Person centred nursing care in radiation oncology : a case study

Purpose The aim of this case study is to describe clinical staff perceptions of implementing a person-centred model of nursing in an outpatient radiotherapy treatment department, using a Primary Nursing/Collaborative Practice framework. The questions are: 1) what are the nursing and radiotherapy staff perspectives of the changed model of care, 2) what factors impacted on aspects of the evolving model?, and 3) how was interdisciplinary collaboration influenced by the new model? Methods An instrumental case study addressed the multiple perspectives of several radiotherapy health professionals, within a qualitative approach, to assess the new model of nursing care. Interview data were obtained from thirteen clinical staff over a six month period approximately one year after the model was implemented. Results The new model supports nurses to work more closely with the individual patient, with some perceived positive patient outcomes. Nurses reported increased satisfaction with their work, more autonomy and responsibility, and improved working relationships with medical staff. They also became more aware of the holistic approach to support positive patient outcomes. However, this study acknowledged that education was required for nurses to provide holistic care, especially in the context of complex interdisciplinary relationships. Conclusions A person-centred nursing approach in radiotherapy represents a radical change to the functional approach, providing some benefits for patients. However, the challenges of providing holistic care in the context of complex interdisciplinary relationships are evident, and this study acknowledges the importance of a team approach to addressing changes in practice in the future.

Mental health facility design: The case for person-centred care

There is a schism between a growing chorus for person-centred models of care and the prevalent paradigms for the design of mental health facilities. This argument proposes that architectural solutions have traditionally been geared around staff-centred concerns like ease of patient management. It suggests that the demands for person-centred models of care are important because evidence suggests that the physical environment is a causal factor in mental illness, and that even minor concessions towards person-centred models of care consistently exert a disproportionate and sustained positive influence on the behaviour of mental health patients. While the traditional mental health unit layout is unsatisfactory for person-centred care and effective recovery, other approaches that have been well tested and found to be effective is described along with a statement about subtle details that will improve facilities for all users.

Patients' outcomes related to person-centred nursing care in radiation oncology: A case study

Abstract Purpose The aim of this case study is to describe patients' responses to nursing care following the implementation of a person-centred model in a radiation oncology department. Method An instrumental case study design utilised surveys to collect data on a range of key patient outcomes: patient satisfaction (PSS), informational issues (RSEP), quality of life (FACT_G), comfort (RTCQ), and emotional status (HADS). This occurred at the beginning of, and twelve months following, the implementation of the new model of care. Results This study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being in the latter part of their course of radiation therapy, patients continue to be satisfied with nursing care. There were significant differences between groups in perceptions of the care environment and the use of the nurse as an acknowledged source of information are noteworthy, since these variables were key targets of the new model of care. The finding that nurses were seen by the post-implementation cohort as more likely to be a source of information is an important indicator that the nurses' presence was noted by patients, and they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. Conclusion The person-centred nursing approach in the radiotherapy setting has contributed to some improvements in the provision of patient care. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Comparing international television news : the case of violence presentation in Germany, Great Britain and Russia -- [in German : Gewalt in internationalen Fernsehnachrichten - eine komparative Analyse medialer Gewaltpräsentation in Deutschland, Großbritannien und Russland]

This is an important book that ought to launch a debate about how we research our understanding of the world, it is an innovative intervention in a vital public issue, and it is an elegant and scholarly hard look at what is actually happening. Jean Seaton, Prof of Media History, U of Westminster, UK & Official Historian of the BBC -- Summary: This book investigates the question of how comparative studies of international TV news (here: on violence presentation) can best be conceptualized in a way that allows for crossnational, comparative conclusions on an empirically validated basis. This book shows that such a conceptualization is necessary in order to overcome existing restrictions in the comparability of international analysis on violence presentation. Investigated examples include the most watched news bulletins in Great Britain (10o'clock news on the BBC), Germany (Tagesschau on ARD) and Russia (Vremja on Channel 1). This book highlights a substantial cross-national violence news flow as well as a cross-national visual violence flow (key visuals) as distinct transnational components. In addition, event-related textual analysis reveals how the historical rootedness of nations and its symbols of power are still manifested in televisual mediations of violence. In conclusion, this study lobbies for a conscientious use of comparative data/analysis both in journalism research and practice in order to understand what it may convey in the different arenas of today’s newsmaking.

