"I will start treatment when I think the time is right":HIV-positive gay men talk about their decision not to access antiretroviral therapy.

In a qualitative study, 20 HIV-infected Australian gay men were interviewed about their decision not to access antiretroviral drug therapy. The main reasons given for the decision were fear of side effects; fear of long-term damage to body organs; the inconvenience of the treatment regimens; belief that the regimen's demands would be a threat to morale; and belief that there was no reason to start therapy in the absence of AIDS-related symptoms. Actions taken by the men to monitor and maintain their health included seeing a doctor regularly; having regular T-cell and viral load tests; and trying to maintain a positive outlook by not letting HIV/AIDS 'take over' their lives. Almost half the men considered they had been subjected to unreasonable pressure to access therapy and there was considerable pride at having resisted this pressure. The findings suggest that the men disagreed with the biomedical model for managing HIV/AIDS only on the question of if and when to access therapy. They also suggest that underlying the men's dissent from the biomedical model was a different mode of thinking than is required by the model: while the model demands thinking that is abstract, the men focused strongly on factors close to the 'here and now' of immediate experience. The practical implications of the findings are explored.

Exacerbation of symptoms among people with multiple sclerosis: impact on sexuality and relationships over time

This study was designed to evaluate the impact of an exacerbation in symptoms among men and women with multiple sclerosis (MS) on sexuality and relationship satisfaction. A total of 321 people with MS (120 men, M age = 48.10 years; 201 women, M age = 45.78 years), and 239 people from the general population (79 men, M age = 53.93 years; 160 women, M age = 45.89 years) completed measures of relationship satisfaction and sexuality, and then completed these measures again 18 months later. The results demonstrated that both men and women with MS reported significantly higher levels of sexual dysfunction than did the general population. The no exacerbation group also reported significantly lower levels of sexual activity and of relationship satisfaction than the general population group over the 18-month period. Women in all groups reported significantly higher levels of sexual dysfunction but also higher levels of sexual activity than did men at each time period. They also reported significantly higher levels of sexual satisfaction at the 18-month follow up. These results suggest that men and women respond in similar ways to MS, and that people with MS do not necessarily experience poorer levels of sexual interaction or relationship quality when they experience an increase in their physical symptoms.

Facilitating online privacy on eCommerce websites: an Australian experience

As traditional organizations using their websites for eCommerce transactions are increasing at an exponential rate, privacy concerns of users are also on the rise. To gain an insight into these concerns, existing policies and legislation, we conducted the research reported in this paper, in 2003. To augment the literature synthesis, a multiple case study analysis was conducted, based on six large organisations in Australia. Our research findings suggested that in the Australian context, an online privacy policy (OPP) on the website which complies with the Privacy Act, supported by few best practices are reasonably able to address online privacy concerns. However, these findings are restricted in time frame, indicative and relevant in the Australian context. Nevertheless, we hope to stimulate academic research enquiry and discussion forums through this research.

Learning in virtual teams: exploring the student experience

In 2005 an existing undergraduate course in project management was converted from face-to-face mode to wholly online mode. Wholly online mode means that there are no face-to-face classes at all, and all teaching and learning is facilitated through an online environment.

The revised project management course was designed with an underlying problem-based learning (PBL) pedagogy and used a simulated, fictitious telecommunications company, United Enterprises (UE), as a case study learning resource. The students worked in virtual teams to complete online learning activities and to solve authentic project management tasks for UE. Employees of UE were available online to provide direction and answer further questions about the tasks.

The overall research study used an action research methodology in which feedback was elicited from two groups of stakeholders involved in the project management course - students and teaching staff. The feedback was used to plan, develop and implement the new Information Technology (IT) Professional Practice course.

This paper reports on the findings of three anonymous student surveys that were conducted after each of the main project management topics and tasks were completed. The surveys sought feedback in a number of areas. However, the feedback reported here relates specifically to student opinions about their experiences of working in virtual teams within the learning environment. Other aspects of the research, including student perceptions of UE and feedback from the teaching staff, are not reported here.

Across the three surveys, most students indicated that they valued the opportunity to discuss various aspects of the course with peers and teaching staff online, and to interact with real-life employees of UE. Although discussion forums were the prescribed method for communication other forms of communication such as email, chat and face-to-face meetings were also used. According to the students, the best things about online group work were that it provides the flexibility of time and place; it allows communication and participation to be recorded; and is an ‘efficient’ way of working. The worst things about online group work were that communication is more difficult and that team members leave participation and submission to
the last minute. While up to 15 percent of students did not like the experience of online group work at all, overall students were generally satisfied with this style of learning and enjoyed the experience of working collaboratively within a virtual team.

The research has highlighted a number of areas where improvements can be made to the student experience of working in virtual teams. These improvements will be adopted in the development and delivery of the new course as part of the action research study.

