New graduate occupational therapists feelings of preparedness for practice in Australia and Aotearoa/New Zealand

Aim The development of competent future allied health professionals through academic programmes, professional support and practical education is continually evolving. The aim of this study was to explore the feelings of newly graduated occupational therapists in Australia and Aotearoa/New Zealand regarding their education and work preparedness. Methods Newly graduated occupational therapists from Australia (n = 178) and Aotearoa/New Zealand (n = 53) who had completed their occupational therapy studies in 2007 were recruited. Participants completed an online survey which explored their preparedness for work; based on professional competencies. Results Most newly graduated occupational therapists felt somewhat prepared for practice. However, only 17.1% of Australian new graduates, and even fewer (8.5%) of Aotearoa/New Zealand new graduates felt very well prepared. Participants felt more prepared for the competencies required for ‘managing inwards’ (including interpersonal skills) and less prepared for those required for ‘managing outwards’ (including evidence-based practice). Conclusions This study provides the first international comparison into the feelings of competence and preparedness for practice of new graduates of occupational therapy from Australia and Aotearoa/New Zealand. Given the importance of competencies, such as evidence-based practice to the progress of the profession, there is a need to further explore methods to increase feelings of preparedness in these areas.

‘Working with the team’ : an exploratory study of improved type 2 diabetes management in a new model of integrated primary/secondary care

This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabetes management, the Brisbane South Complex Diabetes Service (BSCDS), related to improved diabetes management in a selected group of patients. We used a qualitative research design to obtain detailed accounts from the BSCDS via semi-structured interviews with 10 patients. The interviews were fully transcribed and systematically coded using a form of thematic analysis. Participants’ responses were grouped in relation to: (1) Patient-centred care; (2) Effective multiprofessional teamwork; and (3) Empowering patients. The key features of this integrated primary/secondary care model were accessibility and its delivery within a positive health care environment, clear and supportive interpersonal communication between patients and health care providers, and patients seeing themselves as being part of the team-based care. The BSCDS delivered patient-centred care and achieved patient engagement in ways that may have contributed to improved type 2 diabetes management in these participants.

Conflict and communication among engineers

The trend of cultural diversity is increasing in all organizations, especially engineering ones, due to globalization, mergers, joint ventures and the movement of the workforce. The collaborative nature of projects in engineering industries requires long-term teamwork between local and international engineers. Research confirms a specific culture among engineering companies that isassumed to have a negative effect on collaboration and communication among co-workers. Multicultural workplaces have been reported as challenging environments in the engineering work culture, which calls for more research among engineering organizations. An everyday challenge for co-workers, especially in culturally diverse contexts, is handling interpersonal conflict. This perceived conflict among individuals can happen because of actual differences in tasks or relationships. Research demonstrates that task conflict at the group level has some positive effects on decision-making and innovation, while it has negative effects on employees’ work attitude and performance. However, relationship conflict at the individual level has only negative effects including frustration, tension, low job satisfaction, high employee turnover and low productivity. Outcomes of both task and relationship conflict at individual level can have long-term negative consequences like damaged organizational commitment. One of the most important sources of differences between individuals, which results in conflict, is their cultural backgrounds. First, this thesis suggests that in culturally diverse workplaces, people perceive more relationship conflict than task conflict. Second, this thesis examines interpersonal communication in culturally diverse work places. Communicating effectively in culturally diverse workplaces is crucial for today’s business. Culture has a large effect on the ways that people communicate with each other. Ineffective communication can escalate interpersonal conflict and cause frustration in the long term. Communication satisfaction, defined as enjoying the communication and feeling that the communication was appropriate and effective, has a positive effect on individuals’ psychological wellbeing. In a culturally diverse workplace, it is assumed that individuals feel less satisfied with their interpersonal communications because of their lack of knowledge about other cultures’ communication norms. To manage interpersonal interactions, many authors suggest that individuals need a specific capability, i.e., cultural intelligence (some studies use cultural competence, global intelligence or intercultural competence interchangeably). Some authors argue that cultures are synergic and convergent and the postmodernist definition of culture is just our dominant beliefs. However, other authors suggest that cultural intelligence is the strongest and most comprehensive competency for managing cross-cultural interactions, because various cultures differ so greatly at the micro level. This thesis argues that individuals with a high level of cultural intelligence perceive less interpersonal conflict and more satisfaction with their interpersonal communication. Third, this thesis also looks at individuals' perception of cultural diversity. It is suggested that level of cultural diversity plays a moderating role on all of the proposed relationships (effect of cultural intelligence on perception of relationship conflict/ communication satisfaction) This thesis examines the relationship among cultural diversity, cultural intelligence, interpersonal conflict and communication by surveying eleven companies in the oil and gas industry. The multicultural nature of companies within the oil and gas industry and the characteristics of engineering culture call for more in-depth research on interpersonal interactions. A total of 286 invitation emails were sent and 118 respondents replied to the survey, giving a 41.26 per cent response rate. All the respondents were engineers, engineering managers or practical technicians. The average age of the participants was 36.93 years and 58.82 per cent were male. Overall, 47.6 per cent of the respondents had at least a master’s degree. Totally, 42.85 per cent of the respondents were working in a country that was not their country of birth. The overall findings reveal that cultural diversity and cultural intelligence significantly influence interpersonal conflict and communication satisfaction. Further, this thesis also finds that cultural intelligence is an effective competency for dealing with the perception of interpersonal relationship conflict and communication satisfaction when the level of cultural diversity is moderate to high. This thesis suggests that cultural intelligence training is necessary to increase the level of this competency among employees in order to help them to have better understanding of other cultures. Human resource management can design these training courses with consideration for the level of cultural diversity within the organization.

