Continuity of cancer care: Where do primary care practitioners fit in?

Cancer is the leading cause of illness in Australia and is a national health priority. Primary care in Australia is well positioned to support individuals diagnosed with cancer and their family/caretakers. However, obstacles exist that impact on the quality and continuity of care that primary care providers and community health professionals can provide. A rapid review of the research available revealed that the knowledge, attitudes and beliefs held by health professionals and patients can impact engagement in early detection, treatment and follow-up care. Health professionals have limited knowledge of evidence-based practices, while cancer literacy among minority groups, including Aboriginal Australians, is lower than the population overall. In this paper, we provide a summary of the rapid review of the literature and provide some recommendations based on our research

An overview of sexual assault survivors: a 5 year retrospective study in gynaecology department of NSCB medical college, Jabalpur, Madhya Pradesh, India

Background: Rape and abuse of women are common occurrences, which many times go unreported due to social stigma or fear of retribution. Rape is a crime not against a single human being but against the entire humanity. For granting justice to the rape survivor, it becomes necessary that such matters are properly presented before the Courts of Law. Healthcare workers play an important role in this regard because they are the first people who examine the survivors. They document record of the history and medical condition of the survivor and do relevant sample collection. The objective of this study is to analyze demographic and event characteristics of rape survivors who presented to the gynecology department of Government NSCB MCH, Jabalpur with history of sexual assault.Methods: Data was retrospectively collected from the medico legal records of the department of Gynecology between April 2013 to March 2018.Results: An increase in number of cases of sexual assault reporting to the hospital every year is observed. Age wise distribution showed that 27.66% cases were in age group 6-10 years and 16-20years being the major affected group. Majority of the cases belonged to low socio-economic strata. 91.5% survivors were unmarried. 61.7% of the survivors were from rural areas. 44.7% of survivors reported within a day of the incident and most of the assailants were known to the survivors; only 36.2 % were strangers. Most of the incidences (23.4%) took place in the assailant’s house and survivors house each. In 31.9% cases there was evidence of fresh hymen tear.Conclusions: An understanding of the demography of sexual assault survivors will help us to better train our doctors in proper attitude and handling of such cases, an area often neglected

How can video-reflexive ethnographers anticipate positive impact on healthcare practice?

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 re-flexivity 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

'The obstacle is the way' : methodological challenges and opportunities for video-reflexive ethnography during COVID-19

The COVID-19 pandemic greatly impacted research. In this article, we explore the opportunities and challenges presented by the pandemic to a group of researchers using video-reflexive ethnography (VRE) – a methodology used to understand practices, grounded in: exnovation, collaboration, reflexivity, and care. To understand how the pandemic impacted researchers using VRE, we facilitated two focus groups with 12 members of the International Association of Video-Reflexive Ethnographers. The findings suggest the pandemic exacerbated existing methodological challenges, yet also provided an opportunity reflect on our own practices as researchers, namely: accessing sites, building relationships, facilitating reflexive sessions, and cultivating care. Due to public health measures, some researchers used insiders to access sites. While these insiders shouldered additional burdens, this shift might have empowered participants, increased the salience of the project, and enabled access to rural sites. The inability to access sites and reliance on insiders also impeded researcher ability to build relationships with participants and generate the ethnographic insights often associated with prolonged engagement at a site. In reflexive sessions, researchers had to learn how to manage the technological, logistical, and methodological challenges associated with either themselves or participants being remote. Finally, participants noted that while the transition to more digital methodologies might have increased project reach, there needed to be a mindfulness around cultivating practices of care in the digital world to ensure psychological safety and protect participants data. These findings reflect the opportunities and challenges a group of researchers using VRE had during the pandemic and can be used to stimulate future methodologic discussions

Leadership during a pandemic : a lexical analysis

To manage pandemics, like COVID-19, leadership can enable health services to weather the storm. Yet there is limited clarity on how leadership manifested and was discussed in the literature during COVID-19. This can have considerable public health implications given the importance of leadership in the health sector. This article addresses this missed opportunity by examining the literature on leadership during a pandemic. Following a systematic search of nine academic databases in May 2021, 1,747 publications were screened. Following this, a lexical analysis of the results section was conducted, sourced from a corpus of publications across myriad journals. The results found a prevalence of references to “leader” as a sole actor, risking the perpetuation of a view that critical decisions emanate from a singular source. Moreover, “leadership” was a concept disconnected from the fray of frontline workers, patients, and teams. This suggests a strong need for more diverse vocabularies and conceptions that reflect the “messiness” of leadership as it takes shape in relation to the challenges and uncertainties of COVID-19. There is a considerable opportunity to advance scholarship on leadership via further empirical studies that help to clarify different approaches to lead teams and organizations during a pandemic

