ORCID Profile
0000-0002-9110-1354
Current Organisations
Australian National University
,
University of Technology Sydney
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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.
Gender Specific Studies | Sociological Methodology and Research Methods | Public Health and Health Services not elsewhere classified | Public Health and Health Services | Other Studies in Human Society | Sociology and Social Studies of Science and Technology |
Expanding Knowledge through Studies of Human Society | Nutrition | Child Health | Families and Family Services | Women's Health | Health Policy Evaluation
Publisher: Informa UK Limited
Date: 29-11-2018
DOI: 10.1080/13691058.2017.1404643
Abstract: The promise of egg freezing for women's fertility preservation entered feminist debate in connection with medical and commercial control over, and emancipation from, biological reproduction restrictions. In this paper we explore how women negotiate and make sense of the decision to freeze their eggs. Our analysis draws on semi-structured interviews with 16 women from the Midwest and East Coast regions of the USA who froze their eggs. Rather than freezing to balance career choices and 'have it all', the women in this cohort were largely 'freezing for love' and in the hope of having their 'own healthy baby'. This finding extends existing feminist scholarship and challenges bioethical concerns about egg freezing by drawing on the voices of women who freeze their eggs. By viewing egg freezing as neither exclusively liberation nor oppression or financial exploitation, this study casts egg freezing as an enactment of 'responsible' reproductive citizenship that 'anticipates coupledom' and reinforces the genetic relatedness of offspring.
Publisher: Dialectical Publishing
Date: 10-2011
Publisher: SAGE Publications
Date: 03-2008
Abstract: In this article, we outline a study method with which structural changes to clinical communication were achieved within a local intensive care unit (ICU). The study method involved in-depth, round-the-clock observation, interviewing, and video filming of how intensivists conducted their practices, as well as showing selected footage to the clinicians for feedback. This feedback component iteratively engaged clinicians in problem-solving their own communication difficulties. The article focuses on one such feedback meeting and describes changes to the morning ward round and planning meeting that this feedback process catalyzed: greater time efficiency, a greater presence of intensivists in the ICU, more satisfied nursing staff, and a handover sheet to improve the structure of clinical information exchanges. We argue that in embodying not a descriptive but an interventionist approach to health service provision, this video-ethnographic method has great significance for enhancing clinicians' and researchers' understanding of the rising complexity of in-hospital practices, and for enabling them to intervene in these practices.
Publisher: Wiley
Date: 11-01-2011
DOI: 10.1111/J.1365-2753.2010.01619.X
Abstract: Current perspectives concerning clinical decision making favour inclusion of patient preference for therapy. This exploratory study aimed to forge introductory insights into patient preference for outpatient-based rehabilitation after total knee replacement (TKR). TKR recipients from six public hospitals participating in a prospective, longitudinal study assessing outcomes after surgery were surveyed 1 year after surgery about preferences for rehabilitation. Surveys were conducted face-to-face or via postal questionnaire. Questions included global satisfaction (percentage scale) with therapy received, future preference for therapy and the reasons underpinning preference. Ninety-three (93/115) TKR recipients participated [mean age 68 (SD 8) years 66% female 75% face-to-face interview]. Group-based (39/93) and one-to-one therapies (38/93) were the most common modes experienced. Most participants (81/93) were highly satisfied (satisfaction ≥ 75%). Future preference was associated with satisfaction with past exposure regardless of mode (P = 0.02), hence no overall preference for one mode emerged. Commonality existed in the reasons why patients preferred specific modes. The most common reason for preferring group-based therapy was psychosocial benefit whilst the more personalized approach was the most common reason for preferring one-to-one therapy. Patient global satisfaction is similarly high across different modes of outpatient rehabilitation despite differences in perceived benefits. The association between satisfaction and preference potentially indicates that provided the service is deemed high quality, the actual mode of therapy offered is less important to this patient population. Research is required, however, to establish the relationship between preference and outcome, the stability of preference across time, and the effect of multiple rehabilitation exposures on preference. For now, the quality of current uni-modal programmes could be enhanced by incorporation of features typically associated with alternative modes.
