Gambling & gaming : power relations in dispute resolution

Who, ultimately, has power? Is it the senior executive with his finger on the off switch, is it the users themselves who make the decision to participate and contribute financially, or is it those who report on the actions of the company with the ability to reach large numbers of existing and potential players? In both the gambling and gaming industries, power is up for grabs. This work undertakes to consider how norms are formed in online gaming communities; that is, how the developers and players negotiate amongst themselves both how the game will operate. Also considered is how to resolve disputes that arise, and what power and limitations each side has when they need to make an impact – from developers switching off the server, to players quitting en-mass or causing disruption within the environment (using the recent example of Eve Online). Outside of the direct sphere of the game however a third party lurks – commentators. These may take the form of well established review sites, community forums or, in the case of the gambling industry, dispute resolution services but their power stake is clear – by publicising and interpreting the acts of both developers and players, they are in a position to influence whether current players stick with a company, whether new players join a company and how the company is perceived in the wider community.

Discharge practices for the intensive care patient : a qualitative exploration in the general ward setting

OBJECTIVE: To explore how registered nurses (RNs) in the general ward perceive discharge processes and practices for patients recently discharged from the intensive care unit (ICU). BACKGROUND: Patients discharged from the ICU environment often require complicated and multifaceted care. The ward-based RN is at the forefront of the care of this fragile patient population, yet their views and perceptions have seldom been explored. DESIGN: A qualitative grounded theory design was used to guide focus group interviews with the RN participants. METHODS: Five semi-structured focus group interviews, including 27 RN participants, were conducted in an Australian metropolitan tertiary referral hospital in 2011. Data analyses of transcripts, field notes and memos used concurrent data generation, constant comparative analysis and theoretical sampling. RESULTS: Results yielded a core category of 'two worlds' stressing the disconnectedness between ICU and the ward setting. This category was divided into sub categories of 'communication disconnect' and 'remember the family'. Properties of 'what we say', 'what we write', 'transfer' and 'information needs' respectively were developed within those sub-categories. CONCLUSION: The discharge process for patients within the ICU setting is complicated and largely underappreciated. There are fundamental, misunderstood differences in prioritisation and care of patients between the areas, with a deep understanding of practice requirements of ward based RNs not being understood. The findings of this research may be used to facilitate inter departmental communications and progress practice development.

Withholding and withdrawing life-sustaining treatment in a patient's best interests : Australian judicial deliberations

•Intractable disputes about withholding and withdrawing life-sustaining treatment from adults who lack capacity are rare but challenging. Judicial resolution may be needed in some of these cases. •A central concept for judicial (and clinical) decision making in this area is a patient's “best interests”. Yet what this term means is contested. •There is an emerging Supreme Court jurisprudence that sheds light on when life-sustaining treatment will, or will not, be judged to be in a patient's best interests. •Treatment that is either futile or overly burdensome is not in a patient's best interests. Although courts will consider patient and family wishes, they have generally deferred to the views of medical practitioners about treatment decisions.

Informatics to support patient choice between diverse medical systems

Culturally, philosophically and religiously diverse medical systems including Western medicine, Traditional Chinese Medicine, Ayurvedic Medicine and Homeopathic Medicine, once situated in places and times relatively unconnected from each other, currently co-exist to a point where patients must choose which system to consult. These decisions require comparative analyses, yet the divergence in key underpinning assumptions is so great that comparisons cannot easily be made. However, diverse medical systems can be meaningfully juxtaposed for the purpose of making practical decisions if relevant information is presented appropriately. Information regarding privacy provisions inherent in the typical practice of each medical system is an important element in this juxtaposition. In this paper the information needs of patients making decisions regarding the selection of a medical system are examined.

Maternal psychological distress mediates the relationship between asthma and physician visits in a population-based sample of adolescents

Objective This study examined whether maternal psychological distress mediates the relationship between presence of adolescent asthma and number of physician visits, and whether the association between maternal psychological distress and physician visits is moderated by adolescent general health. Methods Data were obtained from the Mater University Study of Pregnancy and included 4025 adolescents. Path analysis was used to examine mediating and moderating effects. Results Maternal psychological distress was found to partially mediate the relationship between adolescent asthma and number of physician visits, accounting for 25% of the effect of adolescent asthma on physician visits (p = .046). There was no evidence to suggest that adolescent general health moderated the association between maternal psychological distress and physician visits (p = .093). Conclusions The findings suggest that maternal psychological distress is associated with increased physician visits, regardless of adolescents' general health. Lowering maternal psychological distress may serve to reduce health care utilization and costs among adolescents with asthma.

The implications of de‐collectivist industrial relations laws and associated developments for worker health and safety in Australia, 1996–2007

The institutional and regulatory interlinkages between industrial relations (IR) and occupational health and safety (OHS) are seldom explored in the IR literature. This article begins to address this gap by examining regulatory initiatives in Australia during a period of neoliberal government. It examines the laws enacted by the federal government during this period and events and cases arising from these laws that go some way to illustrating their effects. Evidence is also drawn from detailed research on a number of state OHS inspectorates between 2004 and 2006. It is argued that de-collectivist changes to IR laws exacerbated problems posed by the growth of flexible work arrangements and a drop in union density, weakening participatory provisions in OHS laws and promoting work arrangements that undermined OHS standards. The study provides evidence of the implications of a divergence in the trajectory of IR and OHS laws and the importance of better integrating worker protection laws.

Contextualising co-creation of value in electronic personal health records

This conceptual paper is a preliminary part of an ongoing study into take-up of electronic personal health records (ePHRs). The purpose of this work is to contextually ‘operationalise' Grönroos’ (2012) model of value co-creation in service for ePHRs. Using findings in the extant literature we enhance theoretical and practical understanding of the potential for co-creation of value with ePHRs for relevant stakeholders. The research design focused on the selection and evaluation of relevant literature to include in the discussion. The objective was to demonstrate which articles can be used to 'contextualise' the concepts in relation to relevant healthcare providers and patient engagement in the co-creation of value from having shared ePHRs. Starting at the service concept, that is, what the service provider wants to achieve and for whom, there is little doubt that there are recognised benefits that co-create value for both healthcare providers and healthcare consumers (i.e. patients) through shared ePHRs. We further highlight both alignments and misalignments in the resources and activities concepts between stakeholder groups. Examples include the types of functionalities as well as the interactive and peer communication needs perceived as useful for healthcare providers compared to healthcare consumers. The paper has implications for theory and practice and is an original and innovative approach to studying the co-creation of value in eHealth delivery.

Public relations and engagement : theoretical imperatives of a multidimensional concept

Engagement has emerged as important concept in public relations, as stakeholders challenge the discourse of organizational primacy and organizations prioritize the need for authentic stakeholder involvement. As a multidimensional concept, engagement offers a foundation for building organizational relationships, and provides a means to facilitate community–organization interaction. This special issue on engagement and public relations presents a body of work that both explicates and expands the theoretical foundations of engagement, and contributes to scholarly understanding of its contexts, processes, and outcomes.