ORCID Profile
0000-0002-7721-8708
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Sociology of family and relationships | Sociology | Environmental sociology | Sociology of health |
Publisher: Hindawi Limited
Date: 27-07-2022
DOI: 10.1111/HSC.13945
Abstract: Low-dose computed tomography lung cancer screening has mortality benefits. Yet, uptake has been low. To inform strategies to better deliver and promote screening, in 2018, we interviewed 27 long-term smokers immediately following lung cancer screening in Australia, prior to receiving scan results. Existing lung screening studies employ the Health Belief Model. Reflecting growing acknowledgement of the centrality of emotions to screening uptake, we draw on psychological and sociological theories on emotions to thematically and abductively analyse the emotional dimensions of lung cancer screening, with implications for screening promotion and delivery. As smokers, interviewees described feeling stigmatised, with female participants internalising and male participants resisting stigma. Guilt and fear related to lung cancer were described as screening motivators. The screening itself elicited mild positive emotions. Notably, interviewees expressed gratitude for the care implicitly shown through lung screening to smokers. More than in idual risk assessment, findings suggest lung screening c aigns should prioritise emotions. Peer workers have been found to increase cancer screening uptake in marginalised communities, however the risk to confidentiality-especially for female smokers-limits its feasibility in lung cancer screening. Instead, we suggest involving peer consultants in developing targeted screening strategies that foreground emotions. Furthermore, findings suggest prioritising humanistic care in lung screening delivery. Such an approach may be especially important for smokers from low socioeconomic backgrounds, who perceive lung cancer screening and smoking as sources of stigma and face a higher risk of dying from lung cancer and lower engagement with screening.
Publisher: SAGE Publications
Date: 25-07-2016
Abstract: Changes to the purpose and scope of health and physical education (HPE) in schools have prompted revisions in teacher education degrees within Australia. Using a qualitative approach, this study explored HPE teachers’ perceptions of these changes. Of particular interest was pre-service HPE teachers’ reflections on the importance of skill acquisition (also referred to as motor learning) content in their university degree, which focuses on the theories and practices involved in learning movement and perceptual skills. Findings were based on the thematic analysis of four semi-structured focus groups with 25 pre-service HPE teachers at one Australian metropolitan university. Analysis suggests that the importance of skill acquisition and the imperative to increase physical activity without a focus on competence are contradictory priorities within pre-service HPE curricula. The goal of promoting enjoyment of physical education sustained this tension, implying that there is a new discourse in HPE and suggesting the need for further research into the self-reflection and emotional dynamics of pre-service HPE teachers’ reflections on curricula.
Publisher: Informa UK Limited
Date: 10-2009
DOI: 10.1080/09540120902803216
Abstract: This study determines the validity and reliability of the Malay version of the World Health Organization Quality of Life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. A cross-sectional study on 157 patients with HIV seen at the Infectious Disease Unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan was conducted. Factor analysis identified five major domains: physical needs, spirituality, social relationship, psychological, and environment. Significant correlation was found between each domain scores and the general health questions. The instrument was able to discriminate between asymptomatic and symptomatic HIV positive patients for all domain scores except for the spirituality domain. The internal consistency of the five domains ranged from 0.70 to 0.83. The intraclass correlation coefficient (ICC) ranged from 0.60 to 0.87 across all domains. In conclusion, the Malay version of WHOQOL-HIV BREF is a valid and reliable instrument in assessing quality of life in HIV positive patients.
Publisher: SAGE Publications
Date: 05-12-2015
Publisher: Hindawi Limited
Date: 12-2014
DOI: 10.1111/HSC.12132
Abstract: Following changes in the structure and funding of the Australian medical system, patients have become 'consumers' or 'clients'. Family and friends have become 'carers' or 'caregivers', signifying their increased responsibilities as patients move from hospitals to communities. While policy makers embrace the term 'carer', some argue that the title is not widely recognised and has disempowering connotations. This paper examines spouses' reflections on the term 'carer' based on qualitative interviews with 32 Australians caring for a spouse with cancer from a study conducted between 2006 and 2009. Recruitment involved survey and snowball s ling. Following a grounded theory approach, data collection and analysis were performed simultaneously. Using Holland and colleagues' sociocultural 'identity as practice' theory and a thematic approach to analysis, findings depict identification with the 'spouse' and 'carer' label as relationally situated and dependent on meaningful interaction. Although others argue that the term 'carer' is a 'failure', these findings depict identification with the label as contextual, positional and enacted, not fixed. Furthermore, and of most significance to practitioners and policy makers, the title has value, providing carers with an opportunity to position themselves as entitled to inclusion and support, and providing health professionals with a potential indicator of a spouse's increased burden.
Publisher: Informa UK Limited
Date: 15-11-2015
Publisher: University of Otago Library
Date: 14-04-2016
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/16094069221083370
Abstract: Evidence suggests that studies aiming to improve healthcare practice should be flexible and prioritise patient, family and clinician engagement. Video-reflexive ethnography (VRE), a form of qualitative research often employed in healthcare settings, is well-suited to these aims. VRE supplements ethnographic techniques with video-recordings of in situ practices, allowing practitioners to reflect on taken-for-granted practices. Its prioritisation of collaboration, affective entanglement, theory-driven analysis and flexibility – aligned with participatory and post-qualitative inquiry (PQI) – can facilitate reflexivity among researchers and participants for local practice improvement. Yet paradoxically, flexibility can hinder the predictability of impact, and demonstrating likely impact is crucial to securing research funding. This article offers practical advice to qualitative researchers facing this methodological challenge. Using three exemplars, we examine how differing onto-epistemological groundings, conceptualisations of participant engagement and researcher positionings affect the timing, predictability, scalability and transferability of each study’s impact. We show how prioritising affective engagement, flexible goals and collaboration can enable local healthcare practice improvement prioritising theory generation via consultation can lead to traditional, more transferable, forms of impact. We share insights for researchers seeking to improve healthcare using methods inspired by PQI such as VRE. While predicting impact is fraught, optimising conditions for impactful VRE research can be accomplished by: foregrounding epistemology prioritising affective engagement aligning research and stakeholder goals assessing timing and organisational readiness and considering researcher and participant positioning.
Publisher: National Inquiry Services Center (NISC)
Date: 07-2008
Publisher: SAGE Publications
Date: 18-03-2013
Abstract: The Women’s Health and Life Experiences questionnaire measures the prevalence, health implications, and risk factors for domestic violence. This cross-sectional study was conducted to determine the validity and reliability of the Malay version of World Health Organization (WHO) Women’s Health and Life Experiences Questionnaire. Construct validity and reliability assessment of the Malay version of the questionnaire was done on 20 specific items that measure four types of intimate partner violence (IPV) act controlling behaviors (CB), emotional violence (EV), physical violence (PV), and sexual violence (SV), which were considered as the domains of interest. Face-to-face interviewing method was used for data collection. A total of 922 women completed the interviews. The results showed that exploratory factor analysis of four factors with eigenvalues above 1 accounted for 63.83% of the variance. Exploratory factor analysis revealed that all items loaded above 0.40 and the majority of items loaded on factors that were generally consistent with the proposed construct. The internal consistency reliability was good. The Cronbach’s α values ranged from 0.767 to 0.858 across domains. The Malay version of WHO Women’s Health and Life Experiences Questionnaire is a valid and reliable measure of women’s health and experiences of IPV in Malaysia.
