Managing intravenous medications in the non-hospital setting: An ethnographic investigation

Little published information exists about the issues involved in conducting complex intravenous medication therapy in patients' homes. An ethnographic study of a local hospital-in-the-home program in the Australian Capital Territory explored this phenomenon to identify those factors that had an impact on the use of medicine in the home environment. This article focuses on one of the three themes identified in the study-Clinical Practice. Within this theme, topics related to the organization and management of intravenous medications, geography and diversity of patient caseload, and communication in the practice setting are discussed. These findings have important implications for policy development and establishment of a research agenda for hospital-in-the-home services.

Preserving the past in digital memory

The process of researching children’s literature from the past is a growing challenge as resources age and are increasingly treated as rare items, stored away within libraries and other research centres. In Australia, researchers and librarians have collaborated with the bibliographic database AustLit: The Australian Literature Resource to produce the Australian Children’s Literature Digital Resources Project (CLDR). This Project aims to address the growing demand for online access to rare children’s literature resources, and demonstrates the research potential of early Australian children’s literature by supplementing the collection with relevant critical articles. The CLDR project is designed with a specific focus and provides access to full text Australian children’s literature from European settlement to 1945. The collection demonstrates a need and desire to preserve literature treasures to prevent losing such collections in a digital age. The collection covers many themes relevant to the conference including, trauma, survival, memory, survival, hauntings, and histories. The resource provides new and exciting ways with which to research children’s literature from the past and offers a fascinating repository to scholars and professionals of ranging disciplines who are in interested in Australian children’s literature.

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.

A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults.

Background Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults. Methods Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives. Results Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively. Conclusions The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach.

Design and Anthropology

Design and Anthropology challenges conventional thinking regarding the nature of design and creativity, in a way that acknowledges the improvisatory skills and perceptual acuity of people. Combining theoretical investigations and documentation of practice based experiments, it addresses methodological questions concerning the re-conceptualisation of the relation between design and use from both theoretical and practice-based positions. Concerned with what it means to draw 'users' into processes of designing and producing this book emphasises the creativity of design and the emergence of objects in social situations and collaborative endeavours. Organised around the themes of perception and the user-producer, skilled practices of designing and using, and the relation between people and things, the book contains the latest work of researchers from academia and industry, to enhance our understanding of ethnographic practice and develop a research agenda for the emergent field of design anthropology. Drawing together work from anthropologists, philosophers, designers, engineers, scholars of innovation and theatre practitioners, Design and Anthropology will appeal to anthropologists and to those working in the fields of design and innovation, and the philosophy of technology and engineering.

Breastfeeding beliefs and practices of African women living in Brisbane and Perth, Australia

The purpose of this study was to explore the experience of breastfeeding among refugee women from Liberia, Sierra Leone, Burundi and the Democratic Republic of Congo living in two major capital cities in Australia. Participants were recruited from their relevant community associations and via a snowballing technique. Thirty-one women took part in either individual interviews or facilitated group discussions to explore their experiences of breastfeeding in their home country and in Australia. Thematic analysis revealed four main themes: cultural breastfeeding beliefs and practices; stigma and shame around breastfeeding in public; ambivalence towards breastfeeding and breastfeeding support. Women who originated from these four African countries highlighted a significant desire for breastfeeding and an understanding that it was the best method for feeding their infants. Their breastfeeding practices in Australia were a combination of practices maintained from their countries of origin and those adopted according to Australian cultural norms. They exemplified the complexity of breastfeeding behaviour and the relationship between infant feeding with economic status and the perceived social norms of the host country. The results illustrate the need for policy makers and health professionals to take into consideration the environmental, social and cultural contexts of the women who are purportedly targeted for the promotion of breastfeeding.

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.

Cattanach v Melchior : babies, blessings and burdens

This article considers the High Court decision of Cattanach v Melchior, which permitted the recovery of damages for the cost of raising a child born through medical negligence. It discusses the reasoning in each of the judgments and seeks to identify themes so as to explain the divide between the majority and minority. It also considers the impact of legislative intervention in Queensland and New South Wales.