The challenge of reconciling working time demands and life transitions : a policy proposal

Labour markets, like all market institutions, exhibit structural and dynamic characteristics. Both the structural and dynamic characteristics of labour markets inevitably change and evolve over time in response to a host of exogenous and endogenous factors. In the case of the Australian labour market, structural changes are reflected in significant shifts in the industry and occupational composition of employment, the decline of full-time work and the concomitant rise in part-time and atypical forms of employment, demographic changes in the labour force, as well as changes in social and individual preferences. Dynamic shifts can be found in cyclical pattern of employment and wages growth, the growth in labour mobility, and transitions between various labour market states.
The starting point for this paper is that these structural and dynamic changes have given rise to an increase in the likelihood that individuals will experience a transition between various labour market states, and a greater diversity in the range of transitions they may experience over their working life. This acceleration in the rate of transition generates ‘transition costs’ for both employers and employees, as well the likelihood of mismatch between employer and employee working time preferences. As a consequence, existing labour market policy regimes, based on the traditional model of labour market participation over the life course may not provide adequate protection for most workers today.
Gunther Schmid (1998) and others have proposed institutional reforms which promote ‘transitional labour markets’. Transitional labour market institutions are those that allow individuals (and firms) to successfully adjust to critical events. While transitional labour market institutions may consist of traditional ‘active labour market policy’ mechanisms, Schmid and others have proposed a range of innovative policy responses which allow individuals (and firms) to adjust the intensity of their abour market participation over the life cycle. In this paper we use the general approach of advocated by the transitional labour market concept to do three things. First, we investigate the processes by which the nature of labour market transitions has changed over time. Second, we review the range of policy options available to government to smooth labour market dysfunctions associated with labour market transitions, with the objective of ensuring labour markets operate more efficiently and more equitably. Third, we focus on one possible way in which an existing labour market institution, Long Service Leave (LSL), could be reformed to make way for a more comprehensive transitional labour market institution in the form of a ‘working time bank’.

Poesis in diegesis : real-time interactive dance performance

This paper describes the processes of creating a hybrid experience of live performance and virtual imagery in 1 + x: Mid-range Projections, a dance work that uses real-time processing of live feed video to create a duet between dancers and their virtual images. 1 + x is about creating experiences of interiority and intimacy, ironically, through the juxtaposition of virtual images of performers with their real selves. This paper examines how the ideal of reinserting intimacy, humanity and 'presence' into a technologically generated image space, in the case of 1 + x, depends on the precise and delicate manipulation of live-feed video in collaboration with the audience's experience of interactivity. The result is a performance work that creates a poesis of 'presence', through a diegesis that melds real and virtual images on the same screen and the same conceptual and spatial plane - a 'becoming virtual'.

The meaning of work : employees as stakeholders in organizational experience

Researchers and commentators have highlighted changes to individuals' understanding of the meaning of work over time, and particularly the increasing centrality of work in many people's lives today. This highlights the stakeholder role of employees not only in ensuring the organization's long-term viability, but for the organizational culture and overall workplace experience. The concepts of workplace spirituality and authentic leadership have both received attention as tools to aid in employees' connectedness wit the organization and in providing an environment where employees can bring their 'whole self' into the workplace. This paper discusses how these concepts assist in providing understanding of individuals' meaning of work, and highlights questions for future research consideration.

Advanced manufacturing technology adoption - the German experience

The decision process that organisations utilise when evaluating technology investment opportunities is a complex and even political process; however, the correct decision can provide the organisation with considerable operational and competitive benefits. The research presented in this paper presents the findings of a postal survey of the benefits provided by technology investments to large German manufacturers. It was found that only where middle management generated the idea for the advanced manufacturing technology (AMT) investment was success in that investment significantly more likely. Respondents who established a project team to plan the technology proposal, regardless of the department which generated the ideas for technology investment, were not significantly associated with a greater likelihood for success.

The respondents typically took between 3 and 12 months before making the final decision to invest, irrespective of the department generating the idea for the AMT, and a further 6 months to implement the AMT. Respondents who utilised a discounted cashflow analysis took significantly longer to make the final decision to invest. The greatest number of manufacturing outcomes of significantly higher importance was identified for respondents where Engineering, IT or R&D generated the AMT ideas. It was also determined that the respondents most frequently considered AMT investments in computer hardware or software and technical training for process workers to be necessary at the time of considering the investment. Middle management were found to be significantly more concerned than managers on other levels about opposition of workers to the AMT, while the process workers were significantly more concerned about interruptions to the process during installation.

