Power and production in site-based management: the responses of women secondary principals to structural reform in South Australian education

After describing and analysing the purpose and shape of structural reform in Australia, the author uses the data gained from interviews with 16 South Australian women principals, to examine its effects on the work of principals. She uses her analysis to issue some warnings about the current moves to Local School Management in South Australia

Dispositional and maturational development through competency-based training

Presents a perspective on vocational learning that proposes that vocational competence is dependent upon dispositional development, which in turn, results in moves towards maturation. Reports research with unemployed adults engaging in vocational training and resulting in four findings. First, while training packages describe assessable outcomes in competency-referenced terms, trainees describe learning outcomes in non-competency referenced terms. Second, vocational trainees describe their learning in terms of dispositional outcomes; that is, in terms of values, interests and attitudes. Third, dispositions can be categorised in terms of maturational concepts. Fourth, trainees made moves towards maturation as a result of CBT/NEIS training over the six-week period of the course. The findings have important ramifications for all future VET/CBT trainees since it is the researcher's formative theory that maturation is a subset of competence in every vocational skill domain.

Guideline for the non-surgical management of hip and knee osteoarthritis

Introduction: Chronic disease is a major public health burden on Australian society. An increasing proportion of the population has risk factors for, or at least one, chronic disease, leading to increasing public health costs. Health service policy and delivery must not only address acute conditions, it must also effectively respond to the wide range of health and public service requirements of people with chronic illness.^1,2 Strong primary health care policy is an important foundation for a successful national health delivery system and long term management of public health, and is linked to practical outcomes including lower mortality, decreased hospitalisation and improved health outcomes.¹ National strategic health policy has recently given increased recognition to the importance of chronic disease management, with the Australian Federal Government endorsement of a number of initiatives for the prevention (or delay in onset), early detection and evidence based management of chronic disease, including osteoarthritis.^1,3
Chronic musculoskeletal conditions, including arthritis, account for over 4% of the national disease burden in terms of disability adjusted life years. Over 6 million Australians (almost one-third of the population) are estimated to have a chronic musculoskeletal disease; chronic musculoskeletal disease represents the main cause of long term pain and physical disability. In Australia, osteoarthritis is self reported by more than 1.4 million people (7.3% of the population4) and is the tenth most commonly managed problem in general practice.5 This number is set to rise as the elderly population grows. Osteoarthritis exerts a significant burden on the individual and the community through reduction in quality of life, diminished employment capacity and an increase in health care costs. For further details, refer to the Evidence to support the National Action Plan for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis: Opportunities to improve health-related quality of life and reduce the burden of disease and disability (2004).⁶
As such, federal government health policy has identified arthritis as a National Health Priority Area and adopted a number of initiatives aimed at decreasing the burden of chronic disease and disability; raising awareness of preventive disease factors; providing access to evidence based knowledge; and improving the overall management of arthritis within the community.4 In 2002, all Australian health ministers designated arthritis and musculoskeletal conditions as Australia’s seventh National Health Priority Area. In response, a National Action Plan was developed in 2004 by the National Arthritis and Musculoskeletal Conditions Advisory Group (NAMSCAG).6 The aim of this document was to provide a blueprint for national initiatives to improve the health related quality of life of people living with osteoarthritis, rheumatoid arthritis and osteoporosis; reduce the cost and prevalence of these conditions; and reduce the impact on individuals, their carers and their communities within Australia. The National Action Plan was developed to complement both the National Chronic Disease Strategy – which is broader – and the National Service Improvement Framework for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis, in addition to other national and state/ territory structures.

Thai emergency nurses’ management of patients with severe traumatic brain injury: comparison of knowledge and clinical management with best available evidence

Background:
In Thailand, the rate of TBI-related hospitalisation is increasing, however, little is known about the evidence-based management of severe TBI in the developing world. The aim of this study was to explore Thai emergency nurses’ management of patients with severe TBI.

Methods:
An exploratory descriptive mixed method design was used to conduct this two stage study: survey methods were used to examine emergency nurses’ knowledge regarding management of patients with severe TBI (Stage 1) and observational methods were used to examine emergency nurses’ clinical management of patients with severe TBI (Stage 2). The study setting was the emergency department (ED) at a regional hospital in Southern Thailand.

Results:
34 nurses participated in Stage 1 (response rate 91.9%) and the number of correct responses ranged from 33.3% to 95.2%. In Stage 2, a total of 160 points of measurement were observed in 20 patients with severe TBI over 40 h. In this study there were five major areas identified for the improvement of care of patients with severe TBI: (i) end-tidal carbon dioxide (ETCO2) monitoring and targets; (ii) use of analgesia and sedation; (iii) patient positioning; (iv) frequency of nursing assessment; and (v) dose of Mannitol diuretic.

Conclusions:
There is variation in Thai nurses’ knowledge and care practices for patients with severe TBI. To increase consistency of evidence-based TBI care in the Thai context, a knowledge translation intervention that is ecologically valid, appropriate to the Thai healthcare context and acceptable to the multidisciplinary care team is needed.

