Choosing a model of maternity care: decision support needs of Australian women

- BACKGROUND Access to information on the features and outcomes associated with the various models of maternity care available in Australia is vital for women's informed decision-making. This study sought to identify women's preferences for information access and decision-making involvement, as well as their priority information needs, for model of care decision-making. - METHODS A convenience sample of adult women of childbearing age in Queensland, Australia were recruited to complete an online survey assessing their model of care decision support needs. Knowledge on models of care and socio-demographic characteristics were also assessed. - RESULTS Altogether, 641 women provided usable survey data. Of these women, 26.7 percent had heard of all available models of care before starting the survey. Most women wanted access to information on models of care (90.4%) and an active role in decision-making (99.0%). Nine priority information needs were identified: cost, access to choice of mode of birth and care provider, after hours provider contact, continuity of carer in labor/birth, mobility during labor, discussion of the pros/cons of medical procedures, rates of skin-to-skin contact after birth, and availability at a preferred birth location. This information encompassed the priority needs of women across age, birth history, and insurance status subgroups. - CONCLUSIONS This study demonstrates Australian women's unmet needs for information that supports them to effectively compare available options for model of maternity care. Findings provide clear direction on what information should be prioritized and ideal channels for information access to support quality decision-making in practice.

The dynamics of individual teacher autonomy: A case study of teachers' work in a Queensland secondary school

The emphasis on collegiality and collaboration in the literature on teachers' work and school reform has tended to underplay the significance of teacher autonomy. This thesis explores the dynamics of teachers' understandings and experiences of individual teacher autonomy (as contrasted with collective autonomy) in an independent school in Queensland which promoted itself as a 'teachers' school' with a strong commitment to individual teacher autonomy. The research was a case study which drew on methodological signposts from critical, feminist and traditional ethnography. Intensive fieldwork in the school over five months incorporated the ethnographic techniques of observation, interviews and document analysis. Teachers at Thornton College understood their experience of individual autonomy at three interrelated levels--in terms of their work in the classroom, their working life in the school, and their voice in the decision-making processes of the school. They felt that they experienced a great deal of individual autonomy at each of these three levels. These understandings and experiences of autonomy were encumbered or enabled by a range of internal and external stakeholder groups. There were also a number of structural influences (community perceptions, market forces, school size, time and bureaucracy) emerging from the economic, social and political structures in Australian society which influenced the experience of autonomy by teachers. The experience of individual teacher autonomy was constantly shifting, but there were some emergent patterns. Consensus on educational goals and vision, and strong expressions of trust and respect between teachers and stakeholders in the school, characterised the contexts in which teachers felt they experienced high levels of autonomy in their work. The demand for accountability and desire for relatedness motivated stakeholders and structural forces to influence teacher autonomy. Some significant gaps emerged between the rhetoric of a commitment to individual teacher autonomy and decision-making practices in the school, that gave ultimate power to the co-principals. Despite the rhetoric and promotion of non-hierarchical structures and collaborative decision-making processes, many teachers perceived that their experience of individual autonomy remained subject to the exercise of 'partial democracy' by school leaders.

Apprehending the void: Using animation to interpret the genius loci of the Peel Island Lazaret

This practice-led research project harnesses the plasmatic nature of animation (Eisenstein 1989) to embody the in-between state of being of the Peel Island Lazaret on the island of Teerk Roo Ra in Moreton Bay, Queensland. In this project the genius loci of this place is expressed through the development of a series of creative works that employs the unique transformative quality of animation to push and pull at the boundary lines between what can be apprehended as the ‘real’ and the ‘imaginary’. Drawing on the physical approach of Czech surrealist animator Jan Švankmajer and cultural theories from Australian writer Ross Gibson, this study re-members and re-imagines the site of the Lazaret as a liminal, uncanny place. This study investigates how conceptions of place are overlaid by aspects of history, memory and the imagination and these discoveries contribute to the currently limited academic discourse around place and place-making in animation practice in Australia.

Dealing with discomfort: How the unspeakable confounds wicked planning problems

The idea of ‘wicked’ problems has made a valuable contribution to recognising the complexity and challenges of contemporary planning. However, some wicked policy problems are further complicated by a significant moral, psychological, religious or cultural dimension. This is particularly the case for problems that possess strong elements of abjection and symbolic pollution and high degrees of psychosocial sensitivity. Because this affects the way these problems are framed and discussed they are also characterised by high levels of verbal proscription. As a result, they are not discussed in the rational and emotion-free way that conventional planning demands and can become obscured or inadequately acknowledged in planning processes. This further contributes to their wickedness and intractability. Through paradigmatic urban planning examples, we argue that placing their unspeakable nature at the forefront of enquiry will enable planners to advocate for a more contextually and culturally situated approach to planning, which accommodates both emotional and embodied talk alongside more technical policy contributions. Re-imagining wicked problems in this way has the potential to enhance policy and plan-making and to disrupt norms, expose their contingency, and open new ways of planning for both the unspeakable and the merely wicked.

The relevance of composing: Children’s spaces for social agency

This chapter addresses the relevance of composing for young children in creating spaces for social agency. It begins with a working definition of agency, outlines forms of agency and what might constrain it. Referring to case studies of particular children, it then goes on to discuss key themes, which illuminate what is possible and what is at stake when children compose. These overlapping themes include identity (sense of self, belonging), positioning (helping, initiating, befriending, “being bright”), voices (made through sound effects, singing, language style, and appropriating from popular culture and digital worlds), play (appropriating, imagining, designing, and creating), and resistance (not participating, staying silent, moving). Two main cases are drawn upon, those of Ta’Von and Gareth, who demonstrate agency in terms of finding spaces of belonging and meaning-making occasions in the classroom and playground. Vignettes from other children are referred to in order to illustrate common themes.

Improved wound management at lower costs: A sensible goal for Australia

Chronic wounds cost the Australian health system at least US$2·85 billion per year. Wound care services in Australia involve a complex mix of treatment options, health care sectors and funding mechanisms. It is clear that implementation of evidence-based wound care coincides with large health improvements and cost savings, yet the majority of Australians with chronic wounds do not receive evidence-based treatment. High initial treatment costs, inadequate reimbursement, poor financial incentives to invest in optimal care and limitations in clinical skills are major barriers to the adoption of evidence-based wound care. Enhanced education and appropriate financial incentives in primary care will improve uptake of evidence-based practice. Secondary-level wound specialty clinics to fill referral gaps in the community, boosted by appropriate credentialing, will improve access to specialist care. In order to secure funding for better services in a competitive environment, evidence of cost-effectiveness is required. Future effort to generate evidence on the cost-effectiveness of wound management interventions should provide evidence that decision makers find easy to interpret. If this happens, and it will require a large effort of health services research, it could be used to inform future policy and decision-making activities, reduce health care costs and improve patient outcomes.

Carrie the Musical

When Carrie the Musical first debuted in 1988 it (in)famously closed eight days later, earning the dubious title of being one of the biggest flops in the history of Broadway. This revived version of the work, the Queensland premiere of the production, presented at the Brisbane Powerhouse in January 2016, was a calculated experiment in the commercialisation of an historical flop into a contemporary success. Through collaboration between some of Brisbane's most promising young creatives, designers, choreographers musicians and performers, this production became one of the Brisbane Powerhouse's most successful shows and gained local, national and international recognition for its achievements. By pushing the boundaries of the most current trends in contemporary Australian directing and performance making, the creative team was able to draw on their innovative capacity as independent theatre makers to turn a once-maligned work into a modern-day financial and critical success.