GP project: Process and impact evaluation

University of Western Sydney (UWS) was commissioned by the NSW Sexually Transmissible Infections Programs Unit (STIPU) to evaluate the General Practitioner (GP) Project in collaboration Prof. Usherwood and Dr Kang. The GP Project aimed to promote the delivery of evidence-based sexual healthcare within primary care in NSW; this was addressed through the development, promotion, and delivery of nine items tailored for NSW GPs and practice nurses (PNs). For GPs, the items include a double-sided A4-size STI Testing Tool; the online STI Resources for General Practice; a Drivetime Radio Medical CD, which included an interview related to STIs; the Online STI Testing Tool GP Training; an STI Active Learning Module (ALM) for General Practitioners; three sexual health articles in General Practice periodicals; and the Royal Australian College of General Practitioners (RACGP) Check booklet. For PNs, items included the Practice Nurse Postcard on pap smears and chlamydia, and Online STI Practice Nurse Training

The business – government nexus: Impact of government actions and legislation on business responses to climate change

Australia has committed to reducing emissions under the Paris Agreement by 2030, in alignment with the United Nations’ (UN) Sustainability Development goal (SDG) climate action. This article investigates the responses of Australian high-emission businesses to Australian government action and legislation in relation to climate change, specifically the carbon tax, and how this knowledge can assist in delineating future carbon legislation. A qualitative study of the responses of seventeen high emission businesses and three industry associations to carbon legislation during the implementation of the carbon tax in Australia identified the use of resistive, reactive or cooperative strategies by the businesses. Issues related to carbon legislation identified by businesses included differences in time orientation, multiple regulations, political uncertainty, international positioning and the need for long term and consolidated policies. Given these findings, this article argues that well designed top-down legislative measures are necessary to steer businesses towards a carbon neutral regime

‘When a patient chooses to die at home, that’s what they want… comfort, home’ : brilliance in community-based palliative care nursing

Introduction: To redress the scholarly preoccupation with gaps, issues, and problems in palliative care, this article extends previous findings on what constitutes brilliant palliative care to ask what brilliant nursing practices are supported and promoted. Methods: This study involved the methodology of POSH-VRE, which combines positive organisational scholarship in healthcare (POSH) with video-reflexive ethnography (VRE). From August 2015 to May 2017, inclusive, nurses affiliated with a community health service who delivered palliative care, contributed to this study as co-researchers (n = 4) or participants (n = 20). Patients who received palliative care (n = 30) and carers (n = 16) contributed as secondary participants, as they were part of observed instances of palliative care. With a particular focus on the practices and experiences that exceeded expectations and brought joy and delight, the study involved capturing video-recordings of community-based palliative care in situ; reflexively analysing the recordings with the nurses; as well as ethnography to witness, experience, and understand practices and experiences. Data were analysed, teleologically, to clarify what brilliant practices were supported and promoted. Results: Brilliant community-based palliative care nursing largely involved maintaining normality in patients' and carers' lives. The nurses demonstrated this by masking the clinical aspects of their role, normalising these aspects, and appreciating alternative 'normals'. Conclusion: Redressing the scholarly preoccupation with gaps, issues, and problems in palliative care, this article demonstrates how what is ordinary is extraordinary. Specifically, given the intrusiveness and abnormalising effects of technical clinical interventions, brilliant community-based palliative care can be realised when nurses enact practices that serve to promote a patient or carer to normality. Patient or public contribution: Patients and carers contributed to this study as participants, while nurses contributed to this study as co-researchers in the conduct of the study, the analysis and interpretation of the data, and the preparation of the article

How is brilliance enacted in professional practices? : insights from the theory of practice architectures

Brilliance has been overlooked in studies of professional work. This study aimed to understand how brilliant practices are made possible and enacted in a multidisciplinary paediatric feeding clinic, where professionals from different disciplines work together and with parents and carers of children. The existing literature has thematically described brilliance but not theorised how it is accomplished and enabled. Using video reflexive ethnographic methods, the study involved the video-recording of 17 appointments and two reflexive discussions with the participating professionals, who selected and reviewed five episodes exemplifying brilliant care. These were analysed through three themes: carer-friendly and carer-oriented practice; ways of working together; and problem-solving in actu (in the very act of doing). Using the theory of practice architectures, we explored brilliant practices as complexes of sayings, doings, and relatings, identifying the arrangements that enabled those practices and the forms of praxis involved

Leadership During a Pandemic: A Lexical Analysis

To manage pandemics, like COVID-19, leadership can enable health services to weather the storm. Yet there is limited clarity on how leadership manifested and was discussed in the literature during COVID-19. This can have considerable public health implications given the importance of leadership in the health sector. This article addresses this missed opportunity by examining the literature on leadership during a pandemic. Following a systematic search of nine academic databases in May 2021, 1,747 publications were screened. Following this, a lexical analysis of the results section was conducted, sourced from a corpus of publications across myriad journals. The results found a prevalence of references to “leader” as a sole actor, risking the perpetuation of a view that critical decisions emanate from a singular source. Moreover, “leadership” was a concept disconnected from the fray of frontline workers, patients, and teams. This suggests a strong need for more diverse vocabularies and conceptions that reflect the “messiness” of leadership as it takes shape in relation to the challenges and uncertainties of COVID-19. There is a considerable opportunity to advance scholarship on leadership via further empirical studies that help to clarify different approaches to lead teams and organizations during a pandemic.</jats:p