Benchmarking clinical indicators of quality for Australian residential aged care facilities

To undertake exploratory benchmarking of a set of clinical indicators of quality care in residential care in Australia, data were collected from 107 residents within four medium-sized facilities (40–80 beds) in Brisbane, Australia. The proportion of residents in each sample facility with a particular clinical problem was compared with US Minimum Data Set quality indicator thresholds. Results demonstrated variability within and between clinical indicators, suggesting breadth of assessment using various clinical indicators of quality is an important factor when monitoring quality of care. More comprehensive and objective measures of quality of care would be of great assistance in determining and monitoring the effectiveness of residential aged care provision in Australia, particularly as demands for accountability by consumers and their families increase. What is known about the topic? The key to quality improvement is effective quality assessment, and one means of evaluating quality of care is through clinical outcomes. The Minimum Data Set quality indicators have been credited with improving quality in United States nursing homes. What does this paper add? The Clinical Care Indicators Tool was used to collect data on clinical outcomes, enabling comparison of data from a small Australian sample with American quality benchmarks to illustrate the utility of providing guidelines for interpretation. What are the implications for practitioners? Collecting and comparing clinical outcome data would enable practitioners to better understand the quality of care being provided and whether practices required review. The Clinical Care Indicator Tool could provide a comprehensive and systematic means of doing this, thus filling a gap in quality monitoring within Australian residential aged care.

Magnocellular and parvocellular pathway mediated luminance contrast discrimination in amblyopia

To evaluate whether luminance contrast discrimination losses in amblyopia on putative magnocellular (MC) and parvocellular (PC) pathway tasks reflect deficits at retinogeniculate or cortical sites. Fifteen amblyopes including six anisometropes, seven strabismics, two mixed and 12 age-matched controls were investigated. Contrast discrimination was measured using established psychophysical procedures that differentiate MC and PC processing. Data were described with a model of the contrast response of primate retinal ganglion cells. All amblyopes and controls displayed the same contrast signatures on the MC and PC tasks, with three strabismics having reduced sensitivity. Amblyopic PC contrast gain was similar to electrophysiological estimates from visually normal, non-human primates. Sensitivity losses evident in a subset of the amblyopes reflect cortical summation deficits, with no change in retinogeniculate contrast responses. The data do not support the proposal that amblyopic contrast sensitivity losses on MC and PC tasks reflect retinogeniculate deficits, but rather are due to anomalous post-retinogeniculate cortical processing of retinal signals.

Analysis of the effect of negation on information retrieval of medical data

Most information retrieval (IR) models treat the presence of a term within a document as an indication that the document is somehow "about" that term, they do not take into account when a term might be explicitly negated. Medical data, by its nature, contains a high frequency of negated terms - e.g. "review of systems showed no chest pain or shortness of breath". This papers presents a study of the effects of negation on information retrieval. We present a number of experiments to determine whether negation has a significant negative affect on IR performance and whether language models that take negation into account might improve performance. We use a collection of real medical records as our test corpus. Our findings are that negation has some affect on system performance, but this will likely be confined to domains such as medical data where negation is prevalent.

Widening the gap between measurement and modelling of secondary organic aerosol properties?

The link between measured sub-saturated hygroscopicity and cloud activation potential of secondary organic aerosol particles produced by the chamber photo-oxidation of α-pinene in the presence or absence of ammonium sulphate seed aerosol was investigated using two models of varying complexity. A simple single hygroscopicity parameter model and a more complex model (incorporating surface effects) were used to assess the detail required to predict the cloud condensation nucleus (CCN) activity from the subsaturated water uptake. Sub-saturated water uptake measured by three hygroscopicity tandem differential mobility analyser (HTDMA) instruments was used to determine the water activity for use in the models. The predicted CCN activity was compared to the measured CCN activation potential using a continuous flow CCN counter. Reconciliation using the more complex model formulation with measured cloud activation could be achieved widely different assumed surface tension behavior of the growing droplet; this was entirely determined by the instrument used as the source of water activity data. This unreliable derivation of the water activity as a function of solute concentration from sub-saturated hygroscopicity data indicates a limitation in the use of such data in predicting cloud condensation nucleus behavior of particles with a significant organic fraction. Similarly, the ability of the simpler single parameter model to predict cloud activation behaviour was dependent on the instrument used to measure sub-saturated hygroscopicity and the relative humidity used to provide the model input. However, agreement was observed for inorganic salt solution particles, which were measured by all instruments in agreement with theory. The difference in HTDMA data from validated and extensively used instruments means that it cannot be stated with certainty the detail required to predict the CCN activity from sub-saturated hygroscopicity. In order to narrow the gap between measurements of hygroscopic growth and CCN activity the processes involved must be understood and the instrumentation extensively quality assured. It is impossible to say from the results presented here due to the differences in HTDMA data whether: i) Surface tension suppression occurs ii) Bulk to surface partitioning is important iii) The water activity coefficient changes significantly as a function of the solute concentration.

