Using participatory action research in a community-based initiative addressing complex mental health needs

Objective: This paper describes the first phase of a larger project that utilizes participatory action research to examine complex mental health needs across an extensive group of stakeholders in the community. Method: Within an objective qualitative analysis of focus group discussions the social ecological model is utilized to explore how integrative activities can be informed, planned and implemented across multiple elements and levels of a system. Seventy-one primary care workers, managers, policy-makers, consumers and carers from across the southern metropolitan and Gippsland regions of Victoria, Australia took part in seven focus groups. All groups responded to an identical set of focusing questions. Results: Participants produced an explanatory model describing the service system, as it relates to people with complex needs, across the levels of social ecological analysis. Qualitative themes analysis identified four priority areas to be addressed in order to improve the system's capacity for working with complexity. These included: (i) system fragmentation; (ii) integrative case management practices; (iii) community attitudes; and (iv) money and resources. Conclusions: The emergent themes provide clues as to how complexity is constructed and interpreted across the system of involved agencies and interest groups. The implications these findings have for the development and evaluation of this community capacity-building project were examined from the perspective of constructing interventions that address both top-down and bottom-up processes.

Enhancing the capacity of kin caregivers and their families to meet the needs of children left behind

Based on qualitative research of the experiences of 23 kin caregivers and five school personnel, this article explores the role of informal kinship care in addressing the needs of school-age children left behind in rural China. The findings of this study suggest that kin caregivers' child-rearing capacity is limited in the rural context, and they are often overwhelmed by children's diverse and complex needs, particularly their emotional ones. In view of the huge population and their vulnerability, it is imperative for the state to take up its responsibilities and develop specific social work services and other support for children left behind and their families. 根据对23位亲属照顾者和5位学校人员的质性研究，文章探讨在处理中国留守学龄儿童的需要时，非正式亲属照料所担当的角色。研究发现，在农村的亲属照料者的抚养儿童能力有限，而且他们时常在面对儿童众多复杂的需求时应接不暇，问题又以情绪需要尤甚。有见于留守儿童的数目众多和易受伤害，政府急切需要承担相关的责任，为留守儿童及其家庭发展专门的社会工作服务和其他支援。

Experiences of resettled refugees during the 2011 Queensland floods

With projected climatic changes it is expected that refugees and other forced migrants will increasingly spend protracted amounts of time in transit countries or will resettle in locations that experience ecological vulnerability. A submission to the Queensland Floods Commission Inquiry 2011 by MDA reported that the floods displaced about 70 refugee client families and that 30 families had ongoing complex needs at the time of the submission. The findings reported in this chapter are derived from a follow-up of a cohort of men from refugee backgrounds who participated in the 2008–10 SettleMEN project. The chapter provides an insight into the experiences of refugee migrants who experience environmental disaster in a site of settlement

Patient perspectives of using a web based intervention program for patients with type 2 diabetes and acute coronary syndrome

Introduction Research highlights patients with dual diagnoses of type 2 diabetes and acute coronary syndrome (ACS) have higher readmission rates and poorer health outcomes than patients with singular chronic conditions. Despite this, there is a lack of education programs targeted for this dual diagnosis population to improve self-management and decrease negative health outcomes. There is evidence to suggest that internet based interventions may improve health outcomes for patients with singular chronic conditions, however there is a need to develop an evidence base for ACS patients with comorbid diabetes. There is a growing awareness of the importance of a participatory model in developing effective online interventions. That is, internet interventions are more effective if end users’ perceptions of the intervention are incorporated in their final development prior to testing in large scale trials. Objectives This study investigated patients’ perspectives of the web-based intervention designed to promote self-management of the dual conditions in order to refine the intervention prior to clinical trial evaluation. Methods An interpretive approach with thematic analysis was used to obtain deeper understanding regarding participants’ experience when using web-application interventions for patients with ACS and type 2 diabetes. Semi-structured interviews were undertaken on a purposive sample of 30 patients meeting strict inclusion and exclusion criteria to obtain their perspectives on the program. Results Preliminary results indicate patients with dual diagnoses express more complex needs than those with a singular condition. Participants express a positive experience with the proposed internet intervention and emerging themes include that the web page is seen as easy to use and comforting as a support, in that patients know they are not alone. Further results will be reported as they become available. Conclusion The results indicate potential for patient acceptability of the newly developed internet intervention for patients with ACS and comorbid diabetes. Incorporation of patient perspectives into the final development of the intervention is likely to maximise successful outcomes of any future trials that utilise this intervention. Future quantitative evaluation of the effectiveness of the intervention is being planned.

