Survey of intensive care nurses' knowledge relating to the pulmonary artery catheter

In 2003 there was an increase in the use of pulmonary artery catheters in Australia from 12, 000 to 16, 000 units in intensive care and peri-operative care. This survey of intensive care nurses in five intensive care units in Queensland addressed knowledge of use, safety and complications of the pulmonary artery catheter, using a previously validated 31 question multiple choice survey. One hundred and thirty-nine questionnaires were completed, a response rate of 46%. The mean score was 13.3, standard deviation +/-4.2 out of a total of 31 (42.8% correct). The range was 4 to 25. Scores were significantly higher in those participants with more ICU experience, higher nursing grade, a higher self-assessed level of knowledge and greater frequency of PAC supervision. There was no significant correlation between total score and hospital- or university-based education, or total score and public or private hospital participants. Fifty-one per cent were unable to correctly identify the significant pressure change as the catheter is advanced from the right ventricle to the pulmonary artery.

Investigating the dilemmas of ethical social research

The author’s work with a university ethics committee and field research in Pacific New Caledonia is used as a basis to problematise the biomedical research models used by universities in Australia for assessing social research as ethical. The article explores how culturally specific Western emotional bases for ethical decisions are often unexamined. It expresses concerns about gaps in biomedical models by linking the author’s description of field interactions with research participants to debates about the creation of knowledge.

Ethics and health systems research in 'post'-conflict situations

Although considerable attention has been given to ethical issues related to clinical research in developing countries, in particular related to HIV therapy, there has been limited focus on health systems research, despite its increasing importance in the light of current trends in development assistance. This paper examines ethical issues related to health systems research in 'post'-conflict situations, addressing both generic issues for developing countries and those issues specific to 'post'-conflict societies, citing examples from the author's Cambodian experience. It argues that the destruction of health infrastructure results in a loss of structures and processes that would otherwise protect prospective research subjects who are part of vulnerable populations. It identifies the growth of health systems research as part of a trend towards sectoral and programmatic development assistance, the emergence of 'knowledge generation' as a form of research linked to development, and the potential for conflict where multilateral and bilateral donors are both primary funders and users of health systems research. It also examines the position of the health system researcher in relation to the sponsors of this research, and the health system being analysed.

Ethics and intervention: The 'humanitarian exception' and the problem of abuse in the case of Iraq

This article investigates the ethics of intervention and explores the decision to invade Iraq. It begins by arguing that while positive international law provides an important framework for understanding and debating the legitimacy of war, it does not cover the full spectrum of moral reasoning on issues of war and peace. To that end, after briefly discussing the two primary legal justifications for war (implied UN authorization and pre-emptive self-defence), and finding them wanting, it asks whether there is a moral 'humanitarian exceptions to this rule grounded in the 'just war' tradition. The article argues that two aspects of the broad tradition could be used to make a humanitarian case for war: the 'holy war' tradition and classical just war thinking based on natural law. The former it finds problematic, while the latter it argues provides a moral space to justify the use of force to halt gross breaches of natural law. Although such an approach may provide a moral justification for war, it also opens the door to abuse. It was this very problem that legal positivism from Vattel onwards was designed to address. As a result, the article argues that natural law and legal positivist arguments should be understood as complementary sets of ideas whose sometimes competing claims must be balanced in relation to particular cases. Therefore, although natural law may open a space for justifying the invasion of Iraq on humanitarian terms, legal positivism strictly limits that right. Ignoring this latter fact, as happened in the Iraq case, opens the door to abuse.

Should the knowledge-based economy be a savant or a sage? Wisdom and socially intelligent innovation

Discourse about knowledge-based economies rarely moves beyond the commercialization of science and engineering, and is locked in the discursive limits of functionalism. We argue that these discourses limit the scope of what knowledge-based economies might achieve because they are uninformed by an adequate conception of knowledge. In particular, knowledge management and knowledge-based economy discourse has not included the axiological dimension of knowledge that leads to wisdom. Taking an axiological perspective, we can discuss policy frameworks aimed at producing the social structures needed to bring fully formed and fully functioning knowledge societies into being. We argue that while the dominant discourse of industrial modernity remains rationalist, functionalist, utilitarian and technocratic, knowledge-based economies will resemble a savant rather than a sage. A wisdom-based renaissance of humanistic epistemology is needed to avoid increasing social dysfunction and a lack of wisdom in complex technological societies.

Knowledge, economy, technology and society: The politics of discourse

The WSIS is centrally interested in knowledge and has defined for itself a mission that is broadly humanitarian. Its development ‘talk’ is, rightly, replete with notions of equity, preserving culture, justice, human rights and so on. In incorporating such issues into knowledge society and economy discussions, WSIS has adopted a different posture towards knowledge than is seen in dominant discourses. This study analyses the dominant knowledge discourse using a large corpus of knowledge-related policy documents, discourse theory and an interrelational understanding of knowledge. I show that it is important to understand this dominant knowledge discourse because of its capacity to limit thought and action in relation to its central topic, knowledge. The results of this study demonstrate that the dominant knowledge discourse is technocratic, frequently insensitive to the humane mission at the core of the WSIS, and is based on a partial understanding of what knowledge is and how knowledge systems work. Moreover, I show that knowledge is inherently political, that the dominant knowledge discourse is politically oriented towards the concerns of business and technology, but that an emancipatory politics of knowledge is possible.

Knowledge of birds and willingness to support their conservation: an Australian case study

This case study concentrates on the extent of knowledge among the Australian public of Australia's tropical bird species, and their willingness to support their conservation. In order to place this issue in context, we provide background information on the status of Australian bird species, focusing attention on species that occur in tropical Australia. Then, using questionnaire survey results, we consider the hypothesis that the public's support for the conservation of different bird species depends on their understanding of the species' existence and status. Based on results from a sample of residents in Brisbane, Queensland, we found that knowledge of bird species that occur exclusively in the Australian tropics (including tropical Queensland) was very poor compared with that of those occurring in the Brisbane area that are relatively common. Experimental results indicated that when respondents in the sample had an option to allocate A$1,000 between 10 bird species listed in the survey, they allocated more funds to the better-known and more common species, unless they were provided with balanced information about all the selected species. With balanced information, the average allocation to bird species confined mostly to the Australian tropics, particularly those threatened, increased. This demonstrates the conservation implications of information provision about bird species. The results showed that public education can play a crucial role in attempts to conserve bird species that are poorly known and threatened.