Hope seen through the eyes of 10 Australian young people

Aim. The aim of this paper is to report the findings of a phenomenological study that explored hope in 10 young people in Australia.

Background. Evidence suggests many Australian young people are in crisis. Examination of key reports that detail the incidence of suicide, early drug-taking behaviours, homelessness, self-harm behaviours, joblessness, depressive disorders, crime statistics and alcohol abuse suggest that many of today's young people have lost resilience as well as vital connections to their community.

Method. Two methods were employed to encourage the participants to reflect on their experiences of hope – what it is and what it meant to them. The first was to supply participants with a disposable colour film camera and ask them to take pictures that, in their view, showed hope. The second was participation in an in-depth interview that was prompted in part, by their photographs. Interview audiotapes were transcribed verbatim and analysis of the text used the Turner method. The data were collected in 2002.

Findings. Four horizons of hope were revealed: at-one-with; a driving force; having choices; and connecting and being connected. These horizons are discussed, showing how, or if, the literature treats these dimensions of hope. Perspectives are offered on how they might be considered by nurses who are charged with caring for today's young people.

Conclusion. Registered Nurses who work with young people must understand the phenomenon of hope from their unique perspective before they can offer appropriate hope-facilitating strategies.

Still suffering from the `silo effect`: lingering cultural barriers to collaborative care

This research project sought to draw out the contesting definitions of collaborative care among professional subgroups in maternity services. The paper contrasts medical and social models of knowledge and reports on qualitative evidence from midwives and doctors in Australian hospitals. The evidence indicates that collaborative care is welcomed by both midwives and doctors but that there remains a lingering residue of the ‘silo effect’ of the ‘old’ professionalism, characterized by hierarchical relations, divergent philosophies and competing domains. Although a ‘new professionalism’ has emerged that challenges the old hierarchies and professional dependencies, it too harbours lingering residues of the former dichotomy between midwives and obstetricians. These tensions and enmities will need to be resolved before genuine collaboration may take full effect. The objective is a relationship focused model of care that transcends professional or woman-focused models. The ‘new’ professionalism may be expedited through mediation strategies, a version of which is the ‘sociological intervention method’ discussed in this article.

The haemodynamic status of cardiac surgical patients in the initial 2-h recovery period

Background
Critical care nurses caring for cardiac patients in the immediate postoperative period continually make decisions about the implications and treatment of their patients' haemodynamic status.

Aim
The aim of this study was to describe the haemodynamic status of patients on admission to critical care and over the 2-h period following cardiac surgery.

Methods
A quantitative, descriptive design was used. Data were collected using non-participant observation and an observation tool. The sample consisted of 38 patients.

Results
Analysis of data revealed the dynamic nature of the haemodynamic status of postoperative cardiac patients. On admission, 60% of patients (n = 23) were haemodynamically unstable. The instability in these patients (n = 23) was due to hypotension (34%), bleeding (21%) and hypoxaemia (18%). During the 2-h recovery period, 55% of patients were hypotensive, 16% of patients had low cardiac output syndrome and 16% of patients had low systemic vascular resistance (SVR) syndrome. Twenty-one percent of patients experienced bleeding complications. Shivering was a clinically significant problem in terms of occurrence (23%) and duration (X = 45, S.D. = 30 min). Twenty-nine percent of patients (n = 11) had a profound deterioration in haemodynamic status, necessitating urgent interventions.

Conclusion
Haemodynamic parameters indicate that 95% of patients in this study were haemodynamically unstable at some time during the initial 2-h recovery period. These findings inform resourcing decisions by organisations and have implications for nurses' assessment and interventional haemodynamic decision making.

