Lived experience of gay men caring for others with HIV/AIDS : living, loving and dying in the era of HIV/AIDS

This thesis explored gay male carers’ experience of caring for their partner, brother or friend who had HIV/AIDS. Through using phenomenological methodology (van Manen, 1990), the day-to-day caring experiences were uncovered. The data gathered were then analysed through a nursing ‘lens’, with the concept of stigma as an anchoring point. The dual stigmas of homophobia and AIDS phobia impacted on the daily lives of these men as they cared for their loved one. The research identified six themes. These were: 1) the relationship; 2) coping with HIV and AIDS; 3) the corporal impact of HIV/AIDS; 4) experiences of carers including the absence of others; 5) living daily with the virus: Demands of people living with HIV/AIDS (PLWHA); and 6) saying goodbye, but wanting to keep the memory alive. The caring these men undertook, for which they were frequently unprepared, was intensive and complex, but because of their commitment and love they battled on. Because of a sense of shame associated with AIDS phobia on the part of the PLWHA, the carer often had to undertake this care in isolation, without support from family, friends or home health care agencies. The carers struggled with not only the demands of day-to-day care, but also with non-acceptance from family, both of the nature of the relationship with their partner and of their homosexuality. Family members were forced, often with great difficulty, to acknowledge the close commitment the men had to each other. Recognition that one had a terminal disease, HIV/AIDS was also required. The fear of potential transmission was high among carers, friends and family members. Notably, there was an absence of blame on the part of the carer towards his partner for contracting HIV/AIDS. The physical decline and marking of the body further stigmatised the PLWHA, which added to carers’ burdens. They endeavoured to minimise the physical decline in their partner, so he could continue to pass as healthy, and attempted to make the day-to-day living as normal as possible. The methods of combating weight loss and opportunistic infections meant frequent medical appointments, complex intensive medical procedures and help with personal care, which was undertaken at home largely without support from health care staff. Carers frequently struggled also with their partner’s denial of being ill. One strategy all carers used was to escape with their partners from their everyday life in Melbourne and attempt metaphorically to leave the HIV/AIDS behind; this was a time when they could rekindle their life together as it was before HIV/AIDS came into their lives. Some carers chose to holiday without their partner, to give themselves a break from the day-to-day caring, while others planned and took holidays with their partner. The decline of the health in the PLWHA meant that family members had to recognise and accept both the nature of the relationship and the presence of the disease. This recognition and acceptance often came only when the partner was very ill, even at the point of dying. Carers and their partners discussed the potential use of euthanasia, as a means of ending the final phase of life with some dignity. One carer and his partner used euthanasia, despite its illegal status. The main concern for all carers was providing comfort and a reduction in the pain associated with HIV/AIDS for the partner. The widespread grief associated with HIV/AIDS was evident amongst these carers. All had known other gay men who had died, some carers own partner had died, or was about to die. There was an overwhelming sense of grief, which at times was repressed as a means of coping day-to-day. All carers felt it was important and necessary to remember those lost to HIV/AIDS through the various public memorials, as they did not want their partner to be just another faceless person lost to this disease. This phenomenological study of carers’ experience highlights the need for health care workers to be aware of the differing strategies that gay men use to cope with HIV/AIDS. While it may seem that the carers are coping with care of their partner, the outer façade is not always an accurate portrayal of the true situation. Health care workers should enquire as to the assistance these carers need from health care services in order to continue to care for their loved one. Such assistance can be the simple recognition of the partner and acceptance of them as part of the PLWHA’s network; this inclusion and acceptance is half the battle.

