The nursing history of Ngala since 1890: An early parenting organisation in Western Australia

Background: This study was the first phase of a larger study which explored the past, present and future of nursing in early parenting services in Australia. Aim: The aim of this paper is to describe the history of nursing within an early parenting service in Western Australia (WA). Methods: Triangulation of multiple data sources was used to summarise the nursing role over 120 years. The history was discovered through a document analysis of archives, including oral histories, organisational documents, focus groups, nurses’ diaries and interviews with nurses. Findings: The nursing role and context is described over three time periods: 1890–1960; 1960–1990 and 1990–2010. Nursing during the 20th century was influenced by societal and policy changes, but the essence of nursing remained the same with a focus on providing support and education to parents during pregnancy and caring for their babies and young children. Nursing within early parenting up to the 1980s was reasonably static until the move from hospital-based training to the university sector, which was the turning point of change to a new era of professionalisation and ultimately working within an interdisciplinary team. Conclusion: This description of nursing history within one early parenting service has provided insight into this specialist area of nursing

An Exploration of the Past, Present and Future of Nursing in Early Parenting Services in Australia

Nursing has a long history of providing services to families and children over the past century and more within Early Parenting Services (EPS) in Australia. Much has been written on issues regarding the general nursing workforce and requirements for the future, but little is known about the role of nursing within the EPS area around Australia in the context of an interdisciplinary team. The aim of this study was to describe how nursing has responded to the changing needs of EPS in Australia and to investigate nurses’ and allied professionals’ perceptions of the nursing role within an interdisciplinary team. This enabled further reflection on, and consideration of, the future nursing workforce priorities required for EPS nationally. A case study strategy using a mixed methods approach provided an in-depth analysis of the organisation Ngala (a not-for-profit EPS in Perth, Western Australia), as part of a broader network of EPS organisations around Australia. The study involved a three-phase approach, commencing with the focus on Ngala and then moving to the broader context of national services. The first and second phases used qualitative methods. The first phase employed several sources of data collection, such as archived documents, focus groups, interviews and nurses journals. Thematic analysis using the framework of Braun and Clarke (2006) informed the second phase—the national teleconferences. The data from phases one and two informed the third phase, which utilised the instrument design model of Creswell, Fetters and Ivankova (2004) to inform the development of the survey instrument. This approach ensured a strong link between the qualitative methods used and the move to the development of the quantitative phase. A commitment to a quality result in the measuring instrument meant that a reliability and validity criterion was applied. The survey had a 37 per cent response rate via online and postal responses. These data were analysed through survey monkey software. The findings were then compared with relevant literature and theories. The three phases have informed a framework for future direction in the form of a workforce development strategy. Role theory and interprofessional practice theory have contributed to both an understanding of the findings and the recommendations for organisations, nursing practice, education and research. The study conclusions for nursing and early parenting work will assist in future workforce planning at Ngala and EPS around Australia

Father inclusive practice in a parenting and early childhood organisation: The development and analysis of a staff survey

Aim: The successful embedding of father inclusive practice (FIP) in parenting and early childhood organisations is relatively new and therefore challenging to assess. The purpose of this study was to describe the process of adapting an existing tool, the Knowledge about fatherhood checklist (KAFC), to suit the parenting service context and apply the modified survey to establish a baseline of attitudes and practice of all staff at an established parenting and early childhood service in Western Australia, Ngala. Method: Following the application of the KAFC at Ngala in 2016, feedback provided by the staff led to a reflective and iterative process of review to adapt the KAFC. In 2018, all staff were asked to complete the adapted survey – the 23-item Father inclusive practice survey (FIP survey) – in order to assess the attitudes and behaviours of everyone in the organisation. The FIP survey covers aspects of competency as well as knowledge and attitudes in relation to fatherhood or father engagement. Results: Results indicated generally high levels of appreciation of the fathering role by Ngala staff. However, a number of areas for improvement in staff knowledge and attitudes were identified, including the benefit of reflecting on personal experiences of fathering, the awareness of the gendered stereotyped view of men, and the importance of the influence fathers can make in the context of attachment and breastfeeding. Conclusions: The implementation of this FIP survey informs improvements to staff orientation and training in FIP, and provides insights into staff attitudes, beliefs and practice regarding acknowledgement of the important contribution fathers make to the development and wellbeing of their children

