The complexity of social practice : understanding inertia and change in maternity care organizations

Beyond the limited efficiency and economy goals of neoliberal health policy lies the promise of genuine health services reform. In maternity care in particular, recent policy developments have sought to make the management of birth more ‘women-centred and family-friendly’. Interprofessional collaboration and greater consumer participation in policy and decision-making are key means to achieve this goal, but changing the entrenched system of medicalised birth remains difficult. Recent social contestation of maternity care has destabilised but not eradicated pervasive medical hegemony. Further reform requires analysis both of institutionalised patterns of power, and attention to the fluidity and situated knowledge shaping organisational and professional practices. Accordingly, this paper outlines a framework with which to explore the multi-layered social processes involved in implementing organisational and cultural change in maternity care. Analysis of social interventions in health systems, we suggest, can be advanced by drawing on strands from critical organization studies, complexity and critical discourse theories and social practice approaches.

The role of perspective taking in anger arousal

Although there are strong grounds to expect that perspective taking deficits are associated with anger arousal following an interpersonal provocation, there has been little research directly testing this hypothesis. In this study, 636 volunteers were asked to rate their likely reactions to two brief video representations of potentially anger arousing social transgressions. Results confirm the relationship between dispositional perspective taking and the likelihood of anger arousal following an interpersonal provocation. Perspective taking was also predictive of trait anger (negatively) and of the means of control and expression of anger. Associations between personal distress and anger measures indicate the possible influence of the intensity, regulation, and direction of emotion on anger.

The roles of social bonds in the Australian tourism network

There is limited published research on the social bonds between employees in two organizations. This paper aims to examine 1) relationships in the Australian tourism industry, 2) the nature and role of social bonds and commercial friendships, 3) the nature and roles of the investments in economic and social resources, and 4) the nature of personal relationships in the tourism network. The perspective and attitudes of the tourism network participants become clear and their vested interests are highlighted. Network pictures are developed for the 5 key sectors of this industry. The adaptations of these sectors are also discussed. The nature and role of social bonds and commercial friendships is examined. The Leximancer program is used to qualitatively analyze interview transcripts. Findings show the centrality of relationships in this industry and the importance of social bonds to the travel agency sector. This study provides additional insight into the nature of social bonds in the development of successful business to business relationships. A discussion of antecedents and outcomes of social bonds will be further developed.

The role of leadership theory in raising the profile of women in management

Purpose: To consider how leadership theories have helped or hindered raising the profile of women in management and leadership roles.

Design/methodology/approach: This paper traces the earlier leadership theories through to the contemporary research on transactional and transformational leadership styles and offers a viewpoint on how each theory has contributed, or otherwise, to an awareness and acceptance of women in management and leadership roles.

Findings:  In 1990, research began to report gender differences in leadership styles with female managers being seen in positive terms as participative, democratic leaders. More recent work reports that women are believed to exhibit more transformational leadership style than their male colleagues, and this is equated with effective leadership.

Research limitations/implications:  All of the earlier theories on leadership excluded women and this exacerbated the problem of women not being seen as an appropriate fit in a management or leadership role. Recent findings clearly describe that the transformational qualities of leadership that women exhibit are required by the flatter organisational structures of today. Therefore, a more positive outcome for women advancing to senior roles of management or leadership may be observed in the future.

Originality/value:  The paper reviews the major leadership theories, and links these to a timeframe to illustrate how women were not visible in a management context until relatively recently. Such an omission may have contributed to the continuing low numbers of women who advance to senior management and leadership roles.

The role of social networks at different stages of business formation

This study empirically tests the fundamental assumption that social networks are important to entrepreneurs. This assumption underpins most social network research conducted in the field of entrepreneurship and is seldom questioned. Empirical data were drawn from Australia’s participation in the Global Entrepreneurship Monitor project (GEM) from 2000- 2005 – an aggregate sample of 14,205 randomly selected Australians. The study demonstrated: (1) statistically significant differences in social networks when entrepreneurs and non-entrepreneurs are compared and (2) that the structural diversity of social networks changes during the entrepreneurial process. It was found that structural diversity was most important to entrepreneurs in the discovery stage, least important to entrepreneurs in the start-up stage and of medium importance to entrepreneurs in the young business stage.