Crossing Bowen Street : mapping interventions in the classed subject

Synopsis: Crossing Bowen Street Crossing Bowen Street is an extended novel set in Melbourne, Australia. The protagonist, Meg Flanagan, is accepted to teachers' college. Meg is 24 years old and has worked, and lived out of home, since 17. Having completed her year 12 studies part time while working, she has applied to the Melbourne State College for a Bachelor of Education. Melbourne State College is subsequently 'amalgamated'A into Philip University, the original 19th century sandstone institution which borders MSC. Meg has worked as a medical secretary prior to commencing her studies. An only child, she is the first member of her family to go to university, indeed to finish high school. Tertiary study is exciting for Meg and the novel explores the psychic journey as well as the intellectual one, as Meg experiences challenges to the possibilities for her life and the trajectory along which she once assumed it would flow. The narrative is told through episodic and epistolary forms, with particular periods in Meg's cultural and academic life forming the focus, picking up the integral elements of her journey and examining the psychic context and action. Characters in the undergraduate chapters of the novel are somewhat transient, although very important to Meg's rapidly developing, changing sense of herself. The constant 'trying out' of ways of being and even lifestyles sees Meg losing old 'friendships' and making new, even temporary, ones all the time. This allows the opportunity for Meg to explore her feelings about connecting to others and the nature of her relationships. The Meg reflected back to her by others is of constant interest to her, particularly as she is frequently reminded that others see a very different Meg than she does. The novel commences at the outset of Meg's tertiary career, as she initially articulates the extent of her aspiration, of her sense of the possibility of her own life. Each vignette deals, chronologically, with an aspect of Meg's expanding sense of possibility, socially, emotionally, intellectually. Certain vignettes explore her relations with friends and acquaintances in the course, which in turn provide A In 1988, Federal Labor Minister for Education John Dawkins, devised a plan to end the streaming of Australian tertiary institutions and created what is called the Unified National System. This meant that colleges of advanced education and institutes of technology were either created universities in their own right, or more commonly, merged with an appropriate existing university. This process allows a fascinating insight into the class dimensions of hierarchies and stratifications. The need of universities and their members for status has been profoundly underscored. the background and context for her sexual relationships. That aspect of her developing subjectivity provides a marked contrast, which Meg uses as leverage, when set against her sense of herself as a scholar and her growing notion of entitlement, which allows her to 'choose', where previously she believed she had no choice; the choice is a scholarly career. Within all this, Meg discovers and is deeply empowered by certain political left, and feminist, discourses within the university community. She is equally dismayed and alienated by other feminist practices; her growing engagement with her own agency sees her quickly abandoning feminist subject positions previously dear to her, which served a particular purpose and are now superseded. This notion of feeling betrayed by the promise of a value system (or rather, its practitioners) will recur throughout the action of the novel, as Meg moves into an academic role, first as doctoral student and then as academic, seeking to live her values as practice and to remain true to what her trajectory has taught her. This is crystallised in the novel as the role played by the place she came from, and how that informs, and complicates, who she becomes. The novel seeks to explore the fundamental contradictions in doing so, through Meg's increasing awareness that the academy is not the harmonious, class aware institution she has idealised, but a world driven by status and hierarchies. This realisation must be reconciled in the light of Meg's anxieties about her working-class background. Meg's doctoral training at an elite university underscores her developing sense of what constitutes excellence and the role played by highly influential conservative institutions in maintaining social arrangements. As her academic career unfolds, the holding of a Cambridge PhD allows Meg opportunities to make change as certain privileges are afforded her by virtue of her Cambridge status. Yet it is this very notion that she seeks to challenge. Her growing passion for the State University of Victoria, an institution developed for the education of working-class people, informs her activism within the academy. Why are excellence and equity polarised? Why does the institution matter more than the scholarship? Why is so much practice within universities contrary to the values scholars often claim? These questions are explored through the dynamics of academic working life as student and later as a teacher at a university with an explicit equity agenda. The Start of the End (2003): The action commences on a late Friday after at SUV, when the Department of Communication & Cultural Studies has just been advised of Meg's promotion to Associate Professor. This vignette sees the initial soiree and celebrations and allows Meg to reflect on her experience. As her colleagues and friends are congratulating her, a particular student comes looking for Meg. It is clear that Angela Watson needs course advice particularly from Meg. Their discussion seems a straightforward one on the face of it, but it underscores many things; that Meg has come the full circle in her academic life, and what it is that her journey has really been about. The route to professorial appointment is considered, as is the source of Meg's greatest professional joy and fulfillment; is it scholarship, followed by leadership, in her discipline? It is knowing she has continued to speak and act to change the life chances of all students, wherever possible? Or is it the subtle distilling of both of these, along with the knowledge which emerges from the nexus of teaching and research. That scholarship, new knowledge, surely must be taking us somewhere specific in relation to others? The more we know, the more we can do...to what end? From this reflection, we see the action of the novel unfold. We return to this scene at the end of the novel, as Meg considers the trajectory of her life and its themes in her work. The novel ends as she is faced with the next challenge. Arrival (1989): Acceptance sees Meg as she is attempting to transform her life and create a new one. She has just been advised of her admission to an undergraduate Bachelor of Education program, at the major Melbourne teachers' college. Meg shares her rented home with her high school best friend, Anna, and her fiance, Jason, who appears to be superfluous in her life. Meg is aware he is a partner for who she used to be. We see Meg in her job as a medical secretary and this allows the mapping of Meg's sense of her own world, as she travels between home and work. This first stage of