Optimal management of the critically Ill: Anaesthesia, monitoring, data capture, and point-of-care technological practices in ovine models of critical care

Animal models of critical illness are vital in biomedical research. They provide possibilities for the investigation of pathophysiological processes that may not otherwise be possible in humans. In order to be clinically applicable, the model should simulate the critical care situation realistically, including anaesthesia, monitoring, sampling, utilising appropriate personnel skill mix, and therapeutic interventions. There are limited data documenting the constitution of ideal technologically advanced large animal critical care practices and all the processes of the animal model. In this paper, we describe the procedure of animal preparation, anaesthesia induction and maintenance, physiologic monitoring, data capture, point-of-care technology, and animal aftercare that has been successfully used to study several novel ovine models of critical illness. The relevant investigations are on respiratory failure due to smoke inhalation, transfusion related acute lung injury, endotoxin-induced proteogenomic alterations, haemorrhagic shock, septic shock, brain death, cerebral microcirculation, and artificial heart studies. We have demonstrated the functionality of monitoring practices during anaesthesia required to provide a platform for undertaking systematic investigations in complex ovine models of critical illness.

Supporting sleep in early care and education: An assessment of observed sleep-times using a sleep practices optimality index

Aim: The aim was to investigate whether the sleep practices in early childhood education (ECE) settings align with current evidence on optimal practice to support sleep. Background: Internationally, scheduled sleep times are a common feature of daily schedules in ECE settings, yet little is known about the degree to which care practices in these settings align with the evidence regarding appropriate support of sleep. Methods: Observations were conducted in 130 Australian ECE rooms attended by preschool children (Mean = 4.9 years). Of these rooms, 118 had daily scheduled sleep times. Observed practices were scored against an optimality index, the Sleep Environment and Practices Optimality Score, developed with reference to current evidence regarding sleep scheduling, routines, environmental stimuli, and emotional climate. Cluster analysis was applied to identify patterns and prevalence of care practices in the sleep time. Results: Three sleep practices types were identified. Supportive rooms (36%) engaged in practices that maintained regular schedules, promoted routine, reduced environmental stimulation, and maintained positive emotional climate. The majority of ECE rooms (64%), although offering opportunity for sleep, did not engage in supportive practices: Ambivalent rooms (45%) were emotionally positive but did not support sleep; Unsupportive rooms (19%) were both emotionally negative and unsupportive in their practices. Conclusions: Although ECE rooms schedule sleep time, many do not adopt practices that are supportive of sleep. Our results underscore the need for education about sleep supporting practice and research to ascertain the impact of sleep practices in ECE settings on children’s sleep health and broader well-being.

Questionable antibiotic practices: Obtaining reliable estimates of consumer behaviours

Background: Significant recent attention has focussed on the role of antibiotic prescribing and usage with the aim of combating antibiotic resistance, a growing worldwide health concern. A significant gap in this literature concerns the consumption patterns and beliefs of consumers about antibiotics and their effects. We seek to remedy this gap by exploring a range of questionable antibiotic practices and obtaining reliable estimates of their prevalence as well as their normative status. Methods: We conducted an online survey of over 100 consumers. We used a new incentive compatible technique, the Bayesian Truth Serum (BTS), to elicit more truthful responding than standard self-report measures. We asked participants to indicate whether they engaged in a number of practices including whether they had: taken antibiotics when they are out of date and stored antibiotics at home for later use. We then sought estimates of the percentage of other patients (like them) who had engaged in each behaviour, as well as asking them among those patients who had, the percentage that would admit to having done so. We also asked about social acceptability and responsibility of the practices. Results: These results will show for each type of questionable practice how prevalent it is and whether consumers view it as both socially acceptable and socially responsible. We will gain the relative prevalence of each of these practices. Conclusion: These findings are of paramount importance in gaining a better understanding of consumers’ antibiotic consumption patterns. These will be vital for better targeting educational campaigns to lower inappropriate antibiotic consumption.