Letting go of Neo-Liberalism (with some help from Michel Foucault)

Neo-liberalism has become one of the boom concepts of our time. From its original reference point as a descriptor of the economics of the “Chicago School” such as Milton Friedman, or authors such as Friedrich von Hayek, neo-liberalism has become an all-purpose descriptor and explanatory device for phenomena as diverse as Bollywood weddings, standardized testing in schools, violence in Australian cinema, and the digitization of content in public libraries. Moreover, it has become an entirely pejorative term: no-one refers to their own views as “neo-liberal”, but it rather refers to the erroneous views held by others, whether they acknowledge this or not. Neo-liberalism as it has come to be used, then, bears many of the hallmarks of a dominant ideology theory in the classical Marxist sense, even if it is often not explored in these terms. This presentation will take the opportunity provided by the English language publication of Michel Foucault’s 1978-79 lectures, under the title of The Birth of Biopolitics, to consider how he used the term neo-liberalism, and how this equates with its current uses in critical social and cultural theory. It will be argued that Foucault did not understand neo-liberalism as a dominant ideology in these lectures, but rather as marking a point of inflection in the historical evolution of liberal political philosophies of government. It will also be argued that his interpretation of neo-liberalism was more nuanced and more comparative than the more recent uses of Foucault in the literature on neo-liberalism. It will also look at how Foucault develops comparative historical models of liberal capitalism in The Birth of Biopolitics, arguing that this dimension of his work has been lost in more recent interpretations, which tend to retro-fit Foucault to contemporary critiques of either U.S. neo-conservatism or the “Third Way” of Tony Blair’s New Labour in the UK.

Panel studies of new venture creation : a review and suggestions for future research

We review all journal articles based on “PSED-type” research, i.e., longitudinal, empirical studies of large probability samples of on-going, business start-up efforts. We conclude that the research stream has yielded interesting findings; sometimes by confirming prior research with a less bias-prone methodology and at other times by challenging whether prior conclusions are valid for the early stages of venture development. Most importantly, the research has addressed new, process-related research questions that prior research has shunned or been unable to study in a rigorous manner. The research has revealed an enormous and fascinating variability in new venture creation that also makes it challenging to arrive at broadly valid generalizations. An analysis of the findings across studies as well as an examination of those studies that have been relatively more successful at explaining outcomes give good guidance regarding what is required in order to achieve strong and credible results. We compile and present such advice to users of existing data sets and designers of new projects in the following areas: Statistically representative and/or theoretically relevant sampling; Level of analysis issues; Dealing with process heterogeneity; Dealing with other heterogeneity issues, and Choice and interpretation of dependent variables.