seeking her aspiration- to be an English teacher-evolves. As Meg considers the meaning of what she is about to do and how she knows it is right. This involves a consideration of what work means in our lives and how this is different for jobs according to how they are classed. Her relationship with the life she has known, the person she has been, is changing and this change is represented through her relationship with Jason. Meg's first day at teachers' college demonstrates that she is in a constant, often painful, dialogue with herself. The difficulties she encounters in making sense of the relation between her two 'lives' are thrown into sharp relief. The preparation for college sees Meg interrogating herself about how she can be different. Her initial experiences at the College resonate with her highest expectations of the life that awaits her, of the multiple possibilities currently being authored for her. Her first attendance at classes offers the opportunity to try out some of those possibilities, to test them against those she meets and to map the ways she could discover to 'be'. There is much tension and fear, but also endless excitement and these conflicting emotional states parallel and marble each other. It is on this day that she meets Jennifer Wren, her first real friend at university, who offers so many challenges to Meg. Their friendship involves a constant exhausting shift of subject positions, which Meg is able to look back on with affection in years to come. Going Bowling (1989): within a few weeks of commencing at university, Meg is socializing with some of her new friends, having neatly segmented her home and college lives. Meg has already realised that her friendships fall into separate groups; her friendship with Jennifer and the people Jennifer knows does not find its way into this group. They meet in the city to go bowling and have a meal. While Meg really enjoys these new people, already tensions are developing in relations between the group. Their unofficial leader, Rosemary Marshall, has a tendency to seek control and already resistance is showing. Rosemary particularly does not like Jennifer. Meg is enjoying her flirtation with Pete Danville, whom she has assumed to be gay. His very flattering attention has already developed Meg's confidence and stoked her ego, which has eroded in her stagnating relationship with Jason. Rosie has developed a crush on Pete and seems to take the flirtation with Meg personally. Dynamics in the group become slightly uncomfortable but Meg has grown quickly fond of her new friends, especially flamboyant Marina, another whom Rosemary seems to dislike. The discussions which occur during their evening deepen both the relationships and the tensions between them and draw lines which will determine the outcome of their various friendships. The Ball (1990): In the third year of her degree, much has happened to Meg. She is married to Jason, although she omits him from much of her psychic (and practical) life. Meg and her friends attend the Faculty's annual formal dinner dance. Meg has so far managed to balance the competitiveness which occurs between all of them, both academically and personally. The negotiation of her respective friendships with Jennifer and Marina requires a great deal of diplomacy; the subtext in this is very disturbing to Meg. What exactly is the conflict about? She can't be sure why they don't like each other; it could be Marina's smoking, or Jennifer's confidence to spare, but these things also annoy her, yet she does not fight with either girl as they do with each other. Rose has always insisted that the problem is Jennifer's private school background, but Marina went to a catholic girls' school, so what could the difference be? The ball is initially a happy occasion; the girls dress up and they dance and drink champagne together with the boys. But dynamics operating beneath the surface force their way up. Rosie is ready to force Pete to confront her continuing crush on him; Pete confronts Meg about their ongoing flirtation. Meg gives in and admits to herself for the first time that she does want to be with Pete. He is grown up and exciting and strong. He offers her something she has never had with Jason. Married less than a year, she pushes her husband out of her thoughts. The events of the ball force Meg to confront the differences between all her friends and the discomfort this affords everyone. Rosie's continued need for control over the group is acknowledged. Future Present (1991): Meg lives in Carlton with Pete. This is the busiest year thus far in her academic career and the financial, academic and emotional pressure is showing. This vignette gives us the range of Meg's academic activities and the way her life has fallen since the events at the ball eight months earlier. We see Meg grappling with her own evaluation of the changes in her 'way of being'; trying on different ways of living that she has idealised and finding them just as wanting as the last. Meg faces some key existential questions in this vignette and seeks answers which she finally discovers only she can give. Her relationship with Pete, the values and goals they share (and don't share) are thrown into sharp relief and provide a touchstone for the clearer determination of Meg's aspiration and future. Her relationship with various female friends is also revisited and this offers insight into Meg's constant checking of herself against idealised female templates. There is a crisis of identity and strength which constitutes an important fork in Meg's road. Beyond (1992): Beyond sees Meg determinedly seeking ways she can progress towards her goal, while still constantly checking against herself that postgraduate study (let alone a scholarly life) is available to her. We accompany Meg as she seeks and locates the academic path she wants; this is the backdrop for her further psychic exploration of the women who intimidate yet fascinate her, particularly Heloise Waul, who is a significant influence through Meg's postgraduate career. The sites in which Meg's personal struggles manifest are highlighted in this vignette, particularly in terms of dress and cultural pursuit. The conversations between Meg and Heloise also allow an exploration of the feminist politics of that milieu and the class tensions which operate tacitly within those politics. Bound to the Caucus (1992); Meg has now nearly completed her undergraduate degree and has been active for some time in university life and student politics. Her feminist and socialist education is well advanced. Bound to the Caucus shows us Meg in her student politics world for the first time, where the segue of her activism and academic life have taken her. Meg has found female friends who understand that part of her which struggles with inadequacy, although at this point in the novel this common struggle is not well understood or articulated. It is in this vignette that Meg admits her growing attraction for a Liberal student activist, Stuart Noble; this proscribed liaison raises many questions about values and aspiration, as well as the dominant sexual politics of the time and place. Bound to the Caucus also offers insight into the student activism occurring at universities like Philip in the early 1990s. Divergence (1993): Set in 1993, Meg is now in the early weeks of her honours program, although she