Concerning the house museum and the picturesque landscape in the work of Sir John Soane : with raw hints for post-heritage museum space

The picturesque aesthetic in the work of Sir John Soane, architect and collector, resonates in the major work of his very personal practice – the development of his house museum, now the Soane Museum in Lincoln’s Inn Fields in London. Soane was actively involved with the debates, practices and proponents of picturesque and classical practices in architecture and landscape and his lectures reveal these influences in the making of The Soane, which was built to contain and present diverse collections of classical and contemporary art and architecture alongside scavenged curiosities. The Soane Museum has been described as a picturesque landscape, where a pictorial style, together with a carefully defined itinerary, has resulted in the ‘apotheosis of the Picturesque interior’. Soane also experimented with making mock ruinscapes within gardens, which led him to construct faux architectures alluding to archaeological practices based upon the ruin and the fragment. These ideas framed the making of interior landscapes expressed through spatial juxtapositions of room and corridor furnished with the collected object that characterise The Soane Museum. This paper is a personal journey through the Museum which describes and then reviews aspects of Soane’s work in the context of contemporary theories on ‘new’ museology. It describes the underpinning picturesque practices that Soane employed to exceed the boundaries between interior and exterior landscapes and the collection. It then applies particular picturesque principles drawn from visiting The Soane to a speculative project for a house/landscape museum for the Oratunga historic property in outback South Australia, where the often, normalising effects of conservation practices are reviewed using minimal architectural intervention through a celebration of ruinous states.

Nation & internation practices in decision support tools in road asset management

This document provides a review of international and national practices in investment decision support tools in road asset management. Efforts were concentrated on identifying analytic frameworks, evaluation methodologies and criteria adopted by current tools. Emphasis was also given to how current approaches support Triple Bottom Line decision-making. Benefit Cost Analysis and Multiple Criteria Analysis are principle methodologies in supporting decision-making in Road Asset Management. The complexity of the applications shows significant differences in international practices. There is continuing discussion amongst practitioners and researchers regarding to which one is more appropriate in supporting decision-making. It is suggested that the two approaches should be regarded as complementary instead of competitive means. Multiple Criteria Analysis may be particularly helpful in early stages of project development, say strategic planning. Benefit Cost Analysis is used most widely for project prioritisation and selecting the final project from amongst a set of alternatives. Benefit Cost Analysis approach is useful tool for investment decision-making from an economic perspective. An extension of the approach, which includes social and environmental externalities, is currently used in supporting Triple Bottom Line decision-making in the road sector. However, efforts should be given to several issues in the applications. First of all, there is a need to reach a degree of commonality on considering social and environmental externalities, which may be achieved by aggregating the best practices. At different decision-making level, the detail of consideration of the externalities should be different. It is intended to develop a generic framework to coordinate the range of existing practices. The standard framework will also be helpful in reducing double counting, which appears in some current practices. Cautions should also be given to the methods of determining the value of social and environmental externalities. A number of methods, such as market price, resource costs and Willingness to Pay, are found in the review. The use of unreasonable monetisation methods in some cases has discredited Benefit Cost Analysis in the eyes of decision makers and the public. Some social externalities, such as employment and regional economic impacts, are generally omitted in current practices. This is due to the lack of information and credible models. It may be appropriate to consider these externalities in qualitative forms in a Multiple Criteria Analysis. Consensus has been reached in considering noise and air pollution in international practices. However, Australia practices generally omitted these externalities. Equity is an important consideration in Road Asset Management. The considerations are either between regions, or social groups, such as income, age, gender, disable, etc. In current practice, there is not a well developed quantitative measure for equity issues. More research is needed to target this issue. Although Multiple Criteria Analysis has been used for decades, there is not a generally accepted framework in the choice of modelling methods and various externalities. The result is that different analysts are unlikely to reach consistent conclusions about a policy measure. In current practices, some favour using methods which are able to prioritise alternatives, such as Goal Programming, Goal Achievement Matrix, Analytic Hierarchy Process. The others just present various impacts to decision-makers to characterise the projects. Weighting and scoring system are critical in most Multiple Criteria Analysis. However, the processes of assessing weights and scores were criticised as highly arbitrary and subjective. It is essential that the process should be as transparent as possible. Obtaining weights and scores by consulting local communities is a common practice, but is likely to result in bias towards local interests. Interactive approach has the advantage in helping decision-makers elaborating their preferences. However, computation burden may result in lose of interests of decision-makers during the solution process of a large-scale problem, say a large state road network. Current practices tend to use cardinal or ordinal scales in measure in non-monetised externalities. Distorted valuations can occur where variables measured in physical units, are converted to scales. For example, decibels of noise converts to a scale of -4 to +4 with a linear transformation, the difference between 3 and 4 represents a far greater increase in discomfort to people than the increase from 0 to 1. It is suggested to assign different weights to individual score. Due to overlapped goals, the problem of double counting also appears in some of Multiple Criteria Analysis. The situation can be improved by carefully selecting and defining investment goals and criteria. Other issues, such as the treatment of time effect, incorporating risk and uncertainty, have been given scant attention in current practices. This report suggested establishing a common analytic framework to deal with these issues.

