Best practice in a resource vacuum : responding to the accommodation needs of people with high, complex or changing support needs

This paper aims to identify current practice responses to the housing and support needs of people with high, complex or changing support needs. Case studies of current housing dilemmas and responses were provided by Annecto and Scope (Vic), and included data about the responses of other providers known to these agencies. The paper will first present case study data in three categories of accommodation: living independently (ie. living alone in self-rented or self-owned housing with or without formal support); living without a home (ie. living in non permanent or non secure housing); and living in the parental home and planning for change. The case studies are followed by a discussion of the key response strategies evident in each, and an analysis of significant ‘lessons’ for policy.

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.

Can education add value to values? A study of law students

In the global market place the value of education takes on many meanings. In transnational education forums it relates to the market’s assessment (in dollar terms) of a qualification. But can we measure the value-addedness of tertiary education in existential terms? Can we measure the value that tertiary education provides to the enhancement of societies as a whole?

This study attempts to investigate what values are characteristic of Australian lawyers in their last year of law school. It is part of a larger longitudinal study, which aims to determine how values develop or degrade over time and what effect, if any, tertiary education can have in building and perpetuating ‘appropriate’ professional values? Results show that differing values sets do significantly predict behavioural choices on ethical questions presented to participants. The implications of results are discussed in the contexts of ethics education in a tertiary context, and applications for the professions.

Microbial-based therapy of cancer: a new twist to age old practice

The use of bacteria in the regression of tumors has long been known. Various approaches for using bacteria in cancer therapy include the use of bacteria as sensitizing agents for chemotherapy, as delivery agents for cancer drugs and as agents for gene therapy. The tumor regression stimulated by infecting microorganisms has been attributed to activation of the immune system of the host. However, recent studies indicate that when tumor-harboring mice with defective immune systems are infected with certain microorganisms, the regression of the tumor is still observed, suggesting that there are other host factors contributing to the microbial associated regression of tumors. Since the use of live or attenuated bacteria for tumor regression has associated toxic effects, studies are in progress to identify a pure microbial metabolite or any component of the microbial cell that might have anti-cancer activity. It has now been demonstrated that a redox protein from Pseudomonas aeruginosa, a cupredoxin, can enter into human cancer cells and trigger the apoptotic cell death. In vivo, this cupredoxin can lead to the regression of tumor growth in immunodeficient mice harboring xenografted melanomas and breast cancer tumors without inducing significant toxic effects, suggesting that it has potential anti-cancer activity. This bacterial protein interacts with p53 and modulates mammalian cellular activity. Hence, it could potentially be used as an anti-cancer agent for solid tumors and has translational value in tumor-targeted or in combinational-biochemotherapy strategies for cancer treatments. Here, we focus on diverse approaches to cancer biotherapy, including bacteriolytic and bacterially-derived anti-cancer agents with an emphasis on their mechanism of action and therapeutic potential.

Bargaining in the shadow of the Law - using utility functions to support legal negotiation

Most dispute resolution is settled by negotiation rather than litigation. However, such bargaining often occurs in the shadow of the law. To help support interest-based negotiation, we explore the use of utility functions to support negotiation analysis. We discuss in detail a utility function we have developed in the area of family-law mediation. This function is currently being used as the basis of an online dispute resolution system.

Discourses of regeneration in early twentieth-century Britain : from Bedlam to the Imperial War Museum

This paper examines the building that presently houses the Imperial War Museum, investigating the transformation of the archetypal ‘mad space’ of the Bethlem Royal Hospital into what has been described as the ‘biggest boy’s bedroom in London’. Following recent concerns in human geography with Imperial cities, it highlights the differing ways in which this transformation embodies a number of themes of degeneration and regeneration in early twentieth-century Britain.

The delivery of a telephone coaching programme to people with type 2 diabetes by practice nurses in Victoria, Australia : a qualitative evaluation

Aim.  To evaluate telephone coaching undertaken by practice nurses in a randomised controlled trial of self-management support for people with type 2 diabetes.

Background.  Qualitative evaluation of the processes that take place in randomised controlled trials has the advantage of providing information on those variables that contribute to the success or failure of the randomised controlled trial. This additional information can be used to improve or modify chronic disease management programme designs.

Methods.  Grounded theory was used to analyse transcriptions of telephone coaching sessions between practice nurses and patient participants in the randomised controlled trial.

Findings.   Analysis of transcriptions found that patient participants had complex multiple medical conditions to manage, as well as maintaining their daily lives. Two approaches to working with this complexity by practice nurses emerged. We characterised one as ‘treat to target’ and the other as ‘personalised care’. While each approach shapes identities available to patients within the relationship with the practice nurse, the impact or effectiveness of these approaches on outcomes has yet to be reported.

Conclusions.  Telephone coaching takes place in complex social contexts as well as complex medical conditions. People with type 2 diabetes must manage their diabetes care and their care of other conditions within their social contexts. This means a constant negotiation of priorities.

Relevance to clinical practice.  Awareness of how health professional support for patients’ self-management becomes a relationship and element of the negotiated identity of patients is important in adapting clinical guideline-based protocols to achieving targets in the management of chronic illness.

