The clinical landscape of critical care: nurses' decision-making

Background. Many studies have tended to explore individual characteristics that impact on nurses' decision-making, despite significant acknowledgement that context is a major determinant in decision-making. The few studies that have examined environmental influences have tended not to study real decisions in the dynamic and complex clinical environment.

Aims. To investigate environmental influences on nurses' real decisions in the critical care setting.

Method. Naturalistic observations and semi-structured interviews were conducted with 18 critical care nurses in private, public and rural hospitals. Observations and interviews were recorded, transcribed verbatim and coded for themes using content analysis.

Results. All clinical decisions were strongly influenced by the context in which the decision was made. Three main environmental influences were identified: the patient situation, resource availability and interpersonal relationships. Time and risk guided all clinical decisions. Nurses established the state of the situation, the time constraints on decisions and the level of risk involved for both patient and nurse.

Conclusions. Decision-making is a manifestation of the landscape and although an increased understanding of the landscape is required, more important is the need to measure the impact of contextual variables on nurses' decision-making in order to improve health care outcomes.

Estimating population size of the black-eared miner, with an assessment of landscape-scale habitat requirements

The decline of the Black-eared Miner Manorina melanotis has been caused primarily by habitat degradation and vegetation clearance. To better direct conservation actions for this species there was a need to assess habitat requirements on a regional-scale and to estimate the population size using quantitative methods. We used vegetation mapping and the current distribution of the Black-eared Miner to determine regional-scale habitat requirements. These findings were combined with the results of distance sampling to provide population estimates. The species is restricted to large tracts of intact mallee in the Murray Mallee of southeastern Australia that have not been burnt for at least 45 years. The density· of Black-eared Miners is highest in areas that are dominated by mallee- Triodia associations and have not been intensively grazed. The Bookmark Biosphere Reserve supports an estimated 501 (270-927, 95% CI) colonies, containing 3758 (2026-6954) phenotypically pure Black-eared Miners, 2255 (1 215-4170) hybrids and small numbers of Yellow-throated Miners Manorina flavigula. However, the effective population size is considerably smaller (390 Black-eared Miners '(21 0-726) and 234 hybrids (126-433)), due to a skewed adult sex ratio (1 female: 1.81 males) and complex social organization. A smaller population also persists in the Murray Sunset National Park containing 53 (32-85) Black-eared Miner/hybrid colonies. Both populations face a high risk of extinction from large-scale wildfire. The endangered status of the species under IUCN criteria remains warranted.

The phenomenon of resilience in crisis care mental health clinicians

The purpose of this study, undertaken in 2003, was to explore the phenomenon of resilience as experienced by Australian crisis care mental health clinicians working in a highly demanding, complex, specialized and stressful environment. For the purpose of this research, the term 'resilience' was defined as the ability of an individual to bounce back from adversity and persevere through difficult times. The six participants for this study were drawn from Melbourne metropolitan mental health organizations – the disciplines of nursing, allied health and medicine. A number of themes were explicated from the participants' interview transcripts – Participants identified the experience of resilience through five exhaustive descriptions, which included: 'The team is a protective veneer to the stress of the work'; Sense of self; Faith and hope; Having insight; and Looking after yourself. These exhaustive descriptions were integrated into a fundamental structure of resilience for clinicians in this role. The study's findings have the potential to inform organizations in mental health to promote resilience in clinicians, with the potential to reduce the risk of burnout and hence staff attrition, and promote staff retention and occupational mental health.

Dwelling in the landscape: from Blairgowrie House to Portsea Palace

Ackerman begins his book "The Villa" (1995) with these words: 'A villa is a building in the country designed for its owner's enjoyment and relaxation .... [it] accommodates a fantasy which is impervious to reality.' He concludes: , ... the country, in exacting confrontations with the immanent brute forces and sensuous enchantments of nature, prompts inspired responses.' Blairgowrie House - the villa in the landscape - was built in the 1870s and the 'Portsea Palace' - a personal club med resort - in the late 1990s. The notion of an inspired response and the concept of dwelling poetically are manifestly absent in the Portsea Palace. Why?

This paper explores architecture and landscape - particularly 'domestic' architecture and coastal landscapes in Victoria's Nepean Peninsula. It looks closely at what architects mean when they say their design reflects place, relates to site, is climate specific, is close to nature, responds to the landscape, and/or is sensitive to the environment. Exemplars from different centuries are examined in their philosophical contexts and frames of reference. The complexities of the notion of place and identity, belonging, and dwelling (in the Heideggerian sense) are examined to identify the shift that has occurred over time as science and technology have ostensibly freed 'modern man' from 'a direct dependence on places' (Norberg Schultz). The alienation and loss that has eventuated - for humans and for the environment - will be critically analysed and assessed.