Impeding good governance implementation in Indonesian regional government : the effect of a bureaucratic generation gap

The implementation of ‘good governance’ in Indonesia’s regional government sector became a central tenet in governance research following the introduction of the national code for governance in 2006. The code was originally drafted in 1999 as a response to the Asian financial crises and many cases of unearthed corruption, collusion, and nepotism. It was reviewed in 2001 and again in 2006 to incorporate relevant political, economical, and social developments. Even though the national code exists along with many regional government decrees on good governance, the extent of implementation of the tenets of good governance in Indonesia’s regional government is still questioned. Previous research on good governance implementation in Indonesian regional government (Mardiasmo, Barnes and Sakurai, 2008) identified differences in the nature and depth of implementation between various Indonesian regional governments. This paper analyses and extends this recent work and explores key factors that may impede the implementation and sustained application of governance practices across regional settings. The bureaucratic culture of Indonesian regional government is one that has been shaped for over approximately 30 years, in particular during that of the Soeharto regime. Previous research on this regime suggests a bureaucratic culture with a mix of positive and negative aspects. On one hand Soeharto’s regime resulted in strong development growth and strong economic fundamentals, resulting in Indonesia being recognised as one of the Asian economic tigers prior to the 1997 Asian financial crises. The financial crises however revealed a bureaucratic culture that was rife with corruption, collusion, and nepotism. Although subsequent Indonesian governments have been committed to eradicating entrenched practices it seems apparent that the culture is ingrained within the bureaucracy and eradication of it will take time. Informants from regional government agree with this observation, as they identify good governance as an innovative mechanism and to implement it will mean a deviation from the “old ways.” Thus there is a need for a “changed” mind set in order to implement sustained governance practices. Such an exercise has proven to be challenging so far, as there is “hidden” resistance from within the bureaucracy to change its ways. The inertia of such bureaucratic cultures forms a tension against the opportunity for the implementation of good governance. From this context an emergent finding is the existence of a ‘bureaucratic generation gap’ as an impeding variable to enhanced and more efficient implementation of governance systems. It was found that after the Asian financial crises the Indonesian government (both at national and regional level) drew upon a wider human resources pool to fill government positions – including entrants from academia, the private sector, international institutions, foreign nationals and new graduates. It suggested that this change in human capital within government is at the core of this ‘inter-generational divide.’ This divergence is exemplified, at one extreme, by [older] bureaucrats who have been in-position for long periods of time serving during the extended Soeharto regime. The “new” bureaucrats have only sat in their positions since the end of Asian financial crisis and did not serve during Soeharto’s regime. It is argued that the existence of this generation gap and associated aspects of organisational culture have significantly impeded modernising governance practices across regional Indonesia. This paper examines the experiences of government employees in five Indonesian regions: Solok, Padang, Gorontalo, Bali, and Jakarta. Each regional government is examined using a mixed methodology comprising of on-site observation, document analysis, and iterative semi-structured interviewing. Drawing from the experiences of five regional governments in implementing good governance this paper seeks to better understand the causal contexts of variable implementation governance practices and to suggest enhancements to the development of policies for sustainable inter-generational change in governance practice across regional government settings.

