Nursing work and nursing knowledge : exploring the work of women's health nurses, patterns of power and praxis

The majority of women's health nurses in this study work in generalist community health centres. They have developed their praxis within the philosophy and policies of the broader women's health movement and primary health care principles in Australia. The fundamental assumption underlying this study is that women's health nurses possess a unique body of knowledge and clinical wisdom that has not been previously documented and explored. The epistemological base from which these nurses' operate offers important insights into the substantive issues that create and continually shape the practice world of nurses and their clients. Whether this represents a (re)construction of the dominant forms of health care service delivery for women is examined in this study. The study specifically aims at exploring the practice issues and experience of women's health service provision by women's health nurses in the context of the provision of cervical cancer screening services. In mapping this particular group of nurses practice, it sets out to examine the professional and theoretical issues in contemporary nursing and women's health care. In critically analysing the powerful discourses that shape and reshape nursing work, the study raises the concern that previous analyses of pursing work tend to universalise the structural and social subordination of nurses and nursing knowledge. This universalism is most often based on examples of midwifery and nursing work in hospital settings, and subsequently, because of these conceptualisations, all of nursing is too often deemed as a dependent occupation, with little agency, and is analysed as always in relation to medicine, to hospitals, to other knowledge forms. Denoting certain discourses as dominant proposes a relationship of power and knowledge and the thesis argues that all work relations and practices in health are structured by certain power/knowledge relations. This analysis reveals that there IX are many competing and complimentary power/knowledge relations that structure nursing, but that nursing, and in particular women's health nurses, also challenge the power/knowledge relations around them. Through examining theories of power and knowledge the analysis, argues that theoretical eclecticism is necessary to address the complex and varied nature of nursing work. In particular it identifies that postmodern and radical feminist theorising provide the most appropriate framework to further analyse and interpret the work of women's health nurses. Fundamental to the position argued in this thesis is a feminist perspective. This position creates important theoretical and methodological links throughout the whole study. Feminist methodology was employed to guide the design, the collection and the analysis. Intrinsic to this process was the use of the 'voices' of women's health nurses as the basis for theorising. The 'voices' of these nurses are highlighted in the chapters as italicised bold script. A constant companion along the way in examining women's health nurses' work, was the reflexivity with feminist research processes, the theoretical discussions and their 'voices'. Capturing and analysing descriptive accounts of nursing praxis is seen in this thesis as providing a way to theorise about nursing work. This methodology is able to demonstrate the knowledge forms embedded in clinical nursing praxis. Three conceptual threads emerge throughout the discussions: one focuses on nursing praxis as a distinct process, with its own distinct epistemological base rather than in relation to 'other' knowledge forms; another describes the medical restriction and opposition as experienced by this group of nurses, but also of their resistance to medical opposition. The third theme apparent from the interviews, and which was conceptualised as beyond resistance, was the description of the alternative discourses evident in nursing work, and this focused on notions of being a professional and on autonomous nursing praxis. This study concludes that rather than accepting the totalising discourses about nursing there are examples within nursing of resistance—both ideologically and X in practice—to these dominant discourses. Women's health nurses represent an important model of women's health service delivery, an analysis of which can contribute to critically reflecting on the 'paradigm of oppression' cited in nursing and about nursing more generally. Reflecting on women's health service delivery also has relevance in today's policy environment, where structural shifts in Commonwealth/State funding arrangements in community based care, may undermine women's health programs. In summary this study identifies three important propositions for nursing: • nursing praxis can reconstruct traditional models of health care; • nursing praxis is powerful and able to 'resist' dominant discourses; and • nursing praxis can be transformative. Joining feminist perspectives and alternative analyses of power provides a pluralistic and emancipatory politics for viewing, describing and analysing 'other' nursing work. At the micro sites of power and knowledge relations—in the everyday practice worlds of nurses, of negotiation and renegotiation, of work on the margins and at the centre—women's health nurses' praxis operates as a positive, productive and reconstructive force in health care.

