Competition paper. Prostitution and public health in New South Wales

Using historical and contemporary resources, this paper provides a critical account of the contemporary governance of prostitution in New South Wales. A Foucauldian approach is used to analyse the ways in which prostitution has been problematized as a health issue and managed as a public health problem. The analysis differs from other critical studies of prostitution in that it examines specific techniques of power, the operations of which have not been confined to the workings of a repressive criminal justice system. It is shown that there currently co-exists two broad understandings of prostitution in New South Wales, Australia, which have informed current initiatives to manage prostitution. Prostitutes working in public spaces have been presented as sexual agents wilfully engaged in criminal conduct and the spread of contagion. They have been subject to intense official scrutiny and regulated through criminal sanctions. In contrast, prostitutes working in private spaces have been presented as victims of adverse circumstance, deserving of protection and compassion. They have been made subject to strategic interventions that have attempted to normalize prostitution and render the prostitute a hygienic subject.

Managing impressions during institutional change – The role of organisational accounts in legitimation

Public relations literature has only recently drawn on institutional theory to provide insights into legitimacy that go beyond strategic organisational level processes. Many of the existing crisis management studies are approached from a strategic perspective, which have limitations in terms of how organizations manage their legitimacy in relation to broader and often changing social agendas. This study focuses on how impression management is used to deal with legitimacy gaps between organizations and public expectations that draw on an institutional theory perspective. This qualitative study examines the use of organizational accounts through a lens that marries institutional theory and impression management in order to understand how organizations manage their legitimacy. This study of accounts around legitimacy concerns of corporate social responsibility matters shows that organizations relied on their own tangible technical attributes rather than shared norms of what is considered responsible when there are no hard or institutionalised laws and regulations in place around corporate social responsibility concerns. This study offers insights into public relations concerns around impression management during institutional change and in doing so extends existing public relations approaches to crisis management.

Managing climate change ‘by the numbers’ in a UK energy company

This paper examines how ideas and practices of accounting come together in turning the abstract concept of climate change into a new non-financial performance measure in a large energy company in the UK. It develops the notion of ‘governmental management’ to explain how the firm’s carbon dioxide emissions were transformed into a new organisational object that could be made quantifiable, measureable and ultimately manageable because of the modern power of accounting in tying disciplinary subjectivities and objectivities together whilst operating simultaneously at the level of individual and the organisation. Examining these interrelations highlights the constitutive nature of accounting in creating not just new categories for accounting’s attention, but in turn new organisational knowledge and knowledge experts in the making up accounting for climate change. Significantly, it appears these new knowledge experts are no longer accountants: which may help explain accounting’s evolution into evermore spheres of influence as we increasingly choose to manage our world ‘by the numbers’.

Who is seeing the dietitian? we are only seeing the tip of the iceberg

Poor dietary choices are associated with overweight and obesity and the development of chronic conditions. Over 12 million (~60%) Australians are currently overweight or obese. Accredited Practicing Dietitians (APDs) are the experts in nutrition and diet therapy, equipped to provide services and counselling to assist individuals in making dietary modifications to prevent or manage diet-related conditions. However, no existing research has investigated the proportion or characteristics of the Australian population that may be accessing APDs. Data from 25,906 participants in the 2004/05 National Health Survey (NHS) were analysed using logistic regression to identify the sociodemographic and health characteristics of individuals accessing an APD or Nutritionist. Only 0.4% (n = 105) of the sample reported accessing a Dietitian or Nutritionist, this was half the amount accessing a Naturopath. Diabetes Mellitus, cardiovascular disease and obesity were all significantly associated with having seen a Dietitian, and over 90% of those accessing services had a long-term condition. Of the total sample only 10% of those with a diet-related condition had seen an APD or Nutritionist. Household income and education were not associated with accessing an APD. Exploration around the barriers to referral and accessing services may be warranted to assist in enhancing the profile of APDs among the population and other healthcare professionals. The current number of approximately 5000 registered APDs is unlikely to be able to service the proportion of the population who require dietary intervention; further avenues for prevention, rather than acute treatment, and novel strategies for service provision also need to be explored.

Nursing casualisation and communication : a critical ethnography

Aim The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Background Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Design Critical ethnography. Methods Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008–2009. Results The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Conclusion Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management.

