End-of-life care in the intensive care setting : a descriptive exploratory qualitative study of nurses' beliefs and practices

Background: End-of-life care is a significant component of work in intensive care. Limited research has been undertaken on the provision of end-of-life care by nurses in the intensive care setting. The purpose of this study was to explore the end-of-life care beliefs and practices of intensive care nurses. Methods: A descriptive exploratory qualitative research approach was used to invite a convenience sample of five intensive care nurses from one hospital to participate in a semi-structured interview. Interview transcripts were analysed using an inductive coding approach. Findings: Three major categories emerged from analysis of the interviews: beliefs about end-of-life care, end-of-life care in the intensive care context and facilitating end-of-life care. The first two categories incorporated factors contributing to the end-of-life care experiences and practices of intensive care nurses. The third category captured the nurses’ end-of-life care practices. Conclusions: Despite the uncertainty and ambiguity surrounding end-of-life care in this practice context, the intensive care setting presents unique opportunities for nurses to facilitate positive end-of-life experiences and nurses valued their participation in the provision of end-of-life care. Care of the family was at the core of nurses’ end-of-life care work and nurses play a pivotal role in supporting the patient and their family to have positive and meaningful experiences at the end-of-life.Variation in personal beliefs and organisational support may influence nurses’ experiences and the care provided to patients and their families. Strategies to promote an organisational culture supportive of quality end-of-life care practices, and to mentor and support nurses in the provision of this care are needed.

"Food For Thought" Selected Design Installation DIA Homegrown 2011 Life In the Slow Lane Exhibition: Little Stanley Street, South Bank, Brisbane

'Homegrown is an initiative of the Design Institute of Australia–Queensland Branch to promote the collaboration and cultivation of local design talent in Queensland and strengthen the connection between design, plate, planet, people and culture.' Homegrown 2011 Exhibition Catalogue Excerpt

Solo life to Second Life : the design of physical and virtual learning spaces inspired by the drama classroom

This paper explores the design of virtual and physical learning spaces developed for students of drama and theatre studies. What can we learn from the traditional drama workshop that will inform the design of drama and theatre spaces created in technology-mediated learning environments? The authors examine four examples of spaces created for online, distance and on-campus students and discuss the relationship between the choice of technology, the learning and teaching methods, and the outcomes for student engagement. Combining insights from two previous action research projects, the discussion focuses on the physical space used for contemporary drama workshops, supplemented by Web 2.0 technologies; a modular online theatre studies course; the blogging space of students creating a group devised play; and the open and immersive world of Second Life, where students explore 3D simulations of historical theatre sites. The authors argue that the drama workshop can be used as inspiration for the design of successful online classrooms. This is achieved by focusing on students’ contributions to the learning as individuals and group members, the aesthetics and mise-en-scene of the learning space, and the role of mobile and networked technologies. Students in this environment increase their capacity to become co-creators of knowledge and to achieve creative outcomes. The drama workshop space in its physical and virtual forms is seen as a model for classrooms in other disciplines, where dynamic, creative and collaborative spaces are required.

Life cycle of the eel

Poem

Transforming mobile personal life log into autobiographical multimedia eChronicles

Mobile devices are becoming indispensable personal assistants in people's daily life as these devices support work, study, play and socializing activities. The multi-modal sensors and rich features of smartphones can capture abundant information about users' life experience, such as taking photos or videos on what they see and hear, and organizing their tasks and activities using calendar, to-do lists, and notes. Such vast information can become useful to help users recalling episodic memories and reminisce about meaningful experiences. In this paper, we propose to apply autobiographical memory framework to provide an effective mechanism to structure mobile life-log data. The proposed model is an attempt towards a more complete personal life-log indexing model, which will support long term capture, organization, and retrieval. To demonstrate the benefits of the proposed model, we propose some design solutions for enabling users-driven capture, annotation, and retrieval of autobiographical multimedia chronicles tools.

Life impact of ankle fractures : qualitative analysis of patient and clinician experiences

Background: Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. Methods: A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Results: Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. Conclusions: The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

The legitimation and reproduction of discourse-practice gaps in work-life balance

Purpose - Critical scholarship on work-life balance (WLB) and its associated practices maintains that workplace flexibility is more than a quasi-functionalist response to contemporary problems faced by individuals, families or organisations. Beginning with Fleetwood’s contention that WLB discourses have become "detached" from their associated practices, this paper explores how workplace practices support or challenge dominant WLB discourses evident in socio-cultural, political and organisational sources. Design/methodology/approach - We analyse individual and group interview transcripts derived from 122 white-collar employees in two different organisational contexts (one public, one private) in the construction industry in Australia. Findings - Four major themes were identified in the data which illustrate discourse practice gaps. First, the demands facing this particular industry/ sector were framed as heightened and unique. Second, productivity was prioritised, dominating employees’ care-giving and lifestyle concerns. Third, employees’ caring responsibilities were communicated as personal and individual choices. Fourth, commitment and efficiency were judged on the basis of presence in the workplace. Research limitations/implications - Even in industries that have embraced WLB, workplace practices legitimate and reinforce the status quo, and maintain a gap between the promises of WLB and its potential to ameliorate conflict and assist workers to span the boundaries of paid work and other life domains. Originality/value - While the practices demonstrated in the research are focused on one industry, the study provides a critical analysis of how the contextually-influenced meaning of WLB is constructed, created and contested in these workplaces and the effects it produces.

Whole life cycle costing for Malaysia high-rise residential building : a needs?

