Pushing the boundaries' versus identifying the boundaries: An institutional perspective of NPM Principles

This paper considers the boundaries of new public management (NPM) principles in the context of the mandate for a commercial approach within in a New Zealand state-owned enterprise (SOE). Investigating a commercial approach to NPM through an institutional theory lens, the case study highlights complexities and potential conflict between structured NPM principles and the more complex reality. Analysis reveals blurred lines and boundaries have implications for public sector organisations such as SOEs, government and other stakeholders, where managers push the boundaries beyond the point where stakeholders are comfortable. Thus, a key challenge involves developing clearer institutional boundaries to balance freedoms with stakeholder acceptability.

Group of young school girls with teacher [?].

Note in German on back.

The sublime, affective process + architectural production

A year before Kate Nesbitt’s Theorising a New Agenda For Architecture (1996), the author penned a chapter on the significance of the sublime and its contribution to post-modern architecture via the uncanny or disturbing through the theories of Vidler and Eisenman (Nesbit, 1995). Twenty years on, we see its ongoing presence within the contemporary works of artists Kapoor, Ellison and Viola. Eisenmann and Libeskind aside, explicit reference to the Sublime whether through architectural praxis or theory appears to have been trumped by ecological derivatives and associated transactions, as catalyst for new architecture and architectural thinking. For Edmund Burke (1757), the Sublime was seen as a leading, an overpowering of self to a state of intense self-presence, often leading to a state of otherness. To experience the sublime is to experience affect, physiologically overwhelming the mental faculties through intensities of astonishment, terror, obscurity, magnificence, and reverence. Key here is Burke’s articulation of the stages of the sublime encounter, particularly so, its implications for the process of production which architectural theorists appear to have overstepped in their valorisation of the sublime object. This paper seeks to resituate the sublime within the context of architectural production. Through concepts such as material thinking, bodies and making strange, the paper explores a shift in focus toward affective processes traced from Burke’s inquiry. Rather than proposing strategies solely for affect within the work itself, the focus lies upon the designing experience, where blockage and desirous forces are critical partners in the process of production, as revealed through recent studio programs entitled Strange Space.

Sleep and self-regulation from birth to 7 years: A retrospective study of children with and without ADHD at 8-9 years

Objective To examine mean level differences, and longitudinal and reciprocal relations among behavioral sleep problems, emotional dysregulation, and attentional regulation across early childhood for children with and without ADHD at 8-9 years. Method This study used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) – Infant Cohort (n = 4109 analyzed). Children with and without ADHD were identified at age 8-9 years via parent-report of ADHD diagnosis and the 5-item Inattention-Hyperactivity subscale from the Strengths and Difficulties Questionnaire. Maternal report of child sleep problems and self-regulation was collected at 0-1, 2-3, 4-5 and 6-7 years of age. ANOVA was used to compare mean level differences in sleep problems, emotional and attentional regulation by ADHD group. Longitudinal structural equation modeling examined the relations among sleep and self-regulation across time in children with and without ADHD. Results Children with ADHD had persistently elevated levels of sleep problems (from infancy) and emotional and attentional dysregulation compared to controls (from 2-3 years of age). Sleep problems, emotional dysregulation, and attentional regulation were stable over time for both groups. Sleep problems were associated with greater emotional dysregulation two years later from 2-3 years of age for both groups, which in turn was associated with poorer attentional regulation. There was no direct relationship between sleep problems and later attentional regulation. Conclusion Sleep problems in children with and without ADHD are associated with emotional dysregulation, which in turn contributes to poorer attentional functioning. This study highlights the importance of assessing and managing sleep problems in young children.

