(Re)-regulating care : employing foreign carers for older persons in Taiwan

The purpose of this research was to develop a theoretical understanding of the social phenomenon of the employment of foreign carers for older Taiwanese in households. Foreign carers were introduced into Taiwan in 1992 to address the care needs of the older population. By 2012, over 200,000 foreign caregivers from Indonesia, Philippines, and Vietnam were providing care in households in Taiwan. There has been little research on the interactions between and experiences of family employers, foreign carers and older persons receiving care. The theoretical framework brought together symbolic interactionist concepts and the social constructionism of Berger and Luckmann. Data collection and analysis were informed by Charmaz‘s formulation of grounded theory. Two focus groups and 54 in-depth interviews with a total of 57 Indonesian and Vietnamese foreign carers, Taiwanese family employers and older persons receiving care were undertaken. The analytical findings of the research reflect the ways in which the foreign carer, older persons receiving care and family employer participants were socially situated within the research context and how their respective social realities were shaped differently by changing social structures and cultural values within a globalising context. (Re)-regulating care was generated as the core category, forming a coherent and overarching framework that integrated the three analytical dimensions of the reality of the social change, resituating roles and struggling for control. The reality of social change refers to the employment of foreign carers as a manifestation of the reshaping of the social worlds of the three groups of participants. Resituating roles reflects the processes that underpin the hierarchical positioning of participants, the resultant asymmetrical power relations and associated interactions. Struggling for control, depicts how each group employed strategies to create space and identities that would sustain a sense of self and autonomy. In the current situation of economic and social change in Taiwan the three participant groups shared a desire for control. The autonomy of the women employers was negotiated through employment of foreign carers; for the foreign carers, a pragmatic decision to work abroad became a means for personal empowerment; and the older persons receiving care regained some authority through relationships with carers.

Constructions of children's needs in informal kinship care in rural China

Kinship care is the oldest form of alternative child care in the world. Recent years have witnessed a significant increase in the number of children being placed in kinship care across Western countries. However, in contrast to rapid knowledge advances about formal kinship care, far less is known about the needs of children in informal kinship care, especially in Asian contexts. This thesis and the study upon which it is formed sought to redress this knowledge gap. Qualitative approach was adopted to explore social constructions of children in informal kinship care in rural China. Parents in China seeking work in cities have left behind around 58 million rural children, mostly with relatives and without the involvement of the state. The present study examined caregivers’ and school personnel’s understandings of these school-age children’s needs through semi-structured interviews with 23 kin caregivers and five school personnel in Shijiapu Town, Jilin Province, China. The central question that guided the whole study is: What are the needs of children in informal kinship care in rural Jilin Province, China? Interpretative Phenomenological Analysis was used to categorise and interpret the qualitative data. Based on participants’ constructions, this study developed a need model with eight themes. They are: (1) emotional needs and mental health, (2) relationships, (3) empowerment and agency, (4) safety, (5) education, (6) basic care, (7) physical health, and (8) personal development. These needs are grounded in the Chinese context, and therefore a good understanding of Chinese culture is essential to address them. The first four needs particularly capture children’s separations from their parents, and the rest are more general, and can be applied to most Chinese children. To meet the most important need for children left behind, namely education, these caregivers determined that others needs sometimes have to be compromised. Children left behind are a vulnerable group in contemporary rural China, and their diverse needs are attended to by several groups. This study found that as children’s closest kin while their parents are away, caregivers play a vital role in salving the children’s emotional loss. Caregivers’ love and familial obligations strongly motivate them to care for these children, and sensitivity to social stigma makes them strive to show their love and care to compensate for perceived differences between these children and their peers. Caregivers’ efforts to make children happy, however, were sometimes criticised by some school personnel, who see this as spoiling. The conflicting viewpoint between caregivers and school personnel indicate their different roles and perceptions in children’s lives, and the latter influence these children in a more authoritative way. Informal kinship care has several advantages of addressing children’s needs, especially their needs for emotional bonds with family. Community-based kin networks provide children with both emotional and material support. However, these advantages sometimes are restricted by caregivers’ child rearing capacity. Having developed a model of the needs of children left behind in China, this study suggests that caregivers, school personnel and government social services work in harmony to be child-centred and meet these children’s diverse needs. The unmet needs of children left behind mainly result from unbalanced development between urban and rural China, therefore, it is imperative to enhance state policies and programs that improve wellbeing for this growing part of China’s people.