Influencing innovation in SME’s : from designer to transitional engineer

The following paper presents insights found during an ongoing industry engagement with a family-owned manufacturing SME in Australia. The study seeks to unpack cultural, strategic, product opportunities and challenges available to the firm engaging in a design led approach to innovation. Design led innovation finds new market opportunities to innovate through a holistic perspective of both the internal business operations, focusing on the customer experience and external stakeholders. The action research based methodology consisted of 25 semi-structured interviews, a reflective journal and focus group, all of which were analysed thematically. This paper focuses on the resultant themes of the focus group data constituting a discussion around the best strategies to try and integrate design thinking as a fundamental skill across the company. The main thematic results included the participant’s limited views of themselves (in current roles) as being to create ‘buy-in’ to change initiatives, a preference to act as a group to gain traction in the firm, importance of better defining the problem before reaching a design solution and lastly the time required to implement versus the need for change. These findings are valuable in assisting other family owned firms in managing core growth activities with design and innovation initiatives, particularly in the area of new product development.

Ian Weir Research Architect

Dr Ian Weir's practice is driven by a passion for the Fitzgerald Bioregion, a remote, bushfire-prone landscape on the south coats of Western Australia which is renowned internationally for its biodiversity. It is here that Dr Weir collaborates with individuals and organisations from the fields of ecology, botany, bushfire science, land surveying, landscape architecture and art practice, all of whom seek to expand understandings of this remarkable landscape. This diverse practice formation is constructed to address a significant problem beyond the scope of conventional modes of architectural practice: the reconciliation of biodiversity and bushfire with human habitation, through a multimodal approach using art practice cartography and architectural intervention. The chapter articulates Dr Weir's practice through a formation diagram and depicts key works of landscape representaion taken from "Enacted Cartography" and "Lightsite", two of Dr Weir's key research themes.

Dichotomy in the design studio : adapting to new blended learning environments

Since the architectural design studio learning environment was first established in the early 19th century at the École des Beaux-Arts in Paris, there has been a complete transformation in how the discipline of architecture is practiced and how students of architecture acquire information. Digital technologies allow students to access information instantly and learning is no longer confined to the rigid boundaries of a physical campus environment. In many schools of architecture in Australia, the physical design studio learning environments however, remain largely unchanged. Many learning environments could be mistaken for those last refurbished 30 years ago, being devoid of any significant technological intervention. While some teaching staff are eagerly embracing new digital technologies and attempting to modify their pedagogical approaches, the physical design studio learning environment is resistant to such efforts. In a study aimed at better understanding how staff and students adapt to new blended learning environments, a group of 165 second year architecture students at a large school of architecture in Australia were separated into two different design studio learning environments. 70% of students were allocated to a traditional design studio setting and 30% to a new, high technology embedded, prototype digital learning laboratory. The digital learning laboratory was purpose designed for the case-study users, adapted Student-Centred Active Learning Environment for Undergraduate Programs [SCALE-UP] principles, and built as part of a larger university research project. The architecture students attended the same lectures, followed the same studio curriculum and completed the same pieces of assessment; the only major differences were the teaching staff and physical environment within which the studios were conducted. At the end of the semester, all staff and students were asked to complete a questionnaire about their experiences and preferences within the two respective learning environments. The questionnaire response rate represented the opinions of 100% of the 10 teaching staff and over 70% of the students. Using a qualitative grounded theory approach, data were coded, extrapolated and compared, to reveal emerging key themes. The key themes formed the basis for in-depth interviews and focus groups of teaching staff and students, allowing the researchers to understand the data in more detail. The results of the data verified what had become increasingly evident during the course of the semester: an underlying negative resistance to the new digital studio learning environment, by both staff and students. Many participants openly exhibited a yearning for a return to the traditional design studio learning environments, particularly when the new technology caused frustration, by being unreliable or failing altogether. This paper reports on the study, discusses the negative resistance and explores the major contributors to resistance. The researchers are not aware of any similar previous studies across these particular settings and believe that it offers a necessary and important contribution to emergent research about adaptation to new digital learning environments.