The utilisation of skilled immigrants and skilled Refugees in countries of destination

about 82 million immigrants in the OECD area; and worldwide, there are about 191 million immigrants and displaced persons, and some 30-40 million unauthorised immigrants. Also according to recent OECD report, little in-depth research has been carried out to-date to help decision makers in government, business, and society at large, to better understand the complexities and wider consequences of future migration flows. Literatures have also indicated that the lack of a skilled population in muchneeded occupations in countries of destination have contributed to the need to bring in skilled foreign workers. Furthermore, despite current global financial crisis, some areas of occupation are in need of skilled workers such that in a job-scarce environment jobs become fewer and employers are more likely to demand skilled workers from both natives and immigrants. Global competition for labour is expected to intensify, especially for top talent, highly qualified and semi-skilled individuals. This exacerbate the problems faced by current skilled immigrants and skilled refugees, particularly those from non-main English speaking countries who are not employed at optimal skill level in countries of destination. The research study investigates whether skilled immigrants are being effectively utilised in their countries of destination, in the context of employment. In addition to skilled immigrants, data sampling will also include skilled refugees who, although arriving under the humanitarian program, possess formal qualifications from their country of origin. Underlying variables will be explored such as the strength of social capital or interpersonal ties; and human capital in terms of educational attainment and proficiency in the English Language. The aim of the study is to explain the relationship between the variables; and whether the variables influence the employment outcomes. A broad-ranging preliminary literature review has been undertaken to explore the substantial bodies of knowledge on skilled immigrants worldwide, including skilled refugees; and to investigate whether the utilisation issues are universal or specific to a country. In addition, preliminary empirical research and analysis has been undertaken, to set the research focus and to identify the problems beyond literature. Preliminary findings have indicated that immigrants and refugees from non-main English speaking countries are particularly impacted by employment issues regardless of their skills and qualifications acquired in their country of origins; compared with immigrants from main-English speaking countries. Preliminary findings from the literature review also indicate that gaps in knowledge still exist. Although the past two decades have witnessed a virtual explosion of theory and research on international migration, no in-depth research has been located that specifically links immigrants and refugees social and human capitals in terms of employment outcomes. This research study aims to fill these gaps in research; and subsequently contribute to contemporary body of knowledge in literatures on the utilisation of skilled immigrants and skilled refugees, specifically those from non-main English speaking countries. A mixed methods design will be used, which incorporates techniques from both quantitative and qualitative research traditions that will be triangulated at the end of the data collection stage.

The organisation : risk, resilience and governance

Tarrant argues that a solid risk management strategy is critical to building effective, transformational and adaptive organisations. Organisations are a fundamental part of our society and economic system whether they are private, public or not-for-profits. There are very few aspects of our society and economy that don’t rely wholly or in part on the performance of organisations. Disasters and crises are complex and very challenging environments for organisations. How can effective transformational and adaptive capacity become institutionalised and a core part of good governance of organisations? Effective risk management is a critical element in meeting organisational objectives in a turbulent and uncertain environment.

Changing perceptions of preservice teachers : innovations in middle schooling teacher education

For the past twenty years, the disengagement of early adolescents has been the focus of much of the literature related to middle schooling. In response, some universities in Australia have introduced teacher education programs that focus upon graduating specialised middle schooling teachers. The aim of this study was to explore and describe the 38 first-year preservice teachers’ perceptions of their first middle schooling elective unit and ascertain whether the combination of university classes and school-based experiences assisted their development of middle schooling concepts and approaches. Data were gathered using pre-test and post-test questionnaires combined with guided written reflections to record their views before, after and during the unit delivery. Results indicated that initially the preservice teachers had little understanding of middle schooling concepts and pedagogical practices, however, 11 participants recognised that bullying and peer pressure were issues experienced by early adolescents. The reflections, which were presented after their field experiences, focused on teaching, learning, behaviour management, and resources and infrastructure. More school-based experiences linked to theoretical underpinnings can help to facilitate understandings about students in the middle phase.

Ownership structure and business evaluation practices in family SMEs : evidence from empirical research in Italy

