.

Brief opportunistic intervention : the role of psychologists in initiating self-change amongst problem drinkers

Excessive consumption of alcohol is a serious public health problem. While intensive treatments are suitable for those who are physically dependent on alcohol, they are not cost-effective options for the vast majority of problem drinkers who are not dependent. There is good evidence that brief interventions are effective in reducing overall alcohol consumption, alcohol-related problems, and health-care utilisation among nondependent problem drinkers. Psychologists are in an ideal position to opportunistically detect people who drink excessively and to offer them brief advice to reduce their drinking. In this paper we outline the process involved in providing brief opportunistic screening and intervention for problem drinkers. We also discuss methods that psychologists can employ if a client is not ready to reduce drinking, or is ambivalent about change. Depending on the client's level of motivation to change, psychologists can engage in either an education-clarification approach, a commitment-enhancement approach, or a skills-training approach. Routine engagement in opportunistic intervention is an important public-health approach to reducing alcohol-related harm in the community.

Queering cyberspace : fan fiction communities as spaces for expressing and exploring sexuality

The social construction of sexuality over the past one hundred and fifty years has created a dichotomy between heterosexual and non-heterosexual identities that essentially positions the former as “normal” and the latter as deviant. Even Kinsey’s and others’ work on the continuum of sexualities did little to alter the predominantly heterosexist perception of the non-heterosexual as “other” (Kinsey, Pomeroy and Martin 2007; Esterberg 2006; Franceour and Noonan 2007). Some political action and academic work is beginning to challenge such perceptions. Even some avenues of social interaction, such as the recent proliferation of online communities, may also challenge such views, or at least contribute to their being rethought in some ways. This chapter explores a specific kind of online community devoted to fan fiction, specifically homoerotic – or what is known colloquially as “slash” – fan fiction. Fan fiction is fiction, published on the internet, and written by fans of well-known books and television shows, using the characters to create new and varied plots. “Slash” refers to the pairing of two of the male characters in a romantic relationship, and the term comes from the punctuation mark dividing the named pair as, for example, Spock/Kirk from the Star Trek television series. Although there are some slash fan-fiction stories devoted to female-female relationships – called “femmeslash” – the term “slash” generally refers to male-male relationships, and will be utilized throughout this chapter, given that the research discussed focuses on communities centered around one such male pairing.

Are country and cultural values interchangeable? : a case example using occupational stress and coping

Cross-cultural research in occupational stress and coping has produced a wealth of knowledge. Although advancement has been made, there are still problems to be solved. One of these problems is the confusion generated in the literature by researchers claiming nation or country as representing cultural values, and the use of the two terms interchangeably. It remains unclear whether this practice is correct. The present paper reported on this by using 511 full time employees from Australia, Singapore and Sri Lanka to study occupational stress and coping. Results revealed that cultural value paradigm (i.e., Individualism-Collectivism) was distributed across the three nations, such that over 60% of participants across the three nations were either high or low in both I-C paradigms. The findings also indicated that the relationship between cultural value paradigm and country impacted on stress and coping differently. The study shows that significant differences exist within country, as well as between countries, such that any attempt to equate ‘culture’ with ‘country’ becomes problematic. Therefore, these findings establish that country or nation was not the same as culture values and could not be used interchangeably.

Experimental study of the mechanical properties of light gauge cold-formed steels at elevated temperatures

In recent times, light gauge cold-formed steel sections have been used extensively as primary load bearing structural members in many applications in the building industry. Fire safety design of structures using such sections has therefore become more important. Deterioration of mechanical properties of yield stress and elasticity modulus is considered the most important factor affecting the performance of steel structures in fires. Hence there is a need to fully understand the mechanical properties of light gauge cold-formed steels at elevated temperatures. A research project based on experimental studies was therefore undertaken to investigate the deterioration of mechanical properties of light gauge cold-formed steels. Tensile coupon tests were undertaken to determine the mechanical properties of these steels made of both low and high strength steels and thicknesses of 0.60, 0.80 and 0.95 mm at temperatures ranging from 20 to 800ºC. Test results showed that the currently available reduction factors are unsafe to use in the fire safety design of cold-formed steel structures. Therefore new predictive equations were developed for the mechanical properties of yield strength and elasticity modulus at elevated temperatures. This paper presents the details of the experimental study, and the results including the developed equations. It also includes details of a stress-strain model for light gauge cold-formed steels at elevated temperatures.