has been at work on her thesis on the poet William Blake for some months. Living unhappily in a share household near the University, her relationship with Stuart Noble continues to develop, reaching a crisis point in this period. These events occur in the context of Meg's activist career in the Student Left, particularly as she encounters issues of identity around her class, feminism and difference amongst Left women. While Meg fights these battles passionately in an intense milieu, she considers them emotionally in terms of her changing sense of herself. Meg is increasingly aware that the personal impact of her class is changing for her. Additionally, she explores her relation with a 'boyfriend' of right wing political affiliation; Meg comes to recognise that this relationship is undermining her sense of herself in a way that her relationships with women in the left previously did. Honour Roll (1993): Meg is now undertaking honours and this vignette opens with Meg seeing the honours coordinator, Professor Michaela Moore, who approximates all those apparently middle-class traits to which Meg has such a push-pull relation. We see the return of a chapter of the honours thesis, discussion of the content and the constantly shifting subject positions these experiences offer Meg. This vignette also directly introduces Agnes. Mia and Agnes meet Meg after her supervision and this conversation allows very distinct if tacit class themes to develop. Meg has warmed quickly to Agnes, who is unlike anyone she has known; they have much in common in relation to their work and this binds them. Mia continually presents a viewpoint which irritates Meg, in relation to entitlement: to academic life, to funding, even to questioning how these things are enabled. Honour Roll allows us to see Meg's flourishing theoretical and intellectual life and its role in assisting her emotionally as she re-frames the same conundrums that previously constituted obstacles. The Cusp (1993): Meg's developing friendship with Agnes offers her enormous insights into difference and her developing sense of self and aspiration. While the girls come from diametrical backgrounds, they are united by their passion for their research and scholarly work. Meg is increasingly self-conscious through their discussions in terms of how she has seen herself and allowed herself to dream and seek. Cusp is set at the end of the honours year, prior to the release of results. Meg and Agnes explore their feelings about academia and this leads to discussions of purpose and the role of class within that. This vignette also documents Meg's growing social confidence and those aspects of herself which have become so sure to her, that she no longer considers them at all. Whom (1996): [Not included in this abridged edition]. Set at Cambridge, two thirds into Meg's doctorate, Whom shows Meg in the mental space which will take her back to Melbourne and the State University of Victoria. Having risen to the challenge of doctoral study, she is confronted now by deeper demons, and the need to explore and challenge them in the ambivalent context of Cambridge, which so excites her still, but which has proved empty of the profoundly held higher ideals she expected to see reflected. Set in the midst of Meg's doctoral study, this vignette is dramatically abridged in the submission novel. The importance of Whom lies in its concern with Meg's rapidly shifting sense of herself and her own scholarly subjectivity and the changes to these that the culture of Cambridge has wrought. By the second year of her PhD Meg is crystal clear about her goals and decides to spend the long break at home, rather than travelling, because she wishes to 'touch base' with her future. The action described segues into that in Courting the Enemy. Whom describes Meg's ambivalent and contradictory but passionate feelings about Cambridge. Whom demonstrates Meg's increasing anger at the status and privilege to which her education now automatically admits her, and her need to find some sort of stasis and safety in her emotional life. In this vignette, Meg meets her life partner, Jeremy McCallum (I have intentionally reduced the attention in the novel to Meg's romantic life as she matures into her career). Courting the Enemy (late 1990s): By this time, Meg is a senior lecturer in English at the State University of Victoria, which was established in the nineteenth century as the Worker's College. This vignette starts with Meg's attendance at a University Committee which is considering a transformation in relation to equity in admissions policy. Meg was drawn to SUV because of its transparent and determined commitment to educate the children of working-class people. An attack on the equity admission policy of her university galvanizes Meg and some of her colleagues. The action of the vignette considers the role of the scholar, and of such an institution as SUV, in the light of daily academic life. This vignette is primary in its demonstration of the themes of the novel. In the unabridged version, I took the opportunity to illustrate some of the vast range of administrative, intellectual and even physical demands on a senior scholar in the routine of academic life. In placing Meg in this context, I sought to highlight how a scholar of her values and commitment makes sense of the constantly shifting terrain of her working world and how this continually informs her practice. This vignette is also significant for its retrospective description of Meg's employment at SUV some years earlier. Locus: (1995). This piece of writing stands apart from the rest of the novel. I wished to write in a reflective voice, which might be from Meg's journal, were it not in the (omniscient) third person, in order to consider the headspace and meaning-making which occurs as Meg settles into Cambridge, and the lifestyle her situation allows her. Locus is a deeper engagement with Meg's sense of her identity. It considers the impact on her of the physical journeys she must make to match those of her psyche. These are thoughts too personal for a letter, even to Anna. Meg is exploring her ever shifting self and the growth in her self-belief allows her to explore what is rage; that she was bounded by illusions about her worth. Locus seeks to allow some context for Meg's anger at the role Cambridge plays. I seek to create the space in which Meg's dawning self understanding will lead her to her next, driven, purpose. Letters: throughout the novel letters are used to reveal and inform Meg's relationship with her family. This is an intentional device to distance the birth family in an attempt to blur and muddy an assessment of Meg's class through traditional measures. The letters between Meg and Aunty Jean particularly reveal much of the classed emotional antecedents of Meg's life. There are also letters exchanged with Meg's high school best friend, Anna, who has moved to the country and a very different lifestyle. Meg writes to Anna often, using the acceptance she feels in the friendship and her sense that Anna understands her, to touchstone her own emotional growth. Formal letters from institutions ring changes in settings and mark significant points in the geographical and academic trajectory of the character. All the letters serve to introduce time and event changes consistent with the episodic style of the narrative.