Engaging expert contractors: The work health and safety obligations of the business or undertaking

This article examines the legal principles governing the statutory work health and safety general duties of principals who engage expert contractors to carry out work beyond the expertise of the principal. The article examines recent case law in which superior courts accepted the principal’s argument that the engagement of the expert contractor was sufficient to discharge the principal’s statutory work health and safety general duty. It then reframes the debate within the principles of systematic work health and safety management, and key provisions in the harmonised Work Health and Safety Acts—the primary duty of care; the key underpinning principles; the positive and proactive officer’s duty; and the horizontal duty of consultation, cooperation and coordination. It argues that it is likely that courts examining the issue of the principal’s work health and safety obligations under the harmonised Work Health and Safety Acts will require principals to do more to actively manage the work of expert contractors to ensure the health and safety of all workers and others potentially affected by the work.

Analyzing causes for reworks in construction projects in China

Although rework is a common phenomenon in the Chinese construction industry and significantly affects project success, the reasons for rework remain largely unknown and most construction companies are unable to manage the issue effectively. To investigate the causes of rework in construction projects, a total of 39 causes were first identified through a comprehensive literature review and semi-structured interviews with 13 experienced construction professionals in China. A questionnaire survey was further conducted to prioritize these causes, in which unclear project process management, poor quality of construction technology, and the use of poor construction materials rank the highest. Finally, a factor analysis revealed 11 major underlying dimensions of these causes, relating to design management, communication management, field management, project scope management, project process management, active rework, project plan changes, subcontractor management, contract management, owner capability, and the external environment. The contribution of this work lies in its examination of the underlying causes of rework perceived by construction professionals in the world’s largest developing country, which is characterized by its unique economic and social systems. In particular, newly identified causes of contract management, active rework, and scope management help expand existing knowledge of the underlying causes of rework for the global construction community.

Antimicrobial stewardship activities : a survey of Queensland hospitals

Objective: In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. Methods: The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. Results: The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Conclusions: Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. What is known about the topic? The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare-Associated Infections) of the National Safety and Quality Health Service Standards. The intent of AMS is to ensure appropriate prescribing of antimicrobials as part of the broader systems within a health service organisation to prevent and manage healthcare-associated infections, and improve patient safety and quality of care. This criterion also aligns closely with Standard 4: Medication Safety. Despite this recommendation, little is known about what AMS activities are undertaken in these facilities and what additional resources would be required in order to meet these national standards. What does the paper add? This is the first survey that has been conducted of public hospital and health services in Queensland, a large decentralised state in Australia. This paper describes what AMS activities are currently being undertaken, identifies practice gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. What are the implications for practitioners? Several areas for improvement such as reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use have been identified. In addition, there appears to be a lack of resources to support AMS programs in some facilities.

Government grants - an abrogation or management of risks?

New public management (NPFM), with its hands-on, private sector-style performance measurement, output control, parsimonious use of resources, disaggreation of public sector units and greater competition in the public sector, has significantly affected charitable and nonprofit organisations delivering community services (Hood, 1991; Dunleavy, 1994; George & Wilding, 2002). The literature indicates that nonprofit organisations under NPM believe they are doing more for less: while administration is increasing, core costs are not being met; their dependence on government funding comes at the expense of other funding strategies; and there are concerns about proportionality and power asymmetries in the relationship (Kerr & Savelsberg, 2001; Powell & Dalton, 2011; Smith, 2002, p. 175; Morris, 1999, 2000a). Government agencies are under increased pressure to do more with less, demonstrate value for money, measure social outcomes, not merely outputs and minimise political risk (Grant, 2008; McGreogor-Lowndes, 2008). Government-community service organisation relationships are often viewed as 'uneasy alliances' characterised by the pressures that come with the parties' differing roles and expectations and the pressures that come with the parties' differing roles and expectations and the pressurs of funding and security (Productivity Commission, 2010, p. 308; McGregor-Lowndes, 2008, p. 45; Morris, 200a). Significant community services are now delivered to citizens through such relationships, often to the most disadvantaged in the community, and it is important for this to be achieved with equity, efficiently and effectively. On one level, the welfare state was seen as a 'risk management system' for the poor, with the state mitigating the risks of sickness, job loss and old age (Giddens, 1999) with the subsequent neoliberalist outlook shifting this risk back to households (Hacker, 2006). At the core of this risk shift are written contracts. Vincent-Jones (1999,2006) has mapped how NPM is characterised by the use of written contracts for all manner of relations; e.g., relgulation of dealings between government agencies, between individual citizens and the state, and the creation of quais-markets of service providers and infrastructure partners. We take this lens of contracts to examine where risk falls in relation to the outsourcing of community services. First we examine the concept of risk. We consider how risk might be managed and apportioned between governments and community serivce organisations (CSOs) in grant agreements, which are quasiy-market transactions at best. This is informed by insights from the law and economics literature. Then, standard grant agreements covering several years in two jurisdictions - Australia and the United Kingdom - are analysed, to establish the risk allocation between government and CSOs. This is placed in the context of the reform agenda in both jurisdictions. In Australia this context is th enonprofit reforms built around the creation of a national charities regulator, and red tape reduction. In the United Kingdom, the backdrop is the THird Way agenda with its compacts, succeed by Big Society in a climate of austerity. These 'case studies' inform a discussion about who is best placed to bear and manage the risks of community service provision on behalf of government. We conclude by identifying the lessons to be learned from our analysis and possible pathways for further scholarship.

