In Bed with Autobiography: Unravelling the Fabric of Gender and Genre in Women’s Bed(room) Confessions

This thesis consists of a confessional narrative, What My Mother Doesn’t Know, and an accompanying exegesis, And Why I Should (Maybe) Tell Her. The creative piece employs the confessional mode as a subversive device in three separate narratives, each of which situates the bed as a site of resistance. The exegesis investigates how this self-disclosure in a domestic space flouts the governing rules of self-representation, specifically: telling the truth, respecting privacy and displaying normalcy. The female confession, I argue, creates an alternative space in women’s autobiography where notions of truth-telling can be undermined, the political dimensions of personal experience can be uncovered and the discourse of normality can be negotiated. In particular, women’s confessions told in, on or about the bed, dismantle the genre’s illusion of self and confirm the representative aspects of women’s experience. Framed within these parameters of power and powerlessness, the exegesis includes textual analyses of Charlotte Perkins Gilman’s The Yellow Wallpaper (1892), Tracey Emin’s My Bed (1999) and Lauren Slater’s Lying (2000), each of which exposes in a bedroom space, the author’s most obscure, intimate and traumatic experiences. Situated firmly within and against the genre’s traditional masculine domain, the exegesis also includes mediations on the creative work that validate the bed as my fabric for confession.

Evolution and change in industrial clusters : an analysis of Hsinchu and Sophia Antipolis

The aim of this paper is to advance understandings of the processes of cluster-building and evolution, or transformative and adaptive change, through the conscious design and reflective activities of private and public actors. A model of transformation is developed which illustrates the importance of actors becoming exposed to new ideas and visions for industrial change by political entrepreneurs and external networks. Further, actors must be guided in their decision-making and action by the new vision, and this requires that they are persuaded of its viability through the provision of test cases and supportive resources and institutions. In order for new ideas to become guiding models, actors must be convinced of their desirability through the portrayal of models as a means of confronting competitive challenges and serving the economic interests of the city/region. Subsequent adaptive change is iterative and reflexive, involving a process of strategic learning amongst key industrial and political actors.

The Capability of Nurse Practitioners may be Diminished by the Use of Controlling Protocols

Nurse practitioners will become a vital component of the health workforce because of the growing need to manage chronic illness, to deliver effective primary health services, and to manage workforce challenges effectively. In addition, the role of nurse practitioner is an excellent example of increased workforce flexibility and changes to occupational boundaries. This paper draws on an Australasian research project which defined the core role of nurse practitioners, and identified capability as the component of their level of practice that makes their service most useful. We argue that any tendency to write specific protocols to define the limits of nurse practitioner practice will reduce the efficacy of their contribution. The distinction we wish to make in this paper is between guidelines aiming to support practice, and protocols which aim to control practice.

Community engagement and artful academic staff development : a return on expectations through collaborative practice

The changing ownership of roles in organisational work-life leads this paper to examine what universities are doing in their academic development practice through research at an Australian university where ‘artful’ collaboration with the real world aims to build capability for innovative academic community engagement. The paper also presents findings on the ‘return on expectations’ (Hodges, 2004) of community engagement for both academics and their organisational supervisors.

Re-generating the praxis of academic staff development through arts-based learning : beyond paradox

Effective staff development remains a challenge in higher education. This paper examines the non-traditional methodology of arts-based staff development, its potential to foster transformational learning and the practice of professional artistry, through perceptions of program impact. Over a three year period, eighty academics participated in one metropolitan Australian university’s arts-based academic development program. The methodology used one-on-one hermeneutic-based conversations with fifteen self-selected academics and a focus group with twenty other academics from all three years. The paper presents a learning model to engender academic professional artistry. The findings provide developers with support for using a non-traditional strategy of transformational learning.

Researching crime and violence: Untold stories from the field

Undertaking empirical research on crime and violence can be a tricky enterprise fraught with ethical, methodological, intellectual and legal implications. This chapter takes readers on a reflective journey through the qualitative methodologies I used to research sex work in Kings Cross, miscarriages of justice, female delinquency, sexual violence, and violence in rural and regional settings over a period of nearly 30 years. Reflecting on these experiences, the chapter explores and analyses the reality of doing qualitative field research, the role of the researcher, the politics of subjectivity, the exercise of power, and the ‘muddiness’ of the research process, which is often overlooked in sanitised accounts of the research process (Byrne-Armstrong, Higgs and Horsfall, 2001; Davies, 2000).

The design and testing of a daylighting device : optimising the energy and optical performance of Australian commercial buildings

The effective daylighting of multistorey commercial building interiors poses an interesting problem for designers in Australia’s tropical and subtropical context. Given that a building exterior receives adequate sun and skylight as dictated by location-specific factors such as weather, siting and external obstructions; then the availability of daylight throughout its interior is dependant on certain building characteristics: the distance from a window façade (room depth), ceiling or window head height, window size and the visible transmittance of daylighting apertures. The daylighting of general stock, multistorey commercial buildings is made difficult by their design limitations with respect to some of these characteristics. The admission of daylight to these interiors is usually exclusively by vertical windows. Using conventional glazing, such windows can only admit sun and skylight to a depth of approximately 2 times the window height. This penetration depth is typically much less than the depth of the office interiors, so that core areas of these buildings receive little or no daylight. This issue is particularly relevant where deep, open plan office layouts prevail. The resulting interior daylight pattern is a relatively narrow perimeter zone bathed in (sometimes too intense) light, contrasted with a poorly daylit core zone. The broad luminance range this may present to a building occupant’s visual field can be a source of discomfort glare. Furthermore, the need in most tropical and subtropical regions to restrict solar heat gains to building interiors for much of the year has resulted in the widespread use of heavily tinted or reflective glazing on commercial building façades. This strategy reduces the amount of solar radiation admitted to the interior, thereby decreasing daylight levels proportionately throughout. However this technique does little to improve the way light is distributed throughout the office space. Where clear skies dominate weather conditions, at different times of day or year direct sunlight may pass unobstructed through vertical windows causing disability or discomfort glare for building occupants and as such, its admission to an interior must be appropriately controlled. Any daylighting system to be applied to multistorey commercial buildings must consider these design obstacles, and attempt to improve the distribution of daylight throughout these deep, sidelit office spaces without causing glare conditions. The research described in this thesis delineates first the design optimisation and then the actual prototyping and manufacture process of a daylighting device to be applied to such multistorey buildings in tropical and subtropical environments.