This paper presents early results from a pilot project which aims to investigate the relationship between proprietary structure of small and medium- sized Italian family firms and their owners’ orientation towards a “business evaluation process”. Evidence from many studies point out the importance of family business in a worldwide economic environment: in Italy 93% of the businesses are represented by family firms; 98% of them have less than 50 employees (Italian Association of Family Firms, 2004) so we judged family SMEs as a relevant field of investigation. In this study we assume a broad definition of family business as “a firm whose control (50% of shares or voting rights) is closely held by the members of the same family” (Corbetta,1995). “Business evaluation process” is intended here both as “continuous evaluation process” (which is the expression of a well developed managerial attitude) or as an “immediate valuation” (i.e. in the case of new shareholder’s entrance, share exchange among siblings, etc). We set two hypotheses to be tested in this paper: the first is “quantitative” and aims to verify whether the number of owners (independent variable) in a family firm is positively correlated to the business evaluation process. If a family firm is led by only one subject, it is more likely that personal values, culture and feelings may affect his choices more than “purely economic opportunities”; so there is less concern about monitoring economic performance or about the economic value of the firm. As the shareholders’ number increases, economic aspects in managing the firm grow in importance over the personal values and "value orientation" acquires a central role. The second hypothesis investigates if and to what extent the presence of “non- family members” among the owners affects their orientation to the business evaluation process. The “Cramer’s V” test has been used to test the hypotheses; both were not confirmed from these early results; next steps will lead to make an inferential analysis on a representative sample of the population.

Civic engagement and associationalism : the impact of group membership scope versus intensity of participation

The relationship between participation in civic and political activities and membership of voluntary associations is now well established. What is less clear is the relative impacts of how much time people spend on group activities (associational intensity), and the number and type of groups that individuals are involved with (associational scope). Does it matter in terms of civic engagement, for example, whether one is a member of a quilting-circle or trade union? Does it matter whether association ‘membership’ is simply an annual payment or a major commitment of time and energy? In this article, we use a large survey to explore these questions empirically by focusing on the membership patterns and civic engagement practices of 4,001 citizens drawn from eight suburbs across Greater Melbourne, Australia. Our findings indicate that, while associational intensity is positively related to civic engagement, associational scope (the number of group memberships per person), is a more influential determinant of the level of civic and political participation. The results also suggest that while all forms of associationalism are important in terms of fostering greater levels of civic activity, not all forms have the same impact.

Is providing micro-credit social responsible?

Micro-finance, which includes micro-credit as one it its services, has become big business with a range of models – from those that operate on a strictly business basis to those who come from a philanthropic base, through Non Government organisations (NGOs). Success is often measured by the numbers involved and the repayment rates – which are very high, largely because of the lending models used. The purpose of this paper is to identify whether the means used to deliver micro-credit services to the poor are socially responsible. This paper will explore the range of models currently used and propose a model that addresses some of the social responsibility issues that appear to plague delivery. The model is being developed in Beira, the second largest city in Mozambique. Mozambique exhibits many of the characteristics found in other African countries, so the model, if successful, may have implications for other poor African nations.

Changing perceptions of preservice teachers : innovations in middle schooling teacher education

For the past twenty years, the disengagement of early adolescents has been the focus of much of the literature related to middle schooling. In response, some universities in Australia have introduced teacher education programs that focus upon graduating specialised middle schooling teachers. Constructing such programs is at the centre of much debate and discussion, however, it is advocated that positive futures for early adolescents can be enhanced through quality middle schooling teacher education programs (Education Queensland, 2004). At a Queensland university campus, middle schooling elective units were introduced as part of the Bachelor of Education (primary) degree. The design of the units was to support preservice teachers to gain the theoretical and pedagogical knowledge to engage and promote early adolescent learning. An innovative approach to the delivery of the units was promoted by a partnership agreement between local schools and the campus. The partnership allowed preservice teachers to combine university classes with opportunities to visit exemplary classrooms to observe, participate and reflect upon middle school teaching practices. The aim of this study was to explore and describe the 38 first-year preservice teachers’ perceptions of their first middle schooling elective unit and to ascertain whether the combination of university classes and school-based experiences assisted their development of middle schooling concepts and approaches. Data were gathered using pre-test and post-test questionnaires combined with guided written reflections to record their views before, after and during the unit delivery. Results indicated that initially 34 preservice teachers had little understanding of middle schooling concepts and pedagogical practices, however, 11 participants recognised that bullying and peer pressure were issues experienced by early adolescents. The collation of the written reflections supported the combined delivery of the middle years unit further supporting the inclusion of school experiences with university delivered units.

