Alarmed, but not alert in the "war on terror"? The High Court, Thomas V Mowbray and the Defence Power

The article examines the judgment in Thomas v. Mowbray by the High Court in Australia handed down during the so called 'War on Terror'. According to the author, (i) the High Court de-emphasized the importance of the difference between war and peace in fixing the scope of the defence power in the Australian Constitution in a manner which was inconsistent with its earlier celebrated decision in the Communist Party Case in 1950 during the Cold War; and (ii) failed to apply a sufficiently rigorous test of proportionality in characterising the impugned Commonwealth laws. The article discuss the legal background and social implications of the High Court's decision, using the Communist Party Case in 1950 as a point of comparison.

Predicting in-role and extra-role performance by gender

Men and women are said to perceive justice differently, with women proposed to be more concerned with relational issues and men focused more on material issues. In this study, the potential for differential effects of justice on performance by gender was analyzed across the four contemporary types of justice. Respondents were 265 male and 113 female occupationally diverse employees in a single organization. The results show significant differences in how men and women respond to the four justice types with only one - informational justice - acting similarly by gender. Women were more interested in maintaining social harmony than men. The results appear to strongly support the use of the justice judgment model over the group-value model as a means of explaining the gender differences. Implications for management include the importance of informational justice both generally and within the performance appraisal process

Nurses' critical event risk assessments : a judgement analysis

Aims. To explore and explain nurses' use of readily available clinical information when deciding whether a patient is at risk of a critical event.

Background. Half of inpatients who suffer a cardiac arrest have documented but unacted upon clinical signs of deterioration in the 24 hours prior to the event. Nurses appear to be both misinterpreting and mismanaging the nursing-knowledge 'basics' such as heart rate, respiratory rate and oxygenation. Whilst many medical interventions originate from nurses, up to 26% of nurses' responses to abnormal signs result in delays of between one and three hours.

Methods. A double system judgement analysis using Brunswik's lens model of cognition was undertaken with 245 Dutch, UK, Canadian and Australian acute care nurses. Nurses were asked to judge the likelihood of a critical event, 'at-risk' status, and whether they would intervene in response to 50 computer-presented clinical scenarios in which data on heart rate, systolic blood pressure, urine output, oxygen saturation, conscious level and oxygenation support were varied. Nurses were also presented with a protocol recommendation and also placed under time pressure for some of the scenarios. The ecological criterion was the predicted level of risk from the Modified Early Warning Score assessments of 232 UK acute care inpatients.

Results. Despite receiving identical information, nurses varied considerably in their risk assessments. The differences can be partly explained by variability in weightings given to information. Time and protocol recommendations were given more weighting than clinical information for key dichotomous choices such as classifying a patient as 'at risk' and deciding to intervene. Nurses' weighting of cues did not mirror the same information's contribution to risk in real patients. Nurses synthesized information in non-linear ways that contributed little to decisional accuracy. The low-moderate achievement (Ra) statistics suggests that nurses' assessments of risk were largely inaccurate; these assessments were applied consistently among 'patients' (scenarios). Critical care experience was statistically associated with estimates of risk, but not with the decision to intervene.

Conclusion. Nurses overestimated the risk and the need to intervene in simulated paper patients at risk of a critical event. This average response masked considerable variation in risk predictions, the need for action and the weighting afforded to the information they had available to them. Nurses did not make use of the linear reasoning required for accurate risk predictions in this task. They also failed to employ any unique knowledge that could be shown to make them more accurate. The influence of time pressure and protocol recommendations depended on the kind of judgement faced suggesting then that knowing more about the types of decisions nurses face may influence information use.

Relevance to clinical practice. Practice developers and educators need to pay attention to the quality of nurses' clinical experience as well as the quantity when developing judgement expertise in nurses. Intuitive unaided decision making in the assessment of risk may not be as accurate as supported decision making. Practice developers and educators should consider teaching nurses normative rules for revising probabilities (even subjective ones) such as Bayes' rule for diagnostic or assessment judgements and also that linear ways of thinking, in which decision support may help, may be useful for many choices that nurses face. Nursing needs to separate the rhetoric of 'holism' and 'expertise' from the science of predictive validity, accuracy and competence in judgement and decision making.

Evaluation of advanced breast cancer multidisciplinary team meatings

Background: Multidisciplinary team meetings (MDMs) have become an important decision-making forum in oncology. These meetings bring together expertise from each relevant field to improve continuity of care and health care outcomes for cancer patients. However there is a lack of evidence demonstrating the effectiveness of MDT meetings in improving cancer patient outcomes. The aim of this study was to explore the perceived value and potential usefulness of multidisciplinary team meetings for patients with advanced breast cancer (ABC).

