The implications of contractualism for the responsibilisation of higher education

Within the context of heightened perceptions of risk within thehigher education sector worldwide, responsibility for outcomes isincreasingly required not only of universities but, also, ofindividual academics. In turn, contracts have become a key formof governance for institutions in mediating and modulating thisrisk and responsibility. While much writing around the use ofcontracts in higher education has focused on market-based,competitive neoliberal conceptions of contractualism, thisarticle argues that there are, in fact, two largely antagonisticnew modes of contractualism – market contractualism andrelational contractualism – and a third, residual mode, paternalcontractualism. These three modes of contractualism coexistwithin universities, in tension. The article draws on two Australianexemplars to highlight how these tensions play out and tohighlight the potential for contractualism to create spaces forshared goals and projects and shared risks resulting from theways in which responsibility and individual agency are negotiated.

A framework for cloud-based healthcare services to monitor noncommunicable diseases patient

Monitoring patients who have noncommunicable diseases is a big challenge. These illnesses require a continuous monitoring that leads to high cost for patients' healthcare. Several solutions proposed reducing the impact of these diseases in terms of economic with respect to quality of services. One of the best solutions is mobile healthcare, where patients do not need to be hospitalized under supervision of caregivers. This paper presents a new hybrid framework based on mobile multimedia cloud that is scalable and efficient and provides cost-effective monitoring solution for noncommunicable disease patient. In order to validate the effectiveness of the framework, we also propose a novel evaluation model based on Analytical Hierarchy Process (AHP), which incorporates some criteria from multiple decision makers in the context of healthcare monitoring applications. Using the proposed evaluation model, we analyzed three possible frameworks (proposed hybrid framework, mobile, and multimedia frameworks) in terms of their applicability in the real healthcare environment.

Organizational rewards and employee commitment: a Chinese study

Purpose: The purpose of this study is to assess how the cultural value orientations of individual employees moderate their attitudinal responses to different categories of organizational rewards. Specifically, it seeks to examine how one dimension of traditionality, respect for authority, moderates the relationship between affective organizational commitment and three variables: pay satisfaction, autonomy and satisfaction with supervision. Design/methodology/approach: Hierarchical regression analysis was utilized to analyze survey data obtained from a sample of 290 employees of a major Chinese airline company. Findings: Employees high in traditionality were found to exhibit higher levels of affective commitment when autonomy and satisfaction with supervision was low. When autonomy and satisfaction with supervision was high employees low in traditionality exhibited higher levels of emotional attachment to the organization. Research limitations/implications: The cross-sectional design is an obvious limitation of the study. Another limitation relates to the generalizability of the study findings outside the context in which the research was undertaken. Social implications: Organizations should consider taking the cultural orientations of their workforce into account when developing appropriate human resource policies aimed at heightening employee commitment. This should enhance employee well-being, which is especially important in a global economy characterized by uncertainty and rapid change. Originality/value: This is the first study to examine how employees with different cultural value orientations respond to different categories of organizational rewards, in a predominantly traditional society.

Organizational commitment in Chinese small- and medium-sized enterprises: the role of extrinsic, intrinsic and social rewards

This study investigates the relationship between organizational rewards and employee commitment in Chinese small- and medium-sized enterprises (SMEs). Hierarchical regression analysis was utilized to analyse survey data from 286 employees of 11 organizations. In line with what was hypothesized extrinsic rewards were found to be strongly related to both affective and continuance commitment, whereas satisfaction with supervision and role clarity positively influenced affective commitment. In contrast to previous empirical findings, autonomy and training provision were only found to influence continuance commitment. These findings have significant managerial implications regarding the utility of providing organizational rewards to enhance the commitment of Chinese employees. In order to promote employee commitment, SME managers could start by giving their employees greater autonomy and clarity regarding their role in the organization, as well as improving supervisor support. These are relatively inexpensive measures compared to the costly alternatives of improving extrinsic benefit packages and investing in employee training.

6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial

OBJECTIVE:  To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. DESIGN:  Cluster randomised controlled trial. SETTING:  Six Australian hospitals. PARTICIPANTS:  All patients admitted to 24 acute wards during the trial period. INTERVENTIONS:  Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: "falls alert" sign, supervision of patients in the bathroom, ensuring patients' walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. MAIN OUTCOME MEASURES:  The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. RESULTS:  During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients' characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; P<0.001). In all, 1831 falls and 613 fall injuries occurred, and the rates of falls (incidence rate ratio 1.04, 0.78 to 1.37; P=0.796) and fall injuries (0.96, 0.72 to 1.27; P=0.766) were similar in intervention and control wards. CONCLUSIONS:  Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. TRIAL REGISTRATION:  Australian New Zealand Clinical Trials Registry ACTRN12611000332921.