The continuous growth of high-rise residential properties indicates that there is a need for an effective property management system to provide a sustainable high-rise residential property development. As intensive as these studies are, they do not attempt to investigate the correlation between property management systems with the trends of Malaysia high-rise residential property development. By examining the trends and scenario of Malaysia high-rise residential property development, this paper aims to gain an understanding of impacts from the effectiveness of property management in this scope area. Findings from this scoping paper will assist in providing a greater understanding and possible solutions for the current Malaysian property management systems for the expanding high-rise residential unit market.

An exploratory review of whole life cycle costing for Malaysia property development

The demand of implementing Whole Life Cycle Costing (WLCC) towards property development has increased since the launch of Value Management Circular 3/2009 by the Economic Planning Unit Malaysia. The circular made compulsory for all public construction projects and programme including property development estimated more than RM 50 Million to conduct WLCC. However, a knowledge gap on WLCC approach still exists and become a barrier among the practitioner in Malaysia particularly in property development industry. The main focus of this paper is to discuss the WLCC approach and introduce the indicator that need to be considered in Malaysia property development.

Ironmongeries life cycle costing and quality satisfaction

Most commonly, residents are always arguing about the satisfaction of sustainability and quality of their high rise residential property. This paper aim is to maintain the best quality satisfaction of the door hardware by introducing the whole life cycle costing approach to the property manager of the public housing in Johor. This paper looks into the current situation of ironmongeries (door hardware) of 2 public housings in Johor, Malaysia and testing the whole life cycle costing approach towards them. The calculation and the literature review are conducted. The questionnaire surveys of 2 public housings were conducted to make clear the occupants’ evaluation about the actual quality conditions of the ironmongeries in their house. As a result, the quality of door hardware based on the whole life cycle costing approach is one of the best among their previous decision making tool that have been applied. Practitioners can benefit from this paper as it provides information on calculating the whole life costing and making the decisions about ironmongeries selection of their properties.

Whole life cycle costing and quality satisfaction : public housing floor material

Most commonly, residents are always arguing about the satisfaction of sustainability and quality of their high rise residential property. This paper aim is to maintain the best quality satisfaction of the floor materials by introducing the whole life cycle costing approach to the property manager of the public housing in Johor. This paper looks into the current situation of floor material of two public housings in Johor, Malaysia and testing the whole life cycle costing approach towards them. The cost figures may be implemented to justify higher investments, for examples, in the quality or flexibility of building solutions through a long-term cost reduction. The calculation and the literature review are conducted. The questionnaire surveys of two public housings were conducted to make clear the occupants’ evaluation about the actual quality conditions of the floor material in their house. As a result, the quality of floor material based on the whole life cycle costing approach is one of the best among their previous decision making tool that was applied. Practitioners can benefit from this paper as it provides information on calculating the whole life costing and making the decisions for floor material selection for their properties.

The effect of Tai Chi on health related quality of life in people with elevated blood glucose or diabetes : a randomized controlled trial

Purpose The aim was to assess the effects of a Tai Chi based program on health related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control. Method 41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical care control group (N = 21). The Tai Chi group involved 3 x 1.5 hour supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention. Results There were significant improvements in favour of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95% CI = 1.35-9.57, P < 0.05), role physical (mean difference = 18.60, 95% CI = 2.16-35.05, P < 0.05), bodily pain (mean difference = 9.88, 95%CI = 2.06-17.69, P < 0.05) and vitality (mean difference = 9.96, 95% CI = 0.77-19.15, P < 0.05). Conclusions The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.

Modification of advanced programmatic risk analysis and management model for the whole project life cycle’s risks

The advanced programmatic risk analysis and management model (APRAM) is one of the recently developed methods that can be used for risk analysis and management purposes considering schedule, cost, and quality risks simultaneously. However, this model considers those failure risks that occur only over the design and construction phases of a project’s life cycle. While it can be sufficient for some projects for which the required cost during the operating life is much less than the budget required over the construction period, it should be modified in relation to infrastructure projects because the associated costs during the operating life cycle are significant. In this paper, a modified APRAM is proposed, which can consider potential risks that might occur over the entire life cycle of the project, including technical and managerial failure risks. Therefore, the modified model can be used as an efficient decision-support tool for construction managers in the housing industry in which various alternatives might be technically available. The modified method is demonstrated by using a real building project, and this demonstration shows that it can be employed efficiently by construction managers. The Delphi method was applied in order to figure out the failure events and their associated probabilities. The results show that although the initial cost of a cold-formed steel structural system is higher than a conventional construction system, the former’s failure cost is much lower than the latter’s

Life writing

Two hundred years ago life writing was already highly popular in the form of autobiography, memoir, biography, journals, essays and diaries. It now commands a huge share of the publishing market, as there is an enormous demand from readers for narratives based directly on 'real lives'. There is a lot of common ground between the two main forms - autobiography/memoir and biography: both require skilled storytelling [rather than listing facts and events], research and imagination. The quality of the writing itself is crucial to the impact on the reader. A person can have an existing, worthy life but unfortunately write about it (or be written about) in a dull way. And how a person is remembered and valued can be a factor of life writing about or by them. This chapter will define and contextualise life writing, look at specific detailed examples, and offer guidance on how to write effectively.

Bushfire responsive design : real life responses to energy ratings, bushfire standards and biodiverse sites.

Many of the more extreme bushfire prone landscapes in Australia are located in colder climate regions. For such sites, the National Construction Code regulates that houses satisfy both the Australian Standard for Bushfire (AS 3959:2009) and achieve a 6 Star energy rating. When combined these requirements present a considerable challenge to the construction of affordable housing - a problem which is often exacerbated by the complex topography of bushifre prone landscapes. Dr Weir presents a series of case studies from his architetcural practice which highlight the need for further design-led research into affordable housing - a ground up holistic approach to design which recolciles energy performance, human behaviourm, bushland conservation and bushfire safety.