Towering over all : the Italianate villa in the colonial landscape

The Picturesque aesthetic emerged in the later 18th century, uniting the Sublime and the Beautiful and had its roots in the paintings of Claude Lorrain. In Britain, and in Australia, it came to link art, literature and landscape with architecture. The Picturesque aesthetic informed much of colonial culture which was achieved, in part, through the production and dissemination of architectural pattern books catering for the aspirations of the rising middle classes. This was against a background of political change including democratic reform. The Italianate villa, codified and promoted in such pattern books, was a particularly successful synthesis of style, form and function. The first Italianate villa in England, Cronkhill (1803) by John Nash contains all the ingredients which were essential to the model and had a deeper meaning. Deepdene (from 1807) by Thomas Hope gave the model further impetus. The works of Charles Barry and others in a second generation confirmed the model's acceptability. In Britain, its public status peaked with Osborne House (from 1845), Queen Victoria's Italianate villa on the Isle of Wight, Robert Kerr used a vignette of Osborne House on the title page of his sophisticated and influential pattern book, The Gentleman's House (1864,1871). It was one of many books, including those of J.C, Loudon and AJ. Downing, current in colonial Victoria. The latter authors and horticulturists were themselves villa dwellers with libraries and orchards, two criteria for the true villa lifestyle. Situation and a sense of retreat were the two further criteria for the villa lifestyle. As the new colony of Victoria blossomed between 1851 and 1891, the Italianate villa, its garden setting and its landscape siting captured the tenor of the times. Melbourne, the capital was a rich manufacturing metropolis with a productive hinterland and international markets. The people enjoyed a prosperity and lifestyle which they wished to display. Those who had a position in society were keen to demonstrate and protect it. Those with aspirations attempted to provide the evidence necessary for such acceptance, The model matured and became ubiquitous. Its evolution can be traced through a series of increasingly complicated rural and suburban examples, a process which modernist historians have dismissed as a decadent decline. These villas, in fact, demonstrate an increasingly sophisticated retreat by merchants from ‘the Town’ and by graziers from ‘the Country’. In both town and country, the towers of villas mark territory newly acquired. The same claim was often made in humbler situations. Government House, Melbourne (from 1871), a splendid Italianate villa and arguably finer than Osborne House, was set in a cultivated landscape and towered above all It incorporated the four criteria and, in addition, claimed its domain, focused authority and established the colony's social status. It symbolised ancient notions of democracy and idealism but with a modem appreciation for the informal and domestic. Government House in Melbourne is the epitome of the Italianate villa in the colonial landscape and is the climax of the Picturesque aesthetic in Victoria.