Early childhood profiles of sleep problems and self-regulation predict later school adjustment

Background Children’s sleep problems and self-regulation problems have been independently associated with poorer adjustment to school, but there has been limited exploration of longitudinal early childhood profiles that include both indicators. Aims This study explores the normative developmental pathway for sleep problems and self-regulation across early childhood, and investigates whether departure from the normative pathway is associated with later social-emotional adjustment to school. Sample This study involved 2880 children participating in the Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) – Infant Cohort from Wave 1 (0-1 years) to Wave 4 (6-7 years). Method Mothers reported on children’s sleep problems, emotional, and attentional self-regulation at three time points from birth to 5 years. Teachers reported on children’s social-emotional adjustment to school at 6-7 years. Latent profile analysis was used to establish person-centred longitudinal profiles. Results Three profiles were found. The normative profile (69%) had consistently average or higher emotional and attentional regulation scores and sleep problems that steadily reduced from birth to 5. The remaining 31% of children were members of two non-normative self-regulation profiles, both characterised by escalating sleep problems across early childhood and below mean self-regulation. Non-normative group membership was associated with higher teacher-reported hyperactivity and emotional problems, and poorer classroom self-regulation and prosocial skills. Conclusion Early childhood profiles of self-regulation that include sleep problems offer a way to identify children at risk of poor school adjustment. Children with escalating early childhood sleep problems should be considered an important target group for school transition interventions.

Staubkorn im Sandsturm.

Fate of the Jewish physician Karl Goldberg, novel written in 1944. Novel is only partially autobiographical.

Social objectives of fisheries management: What are managers' priorities?

Increasingly, social considerations are having an influence on fisheries policy as well as day-to-day management decision making. Social objectives, unlike economic or conservation objectives, are often poorly defined in fisheries policy, providing substantial leeway for managers to develop management plans in response to the perceived importance of different social outcomes, and potential inconsistencies between different fisheries and jurisdictions. In this paper, through a literature review and workshop with managers across different Australian jurisdictions, we develop a set of social objectives that may be applicable in Australian fisheries. We assess the importance of these different objectives using the Analytic Hierarchy Process, and find considerable diversity in opinion as to which social objectives fisheries management should prioritise to achieve. This diversity of opinion is not directly related to jurisdiction, but does seem related to the context and social environment in which fisheries managers are operating.

Selecting and assessing social objectives for Australian fisheries management

This paper details Australian research that developed tools to assist fisheries managers and government agencies in engaging with the social dimension of industry and community welfare in fisheries management. These tools are in the form of objectives and indicators. These highlight the social dimensions and the effects of management plans and policy implementation on fishing industries and associated communities, while also taking into account the primacy of ecological imperatives. The deployment of these objectives and indicators initially provides a benchmark and, over the life of a management plan, can subsequently be used to identify trends in effects on a variety of social and economic elements that may be objectives in the management of a fishery. It is acknowledged that the degree to which factors can be monitored will be dependent upon resources of management agencies, however these frameworks provide a method for effectively monitoring and measuring change in the social dimension of fisheries management.Essentially, the work discussed in this paper provides fisheries management with the means to both track and begin to understand the effects of government policy and management plans on the social dimension of the fishing industry and its associated communities. Such tools allow the consideration of these elements, within an evidence base, into policy arrangements, and consequently provide an invaluable contribution to the ability to address resilience and sustainability of fishing industries and associated communities.

The Feeding Practices and Structure Questionnaire (FPSQ-28): A parsimonious version validated for longitudinal use from 2-5 years

Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age.

Preventing infections through cleaner hospitals (PITCH): An environmental cleaning bundle

Translating the numerous lengthy cleaning standards and guidelines into meaningful and sustained improvements in cleaning practice is challenging. This research hypothesized that an evidence based cleaning bundle would improve cleaning performance, knowledge and attitudes, and ultimately reduces healthcare associated infections (HAI) in a way that is value for money. A bundle is a small, straightforward set of evidence based practices, that when performed collectively and reliably, improves patient outcomes.

