Menopause as a long-term risk to health : implications of general practitioner accounts of prevention for women’s choice and decision-making

Over the past two decades medical researchers and modernist feminist researchers have contested the meaning of menopause. In this article we examine various meanings of menopause in major medical and feminist literature and the construction of menopause in a semi-structured interview study of general practitioners in rural South Australia. Three discursive themes are identified in these interviews; (i) the hormonal menopause – symptoms, risk, prevention; (ii) the informed menopausal woman; and (iii) decision-making and hormone replacement therapy. By using the discourse of prevention, general practitioners construct menopause in relation to women's health care choices, empowerment and autonomy. We argue that the ways in which these concepts are deployed by general practitioners in this study produces and constrains the options available to women. The implications of these general practitioner accounts are discussed in relation to the proposition that medical and feminist descriptions of menopause posit alternative but equally-fixed truths about menopause and their relationship with the range of responses available to women at menopause. Social and cultural explanations of disease causality (c.f.Germov 1998, Hardey 1998) are absent from the new menopause despite their being an integral part of the framework of the women's health movement and health promotion drawn on by these general practitioners. Further, the shift of responsibility for health to the individual woman reinforces practice claims to empower women, but oversimplifies power relations and constructs menopause as a site of self-surveillance. The use of concepts from the women's health movement and health promotion have nevertheless created change in both the positioning of women as having ‘choices’ and the positioning of some general practitioners in terms of greater information provision to women and an attention to the woman's autonomy. In conclusion, we propose that a new menopause has evolved from a discursive shift in medicine and that there exists within this new configuration, claiming the empowerment of women as an integral part of health care for menopause, the possibility for change in medical practice which will broaden, strengthen, and maintain this position.

A new first-order decision-making model for the procurement of public sector infrastructure: Procedures and Testing

Given global demand for new infrastructure, governments face substantial challenges in funding new infrastructure and delivering Value for Money (VfM). As part of the background to this challenge, a critique is given of current practice in the selection of the approach to procure major public sector infrastructure in Australia and which is akin to the Multi-Attribute Utility Approach (MAUA). To contribute towards addressing the key weaknesses of MAUA, a new first-order procurement decision-making model is presented. The model addresses the make-or-buy decision (risk allocation); the bundling decision (property rights incentives), as well as the exchange relationship decision (relational to arms-length exchange) in its novel approach to articulating a procurement strategy designed to yield superior VfM across the whole life of the asset. The aim of this paper is report on the development of this decisionmaking model in terms of the procedural tasks to be followed and the method being used to test the model. The planned approach to testing the model uses a sample of 87 Australian major infrastructure projects in the sum of AUD32 billion and deploys a key proxy for VfM comprising expressions of interest, as an indicator of competition.

Analysis and optimisation of the preferences of decision-makers in black-start group decision-making

As the first stage of power system restoration after a blackout, an optimal black-start scheme is very important for speeding up the whole restoration procedure. Up to now, much research work has been done on generating or selecting an optimal black-start scheme by a single round of decision-making. However, less attention has been paid for improving the final decision-making results through a multiple-round decision-making procedure. In the group decision-making environment, decision-making results evaluated by different black-start experts may differ significantly with each other. Thus, the consistency of black-start decision-making results could be deemed as an important indicator in assessing the black-start group decision-making results. Given this background, an intuitionistic fuzzy distance-based method is presented to analyse the consistency of black-start group decision-making results. Moreover, the weights of black-start indices as well as the weights of decision-making experts are modified in order to optimise the consistency of black-start group decision-making results. Finally, an actual example is served for demonstrating the proposed method.

Withholding and withdrawal of ‘futile’ life-sustaining treatment : unilateral medical decision-making in Australia and New Zealand

This article examines the law in Australia and New Zealand that governs the withholding and withdrawal of ‘futile’ life-sustaining treatment. Although doctors have both civil and criminal law duties to treat patients, those general duties do not require the provision of treatment that is deemed to be futile. This is either because futile treatment is not in a patient’s best interests or because stopping such treatment does not breach the criminal law. This means, in the absence of a duty to treat, doctors may unilaterally withdraw or withhold treatment that is futile; consent is not required. The article then examines whether this general position has been altered by statute. It considers a range of suggested possible legislation but concludes it is likely that only Queensland’s adult guardianship legislation imposes a requirement to obtain consent to withhold or withdraw such treatment.