The right person, in the right job, with the right skills, at the right time. A workforce-planning model that goes beyond metrics

Purpose – The paper aims to describe a workforce-planning model developed in-house in an Australian university library that is based on rigorous environmental scanning of an institution, the profession and the sector. Design/methodology/approach – The paper uses a case study that describes the stages of the planning process undertaken to develop the Library’s Workforce Plan and the documentation produced. Findings – While it has been found that the process has had successful and productive outcomes, workforce planning is an ongoing process. To remain effective, the workforce plan needs to be reviewed annually in the context of the library’s overall planning program. This is imperative if the plan is to remain current and to be regarded as a living document that will continue to guide library practice. Research limitations/implications – Although a single case study, the work has been contextualized within the wider research into workforce planning. Practical implications – The paper provides a model that can easily be deployed within a library without external or specialist consultant skills, and due to its scalability can be applied at department or wider level. Originality/value – The paper identifies the trends impacting on, and the emerging opportunities for, university libraries and provides a model for workforce planning that recognizes the context and culture of the organization as key drivers in determining workforce planning. Keywords - Australia, University libraries, Academic libraries, Change management, Manpower planning Paper type - Case study

Establishing indigeneity in African pluralities using PRO169 parameters and a case study for measuring their inclusivity

The concept of the indigenous person or group in Africa is a contentious one. The current argument is that there exist no indigenous people in Africa because all Africans are indigenous. The obverse considers those Africans who have not been touched by colonialism and lost their traditional cultures commensurate with attachments to the lands or a distinguishable traditional lifestyle to be indigenous. This paper argues in favor of the latter. People who live in the global telos and do not participate in a distinct traditional culture that has been attached to the land for centuries are not indigenous. It is argued that this cultural divergence between modern and traditional is the major identifying point to settle the indigenous-non indigenous African debate. Finally, the paper looks at inclusive development and provides a new political analysis model for quantifying inclusivity so as to measure the inclusivity of indigenous peoples.

Workplace design in the knowledge economy : a case of the NetWorkPlace™©

This thesis explores a way to inform the architectural design process for contemporary workplace environments. It reports on both theoretical and practical outcomes through an exclusively Australian case study of a network enterprise comprised of collaborative, yet independent business entities. The internet revolution, substantial economic and cultural shifts, and an increased emphasis on lifestyle considerations have prompted a radical re-ordering of organisational relationships and the associated structures, processes, and places of doing business. The social milieu of the information age and the knowledge economy is characterised by an almost instantaneous flow of information and capital. This has culminated in a phenomenon termed by Manuel Castells as the network society, where physical locations are joined together by continuous communication and virtual connectivity. A new spatial logic encompassing redefined concepts of space and distance, and requiring a comprehensive shift in the approach to designing workplace environments for today’s adaptive, collaborative organisations in a dynamic business world, provides the backdrop for this research. Within the duality of space and an augmentation of the traditional notions of place, organisational and institutional structures pose new challenges for the design professions. The literature revealed that there has always been a mono-organisational focus in relation to workplace design strategies. The phenomenon of inter-organisational collaboration has enabled the identification of a gap in the knowledge relative to workplace design. This new context generated the formulation of a unique research construct, the NetWorkPlace™©, which captures the complexity of contemporary employment structures embracing both physical and virtual work environments and practices, and provided the basis for investigating the factors that are shaping and defining interactions within and across networked organisational settings. The methodological orientation and the methods employed follow a qualitative approach and an abductively driven strategy comprising two distinct components, a cross-sectional study of the whole of the network and a longitudinal study, focusing on a single discrete workplace site. The complexity of the context encountered dictated that a multi-dimensional investigative framework was required to be devised. The adoption of a pluralist ontology and the reconfiguration of approaches from traditional paradigms into a collaborative, trans-disciplinary, multi-method epistemology provided an explicit and replicatable method of investigation. The identification and introduction of the NetWorkPlace™© phenomenon, by necessity, spans a number of traditional disciplinary boundaries. Results confirm that in this context, architectural research, and by extension architectural practice, must engage with what other disciplines have to offer. The research concludes that no single disciplinary approach to either research or practice in this area of design can suffice. Pierre Bourdieau’s philosophy of ‘practice’ provides a framework within which the governance and technology structures, together with the mechanisms enabling the production of social order in this context, can be understood. This is achieved by applying the concepts of position and positioning to the corporate power dynamics, and integrating the conflict found to exist between enterprise standard and ferally conceived technology systems. By extending existing theory and conceptions of ‘place’ and the ‘person-environment relationship’, relevant understandings of the tensions created between Castells’ notions of the space of place and the space of flows are established. The trans-disciplinary approach adopted, and underpinned by a robust academic and practical framework, illustrates the potential for expanding the range and richness of understanding applicable to design in this context. The outcome informs workplace design by extending theoretical horizons, and by the development of a comprehensive investigative process comprising a suite of models and techniques for both architectural and interior design research and practice, collectively entitled the NetWorkPlace™© Application Framework. This work contributes to the body of knowledge within the design disciplines in substantive, theoretical, and methodological terms, whilst potentially also influencing future organisational network theories, management practices, and information and communication technology applications. The NetWorkPlace™© as reported in this thesis, constitutes a multi-dimensional concept having the capacity to deal with the fluidity and ambiguity characteristic of the network context, as both a topic of research and the way of going about it.