Critique of "cultural fit" in relation to the recruitment of Indian information technologists for the Y2K project in Australia

In this study of intercultural communication, I investigate the multi-faceted meaning of the expression " cultural fit " in the sense that it is used by recruiters when shortlisting Indian information technologists to fill skills shortages for the Y2K project in Australia. The data is in the form of ten videotaped interviews in Bangalore and the recruiter commentary on those tapes in Melbourne. A crucial decision to be made by recruiters in any shortlisting process is " How will the candidate fit into the workplace?" This question becomes more problematical when applied to overseas-trained professionals. I take a critical approach, drawing principally on the research traditions of linguistics where studies of intercultural communication and workplace interaction intersect, employing chiefly the tools of Critical Discourse Analysis and Interactional Sociolinguistics and the more abstract notions of Bourdieu. A bridge between these different discourse approaches is provided by Sarangi & Roberts < 1999 < who show the connection between the larger institutional order and interactional routines, through an elaboration of frontstage talk and backstage talk following Goffman < 1959 < . An analysis of the interviews < frontstage talk < reveals "cultural fit" to involve a knowledge of institutional talk, in particular, directness. The recruiter commentary < backstage talk < draws attention to issues of intelligibility, body language, technical expertise and workplace values. the study shows that Indian Information Technologists have "partial fit" in that they possess technical fit but do not demonstrate, or lack the opportunity to demonstrate in the interview, Australian workplace values such as small talk, humour and informality. The recruiter judgments were fleeting and apart from checking for intelligibility, were made on the basis of candidates' body language thus highlighting its importance and its relative absence from the discourse approaches mentioned above. This study shows clearly that there is room for more communicative flexibility on the part of all the stakeholders.

Considerations for appraisers in regard to dummy auction bids

Focuses on the auction process and the practice of dummy bids in Melbourne, Victoria. Techniques employed by a dummy bidder during the auction process for a residential real estate; Effect of dummy bidding on market value; Suggested amendments to the auction process.

Bridging the divide: a survey of nurses' opinions regarding barriers to, and facilitators of, research utilization in the practice setting

Background. Many researchers have explored the barriers to research uptake in order to overcome them and identify strategies to facilitate research utilization. However, the research–practice gap remains a persistent issue for the nursing profession.

Aims and objectives. The aim of this study was to gain an understanding of perceived influences on nurses' utilization of research, and explore what differences or commonalities exist between the findings of this research and those of studies that have been conducted in various countries during the past 10 years.

Design. Nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization. The instrument comprised a 29-item validated questionnaire, titled Barriers to Research Utilisation Scale (BARRIERS Scale), an eight-item scale of facilitators, provision for respondents to record additional barriers and/or facilitators and a series of demographic questions.

Method. The questionnaire was administered in 2001 to all nurses (n = 761) working at a major teaching hospital in Melbourne, Australia. A 45% response rate was achieved.

Results. Greatest barriers to research utilization reported included time constraints, lack of awareness of available research literature, insufficient authority to change practice, inadequate skills in critical appraisal and lack of support for implementation of research findings. Greatest facilitators to research utilization reported included availability of more time to review and implement research findings, availability of more relevant research and colleague support.

Conclusion. One of the most striking features of the findings of the present study is that perceptions of Australian nurses are remarkably consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade.

Relevance to clinical practice. If the use of research evidence in practice results in better outcomes for our patients, this behoves us, as a profession, to address issues surrounding support for implementation of research findings, authority to change practice, time constraints and ability to critically appraise research with conviction and a sense of urgency.

Genetic and environmental influences on variation in balance performance among female twin pairs aged 21-82 years

Genetic and environmental influences on variation in balance performance were measured in 93 monozygous and 83 dizygous female twin pairs aged 21–82 years (mean age, 50.5 years) in Melbourne, Australia, between 1999 and 2003. The authors administered clinical (Lord's Balance Test and Step Test) and laboratory tests of static and dynamic balance from the Chattecx Balance System with and without distractor tasks. The authors conducted factor analysis and estimated genetic and environmental variance components and heritability (defined as additive genetic variance as a proportion of all variance, after adjustment for age) using a multivariate normal model with the statistical package FISHER. Three factors were identified and adjusted for age. Heritability was 46% (standard error (SE), 9) for the "sensory balance tests" factor and 30% (SE, 9) for the "static and dynamic perturbations" factor. For both factors, the remaining variance was attributed to unique environmental effects. There was no evidence that genetic factors influenced variation in the "dynamic weight shift tests" factor, with environmental effects shared by twins accounting for 38% (SE, 7) of variance. Neither genetic nor environmental proportions of variance differed significantly between twin subgroups by age (≤50/>50 years). An age-related decline in performance measures was found across the whole sample. These results imply that balance impairments may have a heritable element.

The future of football is female : a case of fan-tastic imaginings?