Publisher: Informa UK Limited
Date: 03-05-2016
DOI: 10.3109/13561820.2016.1144583
Abstract: Interprofessional education and cultural competence are both necessary for health professionals working in interprofessional teams serving erse populations. Using a pre-post-survey case series design, this study evaluates a novel learning activity designed to encourage self-reflection and cultural competence in an Australian interprofessional education context. Undergraduate health professional students in a large subject viewed three 7-15 minute videos featuring interviews with persons of a minority cultural, linguistic, or sexual group who were living with a disability or managing a health condition. Immediately afterwards, students in interprofessional groups completed a structured activity designed to promote interprofessional and cultural reflection. A localised version of a validated scale measured cultural competence before and after the learning activity. Results suggest the value of video-based learning activities based on real-life ex les for improving cultural competence. Despite initially rating themselves highly, 64% of students (n = 273) improved their overall cultural competence, though only by M = 0.13, SD = 0.08, of a 5-point rating-scale interval. A nuanced approach to interpreting results is warranted even slight increases may indicate improved cultural competence. Suggestions for improving the effectiveness of video-based cultural competence learning activities, based on qualitative findings, are provided. Overall the findings attest to the merit of group discussion in cultural competence learning activities in interprofessional education settings. However, the inclusion of group discussions within such learning activities should hinge on group dynamics.
Publisher: Elsevier BV
Date: 2011
Publisher: The Korean Academy of Family Medicine
Date: 20-03-2021
DOI: 10.4082/KJFM.19.0178
Publisher: Springer Science and Business Media LLC
Date: 12-2005
Publisher: SAGE Publications
Date: 12-2017
Abstract: Based in a novel ‘meta-reflexive’ review of sociology of emotions (SoE) articles, we suggest that there are two primary SoE theoretical traditions that function within geographic silos: the USA is distinctly social psychological, while in the UK and Australia, SoE is more aligned with the humanities. In both traditions, parallel calls are emerging for interdisciplinarity and further engagement with physiological and pre-personal elements of emotion. Based in Archer’s and Bourdieu’s concepts of reflexivity, we assert the merits of reflexively examining SoE, and then identify key changes in SoE that have emerged across time and geography. Using Kuhn’s work on paradigm shifts, we conclude that SoE is entering a stage of growth and change, and raise important questions about the subdiscipline’s future direction.
Publisher: Springer Science and Business Media LLC
Date: 04-2005
DOI: 10.1007/S10886-005-3544-X
Abstract: The effect of heartwood extracts from Acacia mangium (heartrot-susceptible) and A. auriculiformis (heartrot-resistant) was examined on the growth of wood rotting fungi with in vitro assays. A. auriculiformis heartwood extracts had higher antifungal activity than A. mangium. The compounds 3,4',7,8-tetrahydroxyflavanone and teracacidin (the most abundant flavonoids in both species) showed antifungal activity. A. auriculiformis contained higher levels of these flavonoids (3.5- and 43-fold higher, respectively) than A. mangium. This suggests that higher levels of these compounds may contribute to heartrot resistance. Furthermore, both flavonoids had strong 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity and laccase inhibition. This suggests that the antifungal mechanism of these compounds may involve inhibition of fungal growth by quenching of free radicals produced by the extracellular fungal enzyme laccase.
Publisher: SAGE Publications
Date: 04-2006
Abstract: I develop a model of electoral competition with partisan c aign support. Voters’ utilities are defined over candidate locations and the amounts of party c aign support that they receive. Parties’ utilities are defined over the location of the winning candidate and how much support they dole out for their candidates. Analytical results identify cases in which parties will successfully pull the electorally induced preferences of their members away from their median voters’ ideal points and towards the party’s most favored policies. Equilibrium results yield several testable hypotheses. First, candidate policy positions and parties’ c aign contributions should be responsive to district partisan predisposition, independent of the policy preferences of a district’s median voter. Second, uncontested elections should occur more often in politically-lopsided districts than in districts where there are more even levels of political competition. Finally, there should be an inverse relationship between candidate policy extremity and partisan c aign support.
Publisher: Oxford University Press (OUP)
Date: 03-03-2021
DOI: 10.1093/PTJ/PZAB078
Abstract: The purpose of this study is to explore academic faculty, employer, and recent graduate perspectives of the work readiness of Australian new graduate physical therapists for private practice and factors that influence new graduate preparation and transition to private practice. This study used a mixed-methods design with 3 surveys and 12 focus groups. A total of 112 participants completed a survey, and 52 participated in focus groups. Descriptive statistics were used to summarize the quantitative data, and thematic analysis was used to analyze the qualitative data. Triangulation across participant groups and data sources was undertaken. Australian new graduate physical therapists were perceived to be “somewhat ready” for private practice and “ready” by their third year of employment. Participants proposed that new graduates bring enthusiasm, readiness to learn, and contemporary, research-informed knowledge. New graduates were also perceived to find autonomous clinical reasoning and timely caseload management difficult to have limited business, marketing, and administration knowledge and skills and to present with underdeveloped confidence, communication, and interpersonal skills. Factors perceived to influence graduate transition included private practice experience, such as clinical placements and employment employer and client expectations of graduate capabilities workplace support university academic preparation and continuing education and in idual graduate attributes and skills. Australian new graduate physical therapists have strengths and limitations in relation to clinical, business, and employability knowledge and skills. New graduate work readiness and transition may be enhanced by additional private practice experience, employer and client expectation management, provision of workplace support, and tailored university and continuing education. The number of new graduate physical therapists employed in private practice in Australia is increasing however, until this study, their work readiness for this setting was unknown. This exploration of new graduate performance in private practice and transition can help to increase understanding and enhancement of work-readiness.
Publisher: Informa UK Limited
Date: 12-2013
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.SOCSCIMED.2010.12.026
Abstract: Carers of cancer patients' emotional responses to cancer diagnoses have been a central focus within psycho-oncology. Some of this literature asserts that the maladaptive coping strategy denial is prevalent amongst carers. Using semi-structured, longitudinal interviews with 32 Australian Capital Territory carers of a spouse with cancer and an interactionist sociology of emotions framework to understanding their emotions, this study aimed to both contribute to the literature on cancer carers' coping strategies and provide a richer sociological depiction of carers' emotional reactions to a cancer diagnosis. The results raise questions about the value of singularly examining denial in cancer carers. Instead, these data suggest that carers use a range of coping strategies in the short-term and do emotion work to adapt to a challenged temporal orientation. The term temporal anomie is offered to describe carers' disrupted orientations in time and facilitate further discussion on the link between time and emotion work. Findings also show the importance of medical professionals' casting of the prognosis, from imminent death to certain future, to this temporal re-orientation and emotion work process. Instead of 'managing hope,' as much of the cancer communication literature describes it, findings suggest that physicians address cancer carers' and patients' temporal anomie. Future research might benefit from moving beyond in idualistic conceptualisations of carers' emotions to include the cultural, temporal and interactionist influences.