Hope promoting strategies of registered nurses

Aim. This paper describes self-reported hope-promoting strategies used by Registered Nurses whilst providing care for older patients in acute and long-term care settings.
Background. The literature is replete with claims that Registered Nurses engage in hope facilitation with their patients. However, these claims are largely conjecture, with few studies empirically identifying the extent to which Registered Nurses use hope interventions with their patients. Further, some authors have questioned whether nurses have the necessary skills to undertake this vital aspect of care.
Methods. In this Gadamerian hermeneutic phenomenological study, undertaken in 2003 in Australia, we used in-depth audiotaped interviews to collect data with 14 Registered Nurses. The interviews were transcribed verbatim and analysed using the Turner method.
Findings. Whilst participants clearly reported that they engaged in hope facilitation with older patients, there were differences between the reported strategies used by Registered Nurses in acute and long-term care settings. Further, the strategies reported were not unique to hope promotion and have been variously described in the literature on caring, presencing, holistic nursing and therapeutic nursing.
Conclusion. It is clear that participants considered hope promotion to be a vital aspect of their care. However, the strategies that they reported were limited and not inclusive of many and varied suggestions emerging from published studies on hope promotion. Therefore, we recommend that nursing curricula, professional development and in-service education programmes place hope facilitation on their agenda and foster a culture in which promoting hope is seen as a vital aspect of nursing care.

The narrative of evaluations: medically supervised injecting centers

Medically supervised injecting centers, or drug consumption rooms are officially sanctioned places where people can inject or smoke illegal drugs in hygienic conditions and under supervision. Their ostensible purposes are to protect the health of drug users and contain the nuisance potential of open drug markets. This article argues that the debates and arguments supporting the establishment and existence of medically supervised injecting centers follow four interweaving narratives. These narratives can be characterized as (1) Caring and humanitarian (2) Elimination of public nuisance (3) Governance of the drug-using subject (4) Neo-liberal, utilitarian, and bureaucratic. These narratives alternatively combine and oppose each other. This means that the analysis of the benefits and problems with such initiatives depends on the perspective of the actors involved and the claims made for their effectiveness.

Educational partnerships on-line: global collaborative learning through an on-line student exchange programme

Deakin University and the University of Calgary have used the internet to provide workplace-based learners with the possibility of a student exchange programme which does not disrupt their careers, lives or families.  The programmes involved in this on-line exchange were both developed in response to the needs of workplace learners and are representative of the role of universities in the field of life-long learning.  This paper describes the first phase of the exchange and discusses the shared pedagogical philosophies and shared implementation of on-line groupware which provided a rationale for the exchange.  The paper will explore the cross-cultural implications of the educational experience and the possibilities such an exchange opens up for life-long learners.

Global now : searching for meaning

How do teacher educators prepare students to become teachers for a world which is global in its outlook and influences? There are now strong imperatives for teacher educators to develop pre- service students' understandings about a world which is 'global'. It is not only curriculum statements, textbooks, films, videos, that are the carriers and resources in global education but teachers themselves through their own stories
and narratives and the meanings attached to these. The role of teachers' lived experiences in teaching global education is often silenced in teacher education courses, policy documents and school classrooms.

In searching for meaning in global education, it is the capacity of the teacher to reflect not only on their own multiple identities but on the nexus between their local and global worlds and the struggle often evident here. A resource teachers have to teach global education is their own stories, lived experiences of being in a global world. This comes from giving meaning to travel, of living in a multi-cultural multi-faith world of viewing and noticing similarities and differences and giving meaning to these.

Despite increasing demands from education systems and governments for teachers to teach with a global focus, many teachers do not feel confident or prepared to do so. Importantly curriculum policy statements are carrying imperatives to teach to a global world that is rapidly changing. Curriculum statements in Society and Environment area in Australia include 'global' in their rationale. However this does not mean that global education is taught nor understood by teachers who translate these documents to practice. In curriculum documents such as those
produced by the state and territory governments there is some inclusion of global education. Singh (1998) argues that there is a marginalisation of global education in official curriculum policies in Australia. Integrating global education into different subjects is really up to the creativity, expertise and experience of teachers. If it is up to teachers to teach global education as stated by Singh then it will be the capacity of the teacher to draw on a range of resources, pedagogy and approaches to teach global education. One resource is teachers' stories and
narratives and students own lived experiences and stories.

Banks (2001, p. 5) states that "teachers must develop reflective cultural national and global identifications themselves if they are to help students become thoughtful caring and reflective citizens in a multicultural world society." Teacher educators who wish to embed global perspectives in their teaching require reflective practices on their own identities, prejudices, choice of curriculum content and pedagogy.