Climate change adaptation in urban systems : strategies for planning regimes

Adaptation is increasingly being viewed as a necessary response tool in respect of climate change effects. Though the subject of significant scholarly and professional attention, adaptation still continues to lag behind mitigation in the climate change discourse. However, this situation looks likely to change over the coming years due to a increasing scientific acceptance that certain climate change effects are now inevitable. The purpose of this research is to illustrate, consider and demonstrate how urban planning regimes can use some of their professional tools to develop adaptation strategies and interventions in urban systems. These tools include plan-making, development management, urban design and place-making. Urban systems contribute disproportionately to climate change and will also likely suffer considerably from the resulting effects. Moreover, the majority of the world’s population is now urbanised, suggesting that adaptation will be crucial in order to develop urban systems that are resilient to climate change effects. Informed by a reflexive, qualitative methodology, this paper offers an informed understanding and illustration of adaptation as a climate change response, its use in urban systems and some of the roles and strategies that planning may take in developing and implementing urban adaptation. It concludes that urban planning regimes can have key roles in adapting urban systems to numerous climate change effects.

Sharing news, making sense, saying thanks : patterns of talk on twitter during the Queensland floods

This paper examines the discursive aspects of Twitter communication during the floods in the summer of 2010–2011 in Queensland, Australia. Using a representative sample of communication associated with the #qldfloods hashtag on Twitter, we coded and analysed the patterns of communication. We focus on key phenomena in the use of social media in crisis communication: communal sense- making practices, the negotiation of participant roles, and digital convergence around shared events. Social media is used both as a crisis communication and emergency management tool, as well as a space for participants to engage in emotional exchanges and communication of distress.

An ecological dynamics approach to skill acquisition : implications for development of talent in sport.

This paper proposes how ecological dynamics, a theory focusing on the performer-environment relationship, provides a basis for understanding skill acquisition in sport. From this perspective, learners are conceptualized as complex, neurobiological systems in which inherent self-organisation tendencies support the emergence of adaptive behaviours under a range of interacting task and environmental constraints. Intentions, perceptions and actions are viewed as intertwined processes which underpin functional movement solutions assembled by each learner during skill acquisition. These ideas suggest that skill acquisition programmes need to sample information from the performance environment to guide behaviour in practice tasks. Skill acquisition task protocols should allow performers to use movement variability to explore and create opportunities for action, rather than constraining them to passively receiving information. This conceptualisation also needs to characterize the design of talent evaluation tests, which need to faithfully represent the perception-action relationships in the performance environment. Since the dynamic nature of changing task constraints in sports cannot be predicted over longer timescales, an implication is that talent programmes should focus on developing performance expertise in each individual, rather than over-relying on identification of expert performers at specific points in time.

Bioecological factors influencing women's alcohol consumption across the life span

Background Substantial changing trends in women’s alcohol consumption show increased proportions women drinking at risky/ high risk levels. Not confined to the younger female population, these increases are also occurring in older female age groups (aged 35 and over), posing a set of risks differing to those of their male counterparts. However, little research investigates the influences behind these changing trends. The current research examined multiple level influences (i.e. cultural, social and psychosocial on women’s drinking across a range of age groups. Methods Semi-structured telephone interviews were conducted with thirty-five women (aged 18-55) residing in Australia. Interview development was guided by an adaptation of Bronfenbrenner’s Bioecological Model of Development to assess multiple areas of influences from cultural through to psychosocial (i.e. intra-individual). Each interview took approximately 1 hour to complete. Findings Bronfenbrenner’s Bioecological Model could account for multiple-level factors impacting women’s drinking with multidirectional influences interacting across each level. Cultural influences included gender roles and national identity. Exosystem influences (e.g. infrastructure, legislation, and media) and microsystem influences (e.g. drinking context, family, partner and peer influence) were clearly identified as impacting drinking behaviours. Finally, at the psychosocial level, attitudes and expectations around the disinhibiting effects of alcohol and social facilitation emerged as key influences. Discussion The outcomes indicated the importance of these influences as women’s alcohol-related attitudes and behaviours changed across a woman’s life span and across age cohorts. Future research will build on these initial findings in order to underpin targeted interventions of the key factors influencing women’s drinking.