The role of wild birds in the transmission of avian influenza for Australia : an ecological perspective

Waterbirds, particularly Anatidae, are natural reservoirs for low-pathogenic avian influenza and have been implicated as the primary source of infection in outbreaks of highly pathogenic avian influenza. An understanding of the movements of birds and the ecology of avian influenza viruses within the wild bird population is essential in assessing the risks to human health and production industries. Marked differences in the movements of Australian birds from those of the Northern Hemisphere emphasises the danger of generalising trends of disease prevalence to Australian conditions. Populations of Anatidae in Australia are not migratory, as they are in the Northern Hemisphere, but rather display typical nomadic traits, sometimes moving large distances across continental Australia in response to flooding or drought. There is little known regular interchange of anatids between Australia and Asia. In contrast, species such as shorebirds and some seabirds are annual migrants to Australia along recognised flyways from breeding grounds in the Northern Hemisphere. Movement into Australia by these species mainly occurs into the north-west and along the east coast over the Pacific Ocean. These species primarily arrive during the Australian spring and form large aggregations along the coastline and on inland wetlands. Other Australian migratory species (passerines, bee-eaters, dollar-birds, cuckoos, doves) regularly move to and from Asia through the Torres Strait Islands. The disease status of these birds is unknown. The movements of some species, particularly anatids and ardeids, which have ranges including Australia and regions where the virus is known to occur, have been poorly studied and there is potential for introduction of avian influenza subtypes via this route. Avian influenza viruses are highly unpredictable and can undergo reassortment to more pathogenic forms. There is insufficient knowledge of the epidemiology and transmission of these viruses in Australia and broad-scale surveillance of wild birds is logistically difficult. Long-term studies of anatids that co-habit with Charadriiformes are recommended. This would provide an indication of the spatial and temporal patterns of subtypes entering Australia and improve our understanding of the ecology of endemic viruses. Until such time as these data become available, Australia's preparedness for avian influenza must focus on biosecurity at the wild bird–poultry interface.

The role of focus groups in a randomised controlled trial : the ADEPT study

In a recent study we developed a decision aid for prenatal testing of fetal abnormalities. The effectiveness of the decision aid compared with a pamphlet in increasing women's informed choice and decreasing conflict was evaluated using a cluster randomised controlled trial, A DEcision aid for Prenatal Testing for fetal abnormalities (ADEPT) [ISRCTN22532458]. Challenged with the need to ensure that the decision aid best suited the needs of women and health professionals involved General Practitioners (GPs), we explored the potential of both quantitative and qualitative methodologies to inform the development phase. In this article we discuss our rationale for, and provide some insights regarding our experience of, using qualitative methods during the development phase of the decision aid.

South Africa's transtion from apartheid : the role of professional closure in the experiences of black chartered accountants

As apartheid gave way to political freedom in South Africa in the last quarter of the 20th century, chartered accounting firms began to hire black South African trainees for the first time. The study examines the oral histories of black chartered accountants within the context of social closure theory and South Africa’s changing political and ideological landscape. The evidence indicates that processes of professional closure and credentialing excluded the majority population from the ranks of the profession on basis of race and class throughout the period 1976–2000.

