Within the context of structural theories this paper examines what health professionals say about their clinical service structures. We firstly trace various conceptual perspectives on clinical service structures, discussing multiple theoretical axes. These theories question whether clinical service structures represent either superficial or more profound changes in hospitals. We secondly explore which view is supported though a content analysis of the free text responses of 111 health professionals (44 doctors, 45 nurses and 22 allied health practitioners) about their clinical service (...) structures in a questionnaire survey in two large hospitals that had implemented clinical service structures three years previously. Commentaries unfavourable toward clinical service structures were made by 47.7% of staff, favourable by 24.3%, mixed (both favourable and unfavourable) by 17.1% and non-evaluative statements were made by 10.8%. The most frequent criticisms were inefficient organisation of change (27%), poor management (24.3%), lack of cooperation between staff (15.9%) and failure to empower health practitioners (13.5%). All professions made more negative than positive evaluations of their clinical service structures but the ratio was highest for doctors and lowest for allied health. Ranking of nurses' and allied health staffs' specific evaluations were similar but both differed significantly from doctors.' Unfavourable or negative comments predominated, and change appears more superficial and less profound than advocates of structural contributions hope. Four types of belief systems about clinical service structures are apparent. Some study participants are disposed toward the status quo; others toward restructuring; yet others are team oriented; and a final group is tribally oriented. The implication of this paper for managers is that more work is needed if clinical service structures are to realise the promise of more multi-disciplinarity and less fragmentation across professional groups. For scholars, the implication is that marrying different theoretical frames with empirical data can serve to produce fresh perspectives and perhaps new insights. (shrink)

Farrell, Marie T Review of: Jesus and the dreaming: Discovering an Australian spirituality through Aboriginal-Christian dialogue, by Frank Fletcher, MSC, ed. Fabian Byers, pp. 344, paperback $24.95.

Farrell, Marie T Review(s) of: The first thing to do is live: Essays sacred and secular, by Adrian Lyons SJ (Melbourne: David Lovell Publishing, 2013), pp. 136, pb $27.95.

St. Augustine of Hippo wrote the ’De Trinitate’ to explain to critics of the Nicene Creed how the Christian doctrine of the divinity and coequality of Father, Son, and Holy Spirit is present in Scripture. He also wanted to convince philosophers that Christ is the Wisdom they sought. Augustine’s third purpose was to correlate the biblical truth that all human persons are created to image God, a Trinity, a communion of love, with the first two Commandments of the Old and (...) New Testaments. Augustine succeeded in showing the need for combining faith and reason for a greater understanding of Scripture as well as for a greater understanding of the true nature and destiny of human persons. Augustine emphasized the scriptural revelation of God as Father, Son, and Holy Spirit, and used reason to convince philosophers that the one and three-Personed God is philosophically and logically defensible. He concluded that the likeness of human persons to Christ and to the Trinity is accomplished not onl. (shrink)

Evidence suggests that the nurse’s role as an advocate for patients and for the professional right to conscience is being eroded because of a lack of conscience protections in the Patient Affordable Care Act and because of a faulty understanding in general of the separation of church and state. While the main task of the principle of separation of church and state is to secure religious liberty, the principle is increasingly interpreted in a secularist way to mean that religion must (...) be confined to the home and church and that people of conscience may not object to immoral practices in the workplace or public square. If nurses must risk their jobs to advocate for their patients, patient care will suffer. National Catholic Bioethics Quarterly 14.1 : 47–52. (shrink)

Augustine of Hippo is a giant in the history of Christian thought, commended by St Jerome for having virtually 're-founded the old faith'.

The Hebrew Scriptures reveal that for the Hebrews the physical body was fundamental. In thinking of human existence they did not isolate mental processes from sense reactions and bodily feelings. The word "heart" was often used instead of a personal pronoun. In Judges 19, "Comfort thy heart with a morsel of bread" means "Give yourself comfort." In Exodus 33:14, "My face will go with thee," means "I will go with thee." The word ruah, or spirit, denoting breath or wind, referred (...) to anyone who by physical energy and mental alertness was full of life. In many cases the word "heart" was used to bring together the feelings, motives, intentions, and other aspects of an individual as a whole. The word "heart" referred to psychic activity, not merely to a physical organ. (shrink)

Today the connection between "person" and the "I" is acknowledged in many respects but not always analyzed. The need to relate it to the reality of the human being has sparked the present investigation of the philosophical anthropology of four thinkers from the late ancient, medieval, and contemporary periods. Although it may seem that the question of the role of the "I" with respect to the human being hinges on the larger problem of objectivity v. subjectivity, this does not seem (...) to be the case. Many topics, however, are necessarily entailed in this investigation such as individuality and universality, soul and body, consciousness and action, substance and history, the self and the other, the metaphysical and the phenomenological, and experience and the ethical. At the end of this study we arrive at more than a grammatical use of the "I." From reflection on the contributions of Plotinus, Augustine, Aquinas, and Wojtyla, the ontological role of the "I" is identified. In doing so, one realizes that the ontological does not forsake the concrete, but penetrates it more deeply. Indeed, that was what Plotinian philosophy claimed to be doing: recognizing the richness of human reality. (shrink)

Eddington, A. The decline of determinism.--Heisenberg, W. and others. Dialogue concerning science and philosophical positions.--Sinnott, E. Biology and freedom.--Nuttin, J. The unconscious and freedom.--Nagel, E. Determinism in history.--Ayer, A. J. Freedom and necessity.--Campbell, C. A. Philosophical defence of freedom.--Hare, R. M. Freedom and reason.--Dewey, J. Freedom as a problem.--Sartre, J.-P. Freedom and total responsibility.--Camus, A. Freedom and rebellion.--Rand, A. Freedom and individualism.--Thévenaz, P. Freedom and action.--Luijpen, W. A. Phenomenology of freedom.--Teilhard de Chardin, P. Cosmic freedom.--Jaspers, K. Freedom and society.--Macmurray, J. (...) Freedom in the personal nexus.--Brunner, A. Incarnation of freedom.--Ricoeur, P. Freedom as human creativity.--Finance, J. de. Freedom and existence.--Bibliography (p. 243-251). (shrink)

Polycentric leadership is a growing issue in the global missions movement. The focus of this article is to help readers understand polycentrism broadly and examine what it means for those seeking to lead fruitfully in God’s mission. Examples will be provided to illustrate what polycentric leadership can look like. Biblical and theological convictions that shape leaders who work out of this paradigm will be examined. The reality of tension points experienced by people who desire to lead from this paradigm will (...) be explored, as well as practical strategies and insights for those who have to navigate these tensions in their missional journeys. Through bringing together these different threads, the goal is for this article is to provide both academic insights and practical assistance for anyone who cares deeply about God’s work around the world and desires to lead fruitfully in a polycentric mission context. (shrink)

Farrell, Marie T Review(s) of: How to read a graveyard: Journeys in the company of the dead, by Peter Stanford (London: Bloomsbury, 2013), pp.263, $32.95.