Consistent with FIFA president Sepp Blatter’s proclamation that the future of football is female, the Australian Football League (AFL) has instituted a range of initiatives in an attempt to present a ‘female friendly’ face and garner women’s support for the national game. Given the large number of women who follow the AFL, especially in comparison to other football codes nationally, it’s worth considering the motivations behind the AFL’s tactics. To what extent does what the AFL think women want correlate with women supporters’ experiences and realities of being a football fan? This paper presents findings from semi-structured and focus group interviews with female AFL fans to gauge their perceptions of being an Australian rules football supporter and its impact on their lived experiences and sense of self. The responses of women supporters are critically assessed in order to contemplate how women negotiate gender identity through their support of a male dominated sport. As well as offering insights into the role gender plays in leisure pursuits such as sport spectatorship, this paper considers how femininity and masculinity might be contested and/or remade through the practice of following football in the Australian context. By demonstrating the range and diversity of women’s experiences, this research has the capacity to generate alternative imaginings of fanship and sporting community beyond gender stereotypes.

Dora Lynnell Wilson (1883-1946) : a life in art

This thesis fills out Wilson's previously unresearched biography and argues for a reassessment of her standing as an important inter-war artist in Melbourne. The role of cultural gatekeepers in building and deconstructing artistic reputation is discussed, with examples of Wilson's art and an inaugural Catalogue of her known works.

The idiosyncratic movement potential of the dancer's subject body in the work "Deep map"

An investigation into choreographic processes employed within contemporary modern dance. This involved the exploration of working methods used in the making of "Deep map" nos.1, 2 & 3, presented in Melbourne from 1997-2000. The focus of that method was the placement of the dancer as 'subject' whilst maintaining the role of the choreographer as 'auteur'.

Homophobic bullying and human rights : non-deficit approaches in queer youth wellbeing policy and practice

This chapter is concerned with ways for improving the capacity of school communities to provide queer young people with stimulating educational experiences that productively engage with the realities of their lives and which promote and enhance their wellbeing. By "queer" or "LBGTI" I mean to refer to all of those young people who do not conform to prevailing expectations regarding gender and sexual identity and behaviours, those young people who may be lesbian,gay, bisexual, transgender or intersexual (lGBTI), as well as all of those young people who have an association with gender and sexual diversity (for example, the straight fey boy who gets called a poofta; the teenage girl with lesbian parents, etc.). Methodologically, this chapter draws on a tradition of Foucauldian cultural analysis which acknowledges that gender and sexual identities are not stable or fixed, but that they are generated by influential discourses (e.g. my identity as a "man" in Melbourne today is mediated by contemporary discourses of masculinity, of Australianness, of class and so on) (for example, see Foucault 1984, 1990, 1992 and 1998).

This chapter argues that conventional approaches to school improvement for queer students normally focus on strategies for reducing the victimisation of teenage homosexuals, and that such strategies rely on dominant discourses of safety and bullying. I examine a recent example of this policy approach and use it as a starting point for considering the benefits and the constraints of a victim-based approach to queer youth wellbeing policy. The chapter then moves into a discussion about the recent introduction of human rights legislation in Victoria and how this can assist a move in policy and practice towards a more positive and diffuse engagement with gender and sexual diversity.

Knowing in, through and about : the PhD journey

This study involves an account of the factors leading to the development and evolution of three public art spaces concerned with contemporary art in the 1980s in Melbourne. The three spaces – Heide Park and Art Gallery, 200 Gertrude Street, and the Australian Centre for Contemporary Art developed programs that promoted and presented contemporary art throughout the eighties. Prior to the 1980s the National Gallery of Victoria was the major public institution concerned with the promotion and presentation of contemporary art in Melbourne.

The study describes and analyses events leading to the establishment of each new space and investigates the formations and groups who played leading roles. A case study approach has been used which explores the networks and groupings that developed in setting up and maintaining each space. Theoretical perspectives drawn from Bourdieu, Williams and Wolff are employed in order to explore the social and cultural meanings of the networks and groups responsible for developing the three art spaces. These perspectives are used to help account for the motives and ideology employed by individuals and groups, such as artists, academics and politicians.

Each of the three spaces mainly developed from different clusters and groups, although some individuals had involvement in more than one of the spaces. The study concludes with a cultural analysis that identifies several key factors, such as forms of patronage, government policy direction and the power and influence of various sectors and formations. Government funding for art is a complex area of activity that draws upon a wide constituency of individuals and agents that include artists, wealthy business people, collectors, and so on. The study reveals much about government intervention and cultural and social formations promoting art in Melbourne during the 1980s.

Using simulated patients to develop doctors' skills in facilitating bahaviour change : addressing childhood obesity

Objectives : This study aimed to describe the application, feasibility and outcomes of using simulated patients (SPs) to increase the skills of general practitioners (GPs) delivering a behavioural intervention to reduce childhood overweight and mild obesity.

