Re-searching ethics : towards a more reflexive critical management studies

Fournier and Grey (2000) suggest that those inhabiting the contested terrain of Critical Management Studies (CMS) share a commitment to identifying inequality and subordination in organizations and to the associated possibility of emancipation, however this is conceived. Despite their additional claim that one crucial distinction between critical and non-critical management studies is the ‘philosophical and methodological reflexivity’ of the former (Fournier and Grey 2000: 19), our review indicates limits to this reflexivity in CMS’s empirical practices – indeed, we argue these may even be counter-productive with regard to its political allegiances. To encourage wider discussion of these issues, we provide a tripartite framework of understandings of research ethics drawn from within and outside the management academy, and interrogate the opportunities and limitations of each for enriching CMS research.

Healthcare in continuum for an ageing population: national self monitoring or remote offshore monitoring for Australia?

Australia is a country, similar to other developed nations, confronting an ageing population with complex demographics. Ensuring continued healthcare for the ageing, while providing sufficient support for the already aged population requiring assistance, is at the forefront of the national agenda. Varied initiatives are with foci to leverage the advantages of lCTs leading to e-Health provisioning and assisted technologies. While these initiatives increasingly put budgetary constraints on local and federal governments, there is also a case for offshore resourcing of non-critical health services, to support, streamline and enhance the continuum of care, as the nation faces acute shortages of medical practitioners and nurses. However, privacy and confidentiality concerns in this context are a significant issue in Australia. In this paper, we take the position that if the National and state electronic health records system initiatives, are fully implemented, offshore resourcing can be a feasible complementary option resulting in a win-win situation of cutting costs and enabling the continuum of healthcare.

SMS-based medical diagnostic telemetry data transmission protocol for medical sensors

People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors.

Healthcare in continuum for an ageing population - national self monitoring or remote offshore monitoring for Australia?

Australia is a country, similar to other developed nations, confronting an ageing population with complex demographics. Ensuring continued healthcare for the ageing, while providing sufficient support for the already aged population requiring assistance, is at the forefront of the national agenda. Varied initiatives are with foci to leverage the advantages of ICTs leading to e-Health provisioning and assisted technologies. While these initiatives increasingly put budgetary constraints on local and federal governments, there is also a case for offshore resourcing of non-critical health services, to support, streamline and enhance the continuum of care, as the nation faces acute shortages of medical practitioners and nurses. However, privacy and confidentiality concerns in this context are a significant issue in Australia. In this paper, we take the position that if the National and state electronic health records system initiatives, are fully implemented, offshore resourcing can be a feasible complementary option resulting in a win-win situation of cutting costs and enabling the continuum of healthcare.

Remotely delivered exercise-based cardiac rehabilitation: design and content development of a novel mHealth platform

BACKGROUND: Participation in traditional center-based cardiac rehabilitation exercise programs (exCR) is limited by accessibility barriers. Mobile health (mHealth) technologies can overcome these barriers while preserving critical attributes of center-based exCR monitoring and coaching, but these opportunities have not yet been capitalized on.

OBJECTIVE: We aimed to design and develop an evidence- and theory-based mHealth platform for remote delivery of exCR to any geographical location.

METHODS: An iterative process was used to design and develop an evidence- and theory-based mHealth platform (REMOTE-CR) that provides real-time remote exercise monitoring and coaching, behavior change education, and social support.

RESULTS: The REMOTE-CR platform comprises a commercially available smartphone and wearable sensor, custom smartphone and Web-based applications (apps), and a custom middleware. The platform allows exCR specialists to monitor patients' exercise and provide individualized coaching in real-time, from almost any location, and provide behavior change education and social support. Intervention content incorporates Social Cognitive Theory, Self-determination Theory, and a taxonomy of behavior change techniques. Exercise components are based on guidelines for clinical exercise prescription.

CONCLUSIONS: The REMOTE-CR platform extends the capabilities of previous telehealth exCR platforms and narrows the gap between existing center- and home-based exCR services. REMOTE-CR can complement center-based exCR by providing an alternative option for patients whose needs are not being met. Remotely monitored exCR may be more cost-effective than establishing additional center-based programs. The effectiveness and acceptability of REMOTE-CR are now being evaluated in a noninferiority randomized controlled trial.

