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.

Ensuring balance in corporate governance : parts 2F.1 and 2F.1A of the Corporations Law

Effective corporate governance must balance the competing, and at times conflicting, objectives of efficient endeavour and accountability. The CLERP amendments to the Corporations Law introduced on 13 March 2000 go a long way towards providing this balance. While the business judgement rule was introduced to promote efficient endeavour, Pts 2F.1 and 2F.1A maintain corporate accountability. This article compares Pts 2F.t and 2F.1A of the Corporations Law. It is argued that, although there are procedural and substantive differences between the two parts that need to be understood by practitioners, the importance of the two Parts is that they work together to provide for a much-needed improvement and enhancement of shareholder rights and remedies, thus upholding accountability in corporate governance.

Specialisation within specialisation? Thoughts on the content of contemporary forensic psychology programs

This paper provides details of, and the rationale for, a Doctorate of Forensic Psychology recently developed at Deakin University, Melbourne, Australia. The course prioritises training in psycho-legal issues with children and young people. In discussing this program, the presenters identify two issue  that guided the development of the program. The first concerns the need to delineate forensic content from that in clinical programs, while still maintaining appropriate focus on the skills needed to work effectively in forensic settings. The second addresses the need for courses to acknowledge the marked diversity among forensic clientele and to develop competencies that lead to effective work practices with these sub-groups. In constructing the Deakin forensic program, it was noted that forensic psychologists required an increasing degree of expertise in the procedural and substantive aspects of the legal system. The authors propose that as forensic psychology gains momentum as a discrete area of expertise, there is an increasing need for practitioners to have a sound understanding of the legal institutions and practices they work under, as well as being able to apply specialist knowledge to particular sub-groups. This paper discusses these issues, and outlines how the authors sought to address them in their course curriculum.

The development of the nutrition and activity knowledge scale for use with people with an intellectual disability

Background Obesity is an increasing health problem for many Australians, no less so among people with an intellectual disability. Behaviour change aimed at improving nutritional intake and increasing levels of physical activity is a requirement for the reduction of obesity. An essential part of this process is to first ascertain the level of knowledge and beliefs people with an intellectual disability have about these behaviours.

Methods The aim of this study was to develop and psychometrically evaluate a scale to assess levels of nutritional and physical activity knowledge among people with an intellectual disability.

Results Seventy-three people with an intellectual disability completed the interview-rated scale at time 1 and 66 of them completed it again at a 3-week re-test.

Conclusions The scale demonstrated strong factorial construct validity, high internal consistency and good temporal stability. The applications of this scale in future research and in intervention programmes are discussed.

Productivity and the knowledge worker

The industrial age of Taylor and Ford transformed the landscape of office buildings. Office spaces were very uniform and highly supervised. People were units of production. Their work activities were routine. Work study, or "time and motion" studies measured outputs.

The current "information age" way of working, combined with major demographic shifts in the workforce (Gen-Xers, career-shifting Baby Boomers and a greater number of women and minority ethnic groups in the workforce), requires major changes in how to support service industry productivity. The motivations of knowledge workers are very different from those of the industrial age worker. Commitment to the organisation has gone as a result of business re-engineering processes that increased productivity but at the expense of job security. Workers are more likely to be "goal-focussed" rather than "prevention focussed" (Meyer et al 2004 2 ) meaning that instead of doing only what is necessary to retain their job, workers actively seek more meaningful work that matches their personal value systems. They even want to have fun at work!

What contribution can the workplace make to support this work and increase productivity? Surveys have indicated that workers spend more than 75% of their time in their own office space with more than half of that time spent in concentrated work. Concentrated work requires quiet with few distractions, yet workers report that distractions are probably the biggest problem hampering their productivity. What are the current workplace solutions to office space usage? Probably the worst option for distractions is frequently used – open-plan offices, which are a more cost-effective use of space, but at the potential expense of productivity. Visioning architects such as Duffy (1999)3 advocate quiet spaces ("dens") where workers can decamp to carry out their concentrated work. But is this workspace as efficient for the worker – who may have to transport materials back and forth?