Publisher: Hindawi Limited
Date: 14-01-2014
DOI: 10.1111/ECC.12175
Abstract: Cancer trajectories now follow a jagged path based on multiple probabilities. Thus, uncertainty now typifies cancer caregiving. What impact does uncertainty have on cancer carer grief? This article explores cancer carers' experiences of loss, based on qualitative interviews with 32 Australian carers of a spouse with cancer. Findings suggest that in addition to conventional and anticipatory grief, many carers experience indefinite loss. Indefinite loss characterised the experiences of spouses caregiving outside of the terminal stage. They experienced the current loss of a taken-for-granted certain future, but the future loss of their spouse remained uncertain. They described a heightened awareness of mortality, and an inability to plan for the future. Losses that are uncertain and potential are largely neglected within the grief literature. In this article, I offer the concept indefinite loss and extend health professionals' understanding of cancer carer loss.
Publisher: Springer Science and Business Media LLC
Date: 12-04-2016
Publisher: Project MUSE
Date: 2021
Publisher: Informa UK Limited
Date: 11-04-2022
DOI: 10.1080/13561820.2022.2052270
Abstract: This paper explores the development and evaluation of the video Observation Tool for Interprofessional Skills (VOTIS). We describe the development of an authentic interprofessional assessment tool that incorporates video reflection and allows formative and summative assessment of in idual learners' interprofessional skills within an authentic interprofessional context. We then investigate its validity and reliability. The VOTIS was developed using a modified Delphi technique. The tool was piloted with 61 students and 11 clinical educators who completed the VOTIS following team meetings where students interacted about their interprofessional clinical work. The following were calculated: internal consistency students' proficiency levels inter-rater reliability between students and clinical educators and inter-rater reliability between clinical educators and an independent rater. Results indicate that the VOTIS has acceptable internal consistency and moderate reliability and has value in evaluating students' interprofessional skills. Study outcomes highlight the need for more explicit wording of tool content and instructions and further clinical educator training to increase the utility and reliability of the VOTIS as a learning and assessment tool.
Publisher: Elsevier BV
Date: 12-2021
Publisher: SAGE Publications
Date: 09-10-2021
DOI: 10.1177/10497323211044468
Abstract: Emotions, like joy and sorrow, feature in illness narratives, dramatizing stories of becoming: sick, well, controlled, in control. However, brief emotions, such as surprise, have received limited analytic attention in cancer illness narratives. Drawing on 20 interviews with 11 participants with erse cancer diagnoses, along with the 455 photographs they produced for this study, we address the complex interactions between discourse, societal expectations, and perceptions in moral-affective economies. Tracing the emergence, deployment, and silencing of surprise provided an avenue to explore connections between affect, morality, advocacy, and philanthropy. We show how surprise works to deny uncertainties couched in in idual risk, and situate cancer causation within the logics of anticipation, (re)producing socio-cultural etiology narratives. Attending to surprise reveals how some cancers are situated as in idual responsibilities, with restricted access to compassion and collective resources. Thus, we interrogate the affective-moral economy underpinning cancer illness narratives, and surprise’s pivotal role in its analysis.
Publisher: Informa UK Limited
Date: 21-09-2023
Publisher: Springer Science and Business Media LLC
Date: 10-02-2017
Publisher: Springer Science and Business Media LLC
Date: 23-05-2019
Publisher: SAGE Publications
Date: 26-11-2022
DOI: 10.1177/13634593221127817
Abstract: Chronic low back pain is characterised by multiple and overlapping biological, psychological, social and broader dimensions, affecting in iduals’ lives. Multidisciplinary pain services have been considered optimal settings to account for the multidimensionality of chronic low back pain but have largely focused on cognitive and behavioural aspects of in iduals’ pain. Social dimensions are usually underexplored, considered outside or beyond healthcare professionals’ scope of practice. Employing Actor Network Theorist Mol’s concept multiplicity, our aim in this paper is to explore how a pain service’s practices bring to the fore the social dimensions of in iduals living with low back pain. Drawing on 32 ethnographic observations and four group exchanges with the service’s clinicians, findings suggest that practices produced multiple enactments of an in idual with low back pain. Although in iduals’ social context was present and manifested during consultations at the pain service (first enactment: ‘the person’), it was often disconnected from care and overlooked in ‘treatment/management’ (second enactment: ‘the patient’). In contrast, certain practices at the pain service not only provided acknowledgement of, but actions towards enhancing, in iduals’ social contexts by adapting rules and habits, providing assistance outside the service and shifting power relations during consultations (third enactment: ‘the patient-person’). We therefore argue that different practices enact different versions of an in idual with low back pain in pain services, and that engagement with in iduals’ social contexts can be part of a service’s agenda.
Publisher: Informa UK Limited
Date: 02-04-2016
Publisher: Springer Science and Business Media LLC
Date: 2009
DOI: 10.1071/AP09008
Publisher: Informa UK Limited
Date: 10-01-2008
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12889-019-7971-Y
Abstract: Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia. Using a semi-structured question guide, eight focus groups and seven in idual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis. The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents. The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs.