Is there a Plan B?: Clinical educators supporting underperforming students in practice settings

The relationship between supervisors and students in work-based clinical settings is complex, but critical to the appropriate development of the learner. This study investigated the experiences of physiotherapy clinical educators of working with underperforming students, and specifically explored educational strategies used with this subgroup of learners. Findings indicated the cyclical relationship between clinical educator's stressful experiences of working in multifaceted roles within a clinical environment and their tendencies to provide 'more more more' - more of the same strategies, more feedback and supervision, and more of themselves - as their primary approach to supporting underperforming students. The data suggest that clinical educators did not have an alternative ('Plan B') if the 'more more more' approach did not produce results. We argue that the problem of managing underperforming students is a complex one without easy solutions but a focus on systems changes rather than upon individual students or clinical educators should be considered.

Self-practice and self-reflection in training of psychological interventions and therapist skills development: A qualitative meta-synthesis review

© 2015 Australian Psychological Society. Objective: The use of self-practice and self-reflection has been proposed as an efficacious strategy in the training of therapists. It has been argued to enhance therapist skills, and a key factor in the development of expertise. This systematic literature review investigated the effect of self-practice and self-reflection on therapist skills development. Method: Studies were identified through Medline, Academic Search Complete, PsychINFO, PsycARTICLES, Proquest, ISI, CINAHL, Cochrane, and Scopus databases. Additional studies were identified through lateral searches of relevant papers' reference lists and direct correspondence with authors of unpublished material. The selection criteria were studies that investigated the effect of self-practice and/or self-reflection on therapist skill development. There was no restriction on sample sizes, design of studies, dates of publication, or peer-reviewed papers. All studies were published in English. Results: Ten studies were included in this review. A thematic analysis was undertaken to analyse qualitative data. Due to inconsistency in the variables investigated across the quantitative studies, quantitative results were not subject to a meta-analysis but simply reported. Finally, qualitative and quantitative data were juxtaposed in a meta-synthesis. Conclusion: The meta-synthesis revealed inconsistencies between the qualitative and quantitative literature and a gap in relation to declarative knowledge. Methodological limitations across studies are discussed and recommendations for future research provided.

Learning vector representation of medical objects via EMR-driven nonnegative restricted Boltzmann machines (eNRBM)

Electronic medical record (EMR) offers promises for novel analytics. However, manual feature engineering from EMR is labor intensive because EMR is complex - it contains temporal, mixed-type and multimodal data packed in irregular episodes. We present a computational framework to harness EMR with minimal human supervision via restricted Boltzmann machine (RBM). The framework derives a new representation of medical objects by embedding them in a low-dimensional vector space. This new representation facilitates algebraic and statistical manipulations such as projection onto 2D plane (thereby offering intuitive visualization), object grouping (hence enabling automated phenotyping), and risk stratification. To enhance model interpretability, we introduced two constraints into model parameters: (a) nonnegative coefficients, and (b) structural smoothness. These result in a novel model called eNRBM (EMR-driven nonnegative RBM). We demonstrate the capability of the eNRBM on a cohort of 7578 mental health patients under suicide risk assessment. The derived representation not only shows clinically meaningful feature grouping but also facilitates short-term risk stratification. The F-scores, 0.21 for moderate-risk and 0.36 for high-risk, are significantly higher than those obtained by clinicians and competitive with the results obtained by support vector machines.

Nonparametric discovery of movement patterns from accelerometer signals

Monitoring daily physical activity plays an important role in disease prevention and intervention. This paper proposes an approach to monitor the body movement intensity levels from accelerometer data. We collect the data using the accelerometer in a realistic setting without any supervision. The ground-truth of activities is provided by the participants themselves using an experience sampling application running on their mobile phones. We compute a novel feature that has a strong correlation with the movement intensity. We use the hierarchical Dirichlet process (HDP) model to detect the activity levels from this feature. Consisting of Bayesian nonparametric priors over the parameters the model can infer the number of levels automatically. By demonstrating the approach on the publicly available USC-HAD dataset that includes ground-truth activity labels, we show a strong correlation between the discovered activity levels and the movement intensity of the activities. This correlation is further confirmed using our newly collected dataset. We further use the extracted patterns as features for clustering and classifying the activity sequences to improve performance.

What factors contribute to failure of fieldwork placement? Perspectives of supervisors and university fieldwork educators

Failing a fieldwork placement can be a challenging and emotional experience. This study aimed to explore the perspectives of placement supervisors and university fieldwork educators (UFEs) of the factors that contribute to occupational therapy students failing placement. Twenty placement supervisors and four UFEs participated, and completed single instance surveys and interviews. Failure of a placement was noted to be a stressful experience for all stakeholders. Reasons identified for student failure included poor communication and reflection skills; non-disclosure of health issues and an inability to accept feedback. Placement supervisors highlighted that although failing a student was difficult, there was a need to uphold the values and standards of the profession. Strategies to facilitate placement success were identified.