Methods: ABC MDMs have been conducted since 2002 at two sites of Eastern Health, the second largest health service in Melbourne. Attendees were invited to complete a confidential questionnaire in November 2007 that comprised seven areas aimed to assess their judgment of how well the MDMs have improved patient management, including medical recommendations, psychosocial care, palliative care, community care, and team development. Average scores were calculated for improvement of each area.

Results: A total of 16 (69%) health practitioners participated in the survey, with main representation from nursing (37%), allied health (25%) and medicine (19%). Preliminary results indicate that the broad areas members reported the meeting had improved patient outcomes were in palliative care and medical management. Specific areas of perceived improvement were medical outcomes for patients; early referral to palliative care services; confirmation of diagnosis; referral to supportive care; and appropriateness of palliative care referrals. Conversely, the area that had least improved was community care, as there was no input from GPs or community services other than palliative care. Attendance by GPs and radiologists were considered important for further improving medical outcomes for patients.

Conclusions: This study demonstrates the perceived value of the MDT approach in the care of ABC patients, particularly in improving patient outcomes. The next stage of this research is to conduct a survey of ABC patient satisfaction level.

Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis.

Introduction: Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals. Design-related bias in evaluations of tool predictive accuracy could lead to overoptimistic results, which would then contribute to program failure in practice.

Methods: A systematic review was undertaken. Two blind reviewers assessed the methodology of relevant publications into a four-point classification system adapted from multiple sources. The association between study design classification and reported results was examined using linear regression with clustering based on screening tool and robust variance estimates with point estimates of Youden Index (= sensitivity + specificity - 1) as the dependent variable. Meta-analysis was then performed pooling data from prospective studies.

Results: Thirty-five publications met inclusion criteria, containing 51 evaluations of fall risk screening tools. Twenty evaluations were classified as retrospective validation evaluations, 11 as prospective (temporal) validation evaluations, and 20 as prospective (external) validation evaluations. Retrospective evaluations had significantly higher Youden Indices (point estimate [95% confidence interval]: 0.22 [0.11, 0.33]). Pooled Youden Indices from prospective evaluations demonstrated the STRATIFY, Morse Falls Scale, and nursing staff clinical judgment to have comparable accuracy.

Discussion: Practitioners should exercise caution in comparing validity of fall risk assessment tools where the evaluation has been limited to retrospective classifications of methodology. Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular settings, but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment.

Behind the scene of knowledge sharing : the impact of task complexity

Numerous empirical studies on knowledge management have examined the relative effectiveness of various enablers, such as organizational structure, technology, culture, managerial system and strategy for knowledge creation and sharing in organizations. While these studies play a critical role in helping us to appreciate the importance of organizational enablers in knowledge management, they have neglected to examine the possible effects of task complexity on the nature and efficacy of knowledge sharing. This study investigates how task complexity influences the mode and effectiveness of knowledge sharing among professional accountants in Malaysia. In particular, it highlights the relationships between different task dimensions and modes of knowledge sharing, and the impact of knowledge sharing on professional competency. This study adopts a process oriented approach based on Nonaka’s (1994) knowledge sharing model. This study reveals that task complexity is significantly related to knowledge sharing. Tasks carried out by professional accountants vary from repetitive or clearly-defined procedural tasks to unstructured tasks that required professional judgment and expertise for successful task performance. While professional accountants are generally keen to gain access to knowledge databases to source for possible task solutions, they are generally hesitant to share their tacit knowledge by transforming the knowledge into explicit form. The finding suggests that there may be cultural-related factors that inhibit sharing of one’s tacit  knowledge totally and completely. This study also shows the existence of a  significant relationship between knowledge sharing and professional  competency, suggesting that the importance of the internalization mode of  knowledge sharing in sustaining the competitive edge of professional  accountants.