Young people with an intellectual disability: risk and resilience.

There is a large body of literature about personal risk and resilience among children and adolescents from a variety of subpopulations. However, in intellectual disability research, resilience has almost exclusively been investigated and reported at the level of family stress and coping rather than an individual child's capacity to function adaptively despite severe risk. In this study young people with an intellectual disability, family members and non-family members (carers, teachers and family friends) were interviewed and asked about the young people’s relationships, coping styles, behaviour patterns and resilience. The main features placing these young people at risk included having autism or inflexible patterns of behaviour, displaying some forms of challenging behaviour, difficulty with receptive and expressive communication, living in families with high competing demands for time and living in a relatively unaccommodating community environment. The main factors leading to resilience were an attractive appearance/disposition, ability to get one’s message across, ability to adapt behaviour to changing contexts, low family stress levels and high sense of competence, stable relationships with supportive others and an accommodating/accepting community environment (both school and social).

Dien Bien Phu: development and conservation in a Vietnamese cultural landscape

It has been possible to nominate places for their cultural landscape values to the World Heritage List since December 1992. The Operational Guidelines (2005) define cultural landscapes as cultural properties that ‘represent the “combined works of nature and man” designated in Article 1 of the Convention’. They are illustrative of the evolution of human society and settlement over time, under the influence of the physical constraints and/or opportunities presented by their natural environment and of successive social, economic and cultural forces, both internal and external’ (Para 47). Refining this further, the World Heritage system recognises three categories of cultural landscapes:

1. Clearly defined landscapes designed and intentionally created by man;

2. Organically evolved landscapes of two subtypes:
·  Relict or fossil landscapes in which an evolutionary process has come to an end but where its distinguishing features are still visible;
·  Continuing landscapes which retain an active social role in contemporary society associated with a traditional way of life and in which the evolutionary process is still in progress and where it exhibits significant material evidence of its evolution over time;

3. Associative cultural landscapes where the outstanding universal value relates to the powerful religious, artistic, or cultural associations of the natural elements rather than the evidence of material culture.

Associations between student pursuit of novel mathematical ideas and resilience

As part of a broader study of characteristics of situations that promote or inhibit spontaneous student exploration of novel mathematical ideas, student inclination to display these spontaneous behaviours was studied in conjunction with resilience. Resilience was operationalised using the dimensions of optimism (Seligman, 1995). Indicators of optimism were identified in post-lesson video-stimulated reconstructive interviews with year eight students. Students who demonstrated the pursuit of novel mathematical ideas were found to also display indicators of resilience.

Affect-regulated indirect effects of trait anxiety and trait resilience on self-esteem

This study examined the influence of trait resilience and trait anxiety on self-esteem and investigated the mediating role of positive and negative affect in this relationship. Specifically, it was proposed that trait resilience and trait anxiety may exert indirect effects on self-esteem by promoting increased positive and negative affect, respectively. The final sample comprised of 240 participants (age, M = 21.55, SD = 4.16) who completed questionnaire measures of trait resilience (CD-RISC; Connor & Davidson, 2003), trait anxiety (STAI-T; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983), affect (PANAS; Watson, Clark, & Tellegen, 1988) and self-esteem (RSES; Rosenberg, 1965). Path analyses (AMOS), controlling for measurement error revealed significant indirect effects of trait anxiety and trait resilience on self-esteem via negative and positive affect. The indirect model provided a very close fit to the data; estimation of the full model (direct paths) did not yield a significantly better fit. It was concluded that the impact of trait anxiety and trait resilience on self-esteem may be due to their effects on regulating affective experiences which in turn may be more proximal predictors of individual feelings of self-worth.

Old buildings, new landscape : Redeveloping historic neighbourhoods - A case study of Xin Tian Di, Shanghai, China

This paper explores the use of tradition by the redevelopment project ofXin Tian Di (New Heaven and Earth) in Shanghai. The paper also identifies the implications of this urban redevelopment project to historic quarters in Chinese cities. An enormous commercial success and new Shanghai icon, Xin Tian Di project has transformed a former residential neighbourhood into a high end entertainment precinct. While the redevelopment ofXin Tian Di has retained the architectural features of the place, the use and interpretation of tradition by the project is problematic. The project shows a tendency where the established idea of tradition is destabilised and challenged. It also highlights issues of cultural authenticity in the redevelopment of historic quarters.