Methods : Five female actors were trained as SPs. A total of 67 GPs from 46 general practices in Melbourne, Victoria, Australia, conducted two simulated consultation visits regarding healthy lifestyle family behaviour change, during which they practised their skills and received formative feedback. The GPs and SPs rated GP performance immediately after each consultation. Subsequently, 139 parents of overweight or obese 5–9-year-old children rated GP performance during real-life consultations. Other measures included child body mass index (BMI) Z-scores (at baseline and at a 9-month follow-up) and GP-reported levels of comfort and competence and the perceived value of SP visits.

Results : Simulated patient ratings, but not GP self-ratings, of GP performance predicted both parent ratings of real-life consultations (Spearman's rho 0.39 for correlation with SP rating at Visit 1) and subsequent reductions in BMI Z-scores between baseline and follow-up (Visit 1, rho &minus; 0.45; Visit 2, rho &minus; 0.46). GP levels of comfort and competence were maintained during and after the SP visits. A total of 95% of GPs rated simulated consultations as useful, although only 18% said they would pay for them.

Conclusions : Simulated patient assessment may predict real patient feedback and clinical outcomes, helping to identify doctors who require further training in behaviour change techniques. Randomised controlled trials may establish whether SPs actually raise skills or improve outcomes.

Are safety-related features of the road environment associated with smaller declines in physical activity among youth?

This study examined how objective measures of the local road environment related to safety were associated with change in physical activity (including active transport) among youth. Few longitudinal studies have examined the impact of the road environment on physical activity among children/adolescents in their neighborhoods. Participants were children aged 8–9 years (n=170) and adolescents aged 13–15 years (n=276) in 2004. Data were collected in 2004 and 2006 during followup of participants recruited initially in 2001 from 19 primary schools in Melbourne, Australia. Walking/cycling to local destinations was parent-reported for children and self-reported by adolescents. Moderate-to-vigorous physical activity (MVPA) during nonschool hours was recorded using accelerometers. Road environment features in each participant’s neighborhood (area within 800 m radius of their home) were measured objectively using a Geographical Information System. Linear regression analyses examined associations between road features and changes in active transport (AT) and MVPA over 2 years. Children’s AT increased but MVPA levels decreased in both age groups; on average, younger girls recorded the greatest declines. The number of traffic/pedestrian lights was associated with ΔAT among younger girls (B=0.45, p=0.004). The total length of walking tracks (in meters) was associated with ΔAT among younger girls (B=0.0016, p=0.015) and adolescent girls (B=0.0016, p=0.002). For adolescent boys, intersection density was associated with ΔAT (B=0.03, p=0.030). Slow points were associated with ΔMVPA among younger boys before school (B=1.55, p=0.021), while speed humps were associated with ΔMVPA among adolescent boys after school (B=0.23, p=0.015). There were many associations for adolescent girls: for example, the total length of local roads (B=0.49, p=0.005), intersection density (B=0.05, p=0.036), and number of speed humps (B=0.33, p=0.020) were associated with ΔMVPA during nonschool hours. Safety-related aspects of the built environment are conducive to physical activity among youth and may help stem age-related declines in physical activity. Passive road safety interventions may promote AT and physical activity among less active girls, in particular.

Role of emergency departments in screening for obese and overweight children

Introduction
Childhood obesity is a major and increasing public health issue. The role of Emergency Departments (EDs) in screening for overweight and obese children has not been studied extensively. The main aim of this study was to estimate the prevalence of overweight children in Emergency Department (ED) populations. A secondary objective was to compare the characteristics of overweight and obese children with healthy weight children.

Methods
This prospective exploratory study was conducted in the two district urban EDs in Melbourne, Australia. A total of 87 ED patients aged 2 to 15 years were included in the study. The main outcome measures were body mass index, weight and height percentiles.

Results
The median absolute BMI was 16.8 (IQR = 15.4 to 18.8). The total number of children found to be overweight (BMI > 85th percentile) or obese (BMI > 95th percentile) was 21.8% (n = 19). Of these, 5.7% (n = 5) of children in this study were classified as obese. Comparison of overweight/obese children and healthy weight children showed no differences in triage but a higher incidence of respiratory illness (15.8% compared to 2.9%).

Conclusions
This pilot study showed that 1 in 5 children who presented to EDs were either overweight or obese suggesting a possible role for EDs in the detection and referral of overweight and obese children to intervention programs. Our findings suggest that a sufficiently powered randomised controlled trial is warranted to examine the effectiveness and efficacy of EDs screening for obese and overweight children.