Implementation of a medication guideline to improve medication safety for patients

Although the incidence of medication error remains unknown, in Australian hospitals, they are thought to occur in 5-20 % of drug administrations 1. Not surprisingly, international debate has focused on the mechanisms to improve the safety of patients. Thus a new National Inpatient Medication Chart (NIMC) was endorsed to improve communication and reduce medication errors 2. This study aimed to investigate the documentation practices of clinicians following the implementation of a medication guideline and NIMC.
A pre and post-test design was used to evaluate the adoption of and adherence to the medication guideline at Western Health, an 850 bed healthcare network in Australia. Audits of inpatient medication charts (N=265) were conducted at 3 months prior to and repeated 4 months (N=290) after implementation. The pre-test data was used to formulate an interdisciplinary organizational strategy that included mandatory education for all clinical staff, practice reminders, decision prompts, a telephone hotline for support, an intranet information website and electronically distributed Frequently Asked Questions.
Pre and post implementation audits highlighted areas of potential medication error. The post-test showed an overall trend towards improvement in documentation. There were significant improvements in 4 critical practices: Drug name clear (p=0.0003); Drug dose clear (p=0.0002); Prescribed frequency equals documented frequency (p=0) and; No signature by administrator (p=0).
The majority of documentation errors showed poor attention to detail and would be considered a slip or lapse in skill based judgment 3. Although this study was designed to evaluate documentation practices, future research should include observation methods to increase our understanding of the context behind the judgments such as work place interruptions, skill mix and knowledge levels. While evidence based guidelines enable work, they are not the actual work or substance of patient care. Organisational systems can assist in preventing unconscious aberrations that lead to error.

Measuring life balance through discrepancy theories and subjective well-being

The concept of life balance implies that there is some optimal time allocation between the various forms o(human activity we engage in each day. So life balance can be measured by the size of the discrepancy between how we should and how we do allocate our time.
If someone chooses to spend all of their discretionary time writing poetry, is this a balanced life? Many people would say no. They would judge such a life to be imbalanced because life is full of competing demands, and writing poetry all day means that other aspects of life are neglected.
But is this just an imposed value judgment, or does the concept of a balanced life have deeper meaning? The answer must lie with whatever we use to measure the outcome. Any conclusion that balance is better than imbalance must be based on empirical evidence. So, what should be measured?

Conceptualising a voluntary certification system for highly accomplished teachers

In this paper I argue that a voluntary certification system for highly accomplished teachers must be part of a coherent system of professional accountability which is developed, implemented and managed by the profession. This would be a system that engages professional judgement of evidence provided by teachers in relation to their professional knowledge and practice, and professional standards for teaching would provide the organising framework for that judgment. It would be a system incorporating and aligning all forms of professional licensure, including entry into the profession and subsequent professional milestones. It would be a system that all partners in the profession across Australia—employers, professional associations, and registration authorities—endorse, participate in and align with.

The profession can take the lead in developing and implementing such a coherent and coordinated national approach by carefully developing a system to recognise and reward highly accomplished teaching. Such a system should aim to recognise and build teacher quality by defining what it is highly accomplished teachers know and are able to do. Moreover, such a system must fi nd ways of making teaching public and acknowledging teaching as intellectual work which involves professional judgment that draws on a recognised professional knowledge base and contextualised knowledge about students and their learning.

The paper is presented in two main sections. First, a proposed conceptual framework for the professional recognition and certification of highly accomplished teachers is outlined. Then, the argument for this proposed conceptual framework is presented drawing on learnings from relevant research and professional activity in both Australia and the USA.

Caprice versus standardization in venture capital decision making

This study examined the criteria used by venture capitalists to evaluate business plans in order to make investment decisions. A literature survey revealed two competing theories: 'espoused criteria' where evaluation decisions are based on what venture capitalists say are the decisive factors, versus the use of 'known attributes' that successful ventures actually possess. Brunswik's Lens Model from Social Judgment Theory guided an empirical investigation of several different evaluation methods based on information contained in 129 business plans submitted for venture capital over a three-year period. Data evaluation culminated in the comparison of the percentage of correct decisions ('hit rate') for each method. We found that decisions based on the known attributes of successful ventures have significantly better hit rates than decisions made using espoused criteria. Discussion centered on the goal of achieving consistency in the conduct of venture analysis. Process standardization can aid in the achievement of consistency. Future research will both deepen and broaden insights.