A qualitative examination of the experience of 'depression' in hospitalized medically ill patients

Background: Research into depression in the medically ill has progressed without sufficient attention being given to the validity, in this group, of the taxonomic categories. We aimed to describe, using qualitative interviews, the experience of 'being depressed', separating experiences that are unique to depression from experiences that are common to being ill and in hospital.
Method: Forty-nine patients hospitalized for medical illness underwent a 30-min interview in which they were asked to 'Describe how you have been unwell and, in particular, how that has made you feel.' From the transcripts, a 'folk' taxonomy was constructed using a phenomenological framework involving four steps: frame elicitation to identify the important themes, componential analysis to systematically cluster the attributes into domains, a comparison of the experiences of patients screening depressed and  not-depressed, and a theoretical analysis comparing the resulting taxonomy with currently used theoretical constructs.
Results: Experiences common to all patients were being in hospital, being ill or in pain, adjusting to not being able to do things, and having time to think. In addition, all participants described being depressed, down or sad. Patients who were identified by screening as being depressed described unique experiences of depression, which included 'having to think about things' (a forceful intrusive thinking), 'not being able to sleep', 'having to rely on others', 'being a burden' to others (with associated shame and guilt), feelings of 'not getting better' and 'feeling like giving up'. Theoretical analysis suggested that this experience of depression fitted well with the concept of demoralization described by Jerome Frank.
Conclusions: Demoralization, which involves feelings of being unable to cope, helplessness, hopelessness and diminished personal esteem, characterizes much of the depression seen in hospitalized medically ill patients

Quality-of-life measurement in patients undergoing radiation therapy for head and neck cancer: a Hong Kong experience

The aims of this study are (1) to establish a reliable and valid quality-of-life (QOL) questionnaire for Chinese patients with head and neck (H&N) cancer who are treated with radiation therapy and (2) to evaluate the impact of the immediate side effects of treatment on the QOL of these patients. The 39-item "Quality of Life Radiation Therapy Instrument with Head and Neck Companion Module" (QOL-RTI/H&N) was translated into Chinese. In the reliability evaluation phase (study module 1), the questionnaire was administered twice to 56 H&N cancer patients, 7 days apart, during the second and third week of radiation therapy. In the validity evaluation phase (study module 2), 138 patients completed the QOL-RTI/H&N before starting and at the end of radiation therapy. Sixty-nine of these 138 patients also completed the QOL-RTI/H&N during the second week of their radiation therapy, at the same time as completing the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaire. Cronbach alpha coefficients were 0.88 for the general-tool QOL-RTI and 0.90 for the H&N subscale. Test-retest reliability was satisfactory with intraclass correlation coefficients of 0.89 for the general-tool QOL-RTI and 0.75 for the H&N subscale. The instrument can discriminate between patients with stage I or II disease and those with stage III or IV disease (P < .05). Concurrent validity was established by the good agreement with the FACT-H&N (r = 0.86, P < .001). A highly significant deterioration was in the QOL from the baseline to the end of treatment (mean difference for general tool = 1.95, P < .001; mean difference for H&N subscale = 4.85, P < .001). The Chinese QOL-RTI/H&N is a reliable and valid tool for determining the QOL in H&N cancer patients receiving radiation therapy. The immediate side effects of treatment had a significantly negative impact on the patients' QOL. The impact was relatively large for the functional and treatment-site aspects.

Bringing Japanese manufacturing systems to America: the feasibility of implementing just-in-time production in the United States

This paper addresses the feasibility of implementing Japanese manufacturing systems in the United States. The recent success of Japanese transplant companies suggests that Just-In-Time (JIT) production is possible within America's industrial environment. Once American workers receive proper training, they have little difficulty participating in rapid setup procedures and utilizing the kanban system. Japanese transplants are gradually developing Japanese-style relationships with their American supplier companies by initiating long-term, mutually beneficial agreements. They are also finding ways to cope with America's problem of distance, which is steadily decreasing as an obstacle to JIT delivery. American companies, however, encounter Significant problems in trying to convert traditionally organized, factories to the JIT system. This paper demonstrates that it is both feasible and beneficial for American manufacturers to implement JIT production techniques. Many of the difficulties manufacturers experience center around a general lack of information about JIT. Once a company realizes its potential for setup-time reduction, a prerequisite for the JIT system, workers and managers can work together to create a new process for handling equipment changeover. Significant results are possible with minimal investment. Also, supervisors often do not realize that the JIT method of ordering goods from suppliers is compatible with current systems. This "kanban system" not only enhances current systems but also reduces the amount of paperwork and scheduling involved. When arranging JlT delivery of supplier goods, American manufacturers tend to overlook important aspects of JIT supplier management. However, by making long-tenn commitments, initiating the open exchange of information, assisting suppliers in reaching new standards of performance, increasing the level of conununication, and relying more on suppliers' engineering capabilities, even American manufacturers can develop Japanese-style supplier relationships that enhance the effectiveness of the system.

