Young adults’ management of Type 1 diabetes during life transitions

Aim. To identify life transitions likely to impact diabetes self-care among young adults with Type 1 diabetes and their coping strategies during transition events.
Background. Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects individuals’ problem-solving, coping abilities and blood glucose levels.
Design. A qualitative interpretive inquiry.
Method. Semi-structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR NVIVO 7 software.
Results. Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes-related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes camps. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self-negotiation to minimise risks’; ‘managing diabetes using previous experiences’; ‘connecting with others with diabetes’; ‘actively seeing information to ‘patch’ knowledge gaps’; and ‘putting diabetes into perspective’.
Conclusions. Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions.
Relevance to clinical practice. It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, individualised and collaborative treatment.

Archipelago design : virtualopolis and the interactive virtual team scenario

Increasingly employers use virtual teams to leverage business knowledge that can solve day to day business problems and create new business opportunities. Consequently, according to Bridgstock, graduates increasingly require virtual teamwork skills such as communication, negotiation and collaboration. The project presented here has researched and trialled the role of a well-designed interactive scenario in developing graduate attributes related to working with others, using virtual business entities across four faculties. One innovative outcome from this has been the scoping and linking of cross-faculty virtual developments into an overarching structure which is easily navigable and engaging for the net generation learner, and capacity building for the university. For clarity, that scaffolding or framework ‘city’ has been called Virtualopolis. This has the potential to link pockets of innovation across the university in the area of experiential learning and virtual work-integrated learning (WIL), the term expolred by Walsh within the context of Briggs' constructive alignment. The prototype workteam scenario has multiple applications, with capacity to be a hurdle requirement, assessment item or training activity depending on the needs of the faculty’s WIL. By developing the online framework or model Virtualopolis, work-integrated teams assessment can be linked across different business entities, and used as skills preparation for experiential learning units such as internships, professional experience and workplace-based projects university-wide. This model has exciting possibilities of transferability across the higher education sector in the linkage of innovative virtual scenarios to reduce developmental costs, assessment tools/resources targeted specifically to graduate attributes, and virtual teamwork capacity building.

Everyday risks and professional dilemmas : fieldwork with alcohol-based (sporting) subcultures

This article discusses some of the everyday risks and professional dilemmas encountered when conducting participant-observation based research into the use and meaning of alcohol among fans of Australian Rules football. The key risks and dilemmas were those that emerged from female researchers entering into a predominantly male football subculture in which alcohol is routinely (and often excessively) consumed, the negotiation of key gatekeepers, the potential dangers of conducting research with participants who are inebriated and the duty of care to research participants. The article draws on an eighteen-month period of ethnographic fieldwork to highlight the risks and dilemmas negotiated and re-negotiated throughout the research process. The article argues that a failure to attend to these and other risks and dilemmas can threaten the viability of research among drinking-based communities and subcultures.

The delivery of a telephone coaching programme to people with type 2 diabetes by practice nurses in Victoria, Australia : a qualitative evaluation

Aim.  To evaluate telephone coaching undertaken by practice nurses in a randomised controlled trial of self-management support for people with type 2 diabetes.

Background.  Qualitative evaluation of the processes that take place in randomised controlled trials has the advantage of providing information on those variables that contribute to the success or failure of the randomised controlled trial. This additional information can be used to improve or modify chronic disease management programme designs.

Methods.  Grounded theory was used to analyse transcriptions of telephone coaching sessions between practice nurses and patient participants in the randomised controlled trial.

Findings.   Analysis of transcriptions found that patient participants had complex multiple medical conditions to manage, as well as maintaining their daily lives. Two approaches to working with this complexity by practice nurses emerged. We characterised one as ‘treat to target’ and the other as ‘personalised care’. While each approach shapes identities available to patients within the relationship with the practice nurse, the impact or effectiveness of these approaches on outcomes has yet to be reported.

Conclusions.  Telephone coaching takes place in complex social contexts as well as complex medical conditions. People with type 2 diabetes must manage their diabetes care and their care of other conditions within their social contexts. This means a constant negotiation of priorities.

Relevance to clinical practice.  Awareness of how health professional support for patients’ self-management becomes a relationship and element of the negotiated identity of patients is important in adapting clinical guideline-based protocols to achieving targets in the management of chronic illness.