The kineikonic mode : a multimodal analysis of students’ claymation movies

Globalised communication in society today is characterised by multimodal forms of meaning making in the context of increased cultural and linguistic diversity. This research paper responds to these imperatives, applying Halliday's (1978, 1994) categories of systemic functional linguistics - representational or ideational, interactive or interpersonal, and compositional or textual meanings. Following the work of Kress (2000), van Leeuwen (Kress and van Leeuwen, 1996), and Jewitt (2006), multimodal semiotic analysis is applied to claymation movies that were collaboratively designed by Year 6 students. The significance of this analysis is the metalanguage for textual work in the kineikonic mode - moving images.

The confidence of speech-language pathology students regarding communicating with people with aphasia

Background Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements. Methods This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA. Results SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17–47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students‘ age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate). Conclusions SLP students who had received aphasia related theoretical coursework, but not commenced clinical placements with PWA, were not confident in their ability to communicate with PWA. Students may benefit from an educational intervention or curriculum modification to incorporate practical training in effective strategies to communicate with PWA, before they encounter PWA in clinical settings. Ensuring students have confidence and knowledge of potential communication strategies to assist communication with PWA may allow them to focus their learning experiences in more specific clinical domains, such as clinical reasoning, rather than building foundation interpersonal communication skills.

Social support promotes psychological well-being following a natural disaster

Receiving emotional support has consistently been demonstrated as an important factor associated with mental health but sparse research has investigated giving support in addition to receiving it or the types of support that predict well-being. In this paper the relationship between giving and receiving instrumental and emotional social support and psychological well-being during and following a natural disaster is investigated. A survey administered between four and six months after fatal floods was conducted with 200 community members consisting of men (n = 68) and women (n = 132) aged between 17 and 87 years. Social support experiences were assessed using the 2-Way Social Support Scale (2-Way SSS; Shakespeare-Finch & Obst, 2011) and eudemonic well-being was measured using the Psychological Well-Being Scale (PWBS; Ryff & Keyes, 1995). Hierarchical multiple regression analyses were used to examine expected relationships and to explore the differential effects of the four factors of the 2-Way SSS. Results indicated that social support shared significant positive associations with domains of psychological well-being, especially with regards to interpersonal relationships. Receiving and giving emotional support were respectively the strongest unique predictors of psychological well-being. However, receiving instrumental support predicted less autonomy. Results highlight the importance of measuring social support as a multidimensional construct and affirm that disaster response policy and practice should focus on emotional as well as instrumental needs in order to promote individual and community psychosocial health following a flooding crisis.