Publisher: Wiley
Date: 15-02-2022
DOI: 10.1111/EJE.12674
Abstract: Smartphone addiction has been associated with sleeping problems and psychological anxiety. However, little is known about the association of smartphone addiction, sleep quality and perceived stress amongst university students particularly in dentistry. This study investigated the association of these variables amongst dental students in a Jordanian dental faculty. A s le of 420 undergraduate dental students enrolled for academic year 2017/2018 at the Jordan University of Science and Technology participated in this study. They were given a set of self-administered questionnaires which consisted of questions regarding demographic information, characteristics of smartphone use, assessment of smartphone addiction, sleep quality as well as perceived stress. The mean Smartphone Addiction Scale (SAS) score amongst Jordanian dental students was high (109.9 ± 23.8). The correlation between SAS and Global Pittsburg Sleep Quality Index (PSQI) score was significant (r = 0.137, P =0.005) indicating that the higher the smartphone addiction level, the poorer the quality of sleep. Similarly, a significant correlation was found between Perceived Stress Scale-10 (PSS-10) score and Global PSQI score (r = 0.348, P < 0.001) which implied that students who have higher perceived stress experienced poorer sleep quality. Year 3 students (clinical year), smartphone addiction and perceived stress were determinants of sleep quality. Dental students who have high levels of smartphone addiction or high perceived stress levels experienced poor sleep quality. Identifying smartphone addicts amongst students as well as stressors are imperative measures to allow timely assistance and support in the form of educational c aigns, counselling, psychotherapy and stress management.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2015
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/AH11086
Abstract: Over the past half century, medical care has become less institutionalised, more autonomous, equitable and less costly. This has led to a shift from hospital-based delivery to community care. This paper examines the experiences of Canberra-based carers following this shift using interview data from a longitudinal qualitative study of 32 informal carers of a spouse with cancer. Cancer patients experienced poorly coordinated care. When carers observed the effects of errors and miscommunication on patients, they felt compelled to coordinate patient care. Interview data suggest that informal carers of cancer patients are relied upon to manage patient care at home and in hospitals, but are not supported in undertaking this responsibility. This implies that carers should be a far more central focus in cancer care reform strategies. What is known about the topic? Shifts in Australian models of care mean much of the care-work associated with cancer has moved from hospitals to home. Little is known about the implications of this shift on carers of cancer patients, a population at high risk of stress, depression and anxiety. What does this paper add? This study offers a rare qualitative approach to understanding the experiences of carers of spouses with cancer in Canberra-based hospitals. Their accounts suggest that cancer carers are relied on to coordinate care for their spouse on a long-term basis at home, in hospitals and across multiple medical modalities. What are the implications for practitioners? This high reliance on an informal caregiving population with a well-documented risk of stress, anxiety and depression suggests that strategic changes need to be made to support carers. As states and territories begin to implement cancer care coordinators as part of a cancer reform strategy, carers should be a central focus.
Publisher: Informa UK Limited
Date: 02-09-2021
Publisher: Inderscience Publishers
Date: 2017
Publisher: SAGE Publications
Date: 26-03-2022
DOI: 10.1177/10497323221084358
Abstract: Despite recommendations to incorporate physical and psychosocial factors when providing care for people with back pain, research suggests that physiotherapists continue to focus on biological aspects. This study investigated how interpersonal and institutional norms influence this continued enactment of the biological aspects of management. We used theoretically-driven analysis, drawing from Foucauldian notions of power, to analyse 28 ethnographic observations of consultations and seven group discussions with physiotherapists. Analysis suggested that physiotherapy training established expectations of what a physiotherapist ‘should’ focus on, and institutional circumstances strongly drew the attention of physiotherapists towards biological aspects. Resistance to these forces was possible when, for ex le, physiotherapists reflected upon their practice, used silences and pauses during consultations, and actively collaborated with patients. These circumstances facilitated use of non-biomedical management approaches. Findings may assist physiotherapists to rework the enduring normative focus on biomedical aspects of care when providing care for patients with back pain.
Publisher: Wiley
Date: 30-09-2008
Publisher: Hindawi Limited
Date: 04-09-2013
DOI: 10.1111/ECC.12121
Abstract: Much of the literature on informal carers of cancer patients is quantitative and psycho-oncology based. This literature has established that cancer carers experience higher rates of stress, depression and anxiety than their non-caregiving counterparts, with younger female carers reporting higher rates of burden and unmet needs. The reasons behind this variation and variations in support preferences are poorly understood: some carers prefer support groups and others prefer practical support. This study takes a sociological approach to exploring carers' varied experiences. Longitudinal interviews were conducted with 32 carers of a spouse with cancers of varying stages and diagnoses in the Australian Capital Territory. Analysis, informed by the discretionary time literature, shows time-sovereignty illuminates much of the variation in carers' emotional experiences and support preferences. Carers with few competing commitments and less onerous caregiving responsibilities had time to experience and unpack the range of emotions associated with cancer, and reconnect with their spouse. These carers preferred emotion-focused support. In contrast, carers with multiple commitments had little time to themselves and viewed emotions as an indulgence. These carers preferred practical support. A time-sovereignty framework offers health and support professionals a means of understanding carers' varying needs and tailoring support services.
Publisher: SAGE Publications
Date: 02-02-2019
Publisher: Wiley
Date: 19-07-2004
Publisher: SAGE Publications
Date: 14-08-2014
Abstract: Informal carers of cancer patients have high rates of burden, stress, anxiety and unmet needs yet, some describe caregiving as fulfilling. Building on the work of Thomas and colleagues, this study takes a sociology of emotions approach to understanding variations in carers of cancer patients’ emotional experiences, using interview data with 32 carers of a spouse with cancer. Analysis indicates that a clearly terminal (negative) prognosis facilitates clear priorities, unambiguous emotion management and improved social bonds. A more ambiguous (positive) prognosis, that includes a greater chance of survival, fosters role conflict, clashing feeling rules and ongoing guilt within spousal carers. This study highlights the importance of a prognosis to emotion management, underscoring a phenomenon that is likely to grow as survival rates continue to improve and explaining some of the variation in carers’ experiences.
Publisher: Wiley
Date: 28-05-2002
Publisher: SAGE Publications
Date: 25-12-2020
Abstract: Motherhood can bring joy and enrichment but may also be associated with stress leading to poor health outcomes and low life satisfaction. Young mothers are a group particularly at risk of adverse outcomes, including increased social, economic, and health disadvantage following early entry to motherhood. This article reports results from a mixed-method study examining variations in levels of social support reported by mothers. Cross-sectional analyses of survey data from the Longitudinal Study of Australian Children showed that young mothers (aged less than 25 years when their child was born) generally reported higher levels of social support, but poorer family relationships than older mothers. In-depth interviews with nine young mothers provided insights into how they perceived support under these circumstances. Our research shows that young mothers often experienced difficult childhoods and strained relationships with parents, but many reconnected with their mothers after pregnancy and saw them as important sources of support.
Publisher: BMJ
Date: 15-11-2022
DOI: 10.1136/SPCARE-2022-004035
Abstract: To detail important lessons learnt while conducting several large, medicinal cannabis (MC) randomised clinical trials in a palliative cancer population. Investigators involved in these trials had several meetings to agree on the major lessons learnt and how the various challenges could be mitigated in the future. The lessons were sorted into separate categories: patient confidentiality, family dynamics, driving, cost, unfounded beliefs, accessing specific MC products, trial funding, telehealth and COVID-19, and miscellaneous issues. Using MC as the intervention arm in such trials entails some unique regulatory, logistical and other challenges. This short report presents key lessons learnt in conducting these randomised controlled trials in a palliative care population for the benefit of future investigators planning similar trials in a similar patient population.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.SOCSCIMED.2022.115422
Abstract: Despite clinicians being important actors in the context of uncertainty, their experiences navigating uncertainty remain largely unexplored. Drawing on a theory-driven post-qualitative approach, we used Mol's logic of choice/care as a lens through which we made sense of interviews with 22 clinicians who work with patients who experience low back pain (LBP). Our analysis suggests that uncertainty is ubiquitous in LBP care and not limited to particular domains. Clinicians navigated uncertainty when considering patients' personal and social contexts making therapeutic decisions navigating emotions and mental health communicating with, and educating, patients, among others. These uncertainties are intertwined with clinical aspects such as treatment choices and evidence-based education about LBP. At times, clinicians resolved these uncertainties by producing certainty at the cost of attending to human aspects of care. We argue that epistemic shifts, theorisation and practical engagement with theory in training, research and clinical practice may prompt clinicians to embrace uncertainty and enact the logic of care.