Innovative Practices in the Australian Built Environment Sector : An Information Resource for Industry

PROJECT BRIEF Information provided by the Built Environment Industry Innovation Council as background to this project includes the following information on construction and innovation within the industry. • The construction industry contributes around $67 billion to GDP and employs around 970,000 and generates exports of nearly $150 million. • The industry has one of the lowest innovation rates of any industry in Australia, ranking third last across all Australian industries in terms of its proportion of business expenditure on innovation, and second last in terms of the proportion of income generated from innovation (ABS, 2006). • Key innovation challenges include addressing energy and water use efficiency, and housing costs in preparing for the implementation of the Carbon Pollution Reduction Scheme. The sector will need to build its capability and capacity to deliver the technical and operational expertise required.The broader Built Environment Innovation Project aims to address the following two objectives: 1. Identify current innovative practice across the Built Environment industry. 2. Develop a knowledge exchange strategy for this information to be disseminated to all industry stakeholders. Industry practice issues are critical to the built environment industry’s ability to innovate, and the BRITE project from the CRC for Construction Innovation has previously undertaken work to identify the key factors that drive innovation. Part 1 of the current project aims to extend this work by conducting a stocktake of current and emerging innovative practices within the built environment industry. Part 2 of the project addresses the second of these objectives, that is, to recommend a knowledge exchange strategy for promoting the wider uptake of innovative practices that makes the information identified in Part 1 of the study (on emerging innovative practices) accessible to Australian built environment industry stakeholders. The project brief was for the strategy to include a mechanism to enable this information resource to be updated as new initiatives/practices are developed. A better understanding of the built environment industry’s own knowledge infrastructure also has the potential to enhance innovation outcomes for the industry. This project will develop a coordinated knowledge exchange strategy, informed by the best available information on current innovation practices within the industry and suggest directions for gaining a better understanding of: the industry contexts that lead to innovative practices; the industry (including enterprise and individual) drivers for innovation; and appropriate knowledge exchange pathways for delivering future industry innovation. A deliverable of Part 2 will be a recommendation for a knowledge exchange strategy to accelerate adoption of innovative practices in the built environment industry, including resource implications and how such a recommendation could be taken forward as an ongoing resource.

The reputation of the corporate social responsibility industry in Australia

Corporate social responsibility (CSR) is increasingly seen as an imperative for sustainable business and there is a growing literature on the effect of CSR on corporate reputation. Despite this, a pall of ambiguity and uncertainty remains around what CSR means and how it should be practiced. This paper offers a unique addition to the body of literature to date by revealing that CSR is an emerging industry in Australia, which is in the process of developing its own reputation as a set of business practices. The paper is based on exploratory qualitative research using a case study methodology. Interviews were conducted with key actors within the industry to investigate shared understandings of what CSR means, perceptions of CSR practice and of the industry as a whole, and who is involved in shaping these perceptions. The research revealed that the CSR industry in Australia is in its early stages of development and is therefore in need of increased internal cooperation if it is to develop a strong reputation.

Developing mathematics understanding and abstraction : the case of equivalence in the elementary years

Generalising arithmetic structures is seen as a key to developing algebraic understanding. Many adolescent students begin secondary school with a poor understanding of the structure of arithmetic. This paper presents a theory for a teaching/learning trajectory designed to build mathematical understanding and abstraction in the elementary school context. The particular focus is on the use of models and representations to construct an understanding of equivalence. The results of a longitudinal intervention study with five elementary schools, following 220 students as they progressed from Year 2 to Year 6, informed the development of this theory. Data were gathered from multiple sources including interviews, videos of classroom teaching, and pre-and post-tests. Data reduction resulted in the development of nine conjectures representing a growth in integration of models and representations. These conjectures formed the basis of the theory.