Targeting histone deacetylases for the treatment of disease : Epigenetics Review Series

The 'histone code' is a well-established hypothesis describing the idea that specific patterns of post-translational modifications to histones act like a molecular 'code' recognized and used by non-histone proteins to regulate specific chromatin functions. One modification, which has received significant attention, is that of histone acetylation. The enzymes that regulate this modification are described as lysine acetyltransferases or KATs, and histone deacetylases or HDACs. Due to their conserved catalytic domain HDACs have been actively targeted as a therapeutic target. The pro-inflammatory environment is increasingly being recognized as a critical element for both degenerative diseases and cancer. The present review will discuss the current knowledge surrounding the clinical potential and current development of histone deacetylases for the treatment of diseases for which a pro-inflammatory environment plays important roles, and the molecular mechanisms by which such inhibitors may play important functions in modulating the pro-inflammatory environment. © 2009 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.

Measuring Nutrition Work Across Queensland

The public health and community nutrition workforce in Queensland has experienced significant change. These changes happened following a new government in 2012, and its response to the National Health and Hospitals Reform and budget constraints. This research documented and analysed current roles and activities of the preventative health nutrition workforce. An online survey was conducted with all positions known to be working in nutrition prevention (n=320). The sample population was generated using existing databases which were validated by comparisons with workforce data from the Queensland Health Department and sector consultation. Snowballing was also used. 128 practitioners responded to the survey (response rate =40%). This was made up of those whose job title included the words “nutritionist” or “dietitian” (n=64) and those whose job title did not (n=61). Three respondents did not supply a title. Ninety-four practitioners had a nutrition or dietetic qualification indicating that a number of the workforce have shifted to more generalist positions. Between 2009 and 2013 there has been a 90% reduction in the state-funded nutrition prevention workforce. The existing reduced workforce is now dispersed across a range of organisations. Areas of workforce growth such as Medicare Locals tend to attract less experienced practitioners (50% had ≤ 5years’ experience). These changes present challenges for the co-ordination and communication of nutrition work and equity and access of service delivery. This research highlights the need for adaptability of the public health and community nutrition workforce. These issues require consideration by the profession.

The sound of silence : the absence of voice in determining flexible working arrangements

In the context of a dramatically reconfigured labour market characterized by an individualistic culture and increasingly enmeshed life domains of employees, there is raised awareness of how employees may shape or modify their work arrangements. A small component of broader scholarship addressing issues that affect the social context in which individuals work, has focused on the role of ‘employee voice' in determining flexible-work outcomes (Donnelly et al., 2012). Employee voice is a broad term incorporating a spectrum of different practices designed to give employees a say in organisational issues and decisions (Dundon et al., 2004). This article extends work on voice and workplace flexibility by focusing not simply on ‘voice' but on its antithesis: employee silence. Silence is defined here, (following Van Dyne et al., 2003), as the intentional withholding of ideas, information and opinions. The consequences of employee silence in achieving work-life preferences are likely to be significant for both individuals and organizations, in achieving for example, the goals of business efficiency and facilitating employees' needs to fulfill multiple roles and minimize work-life interference.

Doing collaborative reflection in the professional experience

Despite the importance of the school-based practicum experience in teacher education programs, only limited research has investigated how supervising and pre-service teacher roles and relationships are interactively achieved in situ. Using conversation analysis, we interrogate extracts of practicum talk between supervising teachers (STs) and their pre-service teachers (PTs), revealing that asymmetrical relationships are talked into being within and through their conversations about classroom practice. We compare the different structural conversational arrangements that are employed when STs provide either positive feedback or raise issues of potential difficulty in relation to their PTs’ observed classroom activities. Analysis reveals that STs tend to make evaluative statements when providing positive feedback, in contrast to initiating a process of critical reflection when talking about the need for improvements in PTs’ pedagogic practices. We conclude by arguing the need for STs to instigate sustained critical and collaborative professional conversations with their PTs during the practicum experience, enabling them to engage in reflective practice and providing them with opportunities to extend their professional knowledge and skills, thereby potentially improving their future classroom practices.