Investigative interviewing of children with intellectual disabilities

This research was designed to examine two broad issues in relation to the investigative interviewing of children (aged 9 to 13 years) with mild and moderate intellectual disabilities. First, how do children with intellectual disabilities perform (relative to children matched for chronological and mental age) when recalling an event in response to various questions? Second, what question types and interview strategies do police officers and caregivers use to elicit accurate and detailed accounts about an event from children with intellectual disabilities? The rationale for exploring each of these issues was to determine possible ways of improving the elicitation of evidence from children with intellectual disabilities. While children with intellectual disabilities constitute a high proportion of all child victims of abuse (Conway, 1994; Goldman, 1994; Morse, et ah, 1970), they rarely provide formal reports of abuse and of those incidents that are reported, few cases progress to court (Henry & Gudjonsson, 1999). Study 1 used a standard interview protocol containing a variety of questions and an interview structure commonly used in investigative interviews. Specifically, the memory and suggestibility of eighty children with either a mild and moderate intellectual disability (M age = 10.85 years) was examined when recalling an innocuous event that was staged at their school. The children's performance was compared with that of two control groups; a group of mainstream children matched for mental age and a group of mainstream children matched for chronological age. Overall, this study showed that children with both mild and moderate intellectual disabilities can provide accurate and highly specific event-related information hi response to questions recommended in best-practice guidelines. However, their recall was less complete and less clear in response to free-narrative prompts and less accurate in response to specific questions when compared to both mainstream age-matched groups. Study 2 provided an in-depth analysis of the types of questions and strategies used by twenty-eight police officers and caregivers when interviewing children with either mild or moderate intellectual disabilities (M age = 11.13 years) about a repeated event that was staged at their school. The results revealed that while the approach used by the police officers was generally consistent with best-practice recommendations (i.e., their interviews contained few leading, coercive or negative strategies), there were many ways in which their approach could be improved. This study also showed that the caregivers used a high proportion of direct and negative strategies to elicit information from their children. Even when caregivers used open-ended questions, their children provided less event-related information than they did to police interviewers. The results of both studies were discussed in relation to current 'best-practice' guidelines for interviewing children and recommendations were offered for improving the quality of field interviews with children who have intellectual disabilities.

The book: production and participation

Purpose – The focus of this paper is on the benefits that may eventuate through new mechanisms of production and distribution. As we enter the twenty-first century, the nature of the book and the structure of the industry which produces it are undergoing radical transformation, as developments in information technology offer new mechanisms for production and distribution. Most of the discussion of these changes is conducted from the perspective of what has been lost through these changes. Design/methodology/approach – This paper reviews the history of the book from the perspective of the disruptive effects of the changes in production technology and impact on the roles involved in production, distribution and reading of books. Darnton’s Communication Circuit is updated to predict future limiting factors and opportunities for participation. Findings – The evolution of the book has seen successive categories of workers involved in book production supplanted by the adoption of new technology. The updated Darnton’s model suggests that the roles involved in the production and distribution of the book will, however, be supplanted in favour of authors and readers of the book in the future. Social implications – The predicted changes will alter the roles of authors and book users. Originality/value – This paper suggests a novel approach to the discussion of the future of book publication and suggests future developments.

Designer policy for carbon and biodiversity co-benefits under global change

Carbon payments can help mitigate both climate change and biodiversity decline through the reforestation of agricultural land. However, to achieve biodiversity co-benefits, carbon payments often require support from other policy mechanisms such as regulation, targeting, and complementary incentives. We evaluated 14 policy mechanisms for supplying carbon and biodiversity co-benefits through reforestation of carbon plantings (CP) and environmental plantings (EP) in Australia's 85.3 Mha agricultural land under global change. The reference policy - uniform payments (bidders are paid the same price) with land-use competition (both CP and EP eligible for payments), targeting carbon - achieved significant carbon sequestration but negligible biodiversity co-benefits. Land-use regulation (only EP eligible) and two additional incentives complementing the reference policy (biodiversity premium, carbon levy) increased biodiversity co-benefits, but mostly inefficiently. Discriminatory payments (bidders are paid their bid price) with land-use competition were efficient, and with multifunctional targeting of both carbon and biodiversity co-benefits increased the biodiversity co-benefits almost 100-fold. Our findings were robust to uncertainty in global outlook, and to key agricultural productivity and land-use adoption assumptions. The results suggest clear policy directions, but careful mechanism design will be key to realising these efficiencies in practice. Choices remain for society about the amount of carbon and biodiversity co-benefits desired, and the price it is prepared to pay for them.

