Contextualizing risk in the assessment of intellectually disabled individuals

In this article we examine the idea of expanding structured clinical judgement from primarily offender variables to a broader framework in which environmental (including staff) variables are given equal consideration in a comprehensive risk appraisal conducted for risk management purposes of intellectually disabled individuals. It is posited that only by contextualizing the individual's risk within environmental variables can an accurate portrayal of current dynamic risk (and hence the management of that risk) be construed.

Risk assessment of child-victim sex offenders for extended supervision in New Zealand

Recently enacted legislation in New Zealand, the Parole (Extended Supervision) Amendment Act 2004, allows for the imposition of up to 10 years of supervision in the community for child-victim sex offenders following their release from prison. The Act requires reports to be written specifically assessing the risk of sexual re-offending against children. This study examined the application of actuarial measures used by the New Zealand Department of Corrections in these assessments, including a computer-scored instrument based on static factors (the Automated Sexual Recidivism Scale; ASRS) and a clinically-based judgement of dynamic risk factors (the SONAR). It was expected that a conservative approach would be taken in making recommendations for or against extended periods of supervision, such that a high score on either measure would predict a recommendation for extended supervision. It was found, however, that a more individualized approach was often taken, whereby a baseline assessment of risk as predicted by the ASRS was adjusted by clinicians based on SONAR ratings. Implications for the practice of risk assessment in sexual re-offending are discussed.

Academic pedagogies, quality logics and performative universities : evaluating teaching and what students want

Universities have focused on teaching and learning at a time when quality has become the marker of distinction in international higher education markets. Education markets have meant pedagogical relations have become contractualised with a focus on student satisfaction, exemplified in consumer-oriented generic evaluations of teaching. This article argues, by analysing one example, that generic evaluations are more about accountability and marketing than about improvement of teaching and learning. Furthermore, what students want is not the only criterion for judging teaching. Rather, professionals require, as do academics, a capacity for critical judgement about what constitutes valued knowledge in the pedagogical relationship between teacher and student.

Tracheostomy decannulation failure rate following critical illness : a prospective descriptive study

Background : Tracheostomy is a well established and practical approach to airway management for patients requiring extended periods of mechanical ventilation or airway protection. Little evidence is available to guide the process of weaning and optimal timing of tracheostomy tube removal. Thus, decannulation decisions are based on clinical judgement. The aim of this study was to describe decannulation practice and failure rates in patients with tracheostomy following critical illness.

Methods : A prospective descriptive study was conducted of consecutive patients who received a tracheostomy at a tertiary metropolitan public hospital intensive care unit (ICU) between March 2002 and December 2006. Data were analysed using descriptive and inferential tests.

Results : Of the 823 decannulation decisions, there were 40 episodes of failed decannulation, a failure rate of 4.8%. These 40 episodes occurred in 35 patients: 31 patients failed once, 3 patients failed twice and 1 patient failed three times. There was no associated mortality. Simple stoma recannulation was required in 25 episodes, with none of these patients readmitted to ICU. Translaryngeal intubation and readmission to ICU took place for the remaining 15 episodes. The primary reason for decannulation failure was sputum retention. Twenty-four patients (60%) failed decannulation within 24 h, with 14 of these occurring within 4 h.

Conclusions : Clinical assessments coupled with professional judgement to decide the optimal time to remove tracheostomy tubes in patients following critical illness resulted in a failure rate comparable with published data. Although reintubation and readmission to ICU was required in just over one third of failed decannulation episodes, there was no associated mortality or other significant adverse events. Our data suggest nurses need to exercise high levels of clinical vigilance during the first 24 h following decannulation, particularly the first 4 h to detect early signs of respiratory compromise to avoid adverse outcomes.

Clinical judgements : research and practice

This paper explores issues that are relevant to the judgements routinely made by clinical psychologists. It first considers the relative merits of clinical and statistical approaches to decision making and notes that although much of the empirical evidence demonstrates the greater accuracy of statistical approaches to making judgements (where appropriate methods exist), they are rarely routinely used. Instead, clinical approaches to making judgements continue to dominate in the majority of clinical settings. Second, common sources of errors in clinical judgement are reviewed, including the misuse of heuristics, clinician biases, the limitations of human information-processing capacities, and the overreliance on clinical interviews. Finally, some of the basic strategies that can be useful to clinicians in improving the accuracy of clinical judgement are described. These include advanced level training programs, using quality instruments and procedures, being wary of overreliance on theories, adhering to the scientist-practitioner approach, and being selective in the distribution of professional efforts and time.