"I can't believe I just said that": Using guided reflections with non-Indigenous pre-service teachers in Australia

This paper explores the use of guided narrative reflection as a strategy used with high-achieving non-Indigenous pre-service teachers in Australia on teaching practicum. We suggest that reflections (and subsequent dialogue) can provide opportunities for non-Indigenous preservice teachers to re-think their beliefs and actions in ways that may intervene in the teaching that often causes educational disadvantage for Aboriginal and Torres Strait Islander students.

ESD starts where STEM stops : integrating the social sciences into STEM

The Earth and its peoples are facing great challenges. As a species, humans are over-consuming the Earth’s resources and compromising the capacity of both natural and social systems to function in healthy and sustainable ways. Education at all levels and in all contexts, has a key role in helping societies move to more sustainable ways of living. Two areas in need of catch-up in relation to Education for Sustainable Development (ESD) are early childhood education and teacher education. Another area of challenge for ESD is the way it is currently oriented. To date, a great deal of emphasis has been placed on scientific and technological solutions to sustainability issues. This has led to an emphasis on STEM education as education’s main way of addressing sustainability. However, in this paper it is argued that sustainably is primarily a social issue that requires interdisciplinary education approaches. STEM approaches to ESD - emphasising knowledge construction and problem-solving - cannot, on their own, deal effectively with attitudes, values and actions towards more sustainable ways of living. In China and Australia, there are already policies, frameworks, guidelines and initiatives, such as Green Schools and Sustainable Schools that support such forms of ESD. STEM educators need to reach out to social scientists and social educators in order to more fully engage with activist and collaborative educational responses that equip learners with the knowledge, dispositions and capacities to ‘make a difference’.

Ruptured relations : guerrilla theatre, time & Pranksterish disability performance practice

Guerrilla theatre tends, by its very definition, to pop up unpredictably – it interrupts what people might see as the proper or typical flow of time, place and space. The subversive tenor of such work means that questions about ‘what has happened’ tend to the decidedly less polite form of ‘WTF’ as passersby struggle to make sense of, and move on from, moments in which accustomed narratives of action and interaction no longer apply. In this paper I examine examples of guerrilla theatre by performers with disabilities in terms of these ruptures in time, and the way they prompt reflection, reconfigure relations, or recede into traditional relations again - focusing particularly on comedian Laurence Clark. Many performers with disabilities – Bill Shannon, Katherine Araniello, Aaron Williamson, Ju Gosling, and others – find guerrilla-style interventions in public places apposite to their aesthetic and political agendas. They prompt passersby to reflect on their relationship to people with disabilities. They can be recorded for later dissection and display, teaching people something about the way social performers, social spectators and society as a whole deal with disability. In this paper, as I unpack Clark's work, I note that the embarrassment that characterises these encounters can be a flag of an ethical process taking place for passersby. Caught between two moments in which time, roles and relationships suddenly fail to flow along the smooth routes of socially determined habits, passersbys’ frowns, gasps and giggles flag difficulties dealing with questions about their attitude to disabled people they do not now know how to answer. I consider the productivity, politics and performerly ethics of drawing passersby into such a process – a chaotic, challenging interstitial time in which a passersbys choices become fodder for public consumption – in such a wholly public way.

The Implications of Activity Based Funding for Emergency Departments : A Comprehensive Literature Review