Use of Property Rights Registers for sustainability : a Queensland Case Study

Sustainable natural resource management has been a concern of governments and legislators for the last 20 years. A key aspect of an effective management framework is easy access to information about rights and obligations in land and the natural resources in, on or below the land. Information about legal interests in land is managed through a Torrens register in each Australian State. These registers are primarily focused on the registration of a narrow group of legal interests in the land, and rights or obligations that fall outside of these recognised interests are not capable of registration. Practices have developed however for the recording of property rights in natural resources either on separate registers, with no link to the Torrens register or on a separate register managed by the Registrar of Titles but having no legal effect on the title to the land. This paper will discuss and analyse the various ways in which registers have been used in Queensland to provide access to information about rights in natural resources, and provide examples as to how this approach has impacted on the desire for sustainable management. It will also provide a critique of the Queensland model, and call for reform of the present system.

A 'deleterious' effect? : Australian legal education and the production of the legal identity

A body of critical legal scholarship argues that, by the time they have completed their studies, students who enter legal education holding social ideals and intending to use their legal education to achieve social change, have become cynical about the ability of the law to do so and no longer possess such ideals. This is explained by critical scholars to be the result of a process of ideological indoctrination, aimed at ensuring that graduates uphold the narrow and conservative interests of the legal profession and capitalist society, being exercised by law schools acting as adjuncts of the legal profession, and exercised upon the passive body of the law student. By using Foucault’s work on knowledge, power, and the subject to interrogate the assumptions upon which this narrative is based, this thesis intends to suggest a way of thinking differently to the approach taken by many critical legal scholars. It then uses an analytics of government (based on Foucault’s notion of ‘governmentality’) to consider the construction of the legal identity differently. It examines the ways in which the governance of the legal identity is rationalised, programmed, and implemented, in three Queensland law schools. It also looks at the way that five prescriptive texts to ‘surviving’ law school suggest students establish and practise a relation to themselves in order to construct their own legal identities. Overall, this analysis shows that governance is not simply conducted in the profession’s interests, but occurs due to a complex arrangement of different practices, which can lead to the construction of skilled legal professional identities as well as ethical lawyer-citizens that hold an interest in justice. The implications of such an analytics provide the basis for original ways of understanding legal education, and legal education scholarship.

The arobase in the libr@ry : new political economies of children’s literatures and literacies

This essay--part of a special issue on the work of Gunther Kress--uses the idea of affordances and constraints to explore the (im)possibilities of new environments for engaging with literature written for children (see Kress, 2003). In particular, it examines a festival of children's literature from an Australian education context that occurs online. The festival is part of a technologically mediated library space designated by the term libr@ry (Kapitzke & Bruce, 2006). The @ symbol (French word "arobase") inserted into the word library indicates that technological mediation has a history, an established set of social practices, and a political economy, which even chatrooms with "real" authors may alter but not fully supplant.

From the panopticon to the playground : disciplinary practices

It is easy to take many of the practices that constitute the contemporary school for granted. Timetables, academic records, rows of desks, playgrounds, guidance counsellors now all seem a natural and inevitable part of an optimal learning environment. However, the evidence suggests that they did not appear by chance. Instead, they were put in place, albeit often in a piecemeal and haphazard way, as part of the process by which a new type of institution was constructed. By understanding the school as a disciplinary society, constituted through a variety of diverse practices, it becomes possible to re-interpret the way we have come to educate ourselves. No longer is the modern school some kind of pedagogic inevitability—simply the best and most obvious way to educate, the end result of two thousand years of trying to finally get it right. Rather, mass schooling, as we know it, is an historical by-product of changes in the way society was organised. It is a contingent collection of particular forms of government, deployed at different historical moments, often for quite different administrative and educational reasons.