Kristevan aesthetics, performativity and the production of situated knowledge

In this paper, I will draw on the work of Julia Kristeva to argue that performativity can be understood in terms of a materialist ontology that underpins creative production and the knowing subject. To understand this, we need to examine the relationship between individual history, biology and culture and processes through which creative practice attributes value by translating psychic representations of affect and drive into verbal and visual signs. Kristeva's aesthetics does not plunge us into an obscure metaphysics, but provides a model for articulating material-discursive practices that emerge from corporeal responses. Enactments, predicated by desire give rise to agency and judgement allowing practice to test theory through the production of situated knowledge.

Kristeva's psychoanalytical position reveals the necessity of linking material and individual practices of art with the social through language and interpretation. Material-discursive practices can only acquire meaning through their relationship between the speaking subject and addressees. Art itself provides us with the means for discovering the knowledge it produces. In and through material practice, the work of art is capable of transferring back to the artist as viewer, structures of meaning that have hitherto been hidden. In practice, this involves a constant movement between the biological self (the self as 'other') and the social self, the ego. In artistic research, it can be said that the first addressee is the artist her/himself, as social other. Constant movement between the two in creative practice can thus be understood as a performative production of knowledge.

Evaluating New Zealand sports stars as celebrity endorsers : intriguing results

Celebrity athlete endorsement of products and services has become prominent in the promotional mixes of New Zealand companies and organisations. For years advertisers and researchers have pondered how successful celebrity athlete endorsement really works. Most suggest some form of transfer of positive images takes place between celebrity and the product or service they are endorsing and source-credibility models have become the preferred research design. The overall objective of this research was to assist sport marketing managers and their advertising agencies in matching celebrities with products and services. An ancillary objective was to compare results obtained from multiple-item and single-item scales. An exploratory study with tertiary students was conducted, using both Ohanian’s (1990) 15 item source-credibility scale and two single-item measures to examine potential “endorsement fit” for four New Zealand sporting heroes. They were Bernice Mene (recently retired national netball team captain), Dean Barker (America’s Cup yachting defender’s helmsman), Mandy Smith (recently retired national women’s hockey team star) and Justin Marshall (All Black rugby’s most capped halfback), all of whom were adjudged by students as physically attractive sports stars. The product reported here against which these athletes were scored was an isotonic sports drink. Results were mixed; the Ohanian source-credibility scale yielded selection of different celebrity athletes to the single-item measures. The research results show that matching celebrities to products for potential endorsement opportunities is a complex issue, leaving scope for judgement and intuition alongside quantification. Still unresolved is the question of multiple-item measures versus single-item measures in advertising and service research.

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.

Metamemory training for memory disorders in adults with a closed head injury

The purpose of the present study was to investigate the efficacy of a memory and metamemory training program on memory performance and metamemory judgement accuracy in adults with a closed head injury. A multiple baseline across subjects design was used with six subjects. All subjects were seen at least two years post-injury. Training included general metamemory information about the nature of memory, use of a specific memory strategy to assist verbal recall (to Preview, Question, Read, State and Test- PQRST), specific metamemory information about the strategy, and a self instruction procedure (WTSC- What is the task, Select a strategy to use, Try out strategy, Check to evaluate strategy effectiveness). During the training period all subjects recalled greater than fifty percent of paragraph ideas while using PQRST. Follow-up tests showed that five of the six subjects maintained recall levels but a gradual decrease in slope was observed over eight weeks post-training. Tests of recall, recognition and metamemory judgements on Sentence and Action Tasks were used to evaluate generalisation of training. Two subjects showed improved recall and two subjects showed improved recognition performance. In addition, four subjects demonstrated greater metamemory judgement accuracy about recognition performance following training. Improved performance post-training was also observed for three subjects on the Rivermead Behavioral Memory Test and the Logical Memory subtest of the Wechsler Memory Scale-Revised, greater than that expected for repeated testing. Several factors were identified as having a role in subjects’ ability to benefit from training.