A critical review of performance measurement methods for healthcare facilities management

This paper aims to define the tools used for performance measurement in Healthcare Facilities Management. The research analyses relevant literature on various tools of performance measurement for healthcare facilities. Contributions made from the literature will be divided into three attributes namely soft performance measurement, hard performance measurement and a hybrid performance measurement. The findings discussed in this paper may give valuable insights to service providers with regards to the incorporation of both soft and hard attributes of performance measurement to strategically manage facilities. The organisation business strategy will eventually gain the benefits by cost saving of non-core activities.

News judgements: a critical examination of reporting non-convictions for minor crimes

This paper considers issues related to the reporting of non-convictions for minor criminal offences. The entry point for the discussion is a content analysis of press court reporting across the Australian state of Victoria that shows that many newspapers report non-convictions. The paper observes that as the practice of reporting non-convictions has extended into digital space, a person the local court decides should not have a black mark recorded against their name can now be named and shamed before a global audience for an indefinite period. 

Developing professional attributes in critical care nurses using Team-Based Learning.

Australian nurses prepare for specialty practice by undertaking postgraduate theoretical and clinical education in partnership models between universities and hospitals. In our global healthcare system, nurses require advanced critical thinking and strong communication skills to provide safe, high quality patient care. Yet, few education programs focus on developing these skills. Team-Based Learning (TBL) is a specific educational strategy that encourages and rewards students to think critically and solve clinical problems individually and in teams. The aim of this study was to investigate critical care nursing students' perceptions and experiences of TBL after it was introduced into the second half of their postgraduate specialty course. Following Ethics Committee approval, thirty-two students were invited to participate in an extended response questionnaire on their perceptions of TBL as part of a larger study. Data were analyzed thematically. Postgraduate students perceived their professional growth was accelerated due to the skills and knowledge acquired through TBL. Four themes underpinned the development and accelerated acquisition of specialty nurse attributes due to TBL: Engagement, Learning Effectiveness, Critical Thinking, and Motivation to Participate. Team-Based Learning offered deep and satisfying learning experiences for students. The early acquisition of advanced critical thinking, teamwork and communication skills, and specialty practice knowledge empowered nurses to provide safe patient care with confidence.

Non-uniform bird assemblages in urban environments : the influence of streetscape vegetation

The urban landscape encompasses a broad spectrum of variable environments ranging from remnant patches to highly modified streetscapes. Despite the expansion of urban environments, few studies have examined the influence of urbanization on faunal diversity, particularly in the Southern Hemisphere. In this study, four broad habitat types were recognized in the urban environment, representing a continuum of modification ranging from parks with remnant vegetation to streetscapes dominated by native vegetation and those dominated by exotic vegetation to recently developed streetscapes. Bird censuses were conducted at 36 sites throughout urban Melbourne, with nine sites surveyed in each habitat type. The four habitat types supported significantly different bird communities based on species richness, abundance and composition suggesting that bird assemblages of urban environments are non-uniform. Parks and native streetscapes generally supported fewer introduced species than exotic and recently developed streetscapes. Overall abundance and richness of species were lower in the exotic and recently developed streetscapes than in parks and native streetscapes. Significant differences were also observed in foraging guilds within the four habitat types, with parks having the most foraging guilds and recently developed streetscapes having the fewest. The transition from native to exotic streetscapes saw the progressive loss of insectivorous and nectarivorous species reflecting a reliance by these species on structurally diverse and/or native vegetation for both shelter and food resources. The implementation of effective strategies and incentives which encourage the planting of structurally diverse native vegetation in streetscapes and gardens should be paramount if avian biodiversity is to be retained and enhanced in urban environments. It is also critical to encourage the maintenance of the existing remnant vegetation in the urban environment.

Parallelization of the discrete gradient method of non-smooth optimization and its applications

We investigate parallelization and performance of the discrete gradient method of nonsmooth optimization. This derivative free method is shown to be an effective optimization tool, able to skip many shallow local minima of nonconvex nondifferentiable objective functions. Although this is a sequential iterative method, we were able to parallelize critical steps of the algorithm, and this lead to a significant improvement in performance on multiprocessor computer clusters. We applied this method to a difficult polyatomic clusters problem in computational chemistry, and found this method to outperform other algorithms.