Publisher: Mary Ann Liebert Inc
Date: 05-2014
Publisher: Informa UK Limited
Date: 31-01-2019
Publisher: Wiley
Date: 07-02-2015
DOI: 10.1111/JOCN.12779
Abstract: This paper explores patients' perspectives on infection prevention and control. Healthcare-associated infections are the most frequent adverse event experienced by patients. Reduction strategies have predominantly addressed front-line clinicians' practices patients' roles have been less explored. Video-reflexive ethnography. Fieldwork undertaken at a large metropolitan hospital in Australia involved 300 hours of ethnographic observations, including 11 hours of video footage. This paper focuses on eight occasions, where video footage was shown back to patients in one-on-one reflexive sessions. Viewing and discussing video footage of clinical care enabled patients to become articulate about infection risks, and to identify their own roles in reducing transmission. Barriers to detailed understandings of preventative practices and their roles included lack of conversation between patients and clinicians about infection prevention and control, and being ignored or contradicted when challenging perceived suboptimal practice. It became evident that to compensate for clinicians' lack of engagement around infection control, participants had developed a range of strategies, of variable effectiveness, to protect themselves and others. Finally, the reflexive process engendered closer scrutiny and a more critical attitude to infection control that increased patients' sense of agency. This study found that patients actively contribute to their own safety. Their success, however, depends on the quality of patient-provider relationships and conversations. Rather than treating patients as passive recipients of infection control practices, clinicians can support and engage with patients' contributions towards achieving safer care. This study suggests that if clinicians seek to reduce infection rates, they must start to consider patients as active contributors to infection control. Clinicians can engage patients in conversations about practices and pay attention to patient feedback about infection risk. This will broaden clinicians' understandings of infection control risks and behaviours, and assist them to support appropriate patient self-care behaviour.
Publisher: Dialectical Publishing
Date: 12-2009
DOI: 10.5172/MRA.3.3.246
Publisher: MDPI AG
Date: 26-01-2018
Publisher: SAGE Publications
Date: 02-2010
Abstract: Drawing on work done in the area of health services research, this article outlines a view of discourse analysis (DA) that approaches discourse as a co-accomplished process involving researcher and research-participant. Without losing sight of the analytical-critical-reflexive moments that have typified discourse analytical endeavours, this article explores a form of DA that moves from discourse as object to be collected and processed away from where it is practised, towards discourse as dynamically emerging reality shared by (clinical) practitioner-participants and researchers, and as flexible means to intervene in the quality and safety of care practices. The article begins with highlighting the productive potential of discourse research in health. The ethics informing this mode of DA, the article goes on to explain, is interested and trustful ‘entanglement’ with those who populate this field of practice and structure it with discourse. Elsewhere referred to as ‘experience-based enquiry’, the initiative to reframe discourse research as a mode of intervention involves keeping practitioners’ interpretations and analysts’ questions, critiques and conclusions in tension. The article argues that this approach capitalizes on the intrinsically reflexive, dialogic and emergent nature of discourse. To illustrate these issues, the article presents two case studies drawn from recent projects that have manifested these researcher and practitioner-participant dynamics. The article concludes that, as emergent practice, the analysis of discourse benefits from entanglement with the people and the contexts where discourse is produced. Here, analysis vacillates between a feedback device that enables both research participants and researchers to re-appraise their and each other’s practices, and a knowledge production device that generalizes about these practices and the changes to these practices that result from the research.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.SOCSCIMED.2013.05.034
Abstract: We report the results of a qualitative study carried out in metropolitan Australia between 2009 and 2011 that canvassed the issue of payment for research oöcyte donation with participants drawn from three potential donor groups fertility patients, reproductive donors and young, non-patient women. Research oöcytes are controversial tissues because women around the world have proved largely unwilling to donate them altruistically. In the ensuing international debate about procurement, the issue of money and its appropriate and inappropriate uses in tissue donation has taken centre stage. While there is now an abundance of expert commentary on this matter, there are almost no studies that probe this issue with potential donor populations. Our study asked the three groups of women about their understandings of altruistic, reimbursed, subsidised, compensated and paid donation for both reproductive and research eggs. We identify a resistance to the introduction of money into the sphere of reproductive donation, which the majority of respondents felt should remain an area of personalised gift relations. In the area of research donation we find a strong relationship between degrees of liquidity (the extent to which money is constrained or unconstrained) and a sense of ethical appropriateness. We also describe a culturally specific sense of fairness and equity among participants, associated with the relatively high public subsidisation of fertility treatment in Australia, which they used to benchmark their sense of appropriate and inappropriate uses of money. While the participant responses reflect the regulatory environment in Australia, particularly the absence of a US style market in reproductive oöcytes, they also make an important contribution to the global debate.