How to Improve Cardiac Surgery Decision Making? In Data Warehousing Perspective

The health system is one sector dealing with very large amount of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Therefore, there is a need for very effective system to capture, collate and distribute this health data. There are number of technologies have been identified to integrate data from different sources. Data warehousing is one technology can be used to manage clinical data in the healthcare. This paper addresses how data warehousing assist to improve cardiac surgery decision making. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. In order to deal with other units efficiently, it is important to integrate disparate data to a single point interrogation. We propose implementing a data warehouse for the cardiac surgery unit at TPCH. The data warehouse prototype developed using SAS enterprise data integration studio 4.2 and data was analysed using SAS enterprise edition 4.3. This improves access to integrated clinical and financial data with, improved framing of data to the clinical context, giving potentially better informed decision making for both improved management and patient care.

Beijing : a media capital in the making

In the two decades since 2001, when China joined the World Trade Organization,the commercialization of the Chinese media has become a significant force. With the increasing demand for original content and a possible “cultural trade deficit” in media content, there has been much discussion about agglomeration and clustering. Beijing, as the national media centre of China, has witnessed the process of media agglomeration while facing the problem of cultural export during the commercialization of the media. Michael Curtin’s idea of media capital, which sees it as absorbing media resources and personnel and exporting media products transnationally, provides a dynamic perspective on understanding media agglomeration and dispersion under different political social and cultural circumstances. Hence, the question of whether Beijing will transform into a transnational media capital is worth studying in order to observe and comprehend China’s media industry in transition. Drawing on Michael Curtin’s three media capital trajectories, this paper interprets tensions and challenges generated in the process of media industry agglomeration and growth in Beijing. Emphasis is placed on the third trajectory, socio-cultural variation.

Interacting constraints shape emergent decision-making of referees

How and why football referees made decisions was investigated. A constructivist grounded theory methodology was undertaken to tap into the experiential knowledge of referees. The participant cohort comprised 7 A-League referees (aged 23 to 35) and 8 local Brisbane league referees (aged 20 to 50), spanning the lowest to highest levels of competition in men’s football in Australia. Results found that referees used ‘four pillars’ to underpin their judgments, these were conceptual notions of: safety, fairness, accuracy and entertainment. A fifth pillar ‘consistency’ referred to the referee’s ‘contextual sensitivity’. Results were explained using an ecological dynamics framework that emphasises the individual-environment scale of analysis. It was concluded that interacting constraints shape emergent decision-making in referees which are nested in task goals.

Making space and place for knowledge communities : lessons for Australian practice

This paper aims to shed light on the planning and development processes of the knowledge-based urban development phenomenon, with respect to the construction of knowledge community precincts. We undertake policy and best practice analyses to learn from the planning and development processes of internationally renowned knowledge community precincts—from Copenhagen, Eindhoven and Singapore. In the light of this, we scrutinise major Australian knowledge community precinct initiatives—from Sydney, Melbourne and Brisbane—to better understand the dynamics of national practices, and benchmark them against the international best practice cases. The paper concludes with a discussion on the study findings and successfully establishing space and place for both knowledge economy and society in Australian cities.

Reshaping children’s knowledge through film making: What to film, how to film and why

How can teachers reinvigorate content area knowledge and representation through filmmaking? We give examples of what to film, how to film, and why, drawing on our visual ethnographic research with Year 5 students in a working class suburb of Logan, Queensland. The unit developed content knowledge of Indigenous places and practices through sensitising activities in nature. Valuing students’ funds of knowledge, we interpreted local places through epistemologies of different cultures. Through filmmaking workshops by a digital artist, students filmed community members in a local shopping mall about their perceptions of health and happiness in local places. Students were positioned as future community leaders, presenting their films at a national conference. To conclude, we map the dominant and marginalised, local and specialised, and print and visual forms of knowledge that were interwoven, reshaped, and shared through multimodal design.

Strategies for embedding agile decision making in aviation infrastructure

As highlighted by previous work in Normal Accident Theory1 and High Reliability Organisations, 2 the ability of a system to be flexible is of critical importance to its capability to prepare for, respond to, and recover from disturbance and disasters. This paper proposes that the research into ‘edge organisations’3 and ‘agility’4 is a potential means to operationalise components that embed high reliable traits in the management and oversight of critical infrastructure systems. Much prior work has focused on these concepts in a military frame whereas the study reported on here examines the application of these concepts to aviation infrastructure, specifically, a commercial international airport. As a commercial entity functions in a distinct manner from a military organisation this study aims to better understand the complementary and contradictory components of the application of agility work to a commercial context. Findings highlight the challenges of making commercial operators of infrastructure systems agile as well as embedding traits of High Reliability in such complex infrastructure settings.