Discovering, applying and integrating self-knowledge : a grounded theory study of learning in life coaching

Professional coaching is a rapidly expanding field with interdisciplinary roots and broad application. However, despite abundant prescriptive literature, research into the process of coaching, and especially life coaching, is minimal. Similarly, although learning is inherently recognised in the process of coaching, and coaching is increasingly being recognised as a means of enhancing teaching and learning, the process of learning in coaching is little understood, and learning theory makes up only a small part of the evidence-based coaching literature. In this grounded theory study of life coaches and their clients, the process of learning in life coaching across a range of coaching models is examined and explained. The findings demonstrate how learning in life coaching emerged as a process of discovering, applying and integrating self-knowledge, which culminated in the development of self. This process occurred through eight key coaching processes shared between coaches and clients and combined a multitude of learning theory.

Management of co-occurring substance use disorders

Reviewing the breadth of current knowledge on schizophrenia, this handbook provides clear, practical guidelines for effective assessment and treatment in diverse contexts. Leading authorities have contributed 61 concise chapters on all aspects of the disorder and its clinical management. In lieu of exhaustive literature reviews, each chapter summarizes the current state of the science; highlights key points the busy practitioner needs to know; and lists recommended resources, including seminal research studies, invaluable clinical tools, and more. Comprehensive, authoritative, and timely, the volume will enable professionals in any setting to better understand and help their patients or clients with severe mental illness.

The work of nurse practitioners : a national work sampling study

Aim: This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. --------- Methods: We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover two weeks of work time from a sampling frame of six weeks. --------- Results: A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.2% and service-related activities made up 31.9%. --------- Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation.

A Delphi study to validate an advanced practice nursing tool

Aim This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce.

Privacy and trust management for electronic health records

Establishing a nationwide Electronic Health Record system has become a primary objective for many countries around the world, including Australia, in order to improve the quality of healthcare while at the same time decreasing its cost. Doing so will require federating the large number of patient data repositories currently in use throughout the country. However, implementation of EHR systems is being hindered by several obstacles, among them concerns about data privacy and trustworthiness. Current IT solutions fail to satisfy patients’ privacy desires and do not provide a trustworthiness measure for medical data. This thesis starts with the observation that existing EHR system proposals suer from six serious shortcomings that aect patients’ privacy and safety, and medical practitioners’ trust in EHR data: accuracy and privacy concerns over linking patients’ existing medical records; the inability of patients to have control over who accesses their private data; the inability to protect against inferences about patients’ sensitive data; the lack of a mechanism for evaluating the trustworthiness of medical data; and the failure of current healthcare workflow processes to capture and enforce patient’s privacy desires. Following an action research method, this thesis addresses the above shortcomings by firstly proposing an architecture for linking electronic medical records in an accurate and private way where patients are given control over what information can be revealed about them. This is accomplished by extending the structure and protocols introduced in federated identity management to link a patient’s EHR to his existing medical records by using pseudonym identifiers. Secondly, a privacy-aware access control model is developed to satisfy patients’ privacy requirements. The model is developed by integrating three standard access control models in a way that gives patients access control over their private data and ensures that legitimate uses of EHRs are not hindered. Thirdly, a probabilistic approach for detecting and restricting inference channels resulting from publicly-available medical data is developed to guard against indirect accesses to a patient’s private data. This approach is based upon a Bayesian network and the causal probabilistic relations that exist between medical data fields. The resulting definitions and algorithms show how an inference channel can be detected and restricted to satisfy patients’ expressed privacy goals. Fourthly, a medical data trustworthiness assessment model is developed to evaluate the quality of medical data by assessing the trustworthiness of its sources (e.g. a healthcare provider or medical practitioner). In this model, Beta and Dirichlet reputation systems are used to collect reputation scores about medical data sources and these are used to compute the trustworthiness of medical data via subjective logic. Finally, an extension is made to healthcare workflow management processes to capture and enforce patients’ privacy policies. This is accomplished by developing a conceptual model that introduces new workflow notions to make the workflow management system aware of a patient’s privacy requirements. These extensions are then implemented in the YAWL workflow management system.

A collaborative approach to home care delivery for older clients: Perspectives of home care providers

A collaborative approach to home care (HC) delivery for older clients has taken centre stage (Nies, 2006). In Finland, public home help and home health care services have been combined to form the home care unit, whose goal is to provide a collaborative approach to care delivery through cooperation and sharing of responsibilities. In this model, the general practitioner (GP), home care nurses (HCN) and home help workers (HHW) care for shared clients. GPs and HCNs provide health care, such as monitoring of clients’ health status, and HHWs assist with personal care tasks such as dressing, washing and meal preparation. As the needs of older clients are multiple, collaboration is needed as one professional group cannot take sole responsibility (Nies, 2006). This paper reports on a study undertaken to examine home care unit care providers’ perspectives of the collaborative approach to HC delivery for older clients.