Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

(Dis)located Olympic Patriots: Sporting Connections, Administrative Communications and Imperial Ether in Interwar New Zealand

During the interwar period (1919–1939), protagonists of the early New Zealand Olympic Committee (NZOC) worked to renegotiate and improve the country's international sporting participation and involvement in the International Olympic Committee. To this end, NZOC effectively used its locally based administrators and well-placed expatriates in Britain to variously assert the organization's nascent autonomy, independence and political power, progress Antipodean athlete's causes and counter any potential doubt about the nation's peripheral position in imperial sporting dialogues. Adding to the corpus of scholarship on New Zealand's ties and tribulations with imperial Britain, both in and beyond sport (e.g. Beilharz and Cox, 2007, “Settler Capitalism Revisited,” Thesis Eleven 88: 112–124; Belich, 2001, Paradise Reforged: A History of the New Zealanders from the 1880s to the Year 2000, Auckland: Allen Lane; Belich, 2007, Making Peoples: A History of the New Zealanders from Polynesian Settlement to the End of the Nineteenth Century, Auckland: The Penguin Group; Coombes, 2006, Rethinking Settler Colonialism: History and Memory in Australia, Canada, Aotearoa New Zealand and South Africa, Manchester: Manchester University Press; MacLean, 2010, “New Zealand (Aotearoa),” In Routledge Companion to Sports History, edited by Steve W. Pope and John Nauright, 510–525, London: Routledge; Phillips, 1984, “Rugby, War and the Mythology of the New Zealand Male,” The New Zealand Journal of History 18 (1): 83–103; Phillips, 1987, A Man's Country: The Image of the Pakeha Male, Auckland: Penguin Books; Ryan, 2004, The Making of New Zealand Cricket, 1832–1914, London: Frank Cass; Ryan, 2005, Tackling Rugby Myths: Rugby and New Zealand Society 1854–2004, Dunedin: University of Otago Press; Ryan, 2007, “Sport in 19th-Century Aotearoa/New Zealand: Opportunities and Constraints,” In Sport in Aotearoa/New Zealand Society, edited by Chris Collins and Steve Jackson, 96–111, Auckland: Thomson), I will examine how the political actions and strategic location of three key NZOC agents (specifically, administrator Harry Amos and expatriates Arthur Porritt and Jack Lovelock) worked in their own particular ways to assert the position of the organization within the global Olympic fraternity. I argue that the efforts of Amos, Porritt and Lovelock also concomitantly served to remind Commonwealth sporting colleagues (namely Britain and Australia) that New Zealand could not be characterized as, or relegated to being, a distal, subdued or subservient colonial sporting partner. Subsequently, I contend that NZOC's development during the interwar period, and particularly the utility of expatriate agents, can be contextualized against historiographical shifts that encourage us to rethink, reimagine and rework narratives of empire, colonization, national identity, commonwealth and belonging.