Connected learning in the library as a product of hacking, making, social diversity and messiness

Learning is most effective when intrinsically motivated through personal interest, and situated in a supportive socio-cultural context. This paper reports on findings from a study that explored implications for design of interactive learning environments through 18 months of ethnographic observations of people’s interactions at “Hack The Evening” (HTE). HTE is a meetup group initiated at the State Library of Queensland in Brisbane, Australia, and dedicated to provide visitors with opportunities for connected learning in relation to hacking, making and do-it-yourself technology. The results provide insights into factors that contributed to HTE as a social, interactive and participatory environment for learning – knowledge is created and co-created through uncoordinated interactions among participants that come from a diversity of backgrounds, skills and areas of expertise. The insights also reveal challenges and barriers that the HTE group faced in regards to connected learning. Four dimensions of design opportunities are presented to overcome those challenges and barriers towards improving connected learning in library buildings and other free-choice learning environments that seek to embody a more interactive and participatory culture among their users. The insights are relevant for librarians as well as designers, managers and decision makers of other interactive and free-choice learning environments.

Making the implicit explicit : successful student skills for commencing cohorts

Making institutional expectations explicit using clear and common language engages commencing students and promotes help-seeking behaviour. When first year students enter university they cross the threshold into an unfamiliar environment (Devlin, Kift, Nelson, Smith & McKay, 2012). Universities endeavour to provide appropriate learning support services and resources; however research suggests that there is limited up take of these services, particularly in high risk students (Nelson-Field & Goodman, 2005). The Successful Student Skills Checklist is a tool which will be trialled during the 2013 Orientation period at the QUT Caboolture campus. The new tool is a response to the university’s commitment to provide “an environment where [students] are supported to take responsibility for their own learning, and to embrace an active role in succeeding to their full potential” (QUT, 2012, 6.2.1). This paper will outline the design of the support tool implemented during Orientation, as well as discuss the anticipated outcomes of the trial.

Urban jungle : making cities healthy places for Australians with neurodiversity

This paper documents a preliminary investigation into the relationship between neurodiversity and the built environment using a pilot project developed with Logan City Council and engaging candidates within the Master of Urban Design at the Queensland University of Technology. The research begins to examine the way many places are designed and built can be alienating and inhibit accessibility to people with movement and sensory differences. Logan Central has been used as a case study area to map the physical attributes, and identify barriers and challenges in the built environment – specifically for people with disabilities but also taking in consideration the wider population. The integration of all individuals – mainstream, those with disability, differences and multigenerational populations – strengthens the social and economic fabric of Australia, enabling its citizens to live healthy, productive, and fulfilling lives.

Making a name for themselves : Karen identity and the politicization of ethnicity in Burma

The history of Karen nationalism has been interpreted in terms of inter-ethnic conflict and conceptualizations of ethnicity have influenced understanding of Karen political identity. While 'Karen' incorporated various linguistic, sociocultural, religious and political sub-groups, the Karen National Union (KNU) elite promoted a singular pan-Karen identity in order to minimize such diversity. As a result, factionalism emerged between different Karen groups, obstructing the KNU's political vision and leaving many Karens dissatisfied with KNU attempts to represent their various interests. The fall of Manerplaw in 1995 was thus the result of intra-ethnic conflict as much as conflict between Karens and non-Karens

Re-framing infrastructure investment decision-making processes : a preliminary scoping study for urban flood risk management in Jakarta, Indonesia

Jakarta, Indonesia’s chronic housing shortage poses multiple challenges for contemporary policy-makers. While it may be in the city’s interest to increase the availability of housing, there is limited land to do so. Market pressures, in tandem with government’s desire for housing availability, demand consideration of even marginal lands, such as those within floodplains, for development. Increasingly, planning for a flood resilient Jakarta is complicated by a number of factors, including: the city is highly urbanized and land use data is limited; flood management is technically complex, creating potential barriers to engagement for both decision-makers and the public; inherent uncertainty exists throughout modelling efforts, central to management; and risk and liability for infrastructure investments is unclear. These obstacles require localized watershed-level participatory planning to address risks of flooding where possible and reduce the likelihood that informal settlements occur in areas of extreme risk. This paper presents a preliminary scoping study for determination of an effective participatory planning method to encourage more resilient development. First, the scoping study provides background relevant to the challenges faced in planning for contemporary Jakarta. Second, the study examines the current use of decision-support tools, such as Geographic Information Systems (GIS), in planning for Jakarta. Existing capacity in the use of GIS allows for consideration of the use of an emerging method of community consultation - Multi-Criteria Decision-Making (MCDM) support systems infused with geospatial information - to aid in engagement with the public and improve decision-making outcomes. While these methods have been used in Australia to promote stakeholder engagement in urban intensification, the planned research will be an early introduction of the method to Indonesia. As a consequence of this intervention, it is expected that planning activities will result in a more resilient city, capable of engaging with disaster risk management in a more effective manner.