Her Majesty moves: Sarah Bernhardt, Queen Elizabeth and the development of motion pictures

Sarah Bernhardt, the greatest theatrical star of the late nineteenth century, enabled and even promoted the association of early film with the British monarchy. She did this literally, by playing the role of Queen Elizabeth in Queen Elizabeth (Les Amours de la Reine Elisabeth, Henri Desfontaines and Louis Mercanton, 1912). Bernhardt also promoted the association of the cinema with monarchy symbolically, making the medium a new empathetic vehicle for the development of celebrity mystique and global power.

The Body of Christ : blasphemy, eroticism and transgression in Martin Scorses's The Last Temptation of Christ

Martin Scorsese’s film The Last Temptation of Christ (1988) has polarised critics and audiences for almost two decades. The film is most often remembered for offending the religious sensibilities of fundamentalist Christians, who objected to Scorsese’s representation of Christ as a neurotic figure who struggles to reconcile his divinity with his sexual impulses.

Even critics who reject the fundamentalist accusations of blasphemy are divided about the film’s value. For example, Rolando Caputo praises the film as an unrecognised masterpiece, which confirms Scorsese’s status as an auteur. Conversely, Leonard W. Levy, dismiss the film as having little artistic merit. This paper re-evaluates the film as a serious theological text by re-examining the film in the light of Michel Foucault’s essay ‘A Preface to Transgression,’ arguing that the film can be read as a sophisticated attempt to examine the connections between corporeality, divinity and human subjectivity.

Seeing Sarah Bernhardt: performance and silent film

The most famous stage actress of the nineteenth century, Sarah Bernhardt enjoyed a surprising renaissance when the 1912 multi-reel film Queen Elizabeth brought her international acclaim. The triumph capped her already lengthy involvement with cinema while enabling the indefatigable actress to reinvent herself in an era of technological and generational change. Placing Bernhardt at the center of the industry's first two decades, Victoria Duckett challenges the perception of her as an anachronism unable to appreciate film's qualities. Instead, cinema's substitution of translated title cards for her melodic French deciphered Bernhardt for Anglo-American audiences. It also allowed the aging actress to appear in the kinds of longer dramas she could no longer physically sustain onstage. As Duckett shows, Bernhardt contributed far more than star quality. Her theatrical practice on film influenced how the young medium changed the visual and performing arts. Her promoting of experimentation, meanwhile, shaped the ways audiences looked at and understood early cinema.

Screening Sarah Bernhardt: reinterpreting acting in silent film

Sarah Bernhardt, the great nineteenth-century theatrical actress, was also the first major international film star. Appearing cross-dressed in a short Hamlet film before international audiences at the Paris Exposition of 1900, this 56-year-old French actress most famously went on to make Camille (La Dame aux Camélias, 1911) and Queen Elizabeth (Les Amours de la Reine Elisabeth, 1912). Later appearing in one of the first celebrity home movies (Sarah Bernhardt at Home, 1915), she also made a WWI propaganda film, Mothers of France (Mères Françaises, 1917). This presentation explores these films as evidence of a productive exchange between the stage and the nascent film industry. Rather than see Bernhardt’s acting as evidence of the theatre’s incommensurability with film, it will demonstrate the legacy of her stage acting as she adapted it to early film. The talk will include screenings of the films accompanied by live music.