Publisher: MDPI AG
Date: 15-01-2019
Abstract: Evidence suggests age and sex differences in risk factors for chronic disease. This study examined lifestyle and biomedical risk factors among men (m) and women (w) in early-middle (25–51 years), middle (52–64) and older (65+) adulthood. Cross-sectional data from the 2011–2012 Australian Health Survey (n = 3024) were analysed. Self-reported dietary, activity, sleep behaviours and collected biomedical data were analysed. Early-middle adults failed to meet fruit, vegetable (95.3%) and sugar-sweetened beverage (SSB, 34.9%) recommendations. Older adults had higher prevalence of overweight/obesity (70%), high blood pressure (38.0%) and fewer met physical activity guidelines (36.3%). Prior to older adulthood, more men consumed SSBs (early-middle m 45.6%, w 24.4% middle m 26.0%, w 19.3%), and fewer met sedentary behaviour recommendations (early-middle m 43.2%, w 62.1% middle m 46.4%, w 63.9%). Differences in overweight/obese women in early-middle (44.8%) to middle adulthood (64.7%) were significant. Biomedical risk was greatest in middle age abnormal cholesterol/lipids increased specifically for women (total cholesterol early-middle 24.9% middle 56.4% abnormal LDL-cholesterol early-middle 23.1% middle 53.9%). Adherence to lifestyle guidelines was low particularly among men. While men exhibited greater clinical risk overall, this significantly increased among women in middle-adulthood. Public health strategies to improve lifestyle, monitor and intervene among middle-aged women are warranted.
Publisher: Informa UK Limited
Date: 10-2005
Publisher: Informa UK Limited
Date: 02-2019
Publisher: Mary Ann Liebert Inc
Date: 04-2023
Publisher: SAGE Publications
Date: 22-08-2012
Abstract: A researcher’s emotional labour is inextricably linked to the methodological and ethical underpinnings of ‘doing’ sensitive and some feminist research. However, a key component of the emotional labour theory does not fit with the emotional labour enacted by some researchers. This article sets out to extend the theory of emotional labour in order to make it more applicable to sensitive and feminist methodologies, and in doing so, it reveals the importance of incorporating emotion in the refinement of theory. Drawing on 20 interviews with female in vitro fertilisation patients, and extracts from a systematically recorded reflexive diary of the researcher, this article contests a key aspect of Hochschild’s theory of emotional labour in its application to sensitive and feminist qualitative researchers. Instead of estrangement from the emotional self as a result of enacting emotional labour, this article suggests that the emotional and biological selves of the researcher can be foregrounded, sometimes unwillingly. The investment of emotional labour must be acknowledged by institutions, managers and methodologists, and further theorising is required to incorporate the critical presence of emotional labour in social science research.
Publisher: Wiley
Date: 19-09-2011
DOI: 10.1111/J.1467-9566.2011.01399.X
Abstract: We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients' and reproductive donors' perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes' fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents' much greater willingness to donate frozen embryos for human embryonic stem cells research.