The dancer, the choreographer and modern dance scholarship: a critical reading

This paper undertakes a critical re-examination of the ways in which dance-making relationships between the dancer and the choreographer in American modern dance have been conceptualised in dance discourses. The essay proposes that a defining aspect of modern dance practices (from the moment that, after Duncan and Fuller, it became a group as well as a solo form) was the dancing together of the choreographer and the dancer(s) as the central mode of dance creation and transmission. In dance discourses, however, this dancing relationship is frequently not acknowledged. Texts by dance scholars Susan Leigh Foster, Amy Koritz and Randy Martin which draw on theoretical frameworks from outside dance are analysed in terms of the ways the theoretical frameworks that underpin them both make it possible to raise the question of the nature of the dance-making relationship while at the same time can also make the dancer's and the choreographer's dancing together invisible or unrepresentable. The analysis shows how scholarly discourses and the theoretical frameworks upon which they are built are already invested in regimes of intelligibility and visibility which have consequences for the representation of modern dance. This analysis forms the basis for proposing the need for a non-individualised, inter-subjective and intercorporeal understanding of the dancer and the choreographer and their relationship in modern dance.

Critical perspectives on refugee policy in Australia : proceedings of the Refugee Rights Symposium hosted by the Institute for Citizenship and Globalisation, Faculty of Arts, Deakin University, December 5, 2002

Keynote addresses: What next for Australia's refugee policy? / Peter Mares -- One year after Tampa: refugees, deportees and TPVs / Chris Sidoti -- Academic papers: The tension of re-other-ing bodies / Snezana Dabic -- Acting for asylum: the nexus of pro-refugee activism in Melbourne / Helen Hintjens & Alison Jarman -- Biopolitics and the 'problem' of the refugee / Matthew Holt -- Temporary protection of refugees: Australian policy and international comparison / Fethi Mansouri & Michael Leach --The not-so-special benefit and non-mutual obligation: refugees on a TPV and income support arrangements / Greg Marston -- Family separation: Somali women in Melbourne / Celia McMichael & Malyun Ahmed -- Embodying exile: protest, performance, trauma and effect in the formation of East Timorese refugee identities / Amanda Wise -- Personal and Community Sector Perspectives -- A personal experience of the TPV policy / Mueen Al-Breihi -- A city of refuge?: protecting the social and cultural rights of refugees in Brisbane / Renae Mann -- Temporary protection visas, recovery from trauma and personal identity / Helen Martin -- All I ask for is protection: young people seeking asylum in Australia / Samira Mohamed.

Dissecting isoform selectivity of P13K inhibitors: the role of non-conserved residues in the catalytic pocket

The last few years have seen the identification of numerous small molecules that selectively inhibit specific class I isoforms of PI3K (phosphoinositide 3-kinase), yet little has been revealed about the molecular basis for the observed selectivities. Using site-directed mutagenesis, we have investigated one of the areas postulated as being critical to the observed selectivity. The residues Thr⁸⁸⁶ and Lys⁸⁹⁰ of the PI3Kγ isoform project towards the ATP-binding pocket at the entrance to the catalytic site, but are not conserved. We have made reciprocal mutations between those residues in the β isoform (Glu⁸⁵⁸ and Asp⁸⁶²) and those in the α isoform (His⁸⁵⁵ and Gln⁸⁵⁹) and evaluated the potency of a range of reported PI3K inhibitors. The results show that the potencies of β-selective inhibitors TGX221 and TGX286 are unaffected by this change. In contrast, close analogues of these compounds, particularly the α-isoform-selective compound (III), are markedly influenced by the point mutations. The collected data suggests two distinct binding poses for these inhibitor classes, one of which is associated with potent PI3Kβ activity and is not associated with the mutated residues, and a second that, in accord with earlier hypotheses, does involve this pair of non-conserved amino acids at the catalytic site entrance and contributes to the α-isoform-selectivity of the compounds studied.

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.

Critical evaluation of cashmere nutrition experiments and suggestions for the design and conduct of successful experiments

Cashmere fibre production is an order of magnitude less than fibre production of Merino sheep or Angora goats and is more difficult to measure. Based on a comparison between cashmere experiments reporting responses to nutrition and those reporting no response, 13 design and management characteristics were identified that are related to the ability of experiments to discriminate among treatments. Methods must be adopted to reduce the variance in cashmere production within treatments, by using sufficient. animals per treatment, having enough replication to provide plenty of degrees of freedom to reduce error terms in analysis, and using pre-experimental cashmere production attributes as co-variants in analysis. It is preferable to use more productive and older goats, and goats that are used to handling, and to the conditions and feed to be used. Nutrition treatments need to produce different live weight growth curves and an appropriate control is needed such as live weight maintenance. As the raw cashmere fleece is composed primarily of hair and other contaminants, careful attention is required to measure, sample and test cashmere. Cashmere growth experiments should start by midsummer and last for at least four and preferably six months. These requirements make it more difficult for many university students to plan, undertake and complete long-term cashmere nutrition experiments without considerable management support.