Ian Weir Research Architect : website

Research background: Communicating the diverse nature of multimodal practice is inherently difficult for the design-led research academic. Websites are an effective means of displaying images and text, but for the user/viewer the act of viewing is often random and disorienting, due to the non-linear means of accessing the information. This characteristic of websites limits the medium’s efficacy in regard to presenting an overarching philosophical standpoint or theme - the key driver behind most academic research. Research Contribution: This website: http://www.ianweirarchitect.com, presents a means of reconciling this problem by presenting a deceptively simple graphic and temporal layout, which limits the opportunity for the user/viewer to become disoriented and miss the key themes and issues that binds, the otherwise divergent, research material together. Research significance: http://www.ianweirarchitect.com, is a creative work that supplements Dr Ian Weir’s exhibition “Enacted Cartography” held in August 2012 in Brisbane and in August/September 2012 in Venice, Italy for the 13th International Architecture Exhibition (Venice Architecture Biennale). Dr Weir was selected by the Australian Institute of Architects to represent innovation in architectural practice for the Institute’s Formations: New Practices in Australian Architecture, exhibition and catalogue (of the same name) held in the Australian Pavilion, The Giardini, Venice. This website is creative output that compliments Dr Weir’s other multimodal outputs including photographic artworks, cartographic maps and architectural designs.

The search for individualism : Self-expression through product personalisation

This research paper explores the impact product personalisation has upon product attachment and aims to develop a deeper understanding of why, how and if consumers choose to do so. The current research in this field is mainly based on attachment theories and is predominantly product specific. This paper researches the link between product attachment and personalisation through in-depth, semi-structured interviews, where the data has been thematically analysed and broken down into three themes, and nine sub-themes. It was found that participants did become more attached to products once they were personalised and the reasons why this occurred varied. The most common reasons that led to personalisation were functionality and usability, the expression of personality through a product and the complexity of personalisation. The reasons why participants felt connected to their products included strong emotions/memories, the amount of time and effort invested into the personalisation, a sense of achievement. Reasons behind the desire for personalisation included co-designing, expression of uniqueness/individualism and having choice for personalisation. Through theme and inter-theme relationships, many correlations were formed, which created the basis for design recommendations. These recommendations demonstrate how a designer could implement the emotions and reasoning for personalisation into the design process.

Building shared situational awareness in surgery through distributed dialogue

Background Failure to convey time-critical information to team members during surgery diminishes members’ perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness. Methods Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semi structured interviews were performed with 24 participants from anaesthesia, surgery, and nursing in the operating rooms of a large metropolitan hospital in Queensland, Australia. Thematic analysis was used. Results: The domain “coordinating decisions in surgery” was generated from textual data. Within this domain, three themes illustrated the dialog of clinical decisions, i.e., synchronizing and strategizing actions, sharing local knowledge, and planning contingency decisions based on priority. Conclusion Strategies used to convey decisions that enhanced shared situational awareness included the use of “self-talk”, closed-loop communications, and “overhearing” conversations that occurred at the operating table. Behaviours’ that compromised a team’s shared situational awareness included tunnelling and fixating on one aspect of the situation.

From entrepreneur to philanthropist : the “second half of the game”

This paper uses interviews with wealthy Australians to examine the progression from entrepreneurship to philanthropy in an Australian context. Understanding the characteristics, behaviours and motivations of this group of entrepreneurs turned philanthropists strengthens the links identified in international research between the entrepreneurship and philanthropic sectors. Three major themes emerging from the qualitative data are explored: first, the tipping points that move individuals (and their partners/families) between the two spheres of activity; and second, the strong motivations for giving that see entrepreneurs identified internationally as more generous than high net worth individuals whose wealth derives from other sources. The third major theme is the modes of giving that distinguish those with an entrepreneurship background from other philanthropists. The unique characteristics of a smaller sub-set of ultra high net worth donors are also explored, and areas for future study are highlighted.