Publisher: SAGE Publications
Date: 05-12-2014
Abstract: This article outlines the main tenets of affect theory and links these to Sloterdijk’s spherology. Where affect foregrounds prepersonal energies and posthuman impulses, spherology provides a lens for considering how humans congregate in constantly reconfiguring socialities in their pursuit of legitimacy and immunity. The article then explores the relevance of “affective spheres” for contemporary social science research. The article’s main argument here is that research of contemporary organisational and professional practices must increasingly be spherogenic, or seeking to build “affective spheres.” The basis of this argument are the in situ complexity and fast-changing nature of practices, and the increasing challenges involved in objectifying or ‘freezing’, and analysing or dissecting such practices. The article draws for its case study on a video-reflexive project conducted in a U.S. health service. The article concludes that the notion of research as spherogenics counterbalances the conventional methodological emphasis on a predetermined stance —whether neutral or political—in our construction and enactment of social science research.
Publisher: MDPI AG
Date: 07-12-2017
DOI: 10.3390/NU9121330
Publisher: SAGE Publications
Date: 27-02-2014
Abstract: When mothers of preterm infants are unable to produce sufficient volumes of breastmilk, neonatologists in many Western countries prescribe pasteurized donor breastmilk. Breastmilk has a paradoxical presence in the neonatal intensive care unit: while it has therapeutic properties, it also has the potential to transmit disease. National health authorities and local neonatal intensive care unit policies each delimit the safety of donor milk by focusing on the presence or absence of pathogens. It is in this light that breastmilk from the human milk bank is both sought and legitimated to minimize safety concerns. This research uses data arising from an ethnographic study of two human milk banks and two neonatal intensive care units in the United States, and 73 interviews with milk donors, neonatal intensive care unit parents and clinicians. The primary research question framing the study was ‘What are the underlying processes and practices that have enabled donor milk to be endorsed as a safe and legitimate feeding option in neonatal intensive care units?’ This study is framed using three key principles of Latour’s ‘new critique’, namely, adding to reality rather than debunking it, getting closer to data rather than turning away from fact and creating arenas in which to assemble. As a result, conceptions of donor milk’s safety are expanded. This case study of donor milk demonstrates how Latour’s new critique can inform science and technology studies approaches to the study of safety in health care.
Publisher: Mary Ann Liebert Inc
Date: 06-2013
Publisher: Springer Science and Business Media LLC
Date: 23-12-2011
DOI: 10.1007/S11673-011-9349-4
Abstract: This article develops a model of informed consent for fresh oöcyte donation for stem cell research, during in vitro fertilisation (IVF), by building on the importance of patients' embodied experience. Informed consent typically focuses on the disclosure of material information. Yet this approach does not incorporate the embodied knowledge that patients acquire through lived experience. Drawing on interview data from 35 patients and health professionals in an IVF clinic in Australia, our study demonstrates the uncertainty of IVF treatment, and the tendency for patients to overestimate their chances of success prior to the experience of treatment. Once in active treatment, however, patients identify their oöcytes as both precious and precarious. We argue that it is necessary to formally include embodied experience as a source of knowledge in informed consent procedures, both for gratuitous donation and for egg-sharing regimes. We recommend that at least one full cycle of IVF be completed before approaching women to ert eggs away from their own fertility treatment.