Publisher: Elsevier BV
Date: 07-2006
Publisher: SAGE Publications
Date: 06-06-2022
DOI: 10.1177/13634593221099108
Abstract: Tobacco control policies reinforce a health imperative that positions citizens as duty-bound to manage their health by abstaining from or quitting smoking. Limited attention is paid to the repercussions – especially for lung screening – of anti-smoking rhetoric emphasising in idual responsibility. Drawing on interviews with 27 long-term smokers involved in an international lung screening trial, this study analysed Australian smokers’ narratives of smoking. By attending to stigma and the use of public health rhetoric within personal narratives, we show how narratives underscoring in idual responsibility for quitting were layered with conflicting explanations of biological responsibility and normative expectations. Ironically, narratives of in idual responsibility potentially undermine smoking cessation. In positioning smokers as responsible for their own healthy choices, such rhetoric also positions smokers as responsible for managing their emotional health, which some did through smoking. Thus, anti-smoking c aigns pit the neoliberal imperative of health against the happiness imperative. These findings have implications for the design and delivery of lung screening c aigns. They also support calls to move beyond health messaging emphasising in idual choice, towards acknowledging the moral power of structures and public health c aigns to discipline citizens in unintended ways.
Publisher: Elsevier BV
Date: 04-2007
Publisher: Springer Science and Business Media LLC
Date: 05-09-2022
DOI: 10.1186/S13063-022-06691-1
Abstract: Recruitment for randomised controlled trials in palliative care can be challenging disease progression and terminal illness underpin high rates of attrition. Research into participant decision-making in medicinal cannabis randomised controlled trials (RCTs) is very limited. Nesting qualitative sub-studies within RCTs can identify further challenges to participation, informing revisions to study designs and recruitment practices. This paper reports on findings from a qualitative sub-study supporting RCTs of medicinal cannabis for symptom burden relief in patients with advanced cancer in one Australian city. Semi-structured qualitative interviews were conducted with 48 patients with advanced cancer, eligible to participate in a medicinal cannabis RCT ( n =28 who consented to participate in an RCT n =20 who declined). An iterative and abductive approach to thematic analysis and data collection fostered exploration of barriers and enablers to participation. Key enablers included participants’ enthusiasm and expectations of medicinal cannabis as beneficial (to themselves and future patients) for symptom management, especially after exhausting currently approved options, and a safer alternative to opioids. Some believed medicinal cannabis to have anti-cancer effects. Barriers to participation were the logistical challenges of participating (especially due to driving restrictions and fatigue), reluctance to interfere with an existing care plan, cost, and concerns about receiving the placebo and the uncertainty of the benefit. Some declined due to concerns about side-effects or a desire to continue accessing cannabis independent of the study. The findings support revisions to subsequent medicinal cannabis RCT study designs, namely, omitting a requirement that participants attend weekly hospital appointments. These findings highlight the value of embedding qualitative sub-studies into RCTs. While some challenges to RCT recruitment are universal, others are context (population, intervention, location) specific. A barrier to participation found in research conducted elsewhere—stigma—was not identified in the current study. Thus, findings have important implications for those undertaking RCTs in the rapidly developing context of medical cannabis.
Publisher: Wiley
Date: 06-11-2022
DOI: 10.1111/HEX.13642
Abstract: Following 2016 legislation permitting limited access to cannabis for research and medicinal purposes, the number of randomized clinical trials (RCTs) investigating the effectiveness of medicinal cannabis (MC) on symptom burden relief in cancer contexts has increased in Australia. This study aimed to understand the perceptions, hopes and concerns of people with advanced cancer regarding the future availability and regulation of MC in Australia. This qualitative study draws on semistructured interviews conducted between February 2019 and October 2020 in Brisbane, Australia, as part of an MC RCT substudy. Interviews were undertaken on 48 patients with advanced cancer in palliative care eligible to participate in an MC trial ( n = 26 participated in an RCT n = 2 participated in a pilot study n = 20 declined). Interviews included a discussion of patients' decision‐making regarding trial participation, concerns about MC and perceptions of future availability, including cost. Transcribed interviews were analysed inductively and abductively, informed by constructivist thematic analysis conventions. Overall, participants supported making MC legally accessible as a prescription‐only medication. Fear of financial toxicity, however, compromised this pathway. Steep posttrial costs of accessing MC prompted several people to decline trial participation, and others to predict—if found effective—that many would either access MC through alternative pathways or reduce their prescribed dosage to enable affordable access. These findings suggest that—despite a relatively robust universal healthcare system—Australians are potentially vulnerable to and fearful of financial toxicity. Prevalent in the United States, financial toxicity occurs when disadvantaged cancer patients access necessary but expensive medications with lasting consequences: bankruptcy, ongoing anxiety and cancer worry. Interview transcripts indicate that financial fears—and the systems sustaining them—may pose a threat to RCT completion and to equitable access to legal MC. Such findings support calls for embedding qualitative substudies and community partnerships within RCTs, while also suggesting the importance of subsidisation to overcoming injustices. A patient advisory committee informed RCT design. This qualitative substudy foregrounds patients' decision‐making, perceptions and experiences.
Publisher: Wiley
Date: 21-12-2022
Abstract: The biopsychosocial model is currently considered by most researchers and clinicians to be the best approach to low back pain (LBP) care. The model was popularised in LBP care in response to some clear deficiencies in earlier biomedical approaches and is now widely recommended in clinical guidelines and policy statements. Yet the biopsychosocial approach has also been critiqued for its narrow conceptualisation and application. In this article, we explore how attending to the multidimensionality of LBP in practice goes beyond a biopsychosocial approach. We engaged with 90 ethnographic observations of clinical practices, 22 collaborative dialogues with clinicians, and eight consultatory meetings with people with experience of LBP to consider the sociomaterialities of clinical practices in two settings: a private physiotherapy practice and a public multidisciplinary pain clinic. Drawing on the work of Annemarie Mol and Rosi Braidotti, our analyses suggest that sociomaterial practices, involving human and non‐human actors, produced multiple objects of clinical attention and ethical concerns about how to attend to this multiplicity well. We argue that the multiplicity of LBP is attended well by reimagining: (1) clinical settings as ‘becoming more‐than‐sterile environments’ where objects, furniture and elements such as tears and laughter help to provide a relational, welcoming and comfortable space to all bodies with LBP (2) differences through ‘becoming minoritarian’ where considering power relations allows actions towards connectiveness and belonging and (3) disciplinary boundaries through ‘becoming interdisciplinary within’ where actions expand traditional scopes of practice. The flux of these multiple becomings moves clinical practice and conceptualisations beyond the biopsychosocial approach to consider a new ethico‐onto‐epistemological approach to LBP care. They invite clinical practices that engage with an ethical multiplicity of LBP care, providing a better understanding of how places, objects, emotions, power, bodies and professions are interconnected and come together in everyday practice.
