Friedrich Hayek and Michael Polanyi in correspondence

Friedrich Hayek and Michael Polanyi corresponded with each other for the best part ofthirty years. They had shared interests that included science, social science, economics,epistemology, history of ideas and political philosophy. Studying their  correspondenceand related writings, this article shows that Hayek and Polanyi were committedLiberals but with different understandings of liberty, the forces that endanger liberty,and the policies required to rescue it.

Does calibration reduce variability in the assessment of accounting learning outcomes?

Reliable, consistent assessment process that produces comparable assessment grades between assessors and institutions is a core activity and an ongoing challenge with which universities have failed to come to terms. In this paper, we report results from an experiment that tests the impact of an intervention designed to reduce grader variability and develop a shared understanding of national threshold learning standards by a cohort of reviewers. The intervention involved consensus moderation of samples of accounting students’ work, with a focus on three research questions. First, what is the quantifiable difference in grader variability on the assessment of learning outcomes in ‘application skills’ and ‘judgement’? Second, does participation in the workshops lead to reduced disparity in the assessment of the students’ learning outcomes in ‘application skills’ and ‘judgement’? Third, does participation in the workshops lead to greater confidence by reviewers in their ability to assess students’ skills in application skills and judgement? Our findings suggest consensus moderation does reduce variability across graders and also builds grader confidence.

Using technology to improve peer review and collaborative conversations to benchmark academic standards

In 2010 the Australian government commissioned the Australian Learning and Teaching Council (ALTC) to undertake a national project to facilitate disciplinary development of threshold learning standards. The aim was to lay the foundation for all higher education providers to demonstrate to the new national higher education regulator, the Tertiary Education Quality and Standards Agency (TEQSA), that graduates achieved or exceeded minimum academic standards. Through a yearlong consultative process, representatives of employers, professional bodies, academics and students, developed learning standards applying to any Australian higher education provider. Willey and Gardner reported using a software tool, SPARKPLUS, in calibrating academic standards amongst teaching staff in large classes. In this paper, we investigate the effectiveness of this technology to promote calibrated understandings with the national accounting learning standards. We found that integrating the software with a purposely designed activity provided significant efficiencies in calibrating understandings about learning standards, developed expertise and a better understanding of what is required to meet these standards and how best to demonstrate them. The software and supporting calibration and assessment process can be adopted by other disciplines, including engineering, seeking to provide direct evidence about performance against learning standards. © 2012 IEEE.

Trace [book of poetry]

This collection of prose poetry creates a naturally intimate world while, at the same time, fluidly examining complex connections between popular and high culture.

Toward a standard approach to measurement and reporting of perioperative mortality rate as a global indicator for surgery

INTRODUCTION: The proportion of patients who die during or after surgery, otherwise known as the perioperative mortality rate (POMR), is a credible indicator of the safety and quality of operative care. Its accuracy and usefulness as a metric, however, particularly one that enables valid comparisons over time or between jurisdictions, has been limited by lack of a standardized approach to measurement and calculation, poor understanding of when in relation to surgery it is best measured, and whether risk-adjustment is needed. Our aim was to evaluate the value of POMR as a global surgery metric by addressing these issues using 4, large, mixed, surgical datasets that represent high-, middle-, and low-income countries. METHODS: We obtained data from the New Zealand National Minimum Dataset, the Geelong Hospital patient management system in Australia, and purpose-built surgical databases in Pietermaritzburg, South Africa, and Port Moresby, Papua New Guinea. For each site, we calculated the POMR overall as well as for nonemergency and emergency admissions. We assessed the effect of admission episodes and procedures as the denominator and the difference between in-hospital POMR and POMR, including postdischarge deaths up to 30 days. To determine the need for risk-adjustment for age and admission urgency, we used univariate and multivariate logistic regression to assess the effect on relative POMR for each site. RESULTS: A total of 1,362,635 patient admissions involving 1,514,242 procedures were included. More than 60% of admissions in Pietermaritzburg and Port Moresby were emergencies, compared with less than 30% in New Zealand and Geelong. Also, Pietermaritzburg and Port Moresby had much younger patient populations (P < .001). A total of 8,655 deaths were recorded within 30 days, and 8-20% of in-hospital deaths occurred on the same day as the first operation. In-hospital POMR ranged approximately 9-fold, from 0.38 per 100 admissions in New Zealand to 3.44 per 100 admissions in Pietermaritzburg. In New Zealand, in-hospital 30-day POMR underestimated total 30-day POMR by approximately one third. The difference in POMR if procedures were used instead of admission episodes ranged from 7 to 70%, although this difference was less when central line and pacemaker insertions were excluded. Age older than 65 years and emergency admission had large, independent effects on POMR but relatively little effect in multivariate analysis on the relative odds of in-hospital death at each site. CONCLUSION: It is possible to collect POMR in countries at all level of development. Although age and admission urgency are strong, independent associations with POMR, a substantial amount of its variance is site-specific and may reflect the safety of operative and anesthetic facilities and processes. Risk-adjustment is desirable but not essential for monitoring system performance. POMR varies depending on the choice of denominator, and in-hospital deaths appear to underestimate 30-day mortality by up to one third. Standardized approaches to reporting and analysis will strengthen the validity of POMR as the principal indicator of the safety of surgery and anesthesia care.