Handhelds nuture inquiring minds : an Australian high school case study

Technology is not always introduced into educational contexts in ways that position pedagogy to the fore. In optimizing learning, forward looking approaches require that we question what it means to be an educated person in the 21st Century and how individuals should engage with technologies to be suitably equipped for emergent knowledge age work. Responses to such ideas typically emphasize collaborative knowledge building where technology is employed as a tool to think with and allows for the active messing with and the development of ideas, rather than merely being a passive window to information. This paper discusses a very deliberate attempt to address a range of imperatives and competing demands within a high school setting where wireless handheld technologies integrated with a learning management system (Moodle) are used to scaffold and implement knowledge sharing and knowledge-building within the school community.

Open source software for workflow management : the case of YAWL

"This column is distinguished from previous Impact columns in that it concerns the development tightrope between research and commercial take-up and the role of the LGPL in an open source workflow toolkit produced in a University environment. Many ubiquitous systems have followed this route, (Apache, BSD Unix, ...), and the lessons this Service Oriented Architecture produces cast yet more light on how software diffuses out to impact us all." Michiel van Genuchten and Les Hatton Workflow management systems support the design, execution and analysis of business processes. A workflow management system needs to guarantee that work is conducted at the right time, by the right person or software application, through the execution of a workflow process model. Traditionally, there has been a lack of broad support for a workflow modeling standard. Standardization efforts proposed by the Workflow Management Coalition in the late nineties suffered from limited support for routing constructs. In fact, as later demonstrated by the Workflow Patterns Initiative (www.workflowpatterns.com), a much wider range of constructs is required when modeling realistic workflows in practice. YAWL (Yet Another Workflow Language) is a workflow language that was developed to show that comprehensive support for the workflow patterns is achievable. Soon after its inception in 2002, a prototype system was built to demonstrate that it was possible to have a system support such a complex language. From that initial prototype, YAWL has grown into a fully-fledged, open source workflow management system and support environment

Health professionals' recognition of co-occurring alcohol and depressive disorders in youth: a survey of Australian general practitioners, psychiatrists, psychologists and mental health nurses using case vignettes

Objective: To examine whether health professionals who commonly deal with mental disorder are able to identify co occurring alcohol misuse in young people presenting with depression. Method: Between September 2006 and January 2007, a survey examining beliefs regarding appropriate interventions for mental disorder in youth was sent to 1710 psychiatrists, 2000 general practitioners (GPs), 1628 mental health nurses, and 2000 psychologists in Australia. Participants within each professional group were randomly given one of four vignettes describing a young person with a DSM-IV mental disorder. Herein is reported data from the depression and depression with alcohol misuse vignettes. Results: A total of 305 psychiatrists, 258 GPs, 292 mental health nurses and 375 psychologists completed one of the depression vignettes. A diagnosis of mood disorder was identified by at least 83.8% of professionals, with no significant differences noted between professional groups. Rates of reported co-occurring substance use disorders were substantially lower, particularly among older professionals and psychologists. Conclusions: GPs, psychologists and mental health professionals do not readily identify co-occurring alcohol misuse in young people with depression. Given the substantially negative impact of co-occurring disorders, it is imperative that health-care professionals are appropriately trained to detect such disorders promptly, to ensure young people have access to effective, early intervention.

A comparison of methods for classifying clinical samples based on proteomics data : a case study for statistical and machine learning approaches

The discovery of protein variation is an important strategy in disease diagnosis within the biological sciences. The current benchmark for elucidating information from multiple biological variables is the so called “omics” disciplines of the biological sciences. Such variability is uncovered by implementation of multivariable data mining techniques which come under two primary categories, machine learning strategies and statistical based approaches. Typically proteomic studies can produce hundreds or thousands of variables, p, per observation, n, depending on the analytical platform or method employed to generate the data. Many classification methods are limited by an n≪p constraint, and as such, require pre-treatment to reduce the dimensionality prior to classification. Recently machine learning techniques have gained popularity in the field for their ability to successfully classify unknown samples. One limitation of such methods is the lack of a functional model allowing meaningful interpretation of results in terms of the features used for classification. This is a problem that might be solved using a statistical model-based approach where not only is the importance of the individual protein explicit, they are combined into a readily interpretable classification rule without relying on a black box approach. Here we incorporate statistical dimension reduction techniques Partial Least Squares (PLS) and Principal Components Analysis (PCA) followed by both statistical and machine learning classification methods, and compared them to a popular machine learning technique, Support Vector Machines (SVM). Both PLS and SVM demonstrate strong utility for proteomic classification problems.