Publisher: Informa UK Limited
Date: 24-06-2017
Publisher: Walter de Gruyter GmbH
Date: 25-04-2003
DOI: 10.1515/HF.2003.035
Abstract: This is the first report of post-harvest wood staining in blackwood ( Acacia melanoxylon R. Br). In Tasmanian sawmills, an orange-brown stain commonly occurs upon cutting fresh blackwood. An investigation of the causal mechanism of stain development was completed using fresh flitches and stockpiled logs. Some fungi and bacteria were isolated from stained and unstained blackwood, but no species was consistently present in stained wood alone. Wood pH did not vary between stained and unstained wood, but there was some evidence of alterations in phenol composition. Blackwood extracts were analysed by HPLC and a minor phenolic compound was detected that was consistently found in stained s les and rarely in unstained. UV spectra indicated that this compound may be a quinone, but mass spectrometry data was inconclusive. Experiments with blackwood extracts showed that addition of oxygen (by means of H 2 O 2 treatment) increased absorbance in the “brown” wavelengths characteristic of stain. This supports the assumption that the stain is an oxidative chemical stain, as it develops quite rapidly from cut surfaces.
Publisher: BRILL
Date: 2018
Publisher: SAGE Publications
Date: 12-04-2019
Abstract: Discussions of crying and love are not what one might expect to find when examining interactions between recreational bodybuilders online. Gendered emotion ideologies, especially related to muscular masculinities, usually forbid men from exhibiting emotional vulnerability in front of other men, as emotional detachment is one of the ways gender hierarchies are maintained. Building on Connell’s concept of ‘hegemonic masculinity’ and Hochschild’s concept of ‘emotion management’, this article analyses emotional exchanges within an international community of male recreational bodybuilders: fans of Aziz Shavershian, known as ‘Zyzz’. We examine the meaning of emotions within the Zyzz fandom’s local hierarchy of masculinities, the expressive freedoms afforded by the context of their emotional interactions, and the strategies employed by Zyzz and fans to traverse masculine emotion ideologies that usually prevent men from expressing love and affection.
Publisher: SAGE Publications
Date: 29-07-2020
Abstract: The contradictory work environments of new economies in late modernity are associated with a range of emotional experiences, requiring erse emotion management strategies. Late modernity offers the capacity to pursue happy, safe, rewarding, and meaningful work for the privileged few a potential trade-off between stressful meaningful and boring precarious work for a greater number and the prospect of non-meaningful, precarious work for many in the new economy characterised by short-term contracts, gig work, precarity, and anxiety. This study draws on data from the 2015–16 Australian Social Attitudes Survey to examine workers’ emotions in various combinations of meaningful and precarious employment, and the degree to which these emotions are managed. It finds that it is best to have secure meaningful work, worst to have highly precarious work, and slightly better to have safe but alienating than risky meaningful work, in terms of avoiding often hidden negative emotions.
Publisher: Wiley
Date: 15-12-2009
DOI: 10.1111/J.1469-8137.2009.03127.X
Abstract: Tree resistance can be enhanced by a variety of biotic and abiotic inducers, including nonpathogenic and pathogenic microbes, and herbivores, resulting in enhanced protection against further biotic injury. Induced resistance (IR) could be a valuable tool in sustainable pest management. IR has been actively studied in herbaceous plant species, and, in recent years, in woody plant species, and is fast emerging as an intriguing, eco‐friendly concept for enhancing tree resistance. However, before application of IR becomes possible, there is a need to increase our knowledge of the mechanisms of defence in forest trees. A richer understanding of these phenomena will play a critical role in developing sustainable integrated pest management strategies. This review summarizes our current knowledge of IR in forest trees, focusing on inducible defence mechanisms, systemic induction of resistance and phytohormone signalling networks. We conclude by discussing the potential advantages and limitations of applying IR‐based management tools in forest systems. Contents Summary 893 I. Introduction 894 II. Induced defence mechanisms in trees 894 III. Systemic induction of resistance 897 IV. Defence signalling networks 900 V. Future prospects: what does IR offer for management of forest systems? 902 Acknowledegements 904 References 904
Publisher: Informa UK Limited
Date: 26-02-2022
Publisher: SAGE Publications
Date: 05-12-2015
Abstract: In qualitative research into emotions, researchers and participants share emotion-laden interactions. Few demonstrate how the analytic value of emotions may be harnessed. In this article we provide an account of our emotional experiences conducting research with two groups: adults living with cystic fibrosis and spouse caregivers of cancer patients. We describe our emotion work during research interviews, and discuss its methodological and theoretical implications. Reflections depict competing emotion norms in qualitative research. Experiences of vulnerability and involuntary “emotional callusing” illustrate the insight into participants’ experiences afforded to us through emotion work. This prompted us to extend Hochschild’s theory to incorporate unconscious activity mediated through habitus, allowing us to demonstrate how the “emotional” nature of emotions research can galvanize analytic insight.
Publisher: Wiley
Date: 03-2001
DOI: 10.1002/PCA.567
Abstract: An efficient system for the analysis of indole alkaloids by HPLC on a reversed-phase column using an ion pair technique is described. The optimised chromatographic conditions allowed the successful separation of 22 standard monoterpenoid indole alkaloids (including some isomers) and tryptamine. The described HPLC system was applied to the analysis of alkaloids in intergeneric somatic hybrid cell cultures of Rauvolfia serpentina x Rhazya stricta.
Publisher: Wiley
Date: 12-05-2006
Publisher: Wiley
Date: 25-11-2022
DOI: 10.1111/MEDU.14700
Abstract: Like medicine and health care, feedback is a practice imbued with emotions: saturated with feelings relevant to one's identity and status within a given context. Often this emotional dimension of feedback is cast as an impediment to be ignored or managed. Such a perspective can be detrimental to feedback practices as emotions are fundamentally entwined with learning. In this critical review, we ask: What are the discourses of emotion in the feedback literature and what ‘work’ do they do? We conducted a critical literature review of emotion and feedback in the three top journals of the field: Academic Medicine , Medical Education and Advances in Health Sciences Education . Analysis was informed by a Foucauldian critical discourse approach and involved identifying discourses of emotion and interpreting how they shape feedback practices. Of 32 papers, four overlapping discourses of emotion were identified. Emotion as physiological casts emotion as internal, biological, ever‐present, immutable and often problematic. Emotion as skill positions emotion as internal, mainly cognitive and amenable to regulation. A discourse of emotion as reflexive practice infers a social and interpersonal understanding of emotions, whereas emotion as socio‐cultural discourse extends the reflexive practice discourse seeing emotion as circulating within learning environments as a political force. Drawing on scholarship within the sociology of emotions, we suggest the merits of studying emotion as inevitable (not pathological), as potentially paralysing and motivating and as situated within (and often reinforcing) a hierarchical social health care landscape. For future feedback research, we suggest shifting towards recognising the discourse‐theory‐practice connection with emotion in health professional education drawing from reflexive and socio‐cultural discourses of emotion.