Developing strong social enterprises : a documentary approach

Social enterprises are diverse in their mission, business structures and industry orientations. Like all businesses, social enterprises face a range of strategic and operational challenges and utilize a range of strategies to access resources in support of their venture. This exploratory study examined the strategic management issues faced by Australian social enterprises and the ways in which they respond to these. The research was based on a comprehensive literature review and semi-structured interviews with 11 representatives of eight social enterprises based in Victoria and Queensland. The sample included mature social enterprises and those within two years of start-up. In addition to the research report, the outputs of the project include a series of six short documentaries, which are available on YouTube at http://www.youtube.com/user/SocialEnterpriseQUT#p/u. The research reported on here suggests that social enterprises are sophisticated in utilizing processes of network bricolage (Baker et al. 2003) to mobilize resources in support of their goals. Access to network resources can be both enabling and constraining as social enterprises mature. In terms of the use of formal business planning strategies, all participating social enterprises had utilized these either at the outset or the point of maturation of their business operations. These planning activities were used to support internal operations, to provide a mechanism for managing collective entrepreneurship, and to communicate to external stakeholders about the legitimacy and performance of the social enterprises. Further research is required to assess the impacts of such planning activities, and the ways in which they are used over time. Business structures and governance arrangements varied amongst participating enterprises according to: mission and values; capital needs; and the experiences and culture of founding organizations and individuals. In different ways, participants indicated that business structures and governance arrangements are important ways of conferring legitimacy on social enterprise, by signifying responsible business practice and strong social purpose to both external and internal stakeholders. Almost all participants in the study described ongoing tensions in balancing social purpose and business objectives. It is not clear, however, whether these tensions were problematic (in the sense of eroding mission or business opportunities) or productive (in the sense of strengthening mission and business practices through iterative processes of reflection and action). Longitudinal research on the ways in which social enterprises negotiate mission fulfillment and business sustainability would enhance our knowledge in this area. Finally, despite growing emphasis on measuring social impact amongst institutions, including governments and philanthropy, that influence the operating environment of social enterprise, relatively little priority was placed on this activity. The participants in our study noted the complexities of effectively measuring social impact, as well as the operational difficulties of undertaking such measurement within the day to day realities of running small to medium businesses. It is clear that impact measurement remains a vexed issue for a number of our respondents. This study suggests that both the value and practicality of social impact measurement require further debate and critically informed evidence, if impact measurement is to benefit social enterprises and the communities they serve.

Selective accumulation of virus-specific CD8+ T cells within the peripheral blood stem cell compartment

The absence of cellular immunity is central to the pathogenesis of herpesvirus-mediated diseases after allogeneic hemopoietic stem cell transplantation (HSCT). For both bone marrow (BM)– and granulocyte-colony stimulating factor–mobilized peripheral blood stem cells (PBSCs) HSCT, donor-derived Epstein-Barr virus (EBV) and cytomegalovirus (CMV) peptide–specific CD8+ T cells clones undergo early expansion and persist long-term, with additional diversification arising from novel antigen-specific clones from donor-derived progenitors. Whether BM or PBSC is the superior source of antiviral CD8+ T cells is unclear. Given that PBSC has largely replaced BM as a source of stem cells for HSCT, it is unlikely that herpesvirus effector T-cell reconstitution will ever be compared prospectively. PBSC grafts contain 10 to 30 times more T cells than BM and a randomized study found proven viral infections were more frequent in BM than PBSC recipients, suggesting viral-specific T-cell immunity is enhanced in PBSC. Recently Moss showed in lung cancer patients that herpesvirus-specific BM-derived CD8+ T cells have unique homing properties relative to herpesvirus-specific CD8+ T cells present in unmobilized peripheral blood (PB). Immunodominant EBV-lytic peptide–specific CD8+ T cells were enriched in BM but were reduced for CMV peptide–specific CD8+ T cells relative to PB. EBV-latent peptide–specific CD8+ T cells were equivalent, which has relevance in the context of posttransplantation lymphoproliferative disorder for which impaired EBV-latent CD8+ T-cell immunity is a risk-factor. A comparison of herpesvirus-specific cellular immunity in PBSC versus PB has yet to be performed.