The role of memory in establishing and destabilising choreographic practice

This practice-based research examines the role of body memory, seen as a multiple and complex process in the development of a choreographic aesthetic, specifically in relationship to the creation of choreography. The thesis explores the idea that a dancer's body memory is not necessarily stable, but rather a constantly altered system.

An evaluation of a mental health screening and referral pathway for community nursing care : nurses' and general practitioners' perspectives

Aims and objectives. To evaluate a feasible, best practice mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia.
Background. War veterans commonly experience mental health difficulties and do not always receive required treatment, as can also occur for war widow(er)s. Whenever opportunity arises, such as during community nursing care, it is vital to identify mental health problems in a health promotion framework.
Design. A clinical pathway was developed by literature review and consultation and then trialled and evaluated using mixed methods – quantitative and qualitative.
Methods. Community nurses who trialled the pathway completed an evaluation survey and attended focus groups. General practitioners responded to an evaluation survey.
Results. Most nurses found the pathway clear and easy to understand but not always easy to use. They emphasised the need to establish trust and rapport with clients prior to implementing the pathway. It was sometimes difficult to ensure effective referral to general practitioners for clients who screened positive for a mental health problem. When referral was accomplished, general practitioners reported adequate and useful information was provided. Some general practitioners also commented on the difficulty of achieving effective communication between general practitioners and nurses.
Conclusions. Nurses and some general practitioners found the pathway useful for their practice. They offered several suggestions for improvement by simplifying the trialled pathway and accompanying guidelines and strategies to improve communication between nurses and general practitioners. This study adds understanding of how community nurses might productively screen for mental health difficulties.
Relevance to clinical practice. The trialled pathway, which was modified and refined following the study, is an evidence-based
resource for community nurses in Australia and similar contexts to guide practise and maximise holistic care for war veterans and war widow(er)s and possibly other client groups.

Research and diabetes nursing. Part 2 : process of critical review

This article is the second in a six-part series addressing research and the DSN. Crirical review is a key aspect of research and evidencebased care and, therefore, of clinical and professional practice. Critical review is an analytical and reflective process that involves judging the quality of research publicarions and their relevance to practice. This article oudines key aspects of how to review publications and conference presentations, how critical review applies to clinical care, and how this process om help develop writing and critical thinking skills. Also addressed are the general aspects of critical review, and a list of further reading and useful websites is provided. Specific considerations for particular research methods such as quantitative, qualitative, evaluation studies and audits will be addressed in later articles in the series.

Cognitive distortions in child sex offenders : an overview theory, research, and practice

A great deal of clinical and research attention has been paid to understanding and explaining child sex offenders’ social cognition. Cognitive distortions have been implicated as a core feature of child sex offenders’ offense supportive cognition. The primary aim of this paper is to critically evaluate the phenomenon of cognitive distortions as currently understood with respect to child sex offenders: it reviews the theoretical and research literature and highlights the implications for clinical practice.

Between theory and practice : Rudolf Steiner as philosopher and architect

The philosophy and architecture of Rudolf Steiner both aim to give formal expression to his esoteric worldview, however, the means of articulating this worldview fundamentally differ within each discipline. Philosophy and architecture are separated by both process and product, and while an interdisciplinary reading of Steiner’s work does make certain connections between them evident, the incorporeal nature of thinking and the physical reality of building inevitably require different skills of their author, as well as different standards by which to assess them. Although he had no formal training as an architect, Steiner believed that his system of Anthroposophy provided a conceptual framework that would inspire a new style of modern architecture imbued with a spiritual dimension. As such, architecture provided Steiner with a means of visually expressing what words could not, and was therefore a necessary and important part of his philosophical pursuit. This paper explores the tension that exists between Steiner’s philosophy and architecture in its translation from theoretical ideas into built form. Steiner’s approach to architectural design was less concerned with the methods and techniques of the craft than with achieving what he saw as architecture’s true purpose - namely to give voice to the inner spiritual content of the work. However, in order to achieve this ultimate goal, a certain level of architectural competence is required. Therefore, Steiner’s ability as an architect to articulate such lofty ideals will also be assessed. Conceived on the edge of theory and practice, Steiner’s work serves to demonstrate the richness and depth that such an approach has to offer the field of architecture.

Family-centred practice : empowerment, self-efficacy, and challenges for practitioners in early childhood education and care

Family-centred practice has been included in the Victoria, Australia Early Years Learning and Development Framework as a key practice principle for professionals working across all early years programs in that state. While this model of partnership for engaging and collaborating with families has long been used in the early intervention sector, the efficacy of adopting this model more widely across the wider early childhood education and care sector has not been explored. This article presents a discussion on family-centred practice as a model for engaging with families in the care and education of their children. Through an analysis of the underlying philosophy and an examination of the core principles and characteristics, the article explores family-centred practice as it sits within a broader theory of partnership. This analysis identifies that while there are essential principles and characteristics that position the model within a partnership framework, it is the notion of empowerment, an underpinning philosophy guiding the model, that adds another dimension to the way practitioners in early childhood education and care settings collaborate with families. In examining the broader early childhood context, the capacity of many early childhood practitioners to effectively implement empowering behaviours is challenged.