Making a difference with a discrete course on accounting ethics

Calls for the expansion of ethics education in the business and accounting curricula have resulted in a variety of interventions including additional material on ethical cases, the code of conduct, and the development of new courses devoted to ethical development [Lampe, J.: 1996]. The issue of whether ethics should be taught has been addressed by many authors [see for example: Hanson, K. O.: 1987; Huss, H. F. and D. M. Patterson: 1993; Jones, T. M.: 1988–1989; Kerr, D. S. and L. M. Smith: 1995; Loeb, S. E.: 1988; McDonald, G. M. and G. D. Donleavy: 1995]. The question addressed in this paper is not whether ethics should be taught but whether accounting students can reason more ethically after an intervention based on a discrete and dedicated course on accounting ethics. The findings in this paper indicate that a discrete intervention emphasising dilemma discussion has a positive and significant effect on students’ moral reasoning and development. The data collected from interviews suggest that the salient influences on moral judgement development include: learning theories of ethics particularly Kohlberg’s theory of cognitive moral reasoning and development; peer learning; and moral discourse. The implications from the findings in this study suggest that moral reasoning is responsive to particular types of ethics intervention and educators should carefully plan their attempts to foster moral judgement development.

Height and cost of buildings in Shanghai and Hong Kong

Initial findings indicated that the curved relationships of height-cost of residential buildings in Shanghai and Hong Kong exhibit different profiles. The differences suggest that, Hong Kong contractors have more expertise in multi-story and high-rise construction than contractors in Shanghai. The dissimilarities also imply that different sets of criteria should be applied in the judgement of height affects on cost in different locations.

Pain relief for the removal of femoral sheath in interventional cardiology adult patients (Review)

Pain relief for removal of femoral sheath after cardiac procedures
Procedures for the non-surgical management of coronary heart disease include balloon angioplasty and intracoronary stenting. At the start of each procedure an introducer sheath is inserted through the skin (percutaneously) into an artery, frequently a femoral artery in the groin. This allows the different catheters used for the procedure to be exchanged easily without causing trauma to the skin. At the end of the procedure the sheath is removed and, if the puncture site isn't "sealed" using a device closure, firm pressure is required over the site for 30 minutes or more to control any bleeding and reduce vascular complications. Removing the sheath and the firm pressure required to control bleeding can cause pain, although this is generally mild. Some centres routinely give pain relief before removal such as intravenous morphine, or an injection of a local anaesthetic in the soft tissue around the sheath (called a subcutaneous injection). Adequate pain control during sheath removal is also associated with a reduced incidence of a vasovagal reaction, a potentially serious complication involving a sudden drop of blood pressure and a slowed heart rate. Four studies were reviewed in total. Three trials involving 498 participants compared subcutaneous lignocaine, a short acting local anaesthetic, with a control group (participants received either no pain relief or an inactive substance known as a placebo). Two trials involving 399 people compared intravenous opioids (fentanyl or morphine) and an anxiolytic (midazolam) with a control group. One trial involving 60 people compared subcutaneous levobupivacaine, a long acting local anaesthetic, with a control group. Intravenous pain regimens and subcutaneous levobupivacaine appear to reduce the pain experienced during femoral sheath removal. However, the size of the reduction was small. A significant reduction in pain was not experienced by participants who received subcutaneous lignocaine or who were in the control group. There was insufficient data to determine a correlation between pain relief administration and either adverse events or complications. Some patients may benefit from routine pain relief using levobupivacaine or intravenous pain regimens. Identifying who may potentially benefit from pain relief requires clinical judgement and consideration of patient preference. The mild level of pain generally experienced during this procedure should not influence the decision as some people can experience moderate levels of pain.