Teaching global education requires a conscious understanding and reflection to begin the journey of self as located in the classroom. The central issue of this paper is to bring forth emphasis on the lived experiences of teachers and teachers educators in order to develop deeper global understandings in students.

Salvage material logistics management for building demolition project

Building demolition imposes substantial environmental impacts. In particular, large amount of demolition wastes are disposed to landfills. A solution to ease the situation is to maximally reuse and recycle waste building material. Management philosophies such as Just-in-time are applied into demolition project management in order to promote reuse and recycling of demolition wastes. Transportation logistics, widely applied in the manufacturing industry, is ideal to be adopted into demolition projects to optimise waste material production, inventorying, and transportation. In particular, it enables right types and amounts of dismantled building materials to be transferred to right location, and at right time, as required by material demanders. Consequently, waste reuse and recycling can be facilitated. Furthermore, logistics management helps the demolition project team to reduce cost, shorten project duration, and satisfy material demanders. Transportation planning concerns thorough preparation technically and managerially on the demolition site for transportation activities. Information exchange is playing a significant role in delivering and sharing information among project participants, including building owner, demolition project team, potential material demanders, and transporters. This research paper aims to identify the role of transportation logistics in a building demolition project and to analyse inventory control, transportation, and various technical aspects of logistic management for demolition wastes.

An investigation of scale economies and quality issues in the teaching and management of large subjects

Many in the tertiary education system have had concerns with the issues surrounding the teaching of large classes, including teaching quality and whether there are effective learning outcomes for students. An issue closely related to quality is the cost of providing an efficacious education system. It is a common perception that large classes are economical to run and small subjects are not. As with any complex issue there are several perspectives that could be utilised, the needs of the institution, the teaching staff, the community or the students, and whether or not these needs are being met.

This study aims to assess whether universities are meeting the needs of students in large marketing classes. For this purpose the study investigates the application of selfdetermination theory and psychological needs satisfaction. The basic needs scale, comprising of three constructs; Control, Competence and Caring was adapted and used to evaluate students' perception of an introductory marketing subject.

The study used a multi-method approach consisting of a literature review, a qualitative phase involving in-depth interviews and focus groups. A survey of 366 students who had undertaken an introductory level marketing subject in a large class format was also conducted. The results show that the psychological needs satisfaction of many students are not being fully realised. It was also found that marketing degree students enjoyed the challenges and were more stimulated by the subject (than students in other degree streams). The higher achieving students enjoyed the challenge of the subject more than the lower achieving students. The implications of these findings and suggestions for
further investigation are discussed.

A technology of study applied in marketing education and supported by self-determination theory

The aim of this study is to assess whether universities are meeting the needs of marketing students in their specific university function of providing knowledge and knowledge processes. This viewpoint is not meant to overlook the university role as a civilizing agent in a constant search for truth (McKenna 2001), but the focus for this study (based as it is in a Faculty of Business and Law) is toward graduates entering the corporate world. Therefore, graduates with suitable discipline knowledge and reasoning skills, in this context, must be able to meet the needs of the corporate marketing sector. Extending this backward to the role of the university, this study is by default seeking to establish if universities are meeting the needs of the corporate sector. A comparison is made between marketing classes using a specific technology of study called an autarchic system, and those classes not using this method. As part of this analysis the study investigates the application of self-determination theory and psychological needs satisfaction. The basic needs scale, comprising of two constructs; Control and Caring was adapted and used to evaluate students' perception of subjects using autarchic study system and those not utilising this methodology.