An evaluation of a national program to implement the cornell scale for depression in dementia into routine practice in aged care facilities

Background: Screening tools have been recommended for use in aged care to improve the detection and treatment of depression. This study aimed to evaluate the impact of a program for the routine implementation of the Cornell Scale for Depression in Dementia in Australian facilities, to determine whether use of the instrument by nurses led to further monitoring of depressive symptoms, medical referral, and changes in treatments prescribed for depression.
Methods: A file review was completed for 412 participants out of a total of 867 older people (47.5%) who resided in ten aged care facilities. The review examined Cornell Scale assessment data, medication charts, medical history, nursing progress notes, and resident care plans. Nursing staff who administered the Cornell Scale to each participant were also interviewed, and ten facilitymanagers took part in an interview to determine barriers to the effective implementation of the instrument.
Results: The Cornell Scale had been administered to 46.8% of the sample in the previous 12 months, with 25% of these participants scoring 9–13 and 27% scoring 14 and above. Less than one third of the residents with high scores were monitored by the staff following the assessment. Only 18% of residents with high scores were referred for further assessment of depression, while 10% received a treatment change.
Conclusions: The absence of a protocol for responding to high Cornell Scale scores limited the potential of this program to result in widespread improved treatment of depressed older people. The use of the Cornell Scale by aged care nurses with limited training raised concern.

Human resource management activities on the front line : a nursing perspective

Objective: To identify the practical human resource management (HRM) issues that may impact on job satisfaction, nurse retention and ultimately quality of patient care of the nurse unit manager's (NUM) role.
Background: NUMs are in the unique position within the healthcare industry to impact upon and effect large numbers of people, including nurses, doctors, patients and their families, and processes on a daily basis. More effective HRM practices could improve performance in terms of staff satisfaction, positive patient outcomes and the cost effectiveness of staff retention.
Method: Two focus groups, one group of nine NUMs and one group of five staff nurses, were conducted at an Australia public hospital. A descriptive phenomenological approach informed data generation and data analysis.
Results: The NUMs reported that they were not adequately trained in the skills required to effectively manage staff conflict such as manipulation and bitterness, requiring disciplinary intervention on an ongoing basis. The consequences included reduced staff morale, decreased staff satisfaction, increased stress to the NUM and ultimately retention issues for both the NUM and Unit staff.
Conclusion: This study highlights the potential impact of inadequate implementation and understanding of HRM policy and practice by NUMS on the front line. Further research is required to understand why this phenomenon exists and how it can be remedied.

Harm reduction as anarchist practice : a user’s guide to capitalism and addiction in North America

In spite of its origins as an illegal, clandestine, grassroots activity that took place either outside or in defiant opposition to state and legal authority, there is growing evidence to suggest that harm reduction in North America has become sanitized and depoliticized in its institutionalization as public health policy. Harm reduction remains the most contested and controversial aspect of drug policy on both sides of the Canada–US border, yet the institutionalization of harm reduction in each national context demonstrates a series of stark contrasts. Drawing from regional case study examples in Canada and the US, this article historically traces and politically re-maps the uneasy relationship between the autonomous political origins of harm reduction, contemporary public health policy, and the adoption of the biomedical model for addiction research and treatment in North America. Situated within a broader theoretical interrogation of the etiology of addiction, this study culminates in a politically engaged critique of traditional addiction research and drug/service user autonomy. Arguing that the founding philosophy and spirit of the harm reduction movement represents a fundamentally anarchist-inspired form of practice, this article concludes by considering tactics for reclaiming and re-politicizing the future of harm reduction in North America.

National nursing registration in Australia : a way forward for nurse practitioner endorsement

Purpose : The move to national registration of health professionals and the creation of the Nursing and Midwifery Board of Australia (NMBA) provides both challenges and opportunities for the regulation of nurse practitioners (NPs) in Australia.

Data sources : National and state health policy documents, accessible on the Internet, concerning the regulation and endorsement processes for NPs in Australia were examined.

Conclusions : The similarities between two of the previous jurisdictional NP endorsement processes in New South Wales and Victoria provide a common ground on which to build a robust national system. However, there are also key differences between these two states. These differences were mainly in the evidence required to assess competency of NP applicants and the authority to prescribe medications. All Victorian NP applicants were required to complete an approved medication subject at a master's level.

Implications for practice : A consistent endorsement process that delivers NPs of the highest standard and allows for efficient use of their skills and expertise is vital. This needs to be performed with the aim of providing high-quality care in a regulatory environment that protects the public and clearly articulates the level of competence expected of all NPs.

Nursing care practices following a percutaneous coronary intervention : results of a survey of Australian and New Zealand cardiovascular nurses

Background: Although there is high-level evidence to guide optimal medical care for percutaneous coronary interventions, there are less explicit guidelines to support nurses in providing care. Aim: This study describes the practice standards and priorities of care of cardiovascular nurses in Australia and New Zealand. Method: Item generation for the survey was informed by an integrative literature review and existing clinical guidelines. A 116-item Web-based survey was administered to cardiovascular nurses, via electronic mail lists of professional cardiovascular nursing organizations, using a secure online data collection system. Results: Data were collected from March 2008 to March 2009. A total of 148 respondents attempted the survey, with 110 (74.3%) completing all items. All respondents were registered nurses with an average of 12.3 (SD, 7.61) years of clinical experience in the cardiovascular setting. A range of practice patterns was evident in ambulation time after percutaneous coronary intervention, methods of sheath removal, pain relief, and patient positioning. Respondents consistently rated psychosocial care a lower priority than other tasks and also identified a knowledge deficit in this area. Conclusion: This survey identified diversity of practice patterns and a range of educational needs. Increasing evidence to support evidence-based practice and guideline development is necessary to promote high-quality care and improved patient outcomes.