Close, but still too far: the experience of Australian people with cancer commuting from a regional to a capital city for radiotherapy treatment

This paper reports the findings of a study undertaken in November 2001 on the experiences of 17 rural people from the regional city of Toowoomba who had been diagnosed with cancer and were required to travel to the capital city of Queensland (Brisbane) for radiotherapy. The interviews were tape recorded; the recordings were transcribed verbatim and analysed for emergent themes and subthemes, following verification by the participants that the transcription was a true record of their experience. The major themes that arose from the study were (1) the burden of travel; (2) the difficulties of living in accommodation that is not one's own home; (3) the financial burden caused by the need to relocate or travel to and from Brisbane; (4) the lack of closeness to family and friends; (5) and feelings of being a burden on others. The findings suggest that at a time of stress, an increasing burden is placed on cancer clients and their families if they are required to travel for radiotherapy. Health professionals who read the results of this study should be aware of the isolation of rural people who have to live in an unfamiliar environment at a time of great stress. Support mechanisms should be put into place in these referral centres to deal with these stressors.

Decoding the mentoring experience : a conversation with Parker Palmer

"I think it would be awesome for everyone to be involved in a mentoring group. A lot of the time I don't think we needed 'guidance' but it was just great social interaction with people you would otherwise not have met" says one student in a University-wide First Year Initiative designed to assist students with the transition to University studies. Parker Palmer (1998, p. 21) describes mentoring as "a mutuality that requires more than meeting the right teacher; the teacher must meet the right student. In this encounter, not only are the qualities of the mentor revealed, but the qualities of the student are drawn out in a way that is equally revealing". In the Faculty of Education's 'pilot program' 54 students (25% of those enrolled in the Bachelor of Education, Primary) were randomly selected to participate. Mentoring groups consisted of six students who chose to meet volunteer staff mentors for six weeks. This paper is a reflection on the mentoring experience of one group that continues to meet regularly. The research question: What was it about the group members that allowed successful mentoring to happen? is addressed through a conversation with Parker's ideas, thereby decoding this rich mentoring experience.

River pilots for time`s flow: identifying factors to guide on-line distance education students in the use of their learning time

This research draws on recent studies of student time perception and use.
Case studies are used contrast the time use experiences of tertiary distance
education (on-line) students with tertiary students studying in traditional faceto-face classes with an online component. Previous studies and experience highlight a mismatch between the measurable and hence ”real” amount of time students spend at their computer and online, with the perceived” (and resented) time spent in online learning. This study uses investigates the recognition and application of factors affecting student perception of time spent in studying and learning online. It also compares the effectiveness of these factors when applied to distance education based wholly online classes, and face-to-face classes with an online component.
Some of the factors were measurably successful in reducing students’
perceptions of time “wasted” online, while others produced considerable
insight into face-to-face students perceptions of time used in study. The
factors included much greater focus on the person who was a student and
their expectations and time/life experiences while learning; the support and
use of alternative technologies such as mobile phones as learning and
communication too; a higher level of administrative and academic technical
support for the students; convergence of delivery methods; and strategic
involvement of teaching staff in design and delivery of learner management
systems.

Exploring general practitioners' experience of informing women about prenetal screening tests for foetal abnomalities : a qualitative focus group study

Background: Recent developments have made screening tests for foetal abnormalities available earlier in pregnancy and women have a range of testing options accessible to them. It is now recommended that all women, regardless of their age, are provided with information on prenatal screening tests. General Practitioners (GPs) are often the first health professionals a woman consults in pregnancy. As such, GPs are well positioned to inform women of the increasing range of prenatal screening tests available. The aim of this study was to explore GPs experience of informing women of prenatal genetic screening tests for foetal abnormality.
Methods: A qualitative study consisting of four focus groups was conducted in metropolitan and rural Victoria, Australia. A discussion guide was used and the audio-taped transcripts were independently coded
by two researchers using thematic analysis. Multiple coders and analysts and informant feedback were employed to reduce the potential for researcher bias and increase the validity of the findings.
Results: Six themes were identified and classified as 'intrinsic' if they occurred within the context of the consultation or 'extrinsic' if they consisted of elements that impacted on the GP beyond the scope of the
consultation. The three intrinsic themes were the way GPs explained the limitations of screening, the extent to which GPs provided information selectively and the time pressures at play. The three extrinsic
factors were GPs' attitudes and values towards screening, the conflict they experienced in offering screening information and the sense of powerlessness within the screening test process and the health
care system generally. Extrinsic themes reveal GPs' attitudes and values to screening and to disability, as well as raising questions about the fundamental premise of testing.
Conclusion: The increasing availability and utilisation of screening tests, in particular first trimester tests,has expanded GPs' role in facilitating women's informed decision-making. Recognition of the importance
of providing this complex information warrants longer consultations to respond to the time pressures that GPs experience. Understanding the intrinsic and extrinsic factors that impact on GPs may serve to shape
educational resources to be more appropriate, relevant and supportive.