Reassessing Grameen Bank's micro credit programme for poverty alleviation in bangladesh : a new perspective

Rural finance has been a mltior policy in alleviating poverty in developing countries. Of specific interest are the micro credit programmes that target the poorest segment of the population. Despite some successes in particular settings, the efficacy of micro credit programmes has been a mltior concern in recent years. This paper evaluates the success of the Grameen Bank, the premier micro credit provider in rural areas in Bangladesh in the context of contemporary development philosophies. Only a few studies have evaluated the performance of the Grameen Bank from a poverty alleviation perspective. Many have evaluated the efficiency of the Grameen Bank's micro credit programmes using attributes such as the repayment rate. In this paper, we add a new dimension to the literature by arguing that if poverty alleviation is the ultimate objective, then the bank's micro credit programme should be assessed from the borrowers' perspective. Rural credit should be conceptualised not as just an input to production but as a mechanism for rural transformation. Our analysis reveals that while Grameen Bank is an efficient provider of micro credit in rural Bangladesh, its programmes fall short of achieving poverty alleviation for a multitude of borrowers and reshaping the process is hence a critical imperative.

Work teams: perceptions of a ready-made support system?

Much research on work teams has been focused at the team-Ievel,  considering such issues as effectiveness, productivity and overall  interaction. Using qualitative in-depth interviews, the author has asked the question: what is the experience of the individual working within a team? This paper discusses one theme to have emerged, that of perceived emotional support being provided within the team. Respondents' descriptions of emotional support are discussed in terms of acceptance and respect, and of caring. The discussion shows how the provision of this support has implications for how individuals view teams in general, and indicates areas for future research.

Accompanying critically ill relatives in emergency departments

Background. Family members are a crucial part of the holistic approach to care in emergency departments. In particular, they are a group who are vulnerable, yet have been overlooked when considering care options.

Aim. The primary aim of this systematic review was to appraise research relevant to identifying and meeting the needs of family members who accompany a critically ill person into the Emergency Department (ED). The information was intended to inform future research into the care of these people.

Method. A quality assessment strategy was specifically developed to evaluate the various research designs used. The outcomes of the highest quality studies were used to develop evidence-based clinical practice guidelines to inform clinicians caring for family members who accompany a critically ill person into the ED.

Results. Recommendations for family care drawn from this review provide the foundation for more rigorous methodologies in future research into this topic. Key findings concern family needs for communication, proximity, support, comfort, assurance and to locate meaning in the event.

Conclusion. The review has revealed current knowledge about the care of family members who accompany a critically ill person into the ED that provides guidelines for practice. Despite significant limitations, the knowledge can lead to recommendation to guide and inform future intervention research.

Families needs in emergency departments: instument development

Background. Families who accompany critically ill relatives in emergency departments (EDs) are an integral part of the care unit. However, there are few empirical data on their needs during this phase of care. In order to guide quality care, general and specific needs of families accompanying these critically ill relatives should be systematically examined.

Aim. The aim of this pilot project was to test the tool, methods and analysis plan for a study to examine the perceived needs of family members accompanying critically ill patients in EDs and their perceptions of ED staff's ability to meet these needs.

Method. Over a 6-week period in 1996, 84 relatives who met the inclusion criteria were recruited to the study. A postal questionnaire, to uncover the needs of family members, was pilot tested. The questionnaire consisted of 40 need statements reflecting five major themes: meaning, proximity, communication, comfort and support. Of the 84 relatives selected for the study, 73% returned completed questionnaires.

Results. The findings of this pilot study suggest that the questionnaire is a valid and reliable tool for researchers wishing to examine and rank the needs of family members who accompany critically ill people in EDs. In addition, the analysis plan was found to be appropriate.

Conclusions. This pilot study provides both a method and a tool for further research into family needs. Examination of the pilot data supported the reliability and validity of the tool and produced findings that challenge nurses to move beyond traditional practice that has excluded families from being an integral part of caring for critically ill patients in EDs.

Towards ending the silence: working women as carers of children with chronic illness/disability

This research presents stories from Australian women who work and care for a child with a significant chronic illness or disability. The paper considers the theory of Silencing the Self (Jack, 1991) in relation to the reported experiences and behaviours of these women. We report three themes of Caring and Working: "Otherness", "Doing it All" - but "Wanting to Live a Normal Life". As in Jack's study, these women engaged in silencing of the self. However, we also observed other people contributing to their silence and, unlike the respondents in Jack's study, many of these women fought the silence and did not accept that their unhappy situations should continue. They sought a life where silencing may not have been necessary.