Employing sea-level rise scenarios to strategically select sea turtle nesting habitat important for long-term management at a temperate breeding area

Management strategies to protect endangered species primarily focus on safeguarding habitats currently perceived as important (due to high-density use, rarity or contribution to the biological cycle), rather than sites of future ecological importance. This discrepancy is particularly relevant for species inhabiting beaches and coastal areas that may be lost due to sea-level rise over the next 100 years through climate change. Here, we modelled four sea-level rise (SLR) scenarios (0.2, 0.6, 0.9 and 1.3 m) to determine the future vulnerability and viability of nesting habitat (six distinct nesting beaches totalling about 6 km in length) at a key loggerhead sea turtle (Caretta caretta) rookery (Zakynthos, Greece) in the Mediterranean. For each of the six nesting beaches, we identified (1) the area of beach currently used by turtles, (2) the area of the beach anticipated to become inundated under each SLR, (3) the area of beach anticipated to become unsuitable for nesting under each SLR, (4) the potential for habitat loss under the examined SLR, and (5) the extent to which the beaches may shift in relation to natural (i.e. cliffs) and artificial (i.e. beach front development) physical barriers. Even under the most conservative 0.2 m SLR scenario, about 38% (range: 31–48%) total nesting beach area would be lost, while an average 13% (range: 7–17%) current nesting beach area would be lost. About 4 km length of nesting habitat (representing 85% of nesting activity) would be lost under the 0.9 m scenario, because cliffs prevent landward beach migration. In comparison, while the other 2 km of beach (representing 15% nests) is also at high risk, it has the capacity for landward migration, because of an adjoining sand-dune system. Therefore, managers should strengthen actions on this latter area, as a climatically critical safeguard for future sea turtle nesting activity, in parallel to regularly assessing and revising measures on the current high-use nesting habitats of this important Mediterranean loggerhead population.

Relevance of traditional management accounting in the public sector

 The major reforms that the Australian public sector went through in the early 1980s were characterised by a stress on efficiency and effectiveness. The reforms led to the import of a private sector mangement philosophy to the public sector, including private sector based management accounting techniques. It is this import that motivated the critical theoretical discussion presented in this paper concerning the applicability of traditional private sector management accounting techniques in the public sector. The paper sets out the pros and cons of such application and provides directions for future research.

Using smartphones for accountable care and evidence-based decision making in managing gestational diabetes : an Australian case study

Better managing diabetes has become a global priority, especially given the exponential increase in the number of diabetes patients and the financial implications of treating this silent epidemic. In this paper, we focus on how it might be possible to use a mobile technology solution to support and enable superior diabetes monitoring and management. To test this solution, we examined the context of gestational diabetes and adopted a non-blinded randomized control trial with two-arm cross over applied to a private hospital in Victoria, Australia. Further, we use an accountable care system as the theoretical lens and, from this, develop a conceptual framework to bridge evidence-based management with technologies. Theoretically, we unpack McCleallan, McKethan, Lewis, Roski, and Fisher’s (2010) study with our conceptual framework that comprises providers for information (evidence-based management) and technology (smartphone). We enhance Muhlestein, Croshaw, Merrill, Pena, and James’ (2013) accountable care paradigm with three concepts: 1) quality of life, 2) evidence-based management, and 3) affordable care. From the perspective of practice, far-reaching implications have arisen particularly for hospital management pertaining to the cost and quality of care issues. In particular, it appears that adapting mobile technology solutions such as smartphones to support various aspects of care and patient-clinician interactions is a prudent choice to minimize costs and yet provide highquality care.

The relative importance of landscape properties for woodland birds in agricultural environments

1. Studies of landscape change are seldom conducted at scales commensurate with the processes they purport to investigate. Landscape change is a landscape-level process, yet most studies focus on patches. Even when landscape context is considered, inference remains at the patch-level. The unit of investigation must be extended beyond individual patches to whole mosaics in order to advance understanding of faunal responses to landscape change.

2. In this study, we aggregated data from multiple sites per landscape such that both the response and explanatory variables characterized 'whole' landscapes, allowing for landscape-level inference about factors influencing species' incidence.

3. We used hierarchical partitioning and Bayesian variable selection methods to develop species-specific models that examined the influence of four categories of landscape properties – habitat extent, habitat configuration, landscape composition and geographical location – on the incidence of 58 species of woodland-dependent birds in 24 agricultural landscapes (each 100 km2) in south-eastern Australia.

4. There was strong evidence for a positive effect of habitat extent for 27 species. Thirty species were related to at least one of the four landscape composition variables, and geographical location was important for 19 species. Habitat configuration was influential for 13 species and where important, the impacts of fragmentation per se were detrimental.

5. Variation among species in the influential landscape variables indicates that different species respond to different sets of cues in land mosaics. Thus, although all species were grouped a priori as 'woodland-dependent', expectations based on general ecological characteristics may prove unreliable.

6. Synthesis and applications. These results underscore the value of moving beyond the fragmentation paradigm focused on the spatial pattern of habitat vs. non-habitat, to a greater appreciation of the composition and heterogeneity of land mosaics. Landscape-level inference will enable improved conservation outcomes by recognizing the influence of landscape properties on biota and devising strategies at this scale to complement patch-based management. We provide strong empirical evidence that biodiversity management in agricultural landscapes must focus on habitat extent. Complementary management of other landscape attributes, such as habitat aggregation and intensity of agricultural land-use, will also enhance the value of agricultural landscapes for woodland birds.

Understanding informations systems outsourcing success and risks through the lens of cognitive biases

Because outsourcing of information systems (IS) is now widespread, it is generally assumed to be successful. It is also often assumed that outsourcing risks are easily managed. In this paper we adopt an “evidence based management” approach to first test these assumptions through a qualitative metaanalysis of academic studies into IS outsourcing outcomes. Our research reveals a shortage of reliable and valid evidence for outsourcing’s benefits, and for the level of risk involved. We then use data from a series of focus groups to explain the paradox of widespread adoption of a strategy with limited empirical support. These focus groups were interpreted through the lens of research on a
range of cognitive mechanisms and biases that are known to affect decision makers. We conclude that cognitive mechanisms that are likely to affect sourcing decisions include framing biases, cognitive dissonance, attribution error, and the “optimism”, “confirmation”, “disconfirmation” and “overconfidence” biases. Given the shortage of supporting evidence, and the potential for these biases to operate, we argue that researchers need to be more critical in their analysis of reports of the success and risks of IS outsourcing.