Role of leptin receptors in the development of obesity

The focus of this dissertation was leptin and the leptin receptor, and the role of these genes (OB and OB-R) in the development of obesity and type 2 diabetes in humans and Psammomys obesus, a polygenic rodent model of obesity and type 2 diabetes. Studies in humans showed that circulating leptin concentrations were positively associated with adiposity, and independently associated with circulating insulin and triglyceride concentrations. Analysis of two leptin receptor sequence polymorphisms in a Caucasian Australian population and a population of Nauruan males, with very high prevalence rates of obesity, showed no associations between sequence variation within the OB-R gene and obesity- or diabetes-related phenotypic measures. In addition, these two OB-R polymorphisms were not associated with longitudinal changes in body mass or composition in either of the populations examined. A unique analysis of the effects of multiple gene defects in the Nauruan population, demonstrated that the presence of sequence alterations in both the OB and OB-R genes were associated with insulin resistance. Psammomys obesus is regarded as an excellent rodent model in which to study the development of obesity and type 2 diabetes in humans. Examination of circulating leptin concentrations in Psammomys revealed that, as in humans, leptin concentrations were associated with adiposity, and independently associated with circulating insulin concentrations. This animal model was utilised to examine expression of OB-R, and the regulation of expression of this gene after dietary manipulation. OB-R is known to have several isoforms, and in particular, OB-RA and OB-RB gene expression were examined. OB-RB is the main signalling isoform of the leptin receptors. It has a long intracellular domain and has previously been shown to play an important role in energy balance and body weight regulation in rodents and humans. OB-RA is a much shorter isoform of OB-R, and although it lacks the long intracellular domain necessary to activate the JAK/STAT pathway, OB-RA is also capable of signalling, although to a lesser degree than OB-RB. OB-RA is found to be expressed almost ubiquitously throughout the body, and this isoform may be involved in transport of leptin into the cell, although its role remains unclear. OB-RA and OB-RB were both found to be expressed in a large number of tissues in Psammomys obesus. Interestingly, obese Psammomys were found to have lower levels of expression of OB-RA and OB-RB in the hypothalamus, compared to lean animals. This finding raises the possibility that decreased leptin signalling in the brain of obese, hyperleptinemic Psammomys obesus may contribute to the leptin resistance previously described in this animal model. However, the primary defect is unclear, as alternatively, increased circulating leptin concentrations may lead to down-regulation of leptin receptors. The effect of fasting on leptin concentrations and gene expression of OB-RA and OB-RB was also examined. A 24-hour fast resulted in no change in body weight, but a reduction in circulating leptin concentrations, and an increase in hypothalamic OB-RB gene expression in lean Psammomys. In obese animals, fasting again did not alter body weight, but resulted in an increase in both circulating leptin concentrations and hypothalamic OB-RB gene expression. In the liver, fasting resulted in a large increase in OB-RA gene expression in both lean and obese animals. These results highlighted the fact that regulation of leptin receptor gene expression in polygenic models of obesity and type 2 diabetes is complex, and not solely under the control of circulating leptin concentrations. Sucrose-feeding is an established method of inducing obesity and type 2 diabetes in rodents, and this experimental paradigm was utilised to examine the effects of longer term perturbations of energy balance on the leptin signalling pathway in Psammomys obesus. Addition of a 5% sucrose solution to the diet of lean and obese Psammomys resulted in increased body weight in both groups of animals, however only obese Psammomys showed increased fat mass and the development of type 2 diabetes. The changes in body mass and composition with sucrose-feeding were accompanied by decreased circulating leptin concentrations in both groups of animals, as well as a range of changes in leptin receptor gene expression. Sucrose-feeding increased hypothalamic OB-RB gene expression in obese Psammomys only, while in the liver there was evidence of a reduction in OB-RA and OB-RB gene expression in both lean and obese animals. The direct effects of sucrose on the leptin signalling pathway are unclear, however it is possible to speculate that the effect of sucrose to decrease leptin concentrations may have been involved in the exacerbation of obesity and the development of type 2 diabetes in obese Psammomys, From these studies, it appears that sequence variation in the OB and OB-R genes is unlikely to be a major factor in the etiology of obesity in human populations. The ability to examine regulation of expression of these genes in Psammomys obesus, however, has demonstrated that the effects of nutritional modifications on leptin receptor gene expression need closer attention. The role of the OB and OB-R genes in metabolism and the development of type 2 diabetes also warrants further examination, with particular attention on the differential effects of dietary modifications on leptin receptor gene expression across a range of tissues.