Educational interventions for the management of cancer-related fatigue in adults

Background: Cancer-related fatigue is reported as the most common and distressing symptom experienced by patients with cancer. It can exacerbate the experience of other symptoms, negatively affect mood, interfere with the ability to carry out everyday activities, and negatively impact on quality of life. Educational interventions may help people to manage this fatigue or to cope with this symptom, and reduce its overall burden. Despite the importance of education for managing cancer-related fatigue there are currently no systematic reviews examining this approach. Objectives: To determine the effectiveness of educational interventions for managing cancer-related fatigue in adults. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, OTseeker and PEDro up to 1st November 2016. We also searched trials registries. Selection criteria: We included randomised controlled trials (RCTs) of educational interventions focused on cancer-related fatigue where fatigue was a primary outcome. Studies must have aimed to evaluate the effect of educational interventions designed specifically to manage cancer-related fatigue, or to evaluate educational interventions targeting a constellation of physical symptoms or quality of life where fatigue was the primary focus. The studies could have compared educational interventions with no intervention or wait list controls, usual care or attention controls, or an alternative intervention for cancer-related fatigue in adults with any type of cancer. Data collection and analysis: Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. Trial authors were contacted for additional information. A third independent person checked the data extraction. The main outcome considered in this review was cancer-related fatigue. We assessed the evidence using GRADE and created a 'Summary of Findings' table. Main results: We included 14 RCTs with 2213 participants across different cancer diagnoses. Four studies used only 'information-giving' educational strategies, whereas the remainder used mainly information-giving strategies coupled with some problem-solving, reinforcement, or support techniques. Interventions differed in delivery including: mode of delivery (face to face, web-based, audiotape, telephone); group or individual interventions; number of sessions provided (ranging from 2 to 12 sessions); and timing of intervention in relation to completion of cancer treatment (during or after completion). Most trials compared educational interventions to usual care and meta-analyses compared educational interventions to usual care or attention controls. Methodological issues that increased the risk of bias were evident including lack of blinding of outcome assessors, unclear allocation concealment in over half of the studies, and generally small sample sizes. Using the GRADE approach, we rated the quality of evidence as very low to moderate, downgraded mainly due to high risk of bias, unexplained heterogeneity, and imprecision. There was moderate quality evidence of a small reduction in fatigue intensity from a meta-analyses of eight studies (1524 participants; standardised mean difference (SMD) -0.28, 95% confidence interval (CI) -0.52 to -0.04) comparing educational interventions with usual care or attention control. We found low quality evidence from twelve studies (1711 participants) that educational interventions had a small effect on general/overall fatigue (SMD -0.27, 95% CI -0.51 to -0.04) compared to usual care or attention control. There was low quality evidence from three studies (622 participants) of a moderate size effect of educational interventions for reducing fatigue distress (SMD -0.57, 95% CI -1.09 to -0.05) compared to usual care, and this could be considered clinically significant. Pooled data from four studies (439 participants) found a small reduction in fatigue interference with daily life (SMD -0.35, 95% CI -0.54 to -0.16; moderate quality evidence). No clear effects on fatigue were found related to type of cancer treatment or timing of intervention in relation to completion of cancer treatment, and there were insufficient data available to determine the effect of educational interventions on fatigue by stage of disease, tumour type or group versus individual intervention. Three studies (571 participants) provided low quality evidence for a reduction in anxiety in favour of the intervention group (mean difference (MD) -1.47, 95% CI -2.76 to -0.18) which, for some, would be considered clinically significant. Two additional studies not included in the meta-analysis also reported statistically significant improvements in anxiety in favour of the educational intervention, whereas a third study did not. Compared with usual care or attention control, educational interventions showed no significant reduction in depressive symptoms (four studies, 881 participants, SMD -0.12, 95% CI -0.47 to 0.23; very low quality evidence). Three additional trials not included in the meta-analysis found no between-group differences in the symptoms of depression. No between-group difference was evident in the capacity for activities of daily living or physical function when comparing educational interventions with usual care (4 studies, 773 participants, SMD 0.33, 95% CI -0.10 to 0.75) and the quality of evidence was low. Pooled evidence of low quality from two of three studies examining the effect of educational interventions compared to usual care found an improvement in global quality of life on a 0-100 scale (MD 11.47, 95% CI 1.29 to 21.65), which would be considered clinically significant for some. No adverse events were reported in any of the studies. Authors' conclusions: Educational interventions may have a small effect on reducing fatigue intensity, fatigue's interference with daily life, and general fatigue, and could have a moderate effect on reducing fatigue distress. Educational interventions focused on fatigue may also help reduce anxiety and improve global quality of life, but it is unclear what effect they might have on capacity for activities of daily living or depressive symptoms. Additional studies undertaken in the future are likely to impact on our confidence in the conclusions. The incorporation of education for the management of fatigue as part of routine care appears reasonable. However, given the complex nature of this symptom, educational interventions on their own are unlikely to optimally reduce fatigue or help people manage its impact, and should be considered in conjunction with other interventions. Just how educational interventions are best delivered, and their content and timing to maximise outcomes, are issues that require further research

The Influence of Communication Channel Interactivity on Investors’ Response to Managements’ Linguistic Choices

More firms are now disseminating financial information via the internet, and digital technology allows firms to communicate in a more interactive manner compared to traditional paper-based communication channels. Further, various levels of interactivity exist even within online communication channels. We conduct an experiment to examine how online communication channel interactivity affects investor information processing, as evidenced by investors’ reactions to managers’ linguistic choices within financial disclosures, i.e., term specificity (firm-specific versus general terms) and language extremity (moderately versus extremely positive language). We find that a more interactive channel causes investors to be more sensitive to managers’ linguistic choices, and there is an interactive effect of term specificity and language extremity on investment willingness. Specifically, when managers use moderately (extremely) positive language, investors are more (less) willing to invest in a company with its financial disclosures containing firm-specific (versus general) terms. However, such an interactive effect is much weaker when the communication channel is less interactive. Our findings are important for investors, managers, and regulators to understand how investors’ perceptions and investment decisions could be changed when information is communicated via a more interactive channel

Finding Common Ground: Collaboration Across the Disciplines in the Scholarship of Teaching

Many recent writings on the scholarship of teaching discuss the need to locate this scholarship within the disciplines. The authors argue that while scholarship within the disciplines is important, it should not come at the expense of work across the disciplines. They demonstrate the usefulness of cross-disciplinary collaboration for the scholarship of teaching and learning through the specific example of how collaboration contributed to their understanding of the role of such scholarship in the teaching of mathematics and negotiations courses. The authors also outline some of the pitfalls of cross-disciplinary collaboration, and they offer suggestions for beginning collaborative initiatives