Parent views of play in the Preparatory Year in Queensland

Over the past ten years, Queensland has experienced a period of significant education reform including the introduction in 2007 of a Preparatory Year of schooling for children aged five years. Recently, the development of a new Australian Curriculum represents a further curriculum reform impacting on Prep in Queensland, as Prep is, for the first time, part of the broader school curriculum and specific content is to be taught. The place of play as a context for learning is a current topic of interest during this period of change, and this thesis argues that consideration of parent views with regard to play and its place in Prep is timely and strategic. This thesis reports the findings of a research project that used case study to elicit and describe the ways in which eight parents viewed play in Prep. Analysis of parent interviews identified four themes: (1) parents interpreting play in Prep, (2) play and learning in Prep, (3) the Prep teacher's role in play and (4) parent tensions regarding play and learning in Prep. The results of the study suggest that variation exists in the ways in which parents may view and interpret play in Prep in Queensland. Analysis of the data further suggests that these interpretations may reflect parents' understanding of the Prep program and their attitudes to play and school generally. This thesis suggests that parents may spend limited time in Prep classrooms, which may impact on their understanding of play as a theoretical tenet in Prep and may highlight limitations in parent-teacher partnerships. The results of this study suggest that more attention be given to engaging parents in early childhood programs and eliciting their views on these programs. The results also suggest the importance of early childhood teachers advocating on behalf of play with their teaching colleagues, school leaders and policy makers.

‘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.

The family participation in child care project : educator views

The capacity of educators to work in partnership with families is considered to be a hallmark of quality practice in education and care. The rationale is that ‘children thrive when families and educators work together in partnership to support young children’s learning’ (DEEWR 2009, p. 9).To support genuine partnerships, the Brisbane South Professional Support Network (PSN) is leading a collaborative project, with the Health and Community Services Workforce Council and Queensland University of Technology (QUT), known as the ‘Family Participation in ECEC project’. The overarching aim of the project is to investigate different perspectives of family partnership in ECEC, with a focus on information sharing, information seeking and family participation,to build educator capacity to establish and maintain genuine partnerships with families. Maintaining a practical focus, and linking to the National Quality Framework for Early Childhood Education and Care (Quality Area 6), the study findings offer insight into the different ways that diverse families and educators may view and experience partnership, and as such provide a sound basis for critical reflection, professional learning and improved practice.

Feminist ethics and menopause : autonomy and decision-making in primary medical care

The construction of menopause as a long-term risk to health and the adoption of discourses of prevention has made necessary a decision by women about medical treatment; specifically regarding the use of hormone replacement therapy. In a study of general practitioners’ accounts of menopause and treatment in Australia, women's ‘choice’, ‘informed decision-making’ and ‘empowerment’ were key themes through which primary medical care for women at menopause was presented. These accounts create a position for women defined by the concept of individual choice and an ethic of autonomy. These data are a basis for theorising more generally in this paper. We critically examine the construct of ‘informed decision-making’ in relation to several approaches to ethics including bioethics and a range of feminist ethics. We identify the intensification of power relations produced by an ethic of autonomy and discuss the ways these considerations inform a feminist ethics of decision-making by women. We argue that an ‘ethic of autonomy’ and an ‘offer of choice’ in relation to health care for women at menopause, far from being emancipatory, serves to intensify power relations. The dichotomy of choice, to take or not to take hormone replacement therapy, is required to be a choice and is embedded in relations of power and bioethical discourse that construct meanings about what constitutes decision-making at menopause. The deployment of the principle of autonomy in medical practice limits decision-making by women precisely because it is detached from the construction of meaning and the self and makes invisible the relations of power of which it is a part.

Stakeholder engagement by governance networks : a study of stakeholder engagement by road delivery network in Queensland

This thesis explores how governance networks prioritise and engage with their stakeholders, by studying three exemplars of “Regional Road Group” governance networks in Queensland, Australia. In the context of managing regionally significant road works programs, stakeholder prioritisation is a complex activity which is unlikely to influence interactions with stakeholders outside of the network. However, stakeholder priority is more likely to influence stakeholder interactions within the networks themselves. Both stakeholder prioritisation and engagement are strongly influenced by the way that the networks are managed, and in particular network operating rules and continuing access to resources.