Alcohol-related violence presenting to the emergency department : is ‘glassing’ the big issue?

Objective Describe the characteristics of patients presenting to Emergency Departments (EDs) within Queensland, Australia with injuries due to assault with a glass implement (‘glassing’) and to set this within the broader context of presentations due to alcohol-related violence. Methods Analysis of prospectively collected ED injury surveillance data collated by the Queensland Injury Surveillance Unit (QISU) between 1999 and 2011. Cases of injury due to alcohol-related violence were identified and analysed using coded fields supplemented with qualitative data contained within the injury description text. Descriptive statistics were used to assess the characteristics of injury presentations due to alcohol-related violence. Violence included interpersonal violence and aggression (verbal aggression and object violence). Results A total of 4629 cases were studied. The study population was predominantly male (72%) and aged 18 to 24 (36%), with males in this age group comprising more than a quarter of the study population (28%). Nine percent of alcohol-related assault injuries were a consequence of ‘glassing’. The home was the most common location for alcohol-related violence (31%) and alcohol-related ‘glassings’ (33%). Overall, the most common glass object involved was a bottle (75%), however, within licensed venues an even mix of a drinking glass (44%) and glass bottle (45%) were identified. Conclusions Contrary to public perception generated by media, ‘glassing’ incidents, particularly at licensed venues, constitute a relatively small proportion of all alcohol-related violence. The current study highlights the predominance of young men injured following alcohol-related violence, demonstrating a key focus area within the population for aiming prevention strategies.

Integrating Intangible Cultural Heritage elements and learning strategy : a case study

Tanzania has a rich and diverse cultural history based on community cultural life. However, at present, young people have limited opportunity to exploit this richness of creative expressions and engage in creative jobs as their future career. Hence, the significant challenge remains: how to integrate Intangible cultural heritage elements and learning strategy as a means of promoting creative jobs for youth. This paper presents a case study on 'Strategies for youth employment in Tanzania: A creative industries approach'. The case study employed mixed methods incorporating questionnaires, interviews and focus groups and was held in Dar-Es-Salaam, Mwanza, Dodoma, Lindi and Morogoro from July to October, 2012. This paper discusses some of the issues and argues that there is no virtual utilization of the intangible cultural heritage knowledge and skills in 'putting education to work' (UNESCO, 2012) for the better prospects of youth. Although the discussion is specific to Tanzania, the case may also apply to other developing countries.

The remediation of the personal photograph and the politics of self-representation in digital storytelling

Over the past couple of decades, the cultural field formerly known as ‘domestic’, and later ‘personal’ photography has been remediated and transformed as part of the social web, with its convergence of personal expression, interpersonal communication, and online social networks (most recently via platforms like Flickr, Facebook and Twitter). Meanwhile, the Digital Storytelling movement (involving the workshop-based production of short autobiographical videos) from its beginnings in the mid 1990s relied heavily on the narrative power of the personal photograph, often sourced from family albums, and later from online archives. This paper addresses the new issues arising for the politics of self-representation and personal photography in the era of social media, focusing particularly on the consequences of online image-sharing. It discusses in detail the practices of selection, curation, manipulation and editing of personal photographic images among a group of activist-oriented queer digital storytellers who have in common a stated desire to share their personal stories in pursuit of social change, and whose stories often aim to address both intimate and antagonistic publics.