Publisher: Routledge
Date: 31-01-2019
Publisher: Wiley
Date: 20-03-2015
DOI: 10.1111/MEDU.12686
Publisher: Wiley
Date: 07-06-2023
Abstract: Experiences of advanced cancer are assembled and (re)positioned with reference to illness, symptoms and maintaining ‘wellbeing’. Medical cannabis is situated at a borderline in this and the broader social domain: between stigmatised and normalised recreational and pharmaceutical between perception, experience, discourse and scientific proof of benefit. Yet, in the hyper‐medicalised context of randomised clinical trials (RCTs), cancer, wellbeing and medical cannabis are narrowly assessed using in idualistic numerical scores. This article attends to patients’ perceptions and experiences at this borderline, presenting novel findings from a sociological sub‐study embedded within RCTs focused on the use of medical cannabis for symptom relief in advanced cancer. Through a Deleuzo–Guattarian‐informed framework, we highlight the fragmentation and reassembling of bodies and propose body‐situated experiences of wellbeing in the realm of advanced cancer. Problematising ‘biopsychosocial’ approaches that centre an in idualised disconnected patient body in understandings of wellbeing, experiences of cancer and potential treatments, our findings foreground relational affect and embodied experience, and the role of desire in understanding what wellbeing is and can be. This also underpins and enables exploration of the affective reassembling ascribed to medical cannabis, with particular focus on how it is positioned within RCTs.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Elsevier BV
Date: 02-2011
Publisher: Bristol University Press
Date: 11-2020
DOI: 10.1332/263169020X15893854268688
Abstract: Scholars studying emotions in social life typically work mono-logically, within a paradigmatic c , drawing on distinct theories of emotion. In isolation, each offers a singular conceptualisation of emotions in social life. Working multi-logically, in contrast, offers richer, comparative insight into the layered meanings of emotion relevant to a social context. Rather than treating them as incommensurate, we not only argue for the benefits of drawing on multiple paradigms, methods and theories of emotions in social life, we offer a worked ex le of a post-paradigmatic methodology for analysing emotions in social life that values multi-logicality and epistemic flexibility. Setting aside debates about what emotions are , we work from the premise that different conceptualisations of emotions do things: shape what we see and ignore, and discursively position people. We show how multiple theories and concordant methods can – and should – be applied to studying emotions in social life in the same study. In this empirical illustration of a methodological innovation, we map theories and methodologies of emotions in social life against four research paradigms and against four phases of a study into the emotional dimensions of interprofessional practice, depicting the realisations afforded through a post-paradigmatic methodology for analysing emotions in social life.
Publisher: Informa UK Limited
Date: 07-12-2020
DOI: 10.1080/09638288.2020.1851783
Abstract: Low back pain (LBP) is the leading cause of disability worldwide. Clinical research advocates using the biopsychosocial model (BPS) to manage LBP, however there is still no clear consensus regarding the meaning of this model in physiotherapy and how best to apply it. The aim of this study was to investigate how physiotherapy LBP literature enacts the BPS model. We conducted a critical review using discourse analysis of 66 articles retrieved from the PubMed and Web of Science databases. Analysis suggest that many texts conflated the BPS with the biomedical model [Discourse 1: Conflating the BPS with the biomedical model]. Psychological aspects were almost exclusively conceptualised as cognitive and behavioural [Discourse 2: Cognition, behaviour, yellow flags and rapport]. Social context was rarely mentioned [Discourse 3: Brief and occasional social underpinnings] and other broader aspects of care such as culture and power dynamics received little attention within the texts [Discourse 4: Expanded aspects of care]. Results imply that multiple important factors such as interpersonal or institutional power relations, cultural considerations, ethical, and social aspects of health may not be incorporated into physiotherapy research and practice when working with people with LBP.IMPLICATIONS FOR REHABILITATIONWhen using the biopsychosocial model with patients with low back pain, researchers narrowly focus on biological and cognitive behavioural aspects of the model.Social and broader aspects such as cultural, interpersonal and institutional power dynamics, appear to be neglected by researchers when taking a biopsychosocial approach to the care of patients with low back pain.The biopsychosocial model may be inadequate to address complexities of people with low back pain, and a reworking of the model may be necessary.There is a lack of research conceptualising how physiotherapy applies the biopsychosocial model in research and practice.
Publisher: Elsevier BV
Date: 2007
Publisher: SAGE Publications
Date: 25-11-2015
Publisher: SAGE Publications
Date: 22-01-2019
Abstract: Research focusing on the management of emotion features prominently in studies of employee attrition, gender inequality and workplace satisfaction, but rarely in research on worker solidarity. Against a backdrop of increasing in idualisation within late modern society, research about workplace management of emotion has become bifurcated along sociological or organisational psychology lines. Within the sociology literature, management of emotion is theorised as a commercialised, relational and (often) alienating experience. Within organisational psychology literature and research, the emphasis is on harnessing in idual traits and skills (e.g. emotional intelligence) to regulate emotions for increased productivity and employee retention. In this article, the authors call for a new research agenda that prioritises the examination of solidarity between workers alongside the analysis of emotion management. This call is based in a critical reading of the sociological and organisational psychology scholarship addressing the management of emotions. Through the ex le of teaching work, the authors provide a critique of scholarship on workplace strategies that promote highly in idualised understandings of managing emotions through resilience training and other simplified techniques. They argue that workplaces should recognise the dangers of uncritically adopting in idualised strategies for managing emotions, and propose a research agenda that seeks to understand how emotion management can affect worker solidarity.
Publisher: Elsevier BV
Date: 04-2019
Publisher: Wiley
Date: 16-02-2014
DOI: 10.1111/MEDU.12290
Abstract: During the past decade, several studies have systematically reviewed interprofessional education (IPE), but few have inclusively reviewed this literature. None has focused primarily on IPE in allied health, despite differences in recruitment and socialisation across the health professions. This systematic review seeks to uncover the best approach to pre-licensure, university-based allied health IPE to determine which aspects require modification in which contexts to provide optimal learning experiences. A systematic search of 10 databases was conducted for articles published in English, between January 1998 and January 2013. Studies were included if they used quantitative or qualitative methodologies to report on the outcomes associated with IPE in allied health. Two independent reviewers identified studies that met the inclusion criteria, critically appraised the included studies and extracted data relating to the effectiveness of IPE in allied health. Data were synthesised narratively to address the study aims. Large gaps - relating to methods, theory and context - remain within this body of literature. Studies measured students' attitudes and understanding of other health professional roles, teamwork and knowledge in response to IPE interventions using patient scenarios, lectures and small-group work. Differences in power and curriculum placement were described as factors affecting IPE effectiveness. Evaluation remains the primary aim within this literature. Few studies use theory, take an inductive approach to understanding the processes behind IPE or include detailed participant descriptions. Therefore, we suggest that IPE research is currently caught in an epistemological struggle, between assumptions underpinning biomedical and health science research, and those underpinning education studies. As part of a systems approach to understanding interprofessional socialisation, we call for researchers to take a realistic approach to evaluation that is inclusive of, and responsive to, contextual factors to explore how IPE leads to improved long-term outcomes in differing circumstances.