Monitoring and evaluating surgical care: defining perioperative mortality rate and standardising data collection

BACKGROUND: Case volume per 100 000 population and perioperative mortality rate (POMR) are key indicators to monitor and strengthen surgical services. However, comparisons of POMR have been restricted by absence of standardised approaches to when it is measured, the ideal denominator, need for risk adjustment, and whether data are available. We aimed to address these issues and recommend a minimum dataset by analysing four large mixed surgical datasets, two from well-resourced settings with sophisticated electronic patient information systems and two from resource-limited settings where clinicians maintain locally developed databases. METHODS: We obtained data from the New Zealand (NZ) National Minimum Dataset, the Geelong Hospital patient management system in Australia, and purpose-built surgical databases in Pietermaritzburg, South Africa (PMZ) and Port Moresby, Papua New Guinea (PNG). Information was sought on inclusion and exclusion criteria, coding criteria, and completeness of patient identifiers, admission, procedure, discharge and death dates, operation details, urgency of admission, and American Society of Anesthesiologists (ASA) score. Date-related errors were defined as missing dates and impossible discrepancies. For every site, we then calculated the POMR, the effect of admission episodes or procedures as denominator, and the difference between in-hospital POMR and 30-day POMR. To determine the need for risk adjustment, we used univariate and multivariate logistic regression to assess the effect on relative POMR for each site of age, admission urgency, ASA score, and procedure type. FINDINGS: 1 365 773 patient admissions involving 1 514 242 procedures were included, among which 8655 deaths were recorded within 30 days. Database inclusion and exclusion criteria differed substantially. NZ and Geelong records had less than 0·1% date-related errors and greater than 99·9% completeness. PMZ databases had 99·9% or greater completeness of all data except date-related items (94·0%). PNG had 99·9% or greater completeness for date of birth or age and admission date and operative procedure, but 80-83% completeness of patient identifiers and date related items. Coding of procedures was not standardised, and only NZ recorded ASA status and complete post-discharge mortality. In-hospital POMR range was 0·38% in NZ to 3·44% in PMZ, and in NZ it underestimated 30-day POMR by roughly a third. The difference in POMR by procedures instead of admission episodes as denominator ranged from 10% to 70%. Age older than 65 years and emergency admission had large independent effects on POMR, but relatively little effect in multivariate analysis on the relative odds of in-hospital death at each site. INTERPRETATION: Hospitals can collect and provide data for case volume and POMR without sophisticated electronic information systems. POMR should initially be defined by in-hospital mortality because post-discharge deaths are not usually recorded, and with procedures as denominator because details allowing linkage of several operations within one patient's admission are not always present. Although age and admission urgency are independently associated with POMR, and ASA and case mix were not included, risk adjustment might not be essential because the relative odds between sites persisted. Standardisation of inclusion criteria and definitions is needed, as is attention to accuracy and completeness of dates of procedures, discharge and death. A one-page, paper-based form, or alternatively a simple electronic data collection form, containing a minimum dataset commenced in the operating theatre could facilitate this process. FUNDING: None.

Dirt Babylon

Construction of a school room installation and immersive performance as part of Dirt Babylon Glebe Park (commissioned by Robyn Archer for the Centenary of Canberra) in collaboration with Rebecca Rutter and ex- Splinters artists, November 2013

Continental-scale decreases in shorebird populations in Australia

Decreases in shorebird populations are increasingly evident worldwide, especially in the East Asian–Australasian Flyway (EAAF). To arrest these declines, it is important to understand the scale of both the problem and the solutions. We analysed an expansive Australian citizen-science dataset, spanning the period 1973 to 2014, to explore factors related to differences in trends among shorebird populations in wetlands throughout Australia. Of seven resident Australian shorebird species, the four inland species exhibited continental decreases, whereas the three coastal species did not. Decreases in inland resident shorebirds were related to changes in availability of water at non-tidal wetlands, suggesting that degradation of wetlands in Australia’s interior is playing a role in these declines. For migratory shorebirds, the analyses revealed continental decreases in abundance in 12 of 19 species, and decreases in 17 of 19 in the southern half of Australia over the past 15 years. Many trends were strongly associated with continental gradients in latitude or longitude, suggesting some large-scale patterns in the decreases, with steeper declines often evident in southern Australia. After accounting for this effect, local variables did not explain variation in migratory shorebird trends between sites. Our results are consistent with other studies indicating that decreases in migratory shorebird populations in the EAAF are most likely being driven primarily by factors outside Australia. This reinforces the need for urgent overseas conservation actions. However, substantially heterogeneous trends within Australia, combined with declines of inland resident shorebirds indicate effective management of Australian shorebird habitat remains important.