In their own words : adolescents strategies to prevent friend's risk taking

Injury is a significant public health problem among youth. A primary cause of adolescent injury is risk-taking behavior, including alcohol use, interpersonal violence and road-related risks. A novel approach to prevention is building on friendships by encouraging adolescents to intervene into their friends’ risk taking. Fifty-one early adolescents (13-14 years) and 44 older adolescents (16-17 years) from two Australian schools participated in focus groups, aiming to explore stories of intervening. Findings showed preference for talking to friends; however, participants also spoke to adults, monitored friends’ behavior and planned ahead. Close friendships, perceived harm, and self-efficacy influenced the likelihood of intervening. These findings have implications for the design of risk and injury prevention programs, by suggesting strategies to promote adolescents’ communicative ability for risk reduction. The findings also highlight the language and dialogue of adolescents and suggest that methods for increasing intervening behavior should focus on building social connectedness and increasing self-efficacy.

The intervening role of Agreeableness in the relationship between trait emotional intelligence and Machiavellianism : reassessing the potential dark side of EI

Previous research into the potential ‘dark’ side of trait emotional intelligence (EI) has repeatedly demonstrated that trait EI is negatively associated with Machiavellianism. In this study, we reassess the potential dark side of trait EI, by testing whether Agreeableness mediates and/or moderates the relationship between trait EI and Machiavellianism. Hypothesized mediation and moderation effects were tested using a large sample of 884 workers who completed several self-report questionnaires. Results provide support for both hypotheses; Agreeableness was found to mediate and moderate the relationship between trait EI and Machiavellianism. Overall, results indicate that individuals high in trait EI tend to have low levels of Machiavellianism because they generally have a positive nature (i.e. are agreeable) and not because they are emotionally competent per se. Results also indicate that individuals high in ‘perceived emotional competence’ have the potential to be high in Machiavellianism, particularly when they are low in Agreeableness.

Sharing the news : Dissemination of links to Australian news sites on Twitter

Social media adoption in Australia, which provides the geographic focus for this chapter, has been rapid and substantial (ABC News, 2010) – possibly because of the considerable dispersal of the Australian population across the continent, as well as the significant distance of the country from many of its closest partner nations. Social media can play an important role in strengthening and maintaining interpersonal and professional relationships in spite of such physical distance; in particular, social media services are now well-recognised as important tools for the dissemination of news across many developed nations. Hermida (2010) and Burns (2010) both speak of Twitter as a medium for “ambient news”, for example: always-on, operating as a steady stream in the background and at the edge of users’ conscious perception. Much as ambient music is designed to do, it comes to the fore when notable events (such as major breaking news) lead to an increase in volume and demand a greater level of attention from users.

Young women's recent experience of labour and birth care in Queensland

Background Young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. Methods Secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15–20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. Results In the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. Conclusion This study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time.

End-of-life care in the critical care setting : nurses' practices and factors affecting these practices