Quality as the criterion for delivered information systems effectiveness

One of the major challenges of MIS activities is the difficulty in measuring the effectiveness of delivered systems. The principal purpose of my research is to explore this field in order to develop an instrument by which to measure such effectiveness. Conceptualisation of Information System (IS) Effectiveness has been substantially framed by DeLone and McLean's (1992) Success; Model. But with the innovation in Information Technology (IT) over the past decade, and the constant pressure in IT to improve performance, there is merit in undertaking a fresh appraisal of the issue. This study built on the model of IS Success developed by DeLone and MeLean, but was broadened to include related research from the domains of IS, Management and Marketing. This analysis found that an effective IS function is built on three pillars: the systems implemented; the information held and delivered by these systems; and, the service provided in support of the IS function. A common foundation for these pillars is the concept of stakeholder needs. In seeking to appreciate the effectiveness: of delivered IS applications in relation to the job performance of stakeholders, this research developed an understanding of what quality means in an IT context I argue that quality is a more useful criterion for effectiveness than the more customary measures of use and user satisfaction. Respecification of the IS Success Model was then proposed. The second phase of the research was to test this model empirically through judgment panels, focus groups and interviews. Results consistently supported the structure and components of the respecified model. Quality was determined as a multi-dimensional construct, with the key dimensions for the quality of delivered IS differing from those used in the research from other disciplines. Empirical work indicated that end-user stakeholders derived their evaluations of quality by internally evaluating perceived performance of delivered IS in relation to their expectations for such performance. A short trial explored whether, when overt measurement of expectations was concurrent with the measurement of perceptions, a more revealing appraisal of delivered IS quality was provided than when perceptions alone were measured. Results revealed a difference between the two measures. Using the New IS Success Model as the foundation, and drawing upon the related theoretical and empirical research, an instrument was developed to measure the quality/effectiveness of delivered IS applications. Four trials of this instrument, QUALIT, are documented. Analysis of results from preliminary trials indicates promise in terms of business value: the instrument is simple to administer and has the capacity to pinpoint areas of weakness. The research related to the respecification of the New IS Success Model and the associated empirical studies, including the development of QTJALIT, have both contributed to the development of theory about IS Effectiveness. More precisely, my research has reviewed the components of an information system, the dimensions comprising these components and the indicators of each, and based upon these findings, formulated an instrument by which to measure the effectiveness of a delivered IS.

Facts, threats and reds : common law constitutionalism and the rule of law

In a concurring judgment in Thomas v Mowbray, a High Court of Australia case turning on the Constitutional validity of terrorism-related control orders, Callinan J offers a re-evaluation of the Court’s earlier decision in the Australian Communist Party case to curtail executive power. According to Callinan J, factual matters knowable (but not known) at the time of the earlier decision might have given rise to a different outcome. In a dissenting judgment by Kirby J in the same case the Court’s reasoning in the Australian Communist Party case is robustly defended. These contested issues connect with the theoretical dispute between ‘common law constitutionalism’ and ‘constitutional positivism’ analysed by Dyzenhaus in the context of states of emergency where the limits of executive action and the role of supporting facts become particularly salient. They press the question of the status of the rule of law in the international as well as in the municipal sphere.

The moral reasoning abilities of Australian and Malaysian accounting students : a comparative analysis

If national culture is a significant determinant of ethical attitudes, it is not unreasonable to expect ethical decision-making to be influenced by one's culture. However, problems arise when the notion of right differs from one culture to another. The question addressed in this paper is whether the moral reasoning abilities of Australian and Malaysian accounting students in their final year of study differ because of their cultural upbringing. This study uses primary data collected from 34 final year accounting students (12 Australian and 22 Malaysian) enrolled in an Australian degree program. The test scores collected at the beginning and end of the academic year indicate that culture and other explanatory variables do not have an affect on students' moral judgment. The findings in this study suggest that culture as an independent variable does not influence the way accounting students analyse and resolve ethical dilemmas.

Justice in the workplace : the centrality of social versus judgmental predictors of performance varies by gender

Men and women are said to perceive justice differently, with women proposed to  be more concerned with relational issues and men focused more on material issues. In this study, the potential for differential effects of justice on performance by gender was analyzed across the four contemporary types of justice.  Respondents were 265 male and 113 female occupationally diverse employees in a single organization. The results show significant differences in how men and women respond to the four justice types with only one – informational justice – acting similarly by gender. The differential relationships between each of the justice types and the outcomes by gender highlight the utility of the four factor approach to measuring organizational justice. Women were more interested in maintaining social harmony than men. The results appear to strongly support the use of the justice judgment model over the group-value model as a means of explaining the gender differences. Implications for management include the importance of informational justice both generally and within the performance appraisal process.

Exploration of depressive realism in depression, depression in remission, and dysphoria

This study compared how people with different levels of depression judged their control over a task. People with more severe depression were more accurate in judging their control than were people with less severe depression whilst nondepressed individuals overestimated their control over the task.