Key drivers of the economic burden of community-associated Methicillin-resistant Staphylococcus aureus in Australia

Estimates of the economic cost of community-associated Methicillin-resistant Staphylococcus aureus(CA-MRSA) in the United States (US) are substantial, ranging from $1.4-13.8 billion. In Australia, it has been shown that rates of CA-MRSA are increasing, and individual studies have looked at the morbidity and mortality associated with CA-MRSA, however, it is not clear what is driving the economic burden of CA-MRSA at a national level. This study presents preliminary findings about the key drivers of the economic cost of CA-MRSA infections in Australia

Mutations in known monogenic high bone mass loci only explain a small proportion of high bone mass cases

High bone mass (HBM) can be an incidental clinical finding; however, monogenic HBM disorders (eg, LRP5 or SOST mutations) are rare. We aimed to determine to what extent HBM is explained by mutations in known HBM genes. A total of 258 unrelated HBM cases were identified from a review of 335,115 DXA scans from 13 UK centers. Cases were assessed clinically and underwent sequencing of known anabolic HBM loci: LRP5 (exons 2, 3, 4), LRP4 (exons 25, 26), SOST (exons 1, 2, and the van Buchem's disease [VBD] 52-kb intronic deletion 3'). Family members were assessed for HBM segregation with identified variants. Three-dimensional protein models were constructed for identified variants. Two novel missense LRP5 HBM mutations ([c.518C>T; p.Thr173Met], [c.796C>T; p.Arg266Cys]) were identified, plus three previously reported missense LRP5 mutations ([c.593A>G; p.Asn198Ser], [c.724G>A; p.Ala242Thr], [c.266A>G; p.Gln89Arg]), associated with HBM in 11 adults from seven families. Individuals with LRP5 HBM ( approximately prevalence 5/100,000) displayed a variable phenotype of skeletal dysplasia with increased trabecular BMD and cortical thickness on HRpQCT, and gynoid fat mass accumulation on DXA, compared with both non-LRP5 HBM and controls. One mostly asymptomatic woman carried a novel heterozygous nonsense SOST mutation (c.530C>A; p.Ser177X) predicted to prematurely truncate sclerostin. Protein modeling suggests the severity of the LRP5-HBM phenotype corresponds to the degree of protein disruption and the consequent effect on SOST-LRP5 binding. We predict p.Asn198Ser and p.Ala242Thr directly disrupt SOST binding; both correspond to severe HBM phenotypes (BMD Z-scores +3.1 to +12.2, inability to float). Less disruptive structural alterations predicted from p.Arg266Cys, p.Thr173Met, and p.Gln89Arg were associated with less severe phenotypes (Z-scores +2.4 to +6.2, ability to float). In conclusion, although mutations in known HBM loci may be asymptomatic, they only account for a very small proportion ( approximately 3%) of HBM individuals, suggesting the great majority are explained by either unknown monogenic causes or polygenic inheritance.

Literature, tourism and the city: Writing and cultural change

Today national and regional tourism organizations look to sophisticated cultural tourism programs to enhance the visitor experience for tourists of their particular city. Yet research indicates that a challenge exists in designing and implementing programs that take full advantage of a city’s historical and emergent literary cultures. In this paper we offer critical insights into how literary cultural heritage can foster the development of an integrated and dynamic approach and provide the experience sought by local and global tourists. International exemplars are cited together with an analysis of the Australian city of Brisbane that describes itself as a ‘new world city.’ The findings of our research show that programs that harness diverse literary cultures, rather than adhering to a single literary representation, are better equipped to build identity and thus extend cultural tourism potential.

Researching effective approaches to cleaning in hospitals: Protocol of the REACH study, a multi-site stepped-wedge randomised trial

Background The Researching Effective Approaches to Cleaning in Hospitals (REACH) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices. Methods/design The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections (HAIs). The primary outcome (objective one) is the monthly number of Staphylococcus aureus bacteraemias (SABs), Clostridium difficile infections (CDIs) and vancomycin resistant enterococci (VRE) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome (objective two): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework to support the tailored implementation of the environmental cleaning bundle in each hospital. Discussion Evidence from the REACH trial will contribute to future policy and practice guidelines about hospital environmental cleaning. It will be used by healthcare leaders and clinicians to inform decision-making and implementation of best-practice infection prevention strategies to reduce HAIs in hospitals. Trial registration Australia New Zealand Clinical Trial Registry ACTRN12615000325​505