The failure of Australian legislation on indirect discrimination to detect the systemic racism which prevents Aboriginal people from fully participating in the workforce

Government figures put the current indigenous unemployment rate at around 23%, 3 times the unemployment rate for other Australians. This thesis aims to assess whether Australian indirect discrimination legislation can provide a remedy for one of the causes of indigenous unemployment - the systemic discrimination which can result from the mere operation of established procedures of recruitment and hiring. The impact of those practices on indigenous people is examined in the context of an analysis of anti-discrimination legislation and cases from all Australian jurisdictions from the time of the passing of the Racial Discrimination Act by the Commonwealth in 1975 to the present. The thesis finds a number of reasons why the legislation fails to provide equality of opportunity for indigenous people seeking to enter the workforce. In nearly all jurisdictions it is obscurely drafted, used mainly by educated middle class white women, and provides remedies which tend to be compensatory damages rather than change to recruitment policy. White dominance of the legal process has produced legislative and judicial definitions of "race" and "Aboriginality" which focus on biology rather than cultural difference. In the commissions and tribunals complaints of racial discrimination are often rejected on the grounds of being "vexatious" or "frivolous", not reaching the required standard of proof, or not showing a causal connection between race and the conduct complained of. In all jurisdictions the cornerstone of liability is whether a particular employment term, condition or practice is reasonable. The thesis evaluates the approaches taken by appellate courts, including the High Court, and concludes that there is a trend towards an interpretation of reasonableness which favours employer arguments such as economic rationalism, the maintenance of good industrial relations, managerial prerogative to hire and fire, and the protection of majority rights. The thesis recommends that separate, clearly drafted legislation should be passed to address indigenous disadvantage and that indigenous people should be involved in all stages of the process.

Towards a model of the institutional logics of climate change

The proliferation of innovative schemes to address climate change at international, national and local levels signals a fundamental shift in the priority and role of the natural environment to society, organizations and individuals. This shift in shared priorities invites academics and practitioners to consider the role of institutions in shaping and constraining responses to climate change at multiple levels of organisations and society. Institutional theory provides an approach to conceptualising and addressing climate change challenges by focusing on the central logics that guide society, organizations and individuals and their material and symbolic relationship to the environment. For example, framing a response to climate change in the form of an emission trading scheme evidences a practice informed by a capitalist market logic (Friedland and Alford 1991). However, not all responses need necessarily align with a market logic. Indeed, Thornton (2004) identifies six broad societal sectors each with its own logic (markets, corporations, professions, states, families, religions). Hence, understanding the logics that underpin successful –and unsuccessful– climate change initiatives contributes to revealing how institutions shape and constrain practices, and provides valuable insights for policy makers and organizations. This paper develops models and propositions to consider the construction of, and challenges to, climate change initiatives based on institutional logics (Thornton and Ocasio 2008). We propose that the challenge of understanding and explaining how climate change initiatives are successfully adopted be examined in terms of their institutional logics, and how these logics evolve over time. To achieve this, a multi-level framework of analysis that encompasses society, organizations and individuals is necessary (Friedland and Alford 1991). However, to date most extant studies of institutional logics have tended to emphasize one level over the others (Thornton and Ocasio 2008: 104). In addition, existing studies related to climate change initiatives have largely been descriptive (e.g. Braun 2008) or prescriptive (e.g. Boiral 2006) in terms of the suitability of particular practices. This paper contributes to the literature on logics by examining multiple levels: the proliferation of the climate change agenda provides a site in which to study how institutional logics are played out across multiple, yet embedded levels within society through institutional forums in which change takes place. Secondly, the paper specifically examines how institutional logics provide society with organising principles –material practices and symbolic constructions– which enable and constrain their actions and help define their motives and identity. Based on this model, we develop a series of propositions of the conditions required for the successful introduction of climate change initiatives. The paper proceeds as follows. We present a review of literature related to institutional logics and develop a generic model of the process of the operation of institutional logics. We then consider how this is applied to key initiatives related to climate change. Finally, we develop a series of propositions which might guide insights into the successful implementation of climate change practices.