Informed use of patients' records on trusted health care services

Health care is an information-intensive business. Sharing information in health care processes is a smart use of data enabling informed decision-making whilst ensuring. the privacy and security of patient information. To achieve this, we propose data encryption techniques embedded Information Accountability Framework (IAF) that establishes transitions of the technological concept, thus enabling understanding of shared responsibility, accessibility, and efficient cost effective informed decisions between health care professionals and patients. The IAF results reveal possibilities of efficient informed medical decision making and minimisation of medical errors. Of achieving this will require significant cultural changes and research synergies to ensure the sustainability, acceptability and durability of the IAF

Developing national level informatics competencies for undergraduate nurses : methodological approaches from Australia and Canada

Health information systems are being implemented in countries by governments and regional health authorities in an effort to modernize healthcare. With these changes, there has emerged a demand by healthcare organizations for nurses graduating from college and university programs to have acquired nursing informatics competencies that would allow them to work in clinical practice settings (e.g. hospitals, clinics, home care etc). In this paper we examine the methods employed by two different countries in developing national level nursing informatics competencies expected of undergraduate nurses prior to graduation (i.e. Australia, Canada). This work contributes to the literature by describing the science and methods of nursing informatics competency development at a national level.

Living a managed community lifestyle : lessons from Queensland

Purpose - The paper aims to improve consumer awareness of the complexities of community living. It does this by clarifying how living in a managed community is different from a ‘traditional’ neighbourhood; and identifying matters that can become disputes Design/methodology/approach - The paper builds on research by other authors into strata scheme disputes by examining recent Queensland cases. Findings - Many disputes appear to result from a lack of understanding of the complexities of community living. Matters that should be able to be easily resolved are therefore escalated to formal disputes. Research limitations/implications - The paper considers law and cases from Queensland. The types of matters considered, however, are relevant for any managed community and therefore the research is relevant for all jurisdictions. The research will be of particular interest to jurisdictions looking to boost living density by increasing the development of managed communities. Practical implications - The research will assist in consumer transactions by providing guidance as to the matters to be considering prior to moving into a managed community. More informed decision making by prospective residents will lead to a decreased likelihood of disputes arising. Originality/value - The paper is an up-to-date consideration of the issues arising from community living. It highlights the benefits arising from increased consumer awareness of the complexities of community living and the potential for consumer education to reduce the number of disputes.

A prospective longitudinal survey of fatigue self-management behaviors in patients with advanced cancer

Background: Fatigue is a distressing symptom experienced by approximately 74-88% of patients with advanced cancer. Although there have been advances in managing fatigue with the use of a range of pharmacologic and non-pharmacologic strategies, fatigue is not well-managed in patients with advanced cancer. Objectives: For patients with advanced cancer, the aims of the study were to examine the self-management (SM) behaviours associated with fatigue; the perceived effectiveness of these SM behaviours, and the socio-demographic and clinical factors influencing the effectiveness of these SM behaviours. Methodology: A prospective longitudinal study was undertaken with 152 patients with metastatic breast, lung, colorectal and prostate cancer experiencing fatigue (>3/10) over a two month period. SM behaviours associated with fatigue, medical/demographic characteristics, social support, depression, anxiety, self-efficacy and other symptoms were assessed. Results: Findings indicate that on most fatigue severity measures, levels of fatigue increased slightly over time. On average, participants used nine fatigue SM behaviours at each time point. Participants reported that the most effective SM behaviours were ‘pacing their activities during the day’, ‘planning activities to make the most of energy’, ‘taking short sleeps’, ‘doing things that distract them from their fatigue’, and ‘doing things to improve sleep at night’. Factors associated with the increased effectiveness of fatigue SM behaviours included higher self-efficacy, higher education level, lower levels of depressive symptoms, and lower functional status. These results can be used to inform the design of future interventions to support the use of effective fatigue SM behaviours in this population.