Beyond ‘good’ and ‘evil’: breaking down binary oppositions in holocaust representations of ‘privileged’ Jews

In 1986, Auschwitz survivor Primo Levi’s paradigmatic essay entitled ‘The Grey Zone’ highlighted the complex and sensitive issue of so-called ‘privileged’ Jews, an issue that remains at the margins of popular and academic discourse on the Holocaust. ‘Privileged’ Jews include those prisoners in the Nazi concentration camps and ghettos who held positions that gave them access to material and other benefits whilst compelling them to act in ways that have been judged both self-serving and harmful to fellow inmates. The unprecedented ethical dilemmas that confronted ‘privileged’ Jews may be viewed as exemplifying the ‘limit’ events or experiences that were characteristic of the Holocaust, situating them at the threshold of representation, understanding and judgement. Levi’s essay singles out history and film as particularly predisposed to a simplifying trend he identifies – the ‘Manichean tendency which shuns half-tints and complexities,’ and resorts to the black-and-white binary opposition(s) of ‘friend’ and ‘enemy,’‘good’ and ‘evil.’ In the case of ‘privileged’ Jews in particular, such binary oppositions would appear to be inadequate. Adopting an interdisciplinary approach that incorporates the fields of history, philosophy and literature, this paper analyses representations of ‘privileged’ Jews, particularly those prisoners of the Sonderkommandos who were forced to work in the crematoria. The paper demonstrates how easily the boundary Levi maps out for moral judgement can be crossed. It is shown that while Levi suggests judgement should be suspended when confronted with the experiences of victims in extremis, moral evaluations of ‘privileged’ Jews permeate discussions and representations of the Holocaust. When confronted with such emotionally and morally freighted issues, judgement may itself be seen as a ‘limit of representation.’

Attitudes towards the accounting profession : an Australian perspective

Purpose – This paper aims to examine undergraduate students’ attitudes towards the accounting profession, including accounting as a career, as a discipline, as a profession and perceptions of the work activities of accountants.

Design/methodology/approach – The data set used in this paper was collected via questionnaires. The present study compares several aspects of a prior study of Marriott and Marriott using the Accounting Attitude Scale developed by Nelson.

Findings – Overall, the paper supports the view that exposure to accounting at university does not enhance positive attitudes about accounting as a discipline, but reinforces rule-memorisation, and lack of involvement with conceptual skills or judgement.

Research limitations/implications – The paper only examines students’ attitudes at one point in time and does not attempt to identify whether students’ attitudes change over the period of their study. The paper can only speculate as to why there is a difference between local and international students’ attitude towards the accounting profession. Third, the questionnaire is only administered at one institution. There is a scope to extend this study across institutions as well as conduct a longitudinal study. In order to validate the findings, further research via in-depth interviews with students may help determine the factors that influence students’ attitudes.

Originality/value – The results from this paper are expected to contribute to the body of research by providing accounting educators with insights into how the curriculum may influence students’ attitudes towards the profession, together with implications as to how the profession should be promoted to undergraduate students.

The use of heuristics in valuation practice : implications in a changing market

Despite the existence of prescribed frameworks, valuation remains a cause of much controversy and variety of opinion. It does not matter whether procedures are undertaken in exactly the same way, the conclusion of ‘value’ will vary from valuer to valuer – sometimes considerably. This uncertainty within valuation is founded on property’s heterogeneous nature and the imperfect market that is the property market; in addition to the unpredictability of human behaviour in making judgements (French and Gabrielli 2004). Uncertainty, in valuation is found in the amalgam of locational, physical and legal characteristics and innumerable other forces which control and energise the property market (Whipple 1995). Particular irregular occurrences, or drastic changes in property markets, from either within market evolution or external forces, for example the creation of global financial markets, cause further uncertainty for valuers and provides challenges in identifying ‘market value’ in valuation practice. The praxis of valuation in a commercial sense navigates this complexity using a combination of algorithms and heuristics to identify the value of a property. The application of theoretical mathematical algorithms based on economic theory (Brown 1995), is augmented by valuers’ ability to apply appropriate adjustment based on their knowledge of the market, their ability to analyse, assess and compare the attributes of a property in comparison to its market, and their practical experience (Sliogeriene 2008). Despite the necessity of algorithms, the application of appropriate adjustments and assumptions are important in arriving at a value. This paper is a critical reflection on the basis of valuation practice as guided by standards, methods, and ethics (algorithms), and the use of heuristics in practice. This is important because changes within property markets challenge the inter-relationship between these two aspects of valuation practice. Through the authors’ industry experience and a review of previous research and statements of practice norms this paper provides an analysis of the ability of valuers to address market change in their valuation practices.