Meeting the nutrition challenge of stage 3 renal failure : considerations for nursing practice

Self-care management is needed for effective management of chronic kidney disease. The main aim for treatment or management of chronic kidney disease is to delay the worsening of kidney function, and to prevent or to manage the co-morbidities. Selfcare management is not easy, and patients will face many challenges, especially when they cannot get use to the new treatment plan. One of the challenges they face is dietary restriction, which is a very important aspect in any self-care management programme. Chronic kidney disease patients require a low-protein, low-sodium, low-potassium, and low-phosphorus diet. There are several strategies patients can undertake to ensure adherence, such as self-monitoring their dietary habits and type of food consumed using a food diary; involving social support, such as family members and spouse to help them to adhere to their diet restrictions; setting goals and providing positive reinforcement when they achieved the targeted goals; joining self-management programmes to equip themselves with the necessary skills so that they can better adhere to the treatment regimes, including diet restriction; and lastly, having the knowledge about their regime, and using this knowledge to help them understand and improve their adherence.

Expertise in the illustrative context of BPM

As Business Process Management (BPM) is evolving and organisations are becoming more process oriented, the need for Expertise in BPM amongst practitioners has increased. Proactively managing Expertise in BPM is essential to unlock the potential of BPM as a management paradigm and competitive advantage. Whilst great attention is being paid by the BPM community to the technological aspects of BPM, relatively little research or work has been done concerning the expertise aspect of BPM. There is a substantial body of knowledge on expertise itself, however there is no common framework in existence at the time of writing, describing the fundamental attributes characterising Expertise in the illustrative context of BPM. There are direct implications of the understanding and characterisation of Expertise in the context of BPM as a key strategic component and success factor of BPM itself, as well as for those involved in BPM. Expertise in the context of BPM needs to be characterised to understand it, and be able to proactively manage it. Given the relative infancy of research into Expertise in the context of BPM, an exploration of the relevance and importance of Expertise in the context of BPM was considered essential, to ensure the study itself was of value to the BPM field. The aims of this research are firstly to address the two research questions 'why is expertise important and relevant in the context of BPM?', and 'how can Expertise in the context of BPM be characterised?', and secondly, the development of a comprehensive and validated A-priori model characterising Expertise in the illustrative context of BPM. The study is theory-guided. It has been undertaken via an extensive literature review across relevant literature domains, and a revelatory case study utilising several methods: informal discussions, an open-ended survey, and participant observation. An a-priori model was then developed which comprised of several Constructs and Sub-constructs, and several overall aspects of Expertise in BPM. This was followed by the conduct of interviews in the validation phase of the revelatory case study. The primary contributions of this study are to the fields of expertise, BPM and research. Contributions to the field of expertise include a comprehensive review of expertise literature in general and synthesised critique on expertise research, characterisation of expertise in an illustrative context as a system, and a comprehensive narrative of the dynamics and interrelationships of the core attributes characterising expertise. Contributions to the field of BPM include firstly, the establishment of the importance of understanding Expertise in the context of BPM, including a comprehensive overview of the role the relevance and importance of Expertise in the context of BPM, through explanation of the effect of Expertise in BPM. Secondly, a model characterising Expertise in the context of BPM, which can be used by BPM practitioners to clearly articulate and illuminate the state of Expertise in BPM in organisations. Contributions to the field of research include an extended view of Systems Theory developed, reflecting the importance of the system context in systems thinking, and a narrative on ontological innovation through the positioning of ontology as a meta-model of Expertise in the context of BPM.

Rethinking restrictive practices : a comparative analysis

This paper undertakes the first comparative analysis of restrictive practices legislation in Australia. This legislation, which regulates practices used to manage ‘challenging behaviours’ of people with intellectual disability or cognitive impairment, currently exists in four Australian jurisdictions. The paper demonstrates the gaps in coverage of this legislation and the wide variation of law nationally. We argue that legislation governing restrictive practices is needed, it should regulate the provision of all restrictive practices (not just some) and that there should be a national consistent approach.