Workers know what they need to support their productivity best. On the rare occasions when the staff have been given the opportunity to configure their work-settings, high productivity increases result. Besides noise, environmental quality is perceived as a key factor influencing productivity. Stuffy workplaces generate lethargy. Greater worker satisfaction with their workplace is reported when they have more individual control over the environment.

We need to seriously question the "one-size-fits-all" office building with cellular layouts. Workers need to be involved in the design and fit-out. They need personal control over their environment and an organisation that can support their individual aspirations and values. A number of interventions that could generate significant improvements in knowledge work productivity are proposed.

Risk and resilience, knowledge and imagination: the enlightenment of David Almond's Skellig

In what Ulrich Beck calls "risk society," and Anthony Giddens a "runaway world," a climate of fear and insecurity has been created by scientific progress, leading to a loss of confidence in the ability of experts to manage risk. Resilience is at the forefront of psychology research informing child-rearing strategies (Luthar, et al.); it entails an approach to child welfare that focuses on fostering internal (psychological) and external (cultural) assets that develop a child's ability to triumph over adversity in the form of individual, familial, and cultural stresses.

Bounded and unbounded knowledge : teaching and learning in a web 2 world

beginning of serious problems for the business models of publishers. The ease with which content can be accessed, copied and distributed disrupts the control of those whose role has been to manage and profit from the intellectual property rights of content producers. In effect, the number of “publishers” increased many fold as the Web and other Internet-based technologies became the dominant mode of content distribution. In education, and in other fields, matters of intellectual property, copyright and quality control came to the fore. More recently, with the advent of web based software that makes publishing online available to anyone with access to the Internet the number of “publishers” and modes of publication have increased massively. The shift from a Web which was, for many a read only environment to a read/write Web poses not only ongoing problems for the traditional distributors of content but also now, for the traditional producers of content and knowledge. In this respect, the role of universities as designers and producers of learning materials for credentialed learning is also under challenge. Just as publishers explore alternative business models to adapt to the new digital environment, now universities have begun to explore new ways of working with so-called Web2 software to support teaching and learning online. In particular, some Web2 software affords new opportunities for and different modes of collaboration, which in the view of some points to student participation in knowledge production. While these developments represent important and significant shifts for universities, this paper draws attention to the lack of empirical data and situated contextual knowledge concerning intellectual property rights for knowledge constructed in a collaborative context. In addition, we explore issues in relation to the maintenance of academic integrity and quality where knowledge building takes place in a collaborative, online environment.

The influence of procedural and interactional justice, and disconfirmation on customers post recovery satisfaction evaluations

This study examines the influence of distributive and interactional justice and disconfirmation on customers’ postrecovery satisfaction evaluations, and in so doing, combines, for the first time, two existing instruments to operationalise the interactional justice construct. Using Structural Equation Modelling, the findings suggest that while both disconfirmation and justice are important predictors of satisfaction, distributive justice has the greatest influence. The research presented here reports on a section of a larger experiment-based study examining how customers’ postrecovery satisfaction evaluations are influenced by the way in which the organisation responds to the failure.

Ethics and self-knowledge in corruption related decision making

The nature of corruption in international business is briefly considered and several types of bribes are distinguished. Two managerial decision-models are then proposed, in order to assist international managers faced with corruption-related situations. The first model is based upon an ethical analysis and it conditionally endorses some types of facilitating-payment. The second is based upon a psychological analysis and it involves identification and classification of the generic consequences of bribe payments. The two models are intended to form part of a wider and multifaceted approach to reducing corruption.

Dissociations between implicit and explicit memory in children : the role of strategic processing and the knowledge base

A review of the literature shows that explicit memory develops substantially from three years of age to adulthood, while implicit memory remains stable across this age range. Previously, this developmental dissociation has been attributed to different memory systems, or to confounds with perceptual vs. conceptual processing. Prompted by an alternative developmental framework, the experiments reported here provide evidence against both interpretations. Instead, it will be argued that (a) the implicit - explicit developmental dissociation reflects differences in strategic processing (strategy use and metamemory) across childhood and (b) that implicit memory can show development if a child's knowledge base in the tested domain is developing with age.