Using strengths-based approaches in early years practice and research

Strengths-based approaches draw upon frameworks and perspectives from social work and psychology but have not necessarily been consistently defined or well articulated across disciplines. Internationally, there are increasing calls for professionals in early years settings to work in strengths-based ways to support the access and participation of all children and families, especially those with complex needs. The purpose of this paper is to examine a potential promise of innovative uses of strengths-based approaches in early years practice and research in Australia, and to consider implications for application in other national contexts. In this paper, we present three cases (summarised from larger studies) depicting different applications of the Strengths Approach, under pinned by collaborative inquiry at the interface between practice and research. Analysis revealed three key themes across the cases: (i) enactment of strengths-based principles, (ii) the bi-directional and transformational influences of the Strengths Approach (research into practice/practice into research), and (iii) heightened practitioner and researcher awareness of, and responsiveness to, the operation of power. The findings highlight synergies and challenges to constructing and actualising strengths-based approaches in early years childhood research and practice. The case studies demonstrate that although constructions of what constitutes strengths-based research and practice requires ongoing critical engagement, redefining, and operationalising, using strengths-based approaches in early years settings can be generative and worthwhile.

Barriers, drivers and enablers for transitioning towards innovation in the Australian water sector

The Australian water sector needs to adapt to effectively deal with the impacts of climate change on its systems. Challenges as a result of climate change include increasingly extreme occurrences of weather events including flooding and droughts (Pittock, 2011). In response to such challenges, the National Water Commission in Australia has identified the need for the water sector to transition towards being readily adaptable and able to respond to complex needs for a variety of supply and demand scenarios (National Water Commission, 2013). To successfully make this transition, the sector will need to move away from business as usual, and proactively pursue and adopt innovative approaches and technologies as a means to successfully address the impacts of climate change on the Australian water sector. In order to effectively respond to specific innovation challenges related to the sector, including climate change, it is first necessary to possess a foundational understanding about the key elements related to innovation in the sector. This paper presents this base level understanding, identifying the key barriers, drivers and enablers, and elements for innovative practise in the water sector. After initially inspecting the literature around the challenges stemming from climate change faced by the sector, the paper then examines the findings from the initial two rounds of a modified Delphi study, conducted with experts from the Australian water sector, including participants from research, government and industry backgrounds. The key barriers, drivers and enablers for innovation in the sector identified during the initial phase of the study formed the basis for the remainder of the investigation. Key elements investigated were: barriers – scepticism, regulation systems, inconsistent policy; drivers – influence of policy, resource scarcity, thought leadership; enablers – framing the problem, effective regulations, community acceptance. There is a convincing argument for the water sector transitioning to a more flexible, adaptive and responsive system in the face of challenges resulting from climate change. However, without first understanding the challenges and opportunities around making this transition, the likelihood of success is limited. For that reason, this paper takes the first step in understanding the elements surrounding innovation in the Australian water sector.

Towards adaptive management of QoS-aware service compositions - Functional architecture

Service compositions enable users to realize their complex needs as a single request. Despite intensive research, especially in the area of business processes, web services and grids, an open and valid question is still how to manage service compositions in order to satisfy both functional and non-functional requirements as well as adapt to dynamic changes. In this paper we propose an (functional) architecture for adaptive management of QoS-aware service compositions. Comparing to the other existing architectures this one offers two major advantages. Firstly, this architecture supports various execution strategies based on dynamic selection and negotiation of services included in a service composition, contracting based on service level agreements, service enactment with flexible support for exception handling, monitoring of service level objectives, and profiling of execution data. Secondly, the architecture is built on the basis of well know existing standards to communicate and exchange data, which significantly reduces effort to integrate existing solutions and tools from different vendors. A first prototype of this architecture has been implemented within an EU-funded Adaptive Service Grid project. © 2006 Springer-Verlag.

International students using online information resources to learn : complex experience and learning needs

This paper reports the findings of a qualitative study which investigated 25 international students’ use of online information resources for study purposes at two Australian universities. Using an expanded critical incident approach, the study viewed international students through an information literacy lens, as information-using learners. The findings are presented in two complementary parts: as a word picture that describes their whole experience of using online information resources to learn; and as a tabulated set of critical findings that summarises their associated information literacy learning needs. The word picture shows international students’ resource use as a complex interplay of eight inter-related elements: students; information-learning environment; interactions (with online resources); strengths-challenges; learning-help; affective responses; reflective responses; cultural-linguistic dimensions. In using online resources, the international students experience an array of strengths and challenges, and an apparent information literacy imbalance between their more developed information skills and less developed critical information use. The critical findings about information literacy needs provide a framework for developing an inclusive informed learning approach that responds to international students’ complex information using experiences and needs. While the study is situated in Australia, the findings are of potential interest to educators, information professionals and researchers worldwide who seek to support learning in culturally diverse higher education contexts.

The Complex Politics of Care: Needs and interests, norms and desires

If you want to understand something about a society, and the social contracts that underpin it, then understanding the way it positions women, children, those with corporeal or cognitive differences and other not-quitecitizens is a good place to start. As most now understand, this positioning is not natural; it is part of the high-stakes social, institutional and above all ideological labour of defining the human body, directing human behaviour and determining who will hold agency, authority and power...