Grunt language versus accent : the perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments

Due to the chronic shortages of GPs in Australian rural and remote regions, considerable numbers of international medical graduates (IMG) have been recruited. IMG experience many difficulties when relocating to Australia with one of the most significant being effective GP-patient communication. Given that this is essential for effective consultation it can have a substantial impact on health care. A purposive sample of seven practising GPs (five IMG, two Australian-trained doctors (ATD)) was interviewed using a semistructured face-to-face interviewing technique. GPs from Nigeria, Egypt, United Kingdom, India, Singapore and Australia participated. Interviews were transcribed and then coded. The authors used qualitative thematic analysis of interview transcripts to identify common themes. IMG-patient communication barriers were considered significant in the Wheatbelt region as identified by both IMG and ATD. ATD indicated they were aware of IMG-patient communication issues resulting in subsequent consults with patients to explain results and diagnoses. Significantly, a lack of communication between ATD and IMG also emerged, creating a further barrier to effective communication. Analysis of the data generated several important findings that rural GP networks should consider when integrating new IMG into the community. Addressing the challenges related to cross-cultural differences should be a priority, in order to enable effective communication. More open communication between ATD and IMG about GP-patient communication barriers and education programs around GP-patient communication would help both GP and patient satisfaction.

P.I.C.U., H.D.U., A.O.A. What treatment do we provide?: Current descriptions of the function of intensive care for inpatient Psychiatric Health Care.

Purpose – This paper adds to growing research of psychiatric intensive care units (PICU) by recounting descriptions of psychiatric intensive care settings and discusses the perceptions held by nurses of the organisational interfaces, arrangements and provisions of care in these settings. Design/methodology/approach – Data gathered from focus groups held with nurses from two PICUs was used to establish terminology, defining attributes, related concepts, antecedents, values, processes and concepts related to current practices. A literature search was conducted to permit a review of the conceptual arrangements and contemporary understanding of intensive care for people experiencing acute psychiatric illness based on the perspectives held by the nurses from the focus groups. Findings – Dissonance between service needs and the needs and management of individual patients overshadow strategies to implement comprehensive recovery-oriented approaches. Three factors are reported in this paper that influence standards and procedural practice in PICU; organisational structures; physical structures; and subtype nomenclature. Practical implications – Acute inpatient care is an important part of a comprehensive approach to mental health services. Commonly intensive acute care is delivered in specialised wards or units co-located with acute mental health inpatient units mostly known as PICU. Evidence of the most effective treatment and approaches in intensive care settings that support comprehensive recovery for improved outcomes is nascent. Originality/value – Current descriptions from nurses substantiate wide variations in the provisions, design and classifications of psychiatric intensive care. Idiosyncratic and localised conceptions of psychiatric intensive care are not adequately entailing effective treatment and methods in support of recovery principles for improved and comprehensive outcomes. The authors suggest that more concrete descriptions, guidelines, training and policies for provision of intensive psychiatric health care encompassing the perspective of nursing professionals, would reinforce conceptual construction and thus optimum treatments within a comprehensive, recovery-oriented approach to mental health services.

Primary classroom teachers' use of social and emotional wellbeing programs and the factors influencing program use