Realising policy : the who and how of policy production

This paper identifies a number of strategies employed by policy actors in the production of Australian higher education entry policy during the period 1987 to 1996, with a particular focus on the production of Queensland higher education entry policy text in 1990 (Viviani, 1990, The Review of Tertiary Entrance in Queensland, 1990 , Department of Education, Queensland). The paper begins from the premise that while policy is often intended to be read as if spoken with a single voice, suggesting rational debate and (then) consensus among policy producers, it is more cogently understood as the product of struggle and conflict. Informed by 27 semi-structured interviews with politicians, political advisers, bureaucrats, academics, institutional administrators and independent authorities, the paper addresses the temporary settling of these actors' struggles and conflicts in contexts of policy making through strategies of negotiation. Rather than providing a sequential account of higher education policy that weaves its way through these negotiations, as grand narrative, the paper is more sporadic in its representations of strategies, identifying them in 'local' and specific knowledges and practices. Drawing on Foucault, what emerges is both an archaeology and genealogy of policy production (Gale, 2001, Journal of Education Policy , 16(5), pp. 379-393).

Changing teaching practice using a school improvement cycle

This paper discusses the actions, strategies and responses of teachers during their involvement with a short cycle school improvement model in four schools. The school improvement cycles are designed to build the leadership of principals to support teachers at an individual level through a web of decision making and practices. In these cycles, teachers are both more supported and more accountable for implementing changed classroom practices in order to bring about improved student outcomes. T he school improvement model follows a pattern of decision making and negotiation across and between layers of leadership within the network and the school, but for improvement to occur at the level of the student, the teacher’s pedagogical practices need to be r(e)negotiated to ensure that teaching practice meet the needs of the students.
However, evaluating teacher practice is risky business. Teachers can say, and believe, that their practices are providing the best for their students, but this is an area of uncertainty. Using a number of strategies including observation of teacher meetings, teacher interviews and video capture, the research will investigate the issue of how directives for change are translated into classroom practice. The observation of meetings of teachers will provide an indication of the type of change required and the proposed strategies. Video-capture, which is followed by teacher interviews, will provide further information about changing teaching practice.
With teacher permission, students in the research will also view the video snippets to indicate what particular pedagogy was instrumental in their learning, providing substantial feedback to the teacher on what works best for that cohort of students at that time. Teachers will be provided with the opportunity to reflect on and learn from their practice, using video-capture as a self-reflective tool. Teachers can employ video capture as a strategy to assess their management of students, their pedagogical approaches, teaching strategies and student responses and is an emerging area of research of interest to teachers and teacher educators (e.g. Seidel, Sturmer, Blomberg, Kobarg, Schwindt, 2011). The paper will provide examples of changed teacher practice through vignettes of a number of schools, teachers and classrooms and will explore the methodological reflexivity associated with this dual role of the research: to evaluate, and to support improvement.

Optimal communication amongst team members

We present a formal framework based on the theory of game with incomplete information [5] for modelling the coordination and communication problem among team of collaborative agents, and define what it means by optimal communication in this setting. Although computing an optimal communication strategy for the team is hard in general, we illustrate with an example of collaborative negotiation and meeting scheduling that computation can be substantially reduced when domain dependent assumptions are introduced.

The role of emotional intelligence on the resolution of disputes involving the electronic health record

Numerous authors have expressed concerns that the introduction of the Personally Controlled Electronic Health Record (PCEHR) will lead to an escalation of disputes. Some disputes will concern the accuracy of the record whereas others will arise simply due to greater access to health care records. Online dispute resolution (ODR) programs have been successfully applied to cost-effectively help disputants resolve commercial, insurance and other legal disputes, and can also facilitate the resolution of health care related disputes. However, we expect that health differs from other application domains in ODR because of the emotional engagement patients have with their health and those of loved ones. In this study we will be looking at whether the success of an online negotiation is related to how people recognise and manage emotions, and in particular, their Emotional intelligence score.

The role of representation in teaching and learning ideas about matter

The research described in this paper is designed around the notion that learning involves the recognition and development of students’ representational resources. This paper describes a classroom sequence in Ideas about Matter that focuses on representations and their negotiation, and reports on the effectiveness of this perspective in guiding teaching, and in providing further insight into student learning. Classroom sequences involving two experienced teachers (2008, Year 8 students) and an inexperienced teacher (2010, Year 7 students) were videotaped using a combined focus on the teacher and groups of students. Video analysis software was used to code the variety of representations used teachers and students, and sequences of representational negotiation. The paper reports on the effect of this approach on teacher pedagogy and on student learning of Ideas about Matter. The paper will present data from video of classroom activities, students’ work samples, student and teacher interviews and pre and post-unit testing, to explore what a representational focus might entail in teaching Ideas about Matter, and the role of representations in learning and reasoning and exploring scientific ideas.