Navigating uncertainty in Australia : fostering informed citizenship through teaching controversial issues with pre-service teachers

Australia is a multicultural immigrant society created by public policy and direct state action over a period of two hundred years. It is now one of the world’s most diverse societies. However, like many nations, Australia faces challenges to managing ‘unauthorized arrivals’ who claim to be refugees. The issue of how to deal with unauthorized arrivals is controversial and highly emotive as it challenges public policy and government capacity to manage the multicultural ‘mix’ of Australia’s population. It also raises questions about border security. Given that it is impossible to discern beforehand who is a ‘proper’ refugee and who is not, claims to refugee status by unauthorised arrivals in Australia need to be tested against international convention criteria devised by the United Nations High Commissioner for Refugees (UNHCR). There are no simple solutions to controversial questions such as how and where should unauthorised arrivals, and the children accompanying them, be housed whilst their claims are investigated? Moreover, as this issue continues to prompt division and heated debate in Australian society, teachers new to the profession are often reluctant to explore it in the classroom. However, there are opportunities in national and state curriculum documents for the values dimensions of curriculum inquiries into controversial issues such as this to be addressed. For example, the most recent national statement on the goals for schooling in Australia, the Melbourne Declaration (MCEETYA, 2008), makes clear that Australian students need to be prepared for the challenges of the 21st century and to develop the capacity for innovation and complex problem-solving. The Melbourne Declaration informs the first national curriculum to be implemented in the Australian states and territories, and all other national and state initiatives. Its focus on developing active and informed citizens who can contribute to a socially cohesive society implies a capacity to deal with a range of issues associated with cultural diversity, This chapter explores the ways in which pre-service and early career teachers in one Australian state reflect upon curriculum opportunities to address controversial issues in the social sciences and history classroom. As part of their pre-service education, all the participants in this study completed a final year social science curriculum method unit that embedded a range of controversial issues, including the placement of children in Australian Immigration Detention Centres (IDCs), for investigation. By drawing from interviews and focus groups conducted with different cohorts of pre-service teachers in their final year of university study and beginning years of teaching, this chapter analyses the range of perceptions about how controversial issues can be examined in the secondary classroom as part of fostering informed citizenship. The discussion and analysis of the qualitative data in this study makes no claims for the representativeness of its findings, rather, a range of beginner teacher insights into a complex and important facet of teaching in a period of change and uncertainty is offered.

Achieving competence: The interactional features of children's storytelling

Early years researchers interested in storytelling have largely focused on the development of children’s language and social skills within constructed story sessions. Less focus has been given to the interactional aspects of storytelling in children’s everyday conversation and how the members themselves, the storytellers and story recipients, manage storytelling. An interactional view, using ethnomethodological and conversation analytic approaches, offers the opportunity to study children’s narratives in terms of ‘members work’. Detailed examination of a video-recorded interaction among a group of children in a preparatory year playground shows how the children managed interactions within conversational storytelling. Analyses highlight the ways in which children worked at gaining a turn and made a story tellable within a round of second stories. Investigating children’s competence-in-action ‘from within’, the findings from this research show how children invoke and accomplish competence through their interactions.

Beyond competencies : using a capability framework in developing practice standards for advanced practice nursing

AIM This paper presents a discussion on the application of a capability framework for advanced practice nursing standards/competencies. BACKGROUND There is acceptance that competencies are useful and necessary for definition and education of practice-based professions. Competencies have been described as appropriate for practice in stable environments with familiar problems. Increasingly competencies are being designed for use in the health sector for advanced practice such as the nurse practitioner role. Nurse practitioners work in environments and roles that are dynamic and unpredictable necessitating attributes and skills to practice at advanced and extended levels in both familiar and unfamiliar clinical situations. Capability has been described as the combination of skills, knowledge, values and self-esteem which enables individuals to manage change, be flexible and move beyond competency. DESIGN A discussion paper exploring 'capability' as a framework for advanced nursing practice standards. DATA SOURCES Data were sourced from electronic databases as described in the background section. IMPLICATIONS FOR NURSING As advanced practice nursing becomes more established and formalized, novel ways of teaching and assessing the practice of experienced clinicians beyond competency are imperative for the changing context of health services. CONCLUSION Leading researchers into capability in health care state that traditional education and training in health disciplines concentrates mainly on developing competence. To ensure that healthcare delivery keeps pace with increasing demand and a continuously changing context there is a need to embrace capability as a framework for advanced practice and education.