There has been a rapid escalation in the development and evaluation of social and emotional well-being (SEW) programs in primary schools over the last few decades. Despite the plethora of programs available, primary teachers’ use of SEW programs is not well documented in Australian schools, with even less consideration of the factors influencing program use. A cross-sectional survey was undertaken with primary classroom teachers across twelve schools in the Brisbane and Sunshine Coast Education Districts in Queensland, Australia, during 2005. A checklist of SEW programs and an audit of SEW practices in schools were employed to investigate the number, range and types of SEW programs used by primary classroom teachers and the contextual factors influencing program use. Whilst the majority of implementation studies have been conducted under intervention conditions, this study was designed to capture primary classroom teachers’ day-to-day use of SEW programs and the factors influencing program use under real-world conditions. The findings of this research indicate that almost three quarters of the primary classroom teachers involved in the study reported using at least one SEW program during 2005. Wide variation in the number and range of programs used was evident, suggesting that teachers are autonomous in their use of SEW programs. Evidence-based SEW programs were used by a similar proportion of teachers to non-evidence-based programs. However, irrespective of the type of program used, primary teachers overwhelmingly reported using part of a SEW program rather than the whole program. This raises some issues about the quality of teachers’ program implementation in real-world practice, especially with respect to programs that are evidence-based. A content analysis revealed that a wide range of factors have been examined as potential influences on teachers’ implementation of health promotion programs in schools, including SEW programs, despite the limited number of studies undertaken to date. However, variation in the factors examined and study designs employed both within and across health promotion fields limited the extent to which studies could be compared. A methodological and statistical review also revealed substantial variation in the quality of reporting of studies. A variety of factors were examined as potential influences on primary classroom teachers’ use of SEW programs across multiple social-ecological levels of influence (ranging from community to school and individual levels). In this study, parent or caregiver involvement in class activities and the availability of wellbeing-related policies in primary schools were found to be influential in primary classroom teachers’ use of SEW programs. Teachers who often or always involve parents or caregivers in class activities were at a higher odds of program use relative to teachers who never or rarely involved parents or caregivers in class activities. However, teachers employed in schools with the highest number of wellbeing-related policies available were at a lower odds of program use relative to teachers employed in schools with fewer wellbeing-related policies available. Future research should investigate primary classroom teachers’ autonomy and motivations for using SEW programs and the reasons behind the selection and use of particular types of programs. A larger emphasis should also be placed upon teachers not using SEW programs to identify valid reasons for non-use. This would provide another step towards bridging the gap between the expectations of program developers and the needs of teachers who implement programs in practice. Additionally, the availability of wellbeing-related school policies and the types of activities that parents and caregivers are involved with in the classroom warrant more in-depth investigation. This will help to ascertain how and why these factors influence primary classroom teachers’ use of SEW programs on a day-to-day basis in schools.

(Re)-regulating care : employing foreign carers for older persons in Taiwan

The purpose of this research was to develop a theoretical understanding of the social phenomenon of the employment of foreign carers for older Taiwanese in households. Foreign carers were introduced into Taiwan in 1992 to address the care needs of the older population. By 2012, over 200,000 foreign caregivers from Indonesia, Philippines, and Vietnam were providing care in households in Taiwan. There has been little research on the interactions between and experiences of family employers, foreign carers and older persons receiving care. The theoretical framework brought together symbolic interactionist concepts and the social constructionism of Berger and Luckmann. Data collection and analysis were informed by Charmaz‘s formulation of grounded theory. Two focus groups and 54 in-depth interviews with a total of 57 Indonesian and Vietnamese foreign carers, Taiwanese family employers and older persons receiving care were undertaken. The analytical findings of the research reflect the ways in which the foreign carer, older persons receiving care and family employer participants were socially situated within the research context and how their respective social realities were shaped differently by changing social structures and cultural values within a globalising context. (Re)-regulating care was generated as the core category, forming a coherent and overarching framework that integrated the three analytical dimensions of the reality of the social change, resituating roles and struggling for control. The reality of social change refers to the employment of foreign carers as a manifestation of the reshaping of the social worlds of the three groups of participants. Resituating roles reflects the processes that underpin the hierarchical positioning of participants, the resultant asymmetrical power relations and associated interactions. Struggling for control, depicts how each group employed strategies to create space and identities that would sustain a sense of self and autonomy. In the current situation of economic and social change in Taiwan the three participant groups shared a desire for control. The autonomy of the women employers was negotiated through employment of foreign carers; for the foreign carers, a pragmatic decision to work abroad became a means for personal empowerment; and the older persons receiving care regained some authority through relationships with carers.

Urban Indigenous AOD treatment programs : addressing the lack of evaluative research of culturally appropriate youth services

This presentation discusses the limited research of urban rehabilitation service evaluations and assesses the progress of Goori House Rehabilitation Service, identifying issues preventing a sustainable organisational future.