Publisher: SAGE Publications
Date: 19-05-2020
Publisher: Informa UK Limited
Date: 18-10-2018
DOI: 10.1080/13561820.2018.1536041
Abstract: Utilising frozen section technologies, Mayo Clinic has one of the lowest reoperation rates for breast lumpectomy in the United States. The research reported on sought to understand the successful teamwork between the Breast Surgery Team and the Frozen Section Laboratory at Mayo Clinic. Researchers worked collaboratively with healthcare staff from breast surgery and the frozen section pathology laboratory to identify communication styles and strategies that contribute to the timely and accurate intraoperative evaluation of breast cancer specimens. Using the video-reflexive ethnography (VRE) methodology underpinned by a positive theoretical approach to researching quality and safety in healthcare, the researchers video-recorded the communications associated with specimen resections in surgery and the subsequent pathology diagnoses. Then, 57 staff from the breast surgery and frozen section laboratory teams attended video-reflexivity sessions to collaboratively analyse their communication practices and identify opportunities to optimize interprofessional communication. In this article, we focus on how the flexible, interdisciplinary, and cross-hierarchical communication within the frozen section laboratory supports a rapid and accurate intraoperative evaluation and communication, previously conceptualized by staff as being performed in a linear fashion. Moreover, we detail how the VRE methodology led surgeons and pathologists to implement new strategies and optimize their interprofessional communication.
Publisher: Elsevier
Date: 2019
Publisher: Dialectical Publishing
Date: 12-2009
Publisher: Emerald
Date: 05-04-2011
DOI: 10.1108/09534811111119753
Abstract: This paper aims to present evidence for regarding reflexive practice as the crux of patient safety in tertiary hospitals. Reflexive practice buttresses safety because it is the precondition for flexible systematization – that is, the process that involves frontline clinicians in designing, redesigning and flexibly enacting care processes. The paper presents an account of a collaborative video‐ethnographic project with a multi‐disciplinary team in an acute spinal unit. Video‐ethnography was combined with video‐reflexivity to provide practitioners with the opportunity to become involved in data interpretation and solution generation. The study reveals that an outsider analysts/catalyst (or clinalyst) is critical to engaging frontline practitioners in reflexivity. The clinalyst is able to elicit insights and perspectives that assist practitioners in revisiting and revising their processes and practices, principally because video‐based reflexivity connects “what we do” directly to “who we are”. Because complexity will be an indelible part of health care work, health care organizations should invest in developing “reflexive space” where learning about complexity becomes possible. Instead of continuing to invest in research efforts seeking to derive and test staff compliance with guidelines and protocols, and training centred on simulation, these organization must begin to engage with the lived complexity of clinical work in order to skill up incoming clinicians. Enhancing clinical practitioners' capability to confront complexity in their practices is currently not a standard component of clinical training or work‐based learning. Video‐reflexive ethnography in tertiary health care is unique in involving clinicians in “making sense” of and deriving solutions from lived complexity.
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.SOCSCIMED.2010.08.013
Abstract: Emergency clinicians undertake boundary-work as they facilitate patient trajectories through the Emergency Department (ED). Emergency clinicians must manage the constantly-changing dynamics at the boundaries of the ED and other hospital departments and organizations whose services emergency clinicians seek to integrate. Integrating the care that differing clinical groups provide, the services EDs offer, and patients' needs across this journey is challenging. The journey is usually accounted for in a linear way - as a "continuity of care" problem. In this paper, we instead conceptualize integrated care in the ED using a complex adaptive systems (CAS) perspective. A CAS perspective accounts for the degree to which other departments and units outside of the ED are integrated, and appropriately described, using CAS concepts and language. One year of ethnographic research was conducted, combining observation and semi-structured interviews, in the EDs of two tertiary referral hospitals in Sydney, Australia. We found the CAS approach to be salient to analyzing integrated care in the ED because the processes of categorization, diagnosis and discharge are primarily about the linkages between services, and the communication and negotiation required to enact those linkages, however imperfectly they occur in practice. Emergency clinicians rapidly process large numbers of high-need patients, in a relatively efficient system of care inadequately explained by linear models. A CAS perspective exposes integrated care as management of the patient trajectory within porous, shifting and negotiable boundaries.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Informa UK Limited
Date: 02-01-2020
Publisher: Elsevier BV
Date: 04-2021
Start Date: 08-2018
End Date: 08-2024
Amount: $371,815.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2011
End Date: 04-2014
Amount: $295,670.00
Funder: Australian Research Council
View Funded Activity