Executive Summary Emergency Departments (EDs) locally, nationally and internationally are becoming increasingly busy. Within this context, it can be challenging to deliver a health service that is safe, of high quality and cost-effective. Whilst various models are described within the literature that aim to measure ED ‘work’ or ‘activity’, they are often not linked to a measure of costs to provide such activity. It is important for hospital and ED managers to understand and apply this link so that optimal staffing and financial resourcing can be justifiably sought. This research is timely given that Australia has moved towards a national Activity Based Funding (ABF) model for ED activity. ABF is believed to increase transparency of care and fairness (i.e. equal work receives equal pay). ABF involves a person-, performance- or activity-based payment system, and thus a move away from historical “block payment” models that do not incentivise efficiency and quality. The aim of the Statewide Workforce and Activity-Based Funding Modelling Project in Queensland Emergency Departments (SWAMPED) is to identify and describe best practice Emergency Department (ED) workforce models within the current context of ED funding that operates under an ABF model. The study is comprised of five distinct phases. This monograph (Phase 1) comprises a systematic review of the literature that was completed in June 2013. The remaining phases include a detailed survey of Queensland hospital EDs’ resource levels, activity and operational models of care, development of new resource models, development of a user-friendly modelling interface for ED mangers, and production of a final report that identifies policy implications. The anticipated deliverable outcome of this research is the development of an ABF based Emergency Workforce Modelling Tool that will enable ED managers to profile both their workforce and operational models of care. Additionally, the tool will assist with the ability to more accurately inform adequate staffing numbers required in the future, inform planning of expected expenditures and be used for standardisation and benchmarking across similar EDs. Summary of the Findings Within the remit of this review of the literature, the main findings include: 1. EDs are becoming busier and more congested Rising demand, barriers to ED throughput and transitions of care all contribute to ED congestion. In addition requests by organisational managers and the community require continued broadening of the scope of services required of the ED and further increases in demand. As the population live longer with more lifestyle diseases their propensity to require ED care continues to grow. 2. Various models of care within EDs exist Models often vary to account for site specific characteritics to suit staffing profile, ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Existing and new models implemented within EDs often depend on the target outcome requiring change. Generally this is focussed on addressing issues at the input, throughput or output areas of the ED. Even with models targeting similar demographic or illness, the structure and process elements underpinning the model can vary, which can impact on outcomes and variance to the patient and carer experience between and within EDs. Major models of care to manage throughput inefficiencies include: A. Workforce Models of Care focus on the appropriate level of staffing for a given workload to provide prompt, timely and clinically effective patient care within an emergency care setting. The studies reviewed suggest that the early involvement of senior medical decision maker and/or specialised nursing roles such as Emergency Nurse Practitioners and Clinical Initiatives Nurse, primary contact or extended scope Allied Health Practitioners can facilitate patient flow and improve key indicators such as length of stay and reducing the number of those who did not wait to be seen amongst others. B. Operational Models of Care within EDs focus on mechanisms for streaming (e.g. fast-tracking) or otherwise grouping patient care based on acuity and complexity to assist with minimising any throughput inefficiencies. While studies support the positive impact of these models in general, it appears that they are most effective when they are adequately resourced. 3. Various methods of measuring ED activity exist Measuring ED activity requires careful consideration of models of care and staffing profile. Measuring activity requires the ability to account for factors including: patient census, acuity, LOS, intensity of intervention, department skill-mix plus an adjustment for non-patient care time. 4. Gaps in the literature Continued ED growth calls for new and innovative care delivery models that are safe, clinically effective and cost effective. New roles and stand-alone service delivery models are often evaluated in isolation without considering the global and economic impact on staffing profiles. Whilst various models of accounting for and measuring health care activity exist, costing studies and cost effectiveness studies are lacking for EDs making accurate and reliable assessments of care models difficult. There is a necessity to further understand, refine and account for measures of ED complexity that define a workload upon which resources and appropriate staffing determinations can be made into the future. There is also a need for continued monitoring and comprehensive evaluation of newly implemented workforce modelling tools. This research acknowledges those gaps and aims to: • Undertake a comprehensive and integrated whole of department workforce profiling exercise relative to resources in the context of ABF. • Inform workforce requirements based on traditional quantitative markers (e.g. volume and acuity) combined with qualitative elements of ED models of care; • Develop a comprehensive and validated workforce calculation tool that can be used to better inform or at least guide workforce requirements in a more transparent manner.

Getting a piece of the cloud

Introduction When it comes to sustainable economic development, it is hard to go past the thought of investment in information technology (IT). The foundation of sustainable economic development is sustainable infrastructure. This situation means that investment in IT is about developing sustainable IT infrastructure. An IT infrastructure is a set of IT tools on which organisations could develop applications to manage their varying business processes. At a national economic level, this is all about developing a national IT infrastructure to provide social and economic services to the various stakeholders. Current troubling economic times call for collaboration and centrality in IT infrastructure development. This notion has led to the idea of national broadband networks, sustainable telecommunication platforms, and national IT development plans and goals. However, these thoughts and actions do not directly impact the critical social and economic processes of organisations. That is, these thoughts set the tone and direction of actions