Mixed-dimensional consistent coupling by multi-point constraint equations for efficient multi-scale modeling

Finding an appropriate linking method to connect different dimensional element types in a single finite element model is a key issue in the multi-scale modeling. This paper presents a mixed dimensional coupling method using multi-point constraint equations derived by equating the work done on either side of interface connecting beam elements and shell elements for constructing a finite element multiscale model. A typical steel truss frame structure is selected as case example and the reduced scale specimen of this truss section is then studied in the laboratory to measure its dynamic and static behavior in global truss and local welded details while the different analytical models are developed for numerical simulation. Comparison of dynamic and static response of the calculated results among different numerical models as well as the good agreement with those from experimental results indicates that the proposed multi-scale model is efficient and accurate.

An extension to the rank constraint for improving the reliability of stereo matching algorithms using the rank transform

The rank transform is one non-parametric transform which has been applied to the stereo matching problem The advantages of this transform include its invariance to radio metric distortion and its amenability to hardware implementation. This paper describes the derivation of the rank constraint for matching using the rank transform Previous work has shown that this constraint was capable of resolving ambiguous matches thereby improving match reliability A new matching algorithm incorporating this constraint was also proposed. This paper extends on this previous work by proposing a matching algorithm which uses a dimensional match surface in which the match score is computed for every possible template and match window combination. The principal advantage of this algorithm is that the use of the match surface enforces the left�right consistency and uniqueness constraints thus improving the algorithms ability to remove invalid matches Experimental results for a number of test stereo pairs show that the new algorithm is capable of identifying and removing a large number of in incorrect matches particularly in the case of occlusions

Mediating identity narratives : a case study in queer digital storytelling as everyday activism

Digital Stories are short autobiographical documentaries, often illustrated with personal photographs and narrated in the first person, and typically produced in group workshops. As a media form they offer ‘ordinary people’ the opportunity to represent themselves to audiences of their choosing; and this amplification of hitherto unheard voices has significant repercussions for their social participation. Many of the storytellers involved in the ‘Rainbow Family Tree’ case study that is the subject of this paper can be characterised as ‘everyday’ activists for their common desire to use their personal stories to increase social acceptance of marginalised identity categories. However, in conflict with their willingness to share their personal stories, many fear the risks and ramifications of distributing them in public spaces (especially online) to audiences both intimate and unknown. Additionally, while technologies for production and distribution of rich media products have become more accessible and user-friendly, many obstacles remain. For many people there are difficulties with technological access and aptitude, personal agency, cultural capital, and social isolation, not to mention availability of the time and energy requisite to Digital Storytelling. Additionally, workshop context, facilitation and distribution processes all influence the content of stories. This paper explores the many factors that make ‘authentic’ self-representation far from straight forward. I use qualitative data drawn from interviews, Digital Story texts and ethnographic observation of GLBTQIS participants in a Digital Storytelling initiative that combined face-to-face and online modes of participation. I consider mediating influences in practice and theory and draw on strategies put forth in cultural anthropology and narrative therapy to propose some practical tools for nuanced and sensitive facilitation of Digital Storytelling workshops and webspaces. Finally, I consider the implications of these facilitation strategies for voice, identity and social participation.

Exploring the process of meaning making in healing after childhood sexual assault : a case study approach

Childhood sexual assault (CSA) is one of the most devastating of all traumatic experiences with population studies documenting survivors experiencing higher levels of pathology than general trends in survivors of other traumatic experiences. Yet recent research has demonstrated that far from being permanently crippled by their experiences, many adult survivors of CSA manage to heal and move forward in their lives to experience a rich and fulfilling existence. In this paper two case studies are presented to provide a detailed account of how a person who has experienced CSA may find a pathway to healing. Moreover, data demonstrates that meaning making, spiritual or otherwise, is a pivotal part of acceptance of CSA and ensuing growth. The case studies highlight the unique journeys of two women and the underlying similarities in their pathway to healing. Clinical implications of the research are discussed and specific strategies for encouraging healing and growth are outlined.