Managing infrastructure transitions : a complex adaptive systems perspective

Engineering assets such as roads, rail, bridges and other forms of public works are vital to the effective functioning of societies {Herder, 2006 #128}. Proficient provision of this physical infrastructure is therefore one of the key activities of government {Lædre, 2006 #123}. In order to ensure engineering assets are procured and maintained on behalf of citizens, government needs to devise the appropriate policy and institutional architecture for this purpose. The changing institutional arrangements around the procurement of engineering assets are the focus of this paper. The paper describes and analyses the transition to new, more collaborative forms of procurement arrangements which are becoming increasingly prevalent in Australia and other OECD countries. Such fundamental shifts from competitive to more collaborative approaches to project governance can be viewed as a major transition in procurement system arrangements. In many ways such changes mirror the shift from New Public Management, with its emphasis on the use of market mechanisms to achieve efficiencies {Hood, 1991 #166}, towards more collaborative approaches to service delivery, such as those under network governance arrangements {Keast, 2007 #925}. However, just as traditional forms of procurement in a market context resulted in unexpected outcomes for industry, such as a fragmented industry afflicted by chronic litigation {Dubois, 2002 #9}, the change to more collaborative forms of procurement is unlikely to be a panacea to the problems of procurement, and may well also have unintended consequences. This paper argues that perspectives from complex adaptive systems (CAS) theory can contribute to the theory and practice of managing system transitions. In particular the concept of emergence provides a key theoretical construct to understand the aggregate effect that individual project governance arrangements can have upon the structure of specific industries, which in turn impact individual projects. Emergence is understood here as the macro structure that emerges out of the interaction of agents in the system {Holland, 1998 #100; Tang, 2006 #51}.

The mobile Internet and small business : an exploratory study of needs, uses and adoption with full-adopters of technology

The technological environment in which contemporary small and medium-sized enterprises (SMEs) operate can only be described as dynamic. The exponential rate of technological change, characterised by perceived increases in the benefits associated with various technologies, shortening product life cycles and changing standards, provides for the SME a complex and challenging operational context. The primary aim of this research was to concentrate on those SMEs that had already adopted technology in order to identify their needs for the new mobile data technologies (MDT), the mobile Internet. The research design utilised a mixed approach whereby both qualitative and quantitative data was collected to address the question. Overall, the needs of these SMEs for MDT can be conceptualised into three areas where the technology will assist business practices; communication, eCommerce and security.

Mobile data technology for small business : needs, uses, and adoption

The technological environment in which contemporary small and medium-sized enterprises (SMEs) operate can only be described as dynamic. The exponential rate of technological change, characterised by perceived increases in the benefits associated with various technologies, shortening product life cycles and changing standards, provides the SME a complex and challenging operational context. The primary aim of this research was to identify the needs of SMEs in regional areas for mobile data technologies (MDT). In this study a distinction was drawn between those respondents who were full-adopters of technology, those who were partial-adopters and those who were non-adopters and these three segments articulated different needs and requirements for MDT. Overall the needs of regional SMEs for MDT can be conceptualised into three areas where the technology will assist business practices, communication, e-commerce and security.

Exploring the needs for SMEs for mobile data technologies : the role of qualitative research techniques

The seemingly exponential nature of technological change provides SMEs with a complex and challenging operational context. The development of infrastructures capable of supporting the wireless application protocol (WAP) and associated 'wireless' applications represents the latest generation of technological innovation with potential appeals to SMEs and end-users alike. This paper aims to understand the mobile data technology needs of SMEs in a regional setting. The research was especially concerned with perceived needs across three market segments : non-adopters, partial-adopters and full-adopters of new technology. The research was exploratory in nature as the phenomenon under scrutiny is relatively new and the uses unclear, thus focus groups were conducted with each of the segments. The paper provides insights for business, industry and academics.

Who needs it? An exploratory investigation into the reaction of small and medium enterprises to mobile data technologies

The technological environment in which contemporary small and medium-sized enterprises (SMEs) operate can only be described as dynamic. The seemingly exponential nature of technological change, characterised by perceived increases in the benefits associated with various technologies, shortening product life cycles and changing standards, provides for the small and medium-sized enterprise a complex and challenging operational context. The development of infrastructures capable of supporting the Wireless Application Protocol (WAP)and associated 'wireless' applications represents the latest generation of technological innovation with potential appeal to SMEs and end-users alike. The primary aim of this research was to understand the mobile data technology needs of SMEs in a regional setting. The research was especially concerned with perceived needs across three market segments; non-adopters of new technology, partial-adopters of new technology and full-adopters of new technology. Working with an industry partner, focus groups were conducted with each of these segments with the discussions focused on the use of the latest WP products and services. Some of the results are presented in this paper.

Networks as a novel tool for studying team ball sports as complex social systems

This paper describes and evaluates the novel utility of network methods for understanding human interpersonal interactions within social neurobiological systems such as sports teams. We show how collective system networks are supported by the sum of interpersonal interactions that emerge from the activity of system agents (such as players in a sports team). To test this idea we trialled the methodology in analyses of intra-team collective behaviours in the team sport of water polo. We observed that the number of interactions between team members resulted in varied intra-team coordination patterns of play, differentiating between successful and unsuccessful performance outcomes. Future research on small-world networks methodologies needs to formalize measures of node connections in analyses of collective behaviours in sports teams, to verify whether a high frequency of interactions is needed between players in order to achieve competitive performance outcomes.