Background: Critical care units are designed and resourced to save lives, yet the provision of end-of-life care is a significant component of nursing work in these settings. Limited research has investigated the actual practices of critical care nurses in the provision of end-of-life care, or the factors influencing these practices. To improve the care that patients at the end of life and their families receive, and to support nurses in the provision of this care, further research is needed. The purpose of this study was to identify critical care nurses' end-of-life care practices, the factors influencing the provision of end-of-life care and the factors associated with specific end-of-life care practices. Methods: A three-phase exploratory sequential mixed-methods design was utilised. Phase one used a qualitative approach involving interviews with a convenience sample of five intensive care nurses to identify their end-of-life care experiences and practices. In phase two, an online survey instrument was developed, based on a review of the literature and the findings of phase one. The survey instrument was reviewed by six content experts and pilot tested with a convenience sample of 28 critical care nurses (response rate 45%) enrolled in a postgraduate critical care nursing subject. The refined survey instrument was used in phase three of this study to conduct a national survey of critical care nurses. Descriptive analyses, exploratory factor analysis and univariate general linear modelling was undertaken on completed survey responses from 392 critical care nurses (response rate 25%). Results: Six end-of-life care practice areas were identified in this study: information sharing, environmental modification, emotional support, patient and family-centred decision making, symptom management and spiritual support. The items most frequently identified as always undertaken by critical care nurses in the provision of end-of-life care were from the information sharing and environmental modification practice areas. Items least frequently identified as always undertaken included items from the emotional support practice area. Eight factors influencing the provision of end-of-life care were identified: palliative values, patient and family preferences, knowledge, preparedness, organisational culture, resources, care planning, and emotional support for nurses. Strong agreement was noted with items reflecting values consistent with a palliative approach and inclusion of patient and family preferences. Variation was noted in agreement for items regarding opportunities for knowledge acquisition in the workplace and formal education, yet most respondents agreed that they felt adequately prepared. A context of nurse-led practice was identified, with variation in access to resources noted. Collegial support networks were identified as a source of emotional support for critical care nurses. Critical care nurses reporting values consistent with a palliative approach and/or those who scored higher on support for patient and family preferences were more likely to be engaged in end-of-life care practice areas identified in this study. Nurses who reported higher levels of preparedness and access to opportunities for knowledge acquisition were more likely to report engaging in interpersonal practices that supported patient and family centred decision making and emotional support of patients and their families. A negative relationship was identified between the explanatory variables of emotional support for nurses and death anxiety, and the patient and family centred decision making practice area. Contextual factors had a limited influence as explanatory variables of specific end-of-life care practice areas. Gender was identified as a significant explanatory variable in the emotional and spiritual support practice areas, with male gender associated with lower summated scores on these practice scales. Conclusions: Critical care nurses engage in practices to share control with and support inclusion of families experiencing death and dying. The most frequently identified end-of-life care practices were those that are easily implemented, practical strategies aimed at supporting the patient at the end of life and the patient's family. These practices arguably require less emotional engagement by the nurse. Critical care nurses' responses reflected values consistent with a palliative approach and a strong commitment to the inclusion of families in end-of-life care, and these factors were associated with engagement in all end-of-life care practice areas. Perceived preparedness or confidence with the provision of end-of-life care was associated with engagement in interpersonal caring practices. Critical care nurses autonomously engage in the provision of end-of-life care within the constraints of an environment designed for curative care and rely on their colleagues for emotional support. Critical care nurses must be adequately prepared and supported to provide comprehensive care in all areas of end-of-life care practice. The findings of this study raise important implications, and informed recommendations for practice, education and further research.

No right to live? Malaysia’s Islam and implications for its sexual minority storytellers

This paper discusses the fast emerging challenges for Malay and Muslim sexual minority storytellers in the face of an aggressive state-sponsored Islamisation of a constitutionally secular Malaysia. I examine the case of Azwan Ismail, a gay Malay and Muslim Malaysian who took part in the local ‘It Gets Better’ Project, initiated in December 2010 by Seksualiti Merdeka (an annual sexuality rights festival) and who suffered an onslaught of hostile comments from fellow Malay Muslims. In this paper, I ask how a message aimed at discouraging suicidal tendencies among sexual minority teenagers can go so wrong. In discussing the contradictions between Azwan’s constructions of self and the expectations others have of him, I highlight the challenges for Azwan’s existential self. For storytellers who are vulnerable if visible, the inevitable sharing of a personal story with unintended and hostile audiences when placed online, can have significant repercussions. The purist Sunni Islam agenda in Malaysia not only rejects the human rights of the sexual minority in Malaysia but has influenced and is often a leading hostile voice in both regional and international blocs. This self-righteous and supremacist political Islam fosters a more disabling environment for vulnerable, minority communities and their human rights. It creates a harsher reality for the sexual minority that manifests in State-endorsed discrimination, compulsory counselling, forced rehabilitation and their criminalisation. It places the right of the sexual minority to live within such a community in doubt. I draw on existing literature on how personal stories have historically been used to advance human rights. Included too, is the signifance and implications of the work by social psychologists in explaining this loss of credibility of personal stories. I then advance an analytical framework that will allow storytelling as a very individual form of witnessing to reclaim and regain its ‘truth to power’.