Ignorance of the law as a defence to rape : the destruction of a maxim

In DPP v Morgan, the House of Lords correctly concluded that an accused who entertained a genuine belief that a woman was consenting to carnal knowledge of her person could not be convicted of the common law crime of rape as such a belief and the requisite mens rea to convict were mutually exclusive of one another. Though England and Wales have resiled from this position by virtue of the Sexual Offences Act 2003, s. 1 (b), which allows for conviction upon proof that the accused did not reasonably believe that the complainant was consenting, the Morgan principle has retained its vitality at common law as well as under the various statutory crimes of rape that exist throughout Australia, most notably the provisions of s. 38 of the Crimes Act 1958 (Vic). Despite a long line of Victorian Court of Appeal decisions which have reaffirmed the Morgan principle, the court has construed s. 37AA(b)(ii) of the Act as leaving open the possibility of an acquittal despite the fact that the accused acted with an awareness that one or more factors that are statutorily deemed as negating consent under s. 36(a)-(g) of the Act were operating at the time of his or her sexual penetration; specifically, the court held that the foregoing factors do not necessarily preclude a jury from finding that the accused acted in the genuine belief that the complainant was consenting. This article endeavours to explain how the accused could be aware of such circumstances at the time of penetration, yet still entertain such a belief. The article ultimately concludes that such an anomaly can only be explained through a combination of the poor drafting of s. 37AA(b)(ii) and the court's apparent refusal to follow the longstanding precept that ignorance of the law is never a defence to a crime, ostensibly prompted by its adherence to the cardinal precept that legislation is not to be construed as superfluous.

The intentional teaching of science in early childhood settings

The introduction of the new “Early Years Learning Framework” (DEEWR, 2009) has shifted the focus in Early Childhood Centres (ECC) from incidental learning through play, to planning curriculum with play as the vehicle to achieve learning in science. Using student research, we identified instances of educator practice that fitted with the new framework, and videoed practitioners’ sessions to select vignettes to use as part of an Early Childhood Science Education Unit. This presentation will discuss the varied practitioners’ approaches we saw and students’ and teachers’ interpretations of forms of ‘intentional teaching, with particular reference to science. We formulated an ‘Intentional Teaching Spectrum’ for the purpose of locating along it early childhood educator practice that differed in the opportunities that practice provided for creative and innovative children’s activity. As this work is not yet complete, full analysis of the video material is yet to be completed, so descriptive aspects only will be discussed.

The association between investigative interviewers' knowledge of question type and adherence to best-practice interviewing

It is well established that not all investigative interviewers adhere to ‘best-practice’ interview guidelines (i.e., the use of open-ended questions) when interviewing child witnesses about abuse. However, little research has examined the sub skills associated with open question usage. In this article, we examined the association between investigative interviewers' ability to identify various types of questions and adherence to open-ended questions in a standardized mock interview. Study 1, incorporating 27 trainee police interviewers, revealed positive associations between open-ended question usage and two tasks; a recognition task where trainees used a structured protocol to guide their response and a recall task where they generated examples of open-ended questions from memory. In Study 2, incorporating a more heterogeneous sample of 40 professionals and a different training format and range of tests, positive relationships between interviewers' identification of questions and adherence to best-practice interviewing was consistently revealed. A measure of interviewer knowledge about what constitutes best-practice investigative (as opposed to knowledge of question types) showed no association with interviewer performance. The implications of these findings for interviewer training programs are discussed.

The legal profession and the business of law

‘Professional Responsibility and Ethics’ is one of the ‘Priestley 11’ law subjects compulsorily undertaken by Australian law students who aspire to be admitted to practice. Many of the brightest join the major corporate law firms. Nevertheless, there is little theoretical analysis of how those firms are functioning to affect the professional and ethical conduct of their practitioners in the neoliberal state. In this article it is argued that in the mature and highly competitive marketplace for legal services, rather than working as autonomous professionals, corporate lawyers are now finding themselves working more and more as functionaries subservient to the dictates of their corporate clients. Drawing on interviews with Australian major law firm corporate lawyers and Charles Derber’s theory on the proletarianisation of professional workers, it is argued that corporate lawyers are losing key elements of their professional identity in the impetus to maintain the client list and the profit motive. Furthermore, as the balance of power in the corporate legal sector is shifting from law firms to clients, the professional ethics of law firm lawyers are at risk of being compromised as they find themselves being reduced to little more than ‘flush’ factory fodder for the major corporations.

Myths, mysteries and mates : the experiences of culturally diverse early childhood student teachers.

An initial finding of a PhD study to explore the experiences of culturally diverse early childhood student teachers was that participants found the first year of study the hardest, with peer friendships being critical to success. Through narrative interviews, recent early childhood teacher education graduates reported that making friends proved to be an important survival strategy, restoring a positive sense of self. Vartuli (2005) highlighted the importance of positive self-perception in student teachers, linking this to ongoing teaching practice. This paper discusses the importance of student friendships in relation to successfully completing the first year of teacher education.

Using online video-recorded interviews to connect the theory and practice of inclusive education in a course for student teachers

This article reports on a study into university preservice teachers’ perceptions of online video-recorded interviews as an alternative to the traditional lecture format in a course on inclusive education. With the aim of assisting preservice teachers to link theory and practice, the series of video-recorded interviews focused on key concepts around educating students with diverse needs and abilities. The interviews were conducted between the course coordinator and a number of professionals with relevant field experience in special education and inclusion, and were then made available to preservice teachers online. Survey data indicated that this type of delivery model was perceived as effective in promoting engagement and learning, and in facilitating an understanding of the connection between theory and practice. Implications for teacher education are discussed.