Impro-exchange '10 no. 3

lmpro Exchange brought together practicing artists primarily from NSW but also from other states in Australia to articulate questions and as physically expressed and evoked through improvisation. It was curated by two of Australia's most senior and respected performing artists in the contemporary dance/performance scene- Tess De Quincey and Martin Del Amo. Dialogue across the different backgrounds was both challenging and stimulating. For example, dancers came from Japanese, Pacific Islander, Aboriginal, German and Anglo-Saxon Australian cultural backgrounds. These dancers also spoke/danced from their respective cultural understandings about dance and from the ways of moving these cultures embody. The dancers also ranged across different generations thus requiring negotiation as to what dance means at different ages and how dialogue can be achieved with such different physical capacities. Made possible by the flexibility of improvisation as a medium, the dialogue was important in a sector where dancing careers usually end when dancers reach their early thirties. Equally important, and with such a large group of dancers, was the 'working through' of performance problems about how improvisation can be improvised and composed with such a multiplicity of voices, backgrounds, styles and practices. These negotiations were presented in a one-hour public performance.

A neural network-based multi-agent classifier system with a Bayesian formalism for trust measurement

In this paper, a neural network (NN)-based multi-agent classifier system (MACS) utilising the trust-negotiation-communication (TNC) reasoning model is proposed. A novel trust measurement method, based on the combination of Bayesian belief functions, is incorporated into the TNC model. The Fuzzy Min-Max (FMM) NN is used as learning agents in the MACS, and useful modifications of FMM are proposed so that it can be adopted for trust measurement. Besides, an auctioning procedure, based on the sealed bid method, is applied for the negotiation phase of the TNC model. Two benchmark data sets are used to evaluate the effectiveness of the proposed MACS. The results obtained compare favourably with those from a number of machine learning methods. The applicability of the proposed MACS to two industrial sensor data fusion and classification tasks is also demonstrated, with the implications analysed and discussed.

Next generation robotic counter IED technology : A step change in capability

Improvised Explosive Devices (IEDs) are reported as the number one cause of injury and death for allied troops in the current theater of operation. Deakin University’s Centre for Intelligent Systems Research (CISR) is working on next-generation technology to combat the threat. In 2006 CISR was awarded funding through the Capability and Technology Demonstrator (CTD) Program managed by the Australian Defence Force. The objective was to investigate the use of haptics or force feedback technology for Counter-IED (CIED) tasks. Over the past six years, engineers from CISR have worked alongside Defence stakeholders to develop a series of robotic platforms designed to immerse a soldier in the remote environment. Utilising a natural user interface, haptic force feedback and stereovision, the technology has undergone initial trials in Sydney, Canberra, Woomera and at the CISR testing facility in Geelong, Australia. The technology has proved popular among operators allowing them increased fidelity and manipulation speed while significantly reducing required training. CISR has a history of rapidly delivering technology to meet the needs of police and law enforcement in Australia. The OzBot™ series of robots developed in conjunction with the Victorian Police is currently in service and used extensively for hostage negotiation and first responder roles. The CISR robotics group works on technologies that reduce operator fatigue, minimise training liability and maintenance. Over 55 engineers develop simulation environments for increased training availability and continuous improvement to the current range of mobile platforms, including communications range, payload, manipulator reach and capability. This paper describes a number of the technologies, methods and systems developed by CISR for IED neutralisation, with the aim to increasing military awareness of Australian capability.

Understanding equity as an asset to national interest: developing a social contract analysis of policy

Alongside the influence of market-based reforms in education policy has been the growth of policy that has largely been overlooked – those that outline social contracts. This paper draws on policies that connect with equity as a way of illustrating this social contract turn in policy and develops a conceptualisation of social contracts as they apply to education policy. The argument provides three principles that underpin social contracts, including informed consent, negotiation and accountability. This paper applies these principles to three levels of social contract. At the first level are broad social contracts, which are associated with debates about the kinds of things that states should expect from its citizens, and the things that citizens could expect from governments and the state. The second level of social contract is an institutional or field-based social contract, which spells out the obligations and connections between a specific field and other fields. This level names a kind of social contract that is often exemplified in policies or statements by specific institutions. The third level of social contract deals with contract-like mechanisms embedded in fields that make tangible the obligations and expectations of citizens in fulfilling the expectations of fields.