The role of alcohol consumption in recovering drug users

This thesis found that alcohol consumption by illicit drig users has not been well researched. A qualitative study found alcohol was used as a substitute and believed to be related to illicit substance use. While the quantitative study generated no overall consensus, the research highlighted the need to conduct additional studies into substance abuse. The portfolio explored the relationship between maltreatment and the development of Reactive Attachment Disorder through four case studies of child clients.

Role of new media in Indigenous cultural micro-enterprises

This study examines the use of new media by organisations which represent the oldest culltures on earth, finding that new media have transformed the practices of Indigenous cultural micro-enterprises, by providing an inexpensive channel for global cultural profile, increasing efficiency and viability, and reducing social and geographic discrimination.

Teacher narratives and curricular justice : a study of teachers' work in the disadvantaged schools' program in Victorian education

Investigates teacher contributions to conversations about theory, policy and practice concerning poverty and education. The research examines patterns in teacher interpretive categories drawn from action research texts and associated documentation in the Disadvantaged School Program in Victoria over a twenty year period. Deals theoretically with the sociology of curricular theory, history and practice through the utilisation of feminist, postcolonial and poststructural approaches to society and culture.

Role of emergency departments in screening for obese and overweight children

Introduction
Childhood obesity is a major and increasing public health issue. The role of Emergency Departments (EDs) in screening for overweight and obese children has not been studied extensively. The main aim of this study was to estimate the prevalence of overweight children in Emergency Department (ED) populations. A secondary objective was to compare the characteristics of overweight and obese children with healthy weight children.

Methods
This prospective exploratory study was conducted in the two district urban EDs in Melbourne, Australia. A total of 87 ED patients aged 2 to 15 years were included in the study. The main outcome measures were body mass index, weight and height percentiles.

Results
The median absolute BMI was 16.8 (IQR = 15.4 to 18.8). The total number of children found to be overweight (BMI > 85th percentile) or obese (BMI > 95th percentile) was 21.8% (n = 19). Of these, 5.7% (n = 5) of children in this study were classified as obese. Comparison of overweight/obese children and healthy weight children showed no differences in triage but a higher incidence of respiratory illness (15.8% compared to 2.9%).

Conclusions
This pilot study showed that 1 in 5 children who presented to EDs were either overweight or obese suggesting a possible role for EDs in the detection and referral of overweight and obese children to intervention programs. Our findings suggest that a sufficiently powered randomised controlled trial is warranted to examine the effectiveness and efficacy of EDs screening for obese and overweight children.

The role of reflexive capability in relation to intellectual capital on multi international partnerships

This paper reports the results of an analysis of five Malaysian firms who have worked successfully on multi international partnerships and/or megaprojects. A case study methodology was employed to examine the barriers and successful strategies the firms used in decision making in various international markets. A common characteristic across the firms was the ability to self reflect and adapt their practices to different international conditions despite numerous differences between countries including cultural, social, project governance structures, regulatory, terminology and codes. A reflexive capability model developed from the social sciences theory of individual agent reflexivity was developed to explain the way in which firms as an entity can develop awareness, responsiveness and adaptability for long term success in diverse international markets. This paper builds upon an initial Australian study which developed the model grounded in empirical observations of internationalising design construction firms by presenting the results of a second study of Malaysian firms. Results indicate that the model of reflexivity capability is a useful way to interpret practices that are undertaken in multi partner relationships on larger more complex projects. Successful Malaysian firms within joint venture relationships display an ability to self reflect and adapt. This transformation process is critiqued in relation to the relationships between social, cultural and intellectual capital. Reflexive capability is a characteristic of the successful case study firms working within global models of practice. The reflexive capability model is explained in relation to common themes identified in relation to the management of intellectual capital in successful multi international partnerships and megaprojects.