Publisher: Informa UK Limited
Date: 21-02-2022
DOI: 10.1080/09638288.2022.2040615
Abstract: To explore how uncertainty plays out in low back pain (LBP) care and investigate how clinicians manage accompanying emotions/tensions. We conducted ethnographic observations of clinical encounters in a private physiotherapy practice and a public multidisciplinary pain clinic. Our qualitative reflexive thematic analysis involved abductive thematic principles informed by Fox and Katz (medical uncertainty) and Ahmed (emotions). We identified three themes. (1) Sources of uncertainty: both patients and clinicians expressed uncertainty during clinical encounters (e.g., causes of LBP, mismatch between imaging findings and presentation). Such uncertainty was often accompanied by emotions - anger, tiredness, frustration. (2) Neglecting complexity: clinicians often attempted to decrease uncertainty and associated emotions by providing narrow answers to questions about LBP. At times, clinicians' denial of uncertainty also appeared to deny patients the right to make informed decisions about treatments. (3) Attending to uncertainty?: clinicians attended to uncertainty through logical reasoning, reassurance, acknowledgement, personalising care, shifting power, adjusting language and disclosing risks. Uncertainty pervades LBP care and is often accompanied by emotions, emphasising the need for a healthcare culture that recognises the emotional dimensions of patient-clinician interactions and prepares clinicians and patients to be more accepting of, and clearly communicate about, uncertainty.IMPLICATIONS FOR REHABILITATIONUncertainty pervades LBP care and is often accompanied by emotions.Neglecting complexity in LBP care may compromise person-centred care.Acknowledging uncertainty can enhance communication, balance patient-clinician relationships and address human aspects of care.
Publisher: Oxford University Press (OUP)
Date: 12-03-2009
Abstract: In woody species, potential mechanisms to compensate for tissue loss to herbivory and diseases have been related to post-event shifts in growth, biomass and internal resource allocation patterns, as modulated by external resource limitations. We examined the interactive effects of belowground resource limitations by varying nutrient and water availability, and aboveground carbon limitation imposed by a single defoliation event (40% leaf removal) on stem growth, whole-tree and within-tree resource allocation patterns (total non-structural carbohydrate and nitrogen) and below- and aboveground biomass allocation patterns in 8-month-old, field-grown Eucalyptus globulus Labill. saplings. Two months after treatments were imposed, the direction of the stem growth response to defoliation depended on the abiotic treatment. Five months after defoliation, however, we found little evidence that resource availability constrained the expression of tolerance to defoliation. With the exception of the combined low-nutrient and low-water supply treatment, saplings grown with (1) adequate water and nutrient supplies and even with (2) low-water supply or (3) low-nutrient supply were able to compensate for the 40% foliage loss. The observed compensatory responses were attributed to the activation of several short- and longer-term physiological mechanisms including reduced biomass allocation to coarse roots, mobilization of carbohydrate reserves, robust internal N dynamics and increased ratio of foliage to wood dry mass.
Publisher: Informa UK Limited
Date: 11-01-2023
Publisher: SAGE Publications
Date: 29-11-2023
DOI: 10.1177/20597991221137813
Abstract: The understanding of what ethnography looks like, and its purpose, is continuously evolving. COVID-19 posed a significant challenge to ethnographers, particularly those working in health-related research. Researchers have developed alternative forms of ethnography to overcome some of these challenges we developed the Mobile Instant Messaging Ethnography (MIME) adaptation to ethnography in 2021 to overcome restrictions to our own research with hospital doctors. However, for ethnographic innovations to make a substantial contribution to methodology, they should not simply be borne of necessity, but of a dedicated drive to expand paradigms of research, to empower participant groups and to produce change – in local systems, in participant-collaborators and in researchers and the research process itself. In this paper, we reflect on our experiences using MIME, involving collaborative remote observation and reflection with 28 hospital doctors in Ireland from June to December 2021. After reviewing literature on ethnography in COVID-19 and general epistemological developments in ethnography, we detail the MIME approach and illustrate how MIME presents an evolution of the ethnographic approach, not only practically but in terms of its reflexive shift, its connected and co-creative foundations, and its ability to drive change in research approaches, participant life-worlds and real-world improvement.
Publisher: Wiley
Date: 25-07-2018
DOI: 10.1111/SOC4.12621
Publisher: Springer Science and Business Media LLC
Date: 10-09-2018
Publisher: SAGE Publications
Date: 08-08-2023
DOI: 10.1177/13558196231193862
Abstract: Justice and equity-focused practices in health services play a critical but overlooked role in low back pain (LBP) care. Critical reflexivity – the ability to examine and challenge power relations, and broader social issues embedded in everyday life – can be a useful tool to foster practices that are more socially just. No research has yet explored this approach in back pain health services. This study sought to understand how clinicians construct LBP in relation to broader socio-cultural-political aspects of care and explore if those constructions changed when clinicians engaged with critically reflexive dialogues with researchers. Using critical discourse analysis methods, this qualitative study explored institutionalised patterns of knowledge in the construction of LBP care. We conducted 22 critically reflexive dialogues with 29 clinicians from two health services in Australia – a private physiotherapy clinic and a public multidisciplinary pain clinic. Our analyses suggested that clinicians and services often constructed LBP care at an in idual level. This dominant in idualistic discourse constrained consideration of justice-oriented practices in the care of people with LBP. Through dialogues, discursive constructions of LBP care expanded to incorporate systems and health service workplace practices. This expansion fostered more equitable clinical and service practices – such as assisting patients to navigate health care systems, considering patients’ socioeconomic circumstances when developing treatment plans, encouraging staff discussion of possible systemic changes to enhance justice, and fostering a more inclusive workplace culture. Although such expansions faced challenges, incorporating broader discourses enabled recommendations to address LBP care inequities. Critical reflexivity can be a tool to foster greater social justice within health services. By expanding constructions of LBP care beyond in iduals, critical reflexive dialogues can foster discussion and actions towards more equitable workplace cultures, services and systems.
Start Date: 2016
End Date: 2016
Funder: University of Queensland
View Funded ActivityStart Date: 2011
End Date: 2011
Funder: University of Western Sydney
View Funded ActivityStart Date: 2008
End Date: 2010
Funder: Cancer Australia
View Funded ActivityStart Date: 03-2024
End Date: 03-2